Internet Scientific Publications

Serum Immunoglobulins (IgG, IgA, IgM) levels in Preeclampsia and Eclampsia Pregnancies

2009-11-06T17:58:18-06:00

Bacground: Preeclampsia is the most common pregnancy-specific complication. It is thought to be associated with modulation of immune response. Objective: The aim of this study was to investigate the serum levels of immunoglobulins-IgG, IgA and IgM in pre-eclampsia and eclampsia, and to examine the influence of the immunoglobulins with pre-eclampsia and its complication eclampsia, if any. Methods: The study was conducted among fortythree subjects consisting of seventeen pre-eclampsia patients, eleven eclampsia patients and fifteen healthy normotensisve pregnants of singleton gestations in their third trimester. Serum immunoglobulin levels were analyzed by solid phase indirect ELISA method. Results: It was shown that serum IgG concentrations were 7.95±0.69g/L, 7.66±0.46g/L and 7.10±0.61g/L; IgA concentrations were 4.07±0.32g/L, 4.10±0.32g/L and 3.65±0.32g/L; and IgM concentrations were 2.01±0.21g/L, 2.92±0.29g/L and 2.16±0.16g/L in pre-eclampsia, eclampsia and normotensive pregnant respectively. There were no significant change in IgG and IgA between pre-eclampsia and eclampsia, but IgM level was found to be significantly higher in eclampsia than that in pre-eclampsia (t=7.87, p=0.0001). Except systolic blood pressure with IgG (r=0.689, p=0.04) and to some extent with IgA (r=-0.637, p=0.065), gestational age (r= -0.890, p=0.0001) and proteinuria (r=0.747, p= 0.008) with IgM; none of the maternal characteristics is associated with the serum immunoglobulin concentration in pre-eclampsia or eclampsia. Conclusion: It is revealed that serum immunoglobulins levels are elevated with pre-eclampsia and its complication eclampsia.

Opportunities for Generic Drugs in India

2009-11-06T17:58:17-06:00

Branded drugs play an important role in medications, but generics are their cost effective alternatives. Generics are similar to branded drugs in terms of purity, efficacy and are perceived to be safer as compared to new drug molecules, as they tend to be older and time tested. Indian pharmaceutical market of generic drugs is increasing day by day. The present communication describes various aspects and prospects of generic drugs in Indian Pharmaceutical Sector.

Augmenting hospital funding with user fee charge: The revolving fund scheme.

2009-11-06T17:58:16-06:00

Background: Health care delivery has remained crippled in most third world countries. In Nigeria, various attempts by subsequent governments to improve on it has at best been on paper.Method: Analysis of hospital data for the period spanning 7 years before the onset of the revolving fund and eleven years after its onset was done. Method of application was also documented.Result: Service delivery was improved. Morbidity was reduced. Workers moral were better. However, improved services brought in more patients, resulting in increase mortality. Conclusion: An improved revolving fund scheme practiced by many establishments may improve the general status of our institutions.

Diclofenac As Microspheres

2009-11-06T17:58:15-06:00

Diclofenac is currently the eighth largest-selling drug and the most frequently used NSAID (Non-steroidal anti-inflammatory drug) in the world, since its introduction in Japan in 1974. Diclofenac is among the better tolerated NSAIDs. Only major adverse effect of Diclofenac is that it causes direct and indirect irritation of the gastrointestinal tract (GIT). To reduce the side effects on gastrointestinal tract (GIT) and to improve therapeutic efficacy of Diclofenac, it can be formulated in polymeric microspheres. A brief review on why Diclofenac is incorporated into microspheres, the polymers that can be used, various methods of preparation are given in this review article.

Hemangioblastomas at the University Hospital of the West Indies: a retrospective survey and review of the literature

2009-11-06T17:58:13-06:00

We present our experience with hemangioblastomas at the University Hospital of the West Indies, Jamaica, over a 23 year period, between January 1985 to December 2007.There were a total of five tumors from five patients with an age range of 19 to 49 years and an average age of 32.8 years. The male to female ratio was 1:4. All the tumors were within the posterior cranial fossa and no patient had more than one lesion. None of the patients were diagnosed with polycythemia vera. All patients were found to have hydrocephalus at the time of presentation. All had definitive surgery and the mortality rate was zero. To date, there have been no recurrences. None of the patients were screened for von Hippel Lindau disease.

Cytopathological Review of Breast Lesions In Ile-Ife Nigeria

2009-11-06T17:58:13-06:00

INTRODUCTION: Aspiration Cytology of breast lump is an established method of rapid diagnosis of breast lump..MATERIALS AND METHODS: The FNAC database in our hospital was assessed for relevant information. The diagnostic categories include: Normal, Inflammatory, Benign, Suspiciously Malignant and Malignant.RESULTS: 757 cases were analyzed. The age-range was13-90 years.( mean age 39.1+/- 15.6ears, ) . The peak age group was 20 - 29years (24.3 %). Benign lesions were predominant (50.2%). Malignant lesions (31.4%), suspiciously malignant 9.5% and inflammatory lesions 7.4%.The malignant and suspiciously malignant occur more in the elderly. 5(0.7%) patients were males, three of which were malignant.CONCLUSION: This study further confirms the predominance of benign breast lesions in the young. Malignant lesions predominate in the 4-5th decade of life. However, both diagnoses cut across all age groups. FNAC is a veritable tool for early diagnosis of breast cancer in a low-resource setting such as ours

A Comparative Study of Extra-Amniotic Infusion of Corticosteroids versus Normal Saline for Induction of Labour.

2009-11-06T17:58:12-06:00

Objective: To compare the efficacy of extra-amniotic corticosteroids with normal saline in inducing labor .Material and methods: This was a prospective randomized controlled study. 50 women with a gestational age of 36 to 42 weeks, an unfavourable cervix, and medical indications for delivery were assigned to receive either 20 mg of dexamethasone in saline solution (study group n = 25) or saline solution only (control group n=25) administered extra amniotically through an intracervical inflated Foley balloon catheter.Result: The mean time intervals between induction of labor to the active phase and between induction of labor to delivery were significantly shorter in the study group compared with those of the control group (5.0 ± 1.8 hours vs 6.69 ± 1.52 hours, p < 0.001, 10.27 ± 4.70 hours vs 14.00 ± 5.57 hours, p < 0.05, respectively).Conclusion: Induction of labor with use of an intracervical Foley balloon catheter and extraamniotic corticosteroids reduces the time interval from induction of labor to delivery. Cervical ripening with extra-amniotic corticosteroids possesses the advantages of simplicity, low cost, and lack of systemic or serious side effects.

The incidence and pattern of stroke in bayelsa state, nigeria

2009-11-06T17:58:11-06:00

Stroke is a major cause of death in adults’ world wild and it contributes to disability and reduced quality of life. In this study stroke patients constituted 2.3% of the total hospital admissions and 9.3% of medical admissions. In order to understand the pattern of stroke in Bayelsa state, a total number of 28 stroke patients out of 300 patients that were admitted over a period of seven months, between November 2007 and June 2008 at the Niger Delta University Teaching Hospital, Okolobiri were studied. Questionnaires which assessed their biodata, clinical and laboratory data’s were used. Risk factors assessed were hypertension (89%), alcohol (57%), tobacco smoking (53.5%), Male factor (m: f =1.15:1). The mean age of the study group was 62.2±9. 64% of the stroke patients were in the active social segment of the society. Stroke affected more of the poor society who lived in the rural areas. The prevalence of ischaemic stroke was higher than haemorrhagic stroke. In conclusion, hypertensive heart disease was a major co-morbidity of stroke.

Pott’s Spine With Bilateral Psoas Abscess In A Hiv Positive Patient

2009-11-06T17:58:10-06:00

We describe a case of psoas abscess

Private providers of Healthcare in India: A policy analysis.

2009-11-06T17:58:09-06:00

This paper aims to critically analyze the role of private providers of healthcare in India, especially the unqualified medical practitioners. Due to the critical shortage of human resource for health, unqualified practitioners play an important role in the delivery of healthcare to a large section of society. But their role is often ignored in policy decisions. This paper also makes some practical recommendations on the inclusion of this semi skilled health manpower in the areas which are underserved by the conventional health care infrastructure. We tried to address the issues of cost and quality of care by private providers. We also examined the increasing role of corporate multispecialty hospitals in large metropolitan urban areas.

Recent Techniques For Oral Time Controlled Pulsatile Technology

2009-11-06T17:58:09-06:00

Pulsatile drug delivery system is defined as the rapid and transient release of certain amount of drug molecules within a short time period immediately after a predetermined off-release period, i.e., lag time. [1] Pulsatile drug delivery aims to release drug on programmed pattern i.e. at appropriate time and at appropriate site of action. Pulsatile systems are gaining a lot of interest as the drug is released completely after defined lag time. Pulsatile drug delivery system is time- and site-specific drug delivery system, thus providing special and temporal delivery and increasing patient compliance.

The role of Mondia whitei in reproduction: a review of current evidence

2009-11-06T17:58:08-06:00

Mondia whitei has been used as a traditional cure for male infertility problems for a very long time. Unlike other medicinal plants used for treatment of male infertility, Mondia whitei effects on the male reproductive system have been thoroughly researched. This review sums-up the scientific evidence supporting Mondia whitei as an aphrodisiac.

Affordability of essential medicines used for treating chronic diseases in Malaysia: An academic perspective

2009-11-06T17:58:06-06:00

The aim of this study is to measure the affordability of drugs used in treating common chronic diseases. The study was conducted in the Universiti Sains Malaysia (USM) and in 5 private retail pharmacies. The study measured prescriptions contents of Universiti Sains Malaysia panel of clinics claim forms of patients for the year 2006. Affordability of medicines used was calculated using private retail pharmacies prices. Affordability was expressed as the number of days’ salary required by lowest wage earners to pay for one month treatment. The number of day’s salary would have to pay by the worker ranged from 0.11-6.56 days’, 0.13-2.88 days’, 0.13-4.70 days’ and 1.04-2.93 days’ wage for the treatment of hypertension, diabetes, asthma and for multiple conditions, respectively. Low affordability was noted for most of the branded products, most combined treatments and all multiple chronic cases treatments. Government must intervene to ensure affordability of medicines among the public.

Maternal Deaths During Caesarean Delivery In A Developing Country-Perspective From Nigeria

2009-11-06T17:58:06-06:00

OBJECTIVE: To examine the changing trend in maternal deaths during caesarean delivery in a tertiary care hospital in Nigeria over an 8 year periodMATERIALS/ METHODS:An observational retrospective study was carried out at the University of Nigeria Teaching Hospital (UNTH), Nigeria to determine the causes and risk factors for maternal deaths during caesarean delivery from July 1998 to June 2006. RESULTS: A total of 6798 women delivered during the study period. There were 1579 caesarean sections (23% caesarean section rate).There were nine documented deaths during the course of anaesthesia and surgery to given an incidence of 5.6/1000 anesthetics.Six deaths were directly attributable to anaesthesia, three were indirectly attributable. CONCLUSION: The number of maternal deaths in this study was initially high. Since the increased use of spinal anaesthesia and employment of more doctors, the rates have dropped drastically.

Impacts of deforestation on malaria in south-eastern Nigeria: the epidemiological, socio-economic and ecological implications

2009-11-06T17:58:05-06:00

Forest resources in Nigeria are undergoing severe exploitation pressure due to demographic growth and socio-economic development. Through the process of forest clearing, deforestation alters the ecology of local malaria vectors. The overall goal of this study was to seek to clarify the mechanisms linking deforestation, economic development and malaria epidemiology and the ecological implications. The research methodology stresses a mix scale approach involving social research in areas of active and non-active deforestation in Ebonyi state Nigeria and the descriptive assessment and analysis of the forest resource exploitation issues, as well as the implication for sustainable forest resource management. Findings indicate that the income status of individuals residing in the areas of active deforestation was lower than those of areas of non-active deforestation. Higher yearly episodes of malaria and the tendency to spend less amount of money for malaria treatment characterized the areas of active deforestation and the inhabitants had higher preference for use of woodfuel and use of forest medicinal herbs for malaria treatment. In the areas of active deforestation, the mosquito night biting/landing rates were considerably higher than those of areas of non-active deforestation. Conservation policies aimed at slowing deforestation will impact malaria and would reduce the increasing incidence of deforestation-dependent malaria epidemics.

Knowledge, Attitude And Practice Of Ante-Natal Attendees Toward Prevention Of Mother To Child Transmission (PMTCT) Of Hiv Infection In A Tertiary Health Facility, Northeast-Nigeria

2009-11-06T17:58:02-06:00

Objective: Knowledge, attitude and practice of pregnant women toward PMTCT have not been evaluated in any tertiary health facility in the Northeast Nigeria. Methods: A structured questionnaire was used to obtain data from 172 women that consecutively attended the antenatal clinic of University of Maiduguri Teaching Hospital to determine their level of knowledge, practice and attitude toward PMTCT. sResults: Knowledge on modes of transmission, risky behaviours and prevention of HIV and other STIs was high among the women. The use of breast milk substitute by HIV positive nursing mothers and condom during sexual intercourse did not receive very encouraging responses from 42 (24.4%) and 58 (33.7%) of the women respectively. Those that discourage BMS indicated spouse dislike as a major reason and the fact that the community places higher premium on breastfeeding. Majority of those that discouraged condom use said the practice was against their religious beliefs while a few believes withdrawal before ejaculation and use of antibiotics after sex can equally prevent HIV infection. Conclusion: The pregnant women accepted PMTCT as a veritable means of preventing infants from HIV infection and a means to determine HIV status. Majority implored greater involvement of male partners and other family members during PMTCT counselling sessions. Staff training, awareness creation and community mobilization were identified as key to success of PMTCT programmes and fight against stigma and discrimination.

Gastroenterologist versus Surgeon Performed Endoscopic Gastrostomy: A Multi-Centre Comparative Study.

2009-11-06T17:58:01-06:00

PEG tube placement has been widely embraced by endoscopists as a means of accessing the gastrointestinal tract for feeding. In this study we compared the outcomes of PEG tube placement by gastroenterologists and surgeon endoscopists.Materials and MethodsData on PEG outcomes were retrospectively collected over 31 months from the Georgetown Hospital in the Cayman Islands where PEGs were performed exclusively by surgeons. This was compared with data collected over the same period from the University Hospital of the West Indies in Jamaica where PEGs were performed exclusively by gastroenterologists.ResultsThere were 74 PEG tubes placed by gastroenterologists and 35 placed by surgeons. The gastroenterologists had a higher collective case volume than surgeons (37 vs 18 cases per year). There were no significant differences between gastroenterologist and surgeon performed PEG in terms of procedural success (98.6% vs 100%; P=0.84), overall morbidity (6.8% vs 8.8%; P=0.71), early mortality (4.3% vs 0; P=0.549) or late mortality (11.8% Vs 0; P=0.049).ConclusionsAppropriately trained surgeon endoscopists and gastroenterologists can site PEG tubes with similar success and complication rates.

Tubercular pericardial effusion: a case report

2009-11-06T17:58:00-06:00

A case of tubercular pericardial effusion is reported in a 38 year old male. There were no stigmata of tuberculosis anywhere in the body or the any evidence of immuno-compromised state .Computed tomography scan with polymerase chain reaction was diagnostic in this case. Patient was treated with anti tubercular therapy and responded well.

Sexually Transmitted Diseases- Ten Years Experience In Benue State

2009-11-06T17:57:58-06:00

Prevalence of urinary schistosomiasis among aids patients in otukpo benue state.

2009-11-06T17:57:54-06:00

Background: Although there has been no proven association between urinary schistosomiasis and the human immunodeficiency Virus (HIV) infection, the resulting raw surfaces and wounded mucosa that characterize infestation with genito- urinary schistosomiasis may increase the susceptibility of patients infested with this trematode to HIV infection. Hence, prevention of urinary schistosomiasis may also prevent and reduce susceptibility to HIV infection. The aim of this paper is to determine the prevalence of urinary schistosomiasis among people living with HIV/AIDS (PLWAS) and Non HIV persons in Otukpo , an urban area of Benue state where HIV / AIDS is highly endemic.Methods: sediments of the centrifuge urine of the patient were examined microscopically. Schistosoma haematobium was identified by its terminal spine.Result” four hundred (20% out of two thousand confirmed HIV patients tested positive for schistosomiasis. Two hundred and ninety (14.5%) of the non-HIV infected patients were positive for the trematode.Conclusion: the prevalence of urinary schistosomiasis is high in Otukpo area, both among the PLWAS and on- HIV persons. Preventive interventions for both schistosomiasis and HIV should be intensified in the area.

Autolobectomy in Swyer-James (Mcleod’s) Syndrome: Value of Preoperative V/Q Scan

2009-11-06T11:32:59-06:00

Swyer James (Mcleod’s) syndrome (SJMS) is an uncommon disease and asymptomatic patients may not be diagnosed until later in life. A 34-year-old man with SJMS is presented in this case report. V/Q scan showed markedly diminished perfusion and ventilation in the left upper lobe which was like a surgically resected lobe (autolobectomy). This case report underlines the V/Q scan findings potentially may lead the surgeons for choosing the best surgical treatment plan.

Acute scrotum in children: Role of nuclear testicular scanning in diagnosis

2009-11-06T11:32:58-06:00

Nuclear scanning with Tech 99m pertechnitate has evolved as a major diagnostic tool for evaluating the paediatric patients with acute scrotum. It is simple, quick and accurate for differentiating the patients with testicular torsion from other causes of acute scrotum.Between march 2001 and march 2007,we prospectively studied 148 patients with acute scrotum;out of whom 91 patients were subjected to nuclear scanning.10 patients(9.9%)were diagnosed as having testicular torsion which was confirmed on surgical exploration(accuracy 100%).one patient had epididymo orchitis and one patient had missed torsion..79 patients had normal scan;All the patients with normal scan were managed conservatively with no adverse sequelae on follow up.

Bone Scan Appearance of Bilateral Femoral Head Osteonecrosis Secondary to Polyostotic Fibrous Dysplasia.

2009-11-06T11:32:58-06:00

We present the whole body bone scan images of a 44-year old male who complained of dizziness and vertigo. MRI showed a fibro-osseous lesion at the base of the skull involving the clivus and the greater wing of sphenoid, consistent with fibrous dysplasia. Whole body bone scan showed osteoblastic lesions involving base of the skull, right first rib, and bilateral humeri, suggestive of polyostotic fibrous dysplasia, and intense uptake in both hips. X-ray of the hips showed bilateral coxa magna with extensive hypertrophic changes. Patients with polyostotic fibrous dysplasia are prone to repeated femoral neck fractures which can cause femoral head osteonecrosis. This, we concluded, was the likely cause of intense MDP in both hips.

False-Positive Whole-Body I-131 Scan In Thyroid Carcinoma Caused By Gastrooesophageal Reflux Disease

2009-11-06T11:32:57-06:00

Many false-positive findings on I-131 scans have been reported. Recognition of them may avoid unnecessary repeated therapeutic doses of radioactive iodine. The authors describe a false positive cervical and mediastinal radioiodine uptake due to gastro oesophageal reflux disease in a 63 yr-old man with papillary thyroid cancer. Trough this case report, causes of such scintigraphic features are reviewed.

Nasopharyngeal Carcinoma (NPC) : The value of 18-Florine Fluorodeoxyglucose (FDG) Positron Emission Tomography Computed Tomography (PET / CT) in comparison to conventional imaging modalities Computed Tomography (CT) and Magnetic Resonance Imaging (MRI)

2009-11-06T11:32:49-06:00

PURPOSE: To evaluate the clinical usefulness of 18F FDG PET/CT in the management of NPC in comparison to conventional imaging modalities. METHODS: This retrospective study was done at Ospedale Niguarda, Milan, Italy. Data acquired from 24 NPC patients between May 2003 and December 2006. They had FDG PET/CT and CT or MRI during initial diagnosis and at follow up. Each findings was tabulated and compared with tissue biopsy at diagnosis and clinical status during follow up after therapy. Statistical calculation was done to derive the value of each modalities.RESULTS; The sensitivity and accuracy of PET / CT and CT / MRI are equally high at diagnosis. At follow up, a negative PET / CT finding suggests complete remission with sensitivity and negative predictive value of 100%. CONCLUSIONS: 18F FDG PET/CT is a potential modality to be utilized in following up NPC patients for evaluating response to therapy.

Chronic Lead Exposure in Nuclear Medicine.

2009-11-06T11:32:48-06:00

Mood, Weight, and Physical Activity Among Obese Individuals Enrolled In a Long-term Weight-loss Program: Trajectories and Associations with Gender

2009-11-05T14:59:25-06:00

Objective: To examine the trajectories of mood, weight and physical activity, and associations between mood, weight, and gender, among 213 obese individuals.Methods: Prospective, longitudinal design. Assessments at baseline and 6, 12, and 18 months of Profile of Mood States, Paffenbarger Physical Activity Questionnaire, and weight.Results: Total mood disturbance decreased from baseline to 6 months, with no change thereafter. Weight decreased from baseline to 6 to 12 months, and increased from 12 to 18 months. Physical activity increased from baseline to 6 months, and 12 to 18 months. Increased physical activity predicted greater vigor and less fatigue over time. Females high in distress at 6 months lost less weight than females low in distress and at 18 months gained more weight than those low in distress. There were no such associations among males.Conclusion: The trajectories of mood, weight and physical activity were synchronous only in the short-term. Distress monitoring, targeted to females who relapse, may be warranted.

The War at Home: Consequences of Loving a Veteran of the Iraq and Afghanistan Wars

2009-11-05T14:59:22-06:00

Objective. The experiences of parents, partners, and siblings of Iraq and Afghanistan War veterans were explored, to understand the consequences of repeated deployments on participants’ mental health. Method. Purposive sampling was used. Respondents completed preliminary electronic surveys and participated in one of three focus groups. Results. High levels of relationship and psychological distress exist. Reactions and coping with deployment were split along gender lines, with females reporting anxiety and males reporting avoidance or anger. Veterans returned with significant emotional demands. The need for social and emotional support was identified. Conclusion. Similar to the experiences of spouses of veterans, extended family members are negatively impacted during deployment and reintegration. They are struggling to cope and lack the necessary skills to do so. Attempts at help seeking are unsuccessful. Recommendations include training for clinicians, school counselors and physicians to address the needs of this population, and also development of support groups for families of veterans and the veterans themselves.

Book Review of “Advances in the Use of Hypnosis for Medicine, Dentistry, and Pain Prevention/Management”

2009-11-05T14:59:21-06:00

Change in Serum Trace Elements Concentration before and after Removal of Gallbladder with Gallstone

2009-11-05T13:14:06-06:00

Epidemiological evidence among the human population has shown a significantly increased incidence of gallstone disease worldwide. The levels of nutrients are represented by different physiological and pathological processes. The aim of this work is to analyze the change in trace element (Al, Cd, Cr, Co, Cu, Fe, Pb, Mg, Mn, Ni, Se, and Zn) concentrations of human serum 48h before and after the removal of gallbladder with gallstone in 15 patients by using Inductively Coupled Plasma – Atomic Emission Spectroscopy (ICP-AES). The results showed increased post operative serum Fe, Ni and Se levels and decreased level of other elements significantly. The results were statistically compared (p < 0.05). This study indicates the complexity of interpreting changes in trace elements in serum after surgery.

Peptic ulcer disease and helicobacter pylori infection at kano, nigeria.

2009-11-05T13:14:06-06:00

Background. Helicobacter pylori infection has been identified as an important risk factor for the development of peptic ulcer disease and is probably the most important cause of relapse in those previously treated for peptic ulcer disease. The aim of this study was to determine the prevalence of Helicobacter pylori infection in patients with peptic ulcer disease at the Aminu Kano Teaching Hospital (AKTH), Kano, North-Western Nigeria.Methods. The study was cross sectional and conducted between December 2004 and May 2006. Consecutive patients with endoscopic diagnosis of peptic ulcer disease at the Endoscopy Unit of Aminu Kano Teaching Hospital, Kano were recruited. Other patients who had endoscopy within the study period for dyspepsia but with normal endoscopic findings were recruited as controls. Three gastric antral and two body biopsies were taken from each patient, and histological evaluation for presence of Helicobacter pylori was done using haematoxilin/eosin and modified Giemsa stains.Results. The Prevalence of Helicobacter pylori infectionin all the study subjects was found to be 81%. Helicobacter pylori were found present in 93.3% of patients with peptic ulcer disease. Presence of H. pylori infection in patients with duodenal ulcer and gastric ulcer were 95.8% and 90.9% respectively. However 80% of those with normal endoscopic findings also had Helicobacter pylori infection.Conclusion. Helicobacter pylori infection is very common among patients with peptic ulcer disease in Kano Nigeria. Patients with non-ulcer dyspepsia also have, to a lesser extent a high prevalence of Helicobacter pylori infection.

A Case of Merkel Cell Carcinoma Metastasis to the Head and the Body of the Pancreas

2009-11-05T13:14:05-06:00

Merkel cell carcinoma (MCC) is a rare, cutaneous, malignant tumor of neuroendocrine cells. It has a high propensity for local recurrence and regional lymph node metastasis. Thus far, only two cases of MCC with metastasis to the pancreas have been reported in the scientific literature. Here we present the case of a 65-year-old male who presented with abdominal pain of gradually increasing severity over the past two weeks accompanied by jaundice, lower back pain and non-bloody vomiting. He had been diagnosed with MCC of the right gluteal mass 10 months prior with subsequent excision, radiation and chemotherapy. On current admission, computed tomography revealed two masses on the pancreas. After dual sphinctetomies of the bile duct and pancreatic duct, and covered wall stent placement, presenting symptoms resolved and continued radiation and chemotherapy prescribed. This case illustrates the possibility of metastisis of MCC to the pancreas even with excision, ration therapy, and chemotherapy of the primary site.

Complications Of PEG – Prevention And Management

2009-11-05T13:14:05-06:00

Per cutaneous gastrostomy (PEG) is one of the most common procedure performed by the gastroenterologist for various indications. It has its own complications and morbidity. Complications are divided in the forms of minor and major, though majority of them are minor still they are higher in incidence with high morbidity. This review article illustrates the complications associated with PEG and various methods to prevent and manage the complications.

Long, parallel cystic duct in a patient presenting with obstructive jaundice

2009-11-05T13:14:03-06:00

Cystic duct anomalies are commonly seen on ERCP and MRCP and can pose difficulty during laparoscopic surgery. We report a rare case of a 30-year-old female patient who presented with right upper quadrant pain, tenderness, jaundice, elevated liver function tests, and ultrasound evidence of gall bladder calculi with dilated CBD. Endoscopicretrograde cholangiopancreatography (ERCP) revealed a long, cystic duct running parallel to CBD. Laparoscopic cholecystectomy confirmed long cystic duct.

Acute massive lower gastrointestinal bleeding from a rectal Dieulafoy-like lesion in a patient with chronic liver disease

2009-11-05T13:14:01-06:00

Recurrent and life threatening gastrointestinal hemorrhage occur rarely from Dieulafoy’s lesions. Initially described in the gastric lesser curvature, these lesions have been described in other parts of the gastrointestinal tract. We report a case of acute massive lower gastrointestinal bleeding from a rectal Dieulafoy-like lesion in a patient with a history of chronic liver disease. An overview of the possible etiology and management of this rare presentation is presented.

Caecal Lipoma, Unusual Cause of Recurrent Appendicitis, Case Report and Literature Review

2009-11-05T13:13:59-06:00

Lipoma is called the universal tumour. It can occur anywhere in the body. Caecal lipomas are considered rare probably because they are often asymptomatic or only mildly symptomatic, however they can cause significant pain, melena or diarrhoea or more serious conditions like intussusception and intestinal obstruction.We report a case of caecal lipoma presented as recurrent appendicitis reviewing the literature and evaluating the clinical features, diagnosis and treatment of this disease.

Case Report: Drug Toxicity Leading to Vanishing Bile Duct Syndrome and Cholestatic Jaundice

2009-11-05T13:13:59-06:00

A 37 year old black woman is described with difficult-to-control diabetes (DM), morbid obesity, hypertension, and chronic skin abscesses. During admission for control of skin abscesses, she received trimethoprim-sulfamethoxazole (TMP-SMZ), which was continued for 30 days after discharge. She then required admission for UTI and was treated with antibiotics. Metformin and glimepiride were added at the time of discharge, as parenteral insulin was poorly controlling the DM. Shortly thereafter she developed a cholestatic drug reaction, which progressed to end-stage liver disease (ESLD) with the histologic features of vanishing bile duct syndrome (VBDS). Clinical characteristics of medication-induced cholestatic liver disease and VBDS are discussed.

Pathogenesis of inflammatory bowel disease (IBD)

2009-11-05T13:13:58-06:00

The inflammatory bowel disease (IBD) is chronic inflammatory disease of gastrointestinal tract that include Crohn’s disease and ulcerative colitis, characterized by chronic recurrent ulceration of the bowel and of unknown etiology. They have become important health problems. In present review, the pathophysiology of IBD is reviewed, with emphasis on the genetic predisposition and inflammatory cascades underlying the production of symptoms and the course of the disease.

Hereditary protein C deficiency presenting as venous mesenteric ischemia in three successive generations

2009-11-05T13:13:58-06:00

Mesenteric ischemia is an important cause of short bowel syndrome and death. This is a case report of a 48-year-old man who underwent surgery for suspected acute mesenteric ischemia. The intraoperative findings included acute mesenteric venous thrombosis with gangrene of a short segment of the small bowel. Family history revealed that his father and grandfather died of a similar disease. Laboratory findings showed protein C deficiency. In this situation acute thrombosis can be prevented effectively. Thus, Screening of the first-degree relatives of patients with definitive diagnosis of inherited thrombophilia is highly recommended.

Post-traumatic Hepatic Cyst: An unusual sequel of liver injury

2009-11-05T13:13:57-06:00

Traumatic cysts of liver are amongst the less frequently known sequelae of liver trauma. The incidence of this entity is very low. We report a case of large post-traumatic liver cyst in a young adult male, who sustained blunt abdominal trauma three months back. The cyst was diagnosed by CT scan and was treated by percutaneous drainage of the cyst with supra-cath under ultrasonic guidance. The aim of presentation of this report is to highlight the fact that this rare lesion can be safely treated by this alternative minimally invasive modality in an ambulatory setting.

Umbilical Hernia Rupture Associated with Hepatic Cirrhosis

2009-11-05T13:13:57-06:00

We report an umbilical hernia rupture in a patient with hepatic cirrhosis and ascites. These patients should be identified early and the hernia electively repaired.

Acute mesenteric vein thrombosis after glue injection for Gastric varices – a case report

2009-11-05T13:13:55-06:00

Mesenteric vein thrombosis (MVT) is a relatively rare condition. Here we report a case of MVT following glue injection for fundal varix. MVT is usually characterized by the presence of abdominal pain, which is out of proportion with the physical findings. The etiology of this condition is not known. Embolism can occur through a large porto- venous shunt following glue injection. Mesenteric venous thrombosis (MVT) accounts for 5-10% of patients presenting with acute mesenteric ischemia (AMI)1. The etiology of this entity is not clearly defined. Several hypercoagulable states such as antithrombin III, protein C and protein S deficiencies may play a role in pathogenesis of this entity. Here we report a case of acute mesenteric venous thrombosis following the glue injection therapy for gastric varices.

ERCP in a district general hospital in England: a review of 1550 procedures over nine years

2009-11-05T13:13:51-06:00

Objectives: To describe the practice of ERCP in a district general hospital.Design: Descriptive study with prospective data collection from all patients undergoing ERCP between 1997 and 2006.Endpoints: The main outcomes were technical success (cannulation rates and therapeutic success rates) and safety (complication rate).Results: Technical success rates were high: cannulation of common bile duct was achieved in 95% of all 1550 ERCPs, increasing to 98% during 2001-2006; high success rates were also achieved for sphincterotomy, pre-cut incision, stent insertion and stone removal. The complication rate was low: acute pancreatitis occurred in 3%, perforation in 0.3% and haemorrhage in 0.4%, with a decrease in complications over time; procedure-related mortality was 0.2%. During the study period, the success rates for cannulation and therapeutic procedures increased, while complications decreased.Conclusions: ERCP in a district general hospital was associated with a high degree of technical success and a low risk of complications.

Effect Of Ovariectomy And Of Estrogen Administration Upon Duodenal Ulceration Induced By Cysteamine

2009-11-05T13:13:48-06:00

Duodenal ulcers were induced in ovariectomized, intact and old mice using cyteamine hydrochloride. Under these experimental conditions ovariectomy and old age strikingly increased sensitivity to ulcer induction while estrogen administration showed a decrease in sensitivity to ulcer induction. Nevertheless, the administration of estrogen in old showed no effects in either intact or overiectomized mice. This change in ulcer sensitivity reflected from histological, histochemistry and biochemical studies. The histological study was performed by using haematoxylin-eosin staining technique. The histochemistry of the duodenal region was studied by using periodic acid Schiff reaction (PAS) for glycoproteins. The biochemical study was performed to study various constituents of glycoproteins like hexose, fucose, sialic acid and the protein. The result showed that ulcer severity was more in overiectomized cyteamine treated mice and old mice treated with cyteamine. The histological studies showed the ovariectomy decreased or not shown any change in the ulcer sensitivity considering cryptus Lieburkuhn and bruner’ glands. The same result reflected in histochemistry study by differential intensity in the staining property of the bruners gland. The biochemical study showed that the glycoprotein contents were reduced many folds in overiectomized cyteamine treated mice and their reversal in estrogen administered ovariectomized cysteamine injected mice. These findings prove that estrogen protect the duodenal ulcer form cysteamine administration.

Etiology of thrombosed external hemorrhoids: results from a prospective cohort study

2009-11-05T13:13:44-06:00

Objectivive To find out causes of thrombosed external hemorrhoids (TEH). Subjects and Methods Prospective cohort study of individuals with and without TEH with comparison of answers to a questionnaire. Results One hundred forty-eight individuals were enrolled, 72 patients with TEH and 76 individuals without TEH but with alternative diagnoses, such as a screening colonoscopy or colonic polyps. Six independent variables were found to predict TEH correctly in 79.1% of cases: age of 46 years or younger, use of excessive physical effort, and use of dry toilet paper combined with wet cleaning methods after defecation were associated with a significantly higher risk of developing TEH; use of bathtub, use of the shower, and genital cleaning before sleep at least once a week were associated with a significantly lower risk of developing TEH. Conclusions Six hypotheses on the causes of TEH should be considered in future studies on etiology and prophylaxis of TEH.

Endoscopic Treatment Of Recurrent Gastro-Gastric Stricture Following Revision Of A Divided Roux-En-Y Gastric Bypass

2009-11-05T13:13:40-06:00

Balloon dilation as a treatment for post-surgical anastomotic strictures is minimally invasive and relatively safe. The benefit of “through-the-scope” endoscopic balloon dilation has a reported long-term improvement for patient symptoms. This is a case report of a patient who developed severe dysphagia following revision of a divided Roux-en-Y gastric bypass with formation of a gastro-gastric anastomosis. The patient developed a gastro-gastric anastomotic stricture that rapidly recurred following multiple endoscopic dilations with balloon dilators. Following repeat endoscopic dilations, the anastomotic stricture was treated by submucosal injections of triamcinolone into the stricture, using a protocol described for esophageal strictures. Because this treatment prevented recurrent symptoms, she did not require repeat dilation for 3 months, prior to small intestinal transplantation. Repeat upper endoscopy prior to transplantation surgery revealed a patent gastro-gastric anastomosis. This case report demonstrates that injection of corticosteroid directly into a surgical anastomotic stricture improves the long-term efficacy of dilation.

Radical External Beam Radiotherapy With Intraluminal High Rate Dose Brachytherapy In Patients With Carcinoma Esophagus

2009-11-05T13:13:37-06:00

Aims: - Oesophageal carcinoma is an uncommon malignancy, accounting for approximately 1% of all malignancy and 6% of all gastrointestinal malignancies, patients with carcinoma oesophagus usually present with advanced disease. A combination of external and intraluminal radiation therapy is useful to palliate these patients. We report the findings of a retrospective study done on patients with carcinoma oesophagus who were treated withExternal radiationtherapy Followed by Intraluminal brachytherapy.Methods- 21 patients who received ILBT followed by EBRT in year 2006-7, of unresectable carcinoma oesophagus without any history of previous anticancer treatment were given external radiotherapy, 40 Gy in 20 fractions over 4 weeks. After gap of two to three week all patients were given Intraluminal high dose rate brachytherapy (5 cGy /3fr/one week apart) were enrolled for this retrospective study. After completion of treatment patients were evaluated every moths for clinical response, toxicity and survival. Results- Majority of patients were ranged 48-66, with median age of presentation was 57 years. 20 (95%) were male and 1(5%) was female patient. Dysphagia free survival was seen in 20 (95%) of patients. Recurrence was seen in one (5%) patient after completion of four months of follow up. Complete response seen in 19 patients (90.4%) at the completion of treatment. Two patients (9.52%) showed persistent disease. Conclusions- The use of HDR-ILBRT, as a treatment for unresectable oesophageal cancer, was significantly effective and HDR-ILBRT contributed to improve outcomes, as well as symptoms free survival in patients with advanced oesophageal cancer. Oesophageal stricture is a common late toxicity in IBT for oesophageal carcinoma. Late complications, including oesophageal ulcer and fistula, were not seen in the present study.

Bile composition in patients with noncirrhotic portal hypertension

2009-11-05T13:13:31-06:00

Background and Aims: Stasis is an important predisposing factor for gall bladder sludge and hence gall stones. The present study was done to find out whether bile composition is altered in patients with noncirrhotic portal hypertension with portal biliopathy. Methods: 35 patients with noncirrhotic portal hypertension with portal biliopathy documented on ultrasound, ERCP / MRCP were prospectively evaluated for gallbladder emptying response to fatty meal by ultrasonography using Ellipsoid method. In 10 patients with extra hepatic portal vein obstruction, bile was collected from common bile duct during ERCP for analysis. Ten healthy age and sex matched controls were taken for comparison.Results: The mean age of the patients in our study was 29.93 +11.7 years. Gallstones were seen in 16.1% and sludge was present in 9.6% of patients of extra hepatic portal vein obstruction . Gallbladder varices were seen in 29.03% patients on USG/ Doppler ultrasonography. Gallbladder ejection fraction was significantly less in extra hepatic portal vein obstruction patients than controls (40.6±16.73% vs 57.71±13.25%, p=0.007). Patients with extra hepatic portal vein obstruction had significantly higher cholesterol levels (10.32+2.96) than in controls (6.86+3.36) (p<.02) and the bile acid levels were also higher in patients than controls although statistically not significant (p=0.07)). The cholesterol saturation index was comparable in patients with extra hepatic portal vein obstruction and controls. Conclusions: Ejection fraction was significantly lower in extra hepatic portal vein obstruction compared to controls. Extra hepatic portal vein obstruction patients had significantly higher cholesterol levels than in controls and the bile acid levels were also higher in patients than controls although statistically not significant .

Verrucous Cyst In An Immunocompromised Patient

2009-11-04T22:37:49-06:00

Verrucous cysts are distinctive cutaneous cysts with a verrucous lining. Like many other squamous cutaneous lesions, verrucous cysts too, are linked to Human Papilloma Virus. Clinically they have been mistaken for epidermoid cysts, dermatofibroma, basal cell carcinoma, and in this case, Kaposi sarcoma. Histologically the lesion is characterized by an intradermal infundibular cyst, lined by papillated epithelium that is marked by prominent hypergranulosis and irregular keratohyaline granules. Often squamous eddies are seen in the epithelium. While the link of verruous cysts with HPV is well documented, we describe a case of a verrucous cyst that occurred in an HIV positive patient.

Lymphoepithelioma-like carcinoma of the ureter

2009-11-04T22:37:48-06:00

We report an extremely rare case of lymphoepithelioma-like carcinoma of the ureter. A 73-year-old man presented with asymptomatic gross hematuria. Based on the clinical diagnosis of a left ureteral tumor, the patient underwent left nephroureterectomy. Histological examination showed lymphoepithelioma-like carcinoma of the ureter with a unique growth pattern of submucosal spread, in which cytokeratin immunohistochemistry clearly demonstrated the cluster of neoplastic cells within the dense lymphocytic infiltrates. The tumor cells showed negative results for the presence of Epstein-Barr virus by Epstein-Barr virus-encoded ribonucleic acid in situ hybridization. The patient was free of tumor recurrence and metastasis 15 months after the operation. To avoid misdiagnosis as chronic inflammation, recognition of this type of tumor is important.

Muir-Torre syndrome – a case report and review of literature

2009-11-04T22:37:47-06:00

Muir-Torre syndrome (MTS) is a rare autosomal dominant condition in which one or more primary malignancies occur together with a sebaceous gland tumor. We report a case of this rare syndrome who presented with a sebaceous epithelioma occurring in association with invasive ductal carcinoma breast (No special type-NST) in a 63 years old female patient. Implications for diagnosis, management and screening of the family members are discussed.

A Case of Primary Osteoma Cutis in an Infant

2009-11-04T22:37:47-06:00

Neck nodules in an infant can occur due to varied etiology. One such condition is Osteoma Cutis.Osteoma Cutis is the organized deposition of calcium and phosphate within the skin, arranged in a manner seen in normal bone formation. It can occur de novo or secondary to systemic disease.We present here an infant with a primary Osteoma Cutis, which would help in understanding the presentation and treatment of the same.

Malignant Melanoma of the Gall Bladder, A Case report and Literature Review.

2009-11-04T22:37:43-06:00

Malignant melanoma is a highly unpredictable tumor, which can metastasize to any organ, including the gallbladder in 4–20% 1,2. Grossly and histologically, the distinction between primary and secondary lesions can be difficult to differentiate because they share many similar characteristics 2. Melanoma involving the biliary tree seldom causes relevant symptoms during life, and that is why few cases are reported in the literatures 2 and those documented in living patients are even fewer 3,5. Herein, we present a case of a 75-year-old female with metastatic melanoma to the gallbladder and a brief review of the literatures.

Benign recurrent intrahepatic cholestasis (BRIC) – a case report and review of literature

2009-11-04T22:37:42-06:00

Benign recurrent intrahepatic cholestasis (BRIC) is a rare hereditary disorder characterized by recurrent and intermittent episodes of cholestasis, episodes of pruritus and jaundice with normal extra hepatic biliary tree.The disease may start in early infancy or childhood but does not proceed to cirrhosis or chronic liver disease. Treatment is mostly symptomatic. Rarity of the disease and its unpredictable clinical morbidity prompted us to report this case.

Significant Eosinophilic Infiltrate of the Breast

2009-11-04T22:37:40-06:00

Background: Prominent tissue eosinophilic infiltrate is encountered in a number of inflammatory states, particularly in allergic diseases, parasitic infection, collagen diseases and hematological malignancies. We searched for significant or prominent eosinophilic infiltrates of the breast in benign and malignant diseases. Methods: All breast cases reported in our institution during the period of 1999-2008 were reviewed for significant or prominent eosinophilic infiltrate.Results: Eight cases were identified. Four cases diagnosed as granulomatous mastitis, one eosinophilic mastitis, two ductal carcinomas and one gynecomastia.Conclusion: Significant eosinophilic infiltrate was identified mainly in cases of mastitis and rarely in breast carcinomas. Although eosinophils can degranulate and release toxic inhibiting factors into tumors, they are uncommonly encountered in breast carcinomas.

Anal gland adenocarcinoma

2009-11-04T22:37:37-06:00

Sequence comparison of the ribosomal DNA internal transcribed spacers (ITSs) and 5.8S ribosomal gene and their secondary structures in 17 Pteriomorphian bivalves

2009-11-04T20:26:39-06:00

Purpose and Approach: The first and second internal transcribed spacer (ITS1 and ITS2) region of the ribosomal DNA and 5.8S rRNA gene from 17 pteriomorphian bivalve species Amusium pleuronectes, Mimichlamys nobilis, Mimichlamys seneatoria, Mimichlamys sp.NT-2006, Minnivolva pyxidatus, Semipallium fulvicostat, Decatopecten radula (Family-Pectinidae), Perna calaiculus, Perna perna, Perna picta and Aulacomy atra maorian (Family-Mytilinae) and Crassostrea ariakensis, Dendostrea crenulifera, Ostrea circumpicta, Hyotissa hyotis and Spondylus varius (Family-Ostreidae)and Saccostrea kegak (Family-Spondylidae) were analyzed.Results: The size of ITS1 sequence ranged from 21bp to 475bp with GC contents ranged from 25.84% to 50.00 %. The size of ITS2 ranged from 233bp to 504bp with GC contents from 28.91% to 51.69%. The size of 5.8S ranged from 127bp to 167bp with GC contents ranged from 32.73% to 46.67% depending on species. Extensive sequence variation and obvious polymorphism were noted for ITS1, ITS2 regions in these species, and ITS2 similarity was higher than that of ITS1 across the species. The size of 5.8S rRNA gene sequence length was specific to family. The phylogenetic tree was constructed by Neighbor-joining method and maximum –parsimony method. The topology indicates that pectinidae was closely related to myitilinae than the ostreidae and spondylidae to Ostreidae. The secondary structure analysis of ITS1, ITS2 and 5.8S indicated a phylogentic relationship among the selected species belonging to different geographical locations.Conclusions: Several common features of secondary structure are shared among these species, with some of them supported by compensative changes suggesting the significant role by ITS2 as an RNA domain during ribosomal biogenesis.

Accuracy of allele frequency estimates in pool DNA analyzed by high-density Illumina Human 610-Quad microarray

2009-11-04T20:26:38-06:00

Purpose: DNA pooling method has been previously proven successful for allele frequency estimation using earlier versions of Illumina Beadchip and Affymetrix GeneChip microarrays. The aim of this study was to evaluate the accuracy of the DNA pooling using the High Density Illumina Infinium microarray system.Patients & methods: The accuracy of three different methods of allele frequency estimation on the High Definition Infinium II Beadchip (Human 610-Quad) was tested using the DNA samples obtained from saliva collected from seven Caucasian subjects who had been individually genotyped. Our first approach was to calculate estimated allelic frequency (expressed as B allele frequency) from pooled DNA sample based on the correlation coefficient obtained for individual SNPs, and to correlate it with the true (real) allele frequency computed using individually genotyped samples. The second approach was to estimate SNP frequency in the pooled DNA sample as calculated automatically by the proprietary Beadstudio software, which is based on the internal calibration and normalization procedures. The third approach was to study the pool allele frequency calculated using the estimation of correlation coefficient from microarray SNP sub-pools.Results and conclusions: All analyzed methods of allelic frequency estimates from pooled DNA produced similar results in respect to the calculated correlation coefficient (R) (R ranging from 0.947 to 0.958 with R>0.99 for correlation between each three of them). All three methods of calculations seem to be sufficient and equally effective for calculation of individual allelic frequency for the given SNPs from the pooled DNA.

Proteomic analysis and characterization of a novel glucansucrase from a newly isolated strain of Leuconostoc mesenteroides AA1

2009-11-04T20:26:35-06:00

PurposeGlucansucrase is an industrially important enzyme that is produced by different species of bacteria like Leuconostoc, Streptococcus and Acetobacter. Among them Leuconostoc mesenteroides is used for the production of glucansucrase that catalyzes the synthesis of a commercially important long chain glucose polymer known as glucan on industrial scale.Due to its increasing demand in various biotechnological industries, isolation of new strains of Leuconostoc mesenteroides for the production of glucansucrase and glucan is of valuable importance.MethodsNew strain of Leuconostoc mesenteroides AA1 was isolated and various biochemical conditions and aspects regarding extracellular glucansucrase activity have been optimized. Glucansucrase was purified to homogeneity using conventional chromatographic techniques. Amino acid analysis and N-Terminal sequence of the purified enzyme was also performed. ResultsGlucansucrase [EC 2.4.1.5] was purified to homogeneity with an overall purification factor of 162.5 times, with a specific activity of 2692 DSU/mg. The native protein showed a molecular mass of 177,000 Da by SDS PAGE. The enzyme exhibited optimum catalytic activity at 35°C and pH 5.0 with 0.1 M citrate phosphate buffer. The kinetic constants Km and Vmax were estimated as 69.88 mM and 61.75 DSU/ml/hr, respectively. The amino acid composition of the enzyme showed that the enzyme is rich in both the basic and polar/hydrophilic amino acid and is less rich in acidic amino acids. The first six amino acid residues at the N-terminal end are D-S-T-N-T-V. ConclusionsThis novel extracellular glucansucrase is significant for industrial perspective and is therefore suggested that this strain can be used for the production of glucansucrase and high molecular weight glucan on a large scale.

Bioinformatics Approach For Conservation Of Fauna and Flora Through Bioprospecting

2009-11-04T20:26:29-06:00

Varieties of valuable compounds like- cosmetics are extracted from various animals. Many companies have catered to this expanding market of cosmetics by introducing various makeup types for which they use vibrant colors that are derived from some unexpected sources, ranging from crusted insects to rust, which is responsible for diminution of biodiversity. Therefore there is a strong need to look for alternative source for these compounds (Bioprospecting). In this paper, a bioinformatics approach has been used to analyze the molecular evolution of known valuable compounds like anthraquinone by analysis of pathway and construction of phylogenetic trees. Phylogenetic analysis provides new horizons for this type of study and shows their worthwhile by giving the answers of their origin, development and other characteristics. The phylogenetic analysis of enzymes was incorporated to know, which species are related and which one is the ancestral species. Bioinformatics database, tools and software which were used in the paper are NCBI, KEGG, BLAST, MULTALIN, PHYLIP.After tracing phylogeny of enzymes involved in anthracene degradation pathway,both the enzymes showed ancestral relationship with Oriya sativa. Therefore Oryza sativa can be an alternative source to obtain anthraquinone of plant origin. when phylogenetic relationship for octaketide synthase was traced it showed relationship with pentaketide synthase of Aloe arborescens and chalcone synthase of Naringenin, Hypericum hookerianum, Vitis vinifera and Senna alata and also with aromatic polyketide synthase of Solenostemon scutellarioides. Therefore they can be alternate source to obtain anthraquinones. A list of valuable secondary metabolites and their possible alternative sources is also discussed in the paper.

Pneumatosis intestinalis with superior mesenteric and hepatic portal venous gas in sigmoid colonic cancer: CT findings.

2009-11-04T15:09:48-06:00

In this article we present a case of colonic cancer with pericolonic abscess, complicated by pneumatosis of the small bowel with gas in inferior and superior mesenteric veins and hepatic portal veins, with emphasis on CT scanning and its diagnostic accuracy.

CT Evaluation Of Parapharyngeal Masses: Pictorial Assay

2009-11-04T15:09:44-06:00

A lesion in the parapharyngeal space can arise within the space or extend secondarily from the surrounding spaces. The origin of a lesion can be assessed by observing the relationship of the lesion to the fat within the prestyloid compartment of the parapharyngeal space [5].

Splenic torsion, an unusual cause of acute abdominal pain.

2009-11-04T15:09:43-06:00

Torsion of spleen is a rare cause of acute abdominalpain leading to splenic infarction. We report a case of splenic torsion in a middle aged female and highlight the role of CT in its diagnosis.

Sunburn appearance on MRI

2009-11-04T15:09:42-06:00

The appearance of solar erythema as an incidental finding in a knee MRI scan is shown.

Magnetic Resonance Imaging findings in a case of intramedullary teratoma of conus medullaris

2009-11-04T15:09:42-06:00

A 6 year old female patient presented with complaints of urinary and fecal incontinence. There was also progressive weakness of both the lower limbs. Physical examination revealed significantly reduced motor and sensory functions in both the limbs. Magnetic Resonance Imaging (MRI) revealed presence of a large intramedullary tumor in the conus medullaris causing its marked expansion. Presence of calcification and fat in the tumor was characteristic of teratoma.

Longitudinal stress fracture of tibia – a rare diagnosis

2009-11-04T15:09:41-06:00

A 44year old female presented in radiology department for evaluation of a left sided distal tibial pain. There was no history of trauma or any unaccustomed exercise. Physical examination was remarkable for significant tenderness to palpation of distal third of left tibia. Presumptive diagnosis of stress fracture or osteoid osteoma was made. Patient was referred for radiological evaluation. roentgenogram revealed focal distal cortical thickening. CT and MRI revealed an unusual type of stress fracture- longitudinal stress fracture of tibia.

Steroid-induced Extensive Bilateral Femoral and Tibial Bone Infarcts in a Patient with Ulcerative Colitis

2009-11-04T15:09:39-06:00

Osteonecrosis is a common complication of chronic or repetitive steroid treatment.A 55 year-old black man with a history of ulcerative colitis for 30 years, treated with multiple courses of steroids is presented in this clinical vignette. Multifocal extensive osteonecrosis was detected on imaging studies.

Radiofrequency denervation of the sacroiliac joint- experiences in a series of 30 patients

2009-11-04T15:09:38-06:00

The sacroiliacal joint can be source of low back pain and radiofrequency denervation was reported to provide pain relief in patients with sacroiliac joint syndrome. We report about our experience with 30 difficult to treat patients with low back pain because of sacroiliac joint syndrome. Six months after the radiofrequency denervation 47% of the patients showed a lasting pain relief. Radiofrequency denervation shows promising results as part of the treatment of sacroiliac joint pain, but randomized controlled trials with larger sample size are thoroughly needed to further determinate its effiacy.

Vein of Galen Malformation

2009-11-04T15:09:36-06:00

We report a case of vein of Galen malformation presented at birth with congestive heart failure with subsequent discussion about this rare anomaly.

Hypoplastic Vertebral Artery as a predisposing cause for dissection

2009-11-04T15:09:34-06:00

Dissection in a hypoplastic vertebral artery is extremely rare and has never been described previously in adults. We report a case of a 28 year old male who developed stroke following dissection in a hypoplastic left vertebral artery. In addition to describing the imaging findings of this rare combination, the authors discuss the role of hypoplasia as a predisposing factor for dissection.

Periadrenal Bronchogenic Cyst with Intracystic Milk of Calcium

2009-11-04T15:09:32-06:00

Retroperitoneal bronchogenic cyst containing intracystic milk of calcium is extremely rare and only one case of retroperitoneal bronchogenic cyst with a small amount of milk of calcium has ever been reported. We report a case of periadrenal retroperitoneal bronchogenic cyst with intracystic milk of calciumn and its serial change into the nodular cyst wall calcifications over the course of two year. The patient was treated with laparoscopic resection of retroperitoneal bronchogenic cyst.

Cranial and Spinal involvement in Neurofibromatosis type 2

2009-11-04T15:09:29-06:00

Neurofibromatosis type 2(NF-2) is an often devastating autosomal dominant disorder which, until relatively recently, was confused with its more common namesake neurofibromatosis type 1. NF2 is a distinct disease which must be separated clinically & radiologically from neurofibromatosis1. Subjects who inherit a mutated allele of the NF2 gene inevitably develop schwannomas, affecting particularly the superior vestibular branch of the 8th cranial nerve, usually bilaterally. Meningiomas and other benign central nervous system tumours such as ependymomas are other common features. Much of the morbidity from these tumours results from their treatment. As a classical tumour suppressor, inactivation of the NF2 gene product, merlin/schwannomin, leads to the development of both NF2 associated and sporadic tumours. Merlin/schwannomin associates with proteins at the cell cytoskeleton near the plasma membrane and it inhibits cell proliferation, adhesion, and migration.

Healthcare Blogging-A review

2009-11-04T15:09:26-06:00

The Internet is changing medicine and web 2.0 is the current buzz word in the world wide web dictionary. According to Dean Giustini in British Medical Journal, web 2.0 means “the web as platform” and “architecture of participation”. It is the web or internet information which is created by the users themselves. Web 2.0 is primarily about the benefits of easy to use and free internet software. For example, blogs and wikis facilitate participation and conversations across a vast geographical expanse. Information pushing devices, like RSS feeds, permit continuous instant alerting to the latest ideas in medicine. Multimedia tools like podcasts and videocasts are increasingly popular in medical schools and medical journals. Recently, there has been no escaping the mention of blogs in the media. Blogging has emerged as a social phenomenon, which has impacted politics, business, and communication. Medical field or healthcare is also not immune to this global phenomenon. Hence this chapter will deal with this phenomenon of blogging, with emphasis on what is a blog, historical significance, various software platforms available, blogging for a physician, pros and cons of blogging in healthcare, examples from popular healthcare blogs and prediction for future trends. This chapter will familiarize the reader about healthcare blogs and their impact on healthcare.

Field Trial Tests On The Efficacy And Residual Effects Of Bistar® 10wp On Mosquitoes And Other Household Arthropod Pests

2009-11-04T12:36:10-06:00

A field test on the efficacy and residual effect of Bistar® 10WP on mosquitoes and other household arthropod pests was conducted at Agu-Owa and Ugbo-Oghe communities in Enugu East Local Government Area of Enugu State, Nigeria. Eighteen four-bedroom apartments noncontiguous with each other and infested with bedbugs and other homestead arthropod pests were selected for the studies from the two communities. In each area, Bistar® 10WP was sprayed in the inside wall surfaces of 3 four-bedroom apartments, lamba cyhalothrin (ICON), was sprayed in another set of 3 four-bedroom apartments and the last 3 houses were used as controls. Pre-and post insecticide application vector monitoring were carried out in the two areas to determine the homestead vector abundance. Insecticide bioassay was carried out to determine the residuality of Bistar® 10WP. Pre-insecticide application vector studies revealed 532 homestead arthropod pests with cockroaches 293(55.08%) and bedbugs 201(37.78%) constituting the bulk of the collections. Post-spray vector evaluation revealed no homestead arthropod in the sprayed areas except in the controls. Bioassay studies showed that Bistar® 10WP compared well with ICON in its efficacy and residuality. Bistar® 10WP was highly accepted by the people as it was odourless and non-irritating to the body and sense organs. More studies were recommended on its efficacy in controlling aquatic and field pests like Glossina species.

Prevalence of sickle cell disease in tribal adolescents of the South Gujarat region, India

2009-11-04T12:36:08-06:00

Objectives: to create awareness, to screen samples of school adolescents and then to reach their community through them by doing surveillance for sickle cell diseaseSettings & Design: School adolescents studying in St Xavier`s high school and Vanraj high school of Umarpada taluka of Surat district were included in the field based cross-sectional studyMethod: After taking permission from school authority, pre-test (n=881) and post-test (n=743) evaluation was done to asses their knowledge regarding SCD. Blood samples of 948 school adolescents were taken for DTT test and then for electrophoresis. Blood samples of motivated parents and friends of those adolescents found positive for DTT was taken in subsequent visit and results were communicated to them.Results: Out of 1081 adolescents, various aspects of sickle cell disease were assessed among 881 during pre-test and among 743 during post-test evaluation. Blood samples of 948 school adolescents were tested for DTT test. Prevalence of sickle cell disease was found 25.5%. Electrophoresis was done in 242 adolescents who found positive for DTT test, of which 92% found having sickle cell trait and 8% having sickle cell disease. Then electrophoresis done among 64 parents and friends and 24 (37.5%) found positive of which 14 (58%) having sickle cell trait and 10 (42%) having sickle cell disease.

Concurrent giardiasis and amoebiasis infections in Nigerian children diagnosed with Plasmodium falciparum malaria: prevalence and pathophysiological implications.

2009-11-04T12:36:07-06:00

The prevalence of giardiasis and amoebiasis as concurrent infections in Nigerian children diagnosed with Plasmodium falciparum malaria was investigated. From the results, 69 (27.6%) of the 250 children diagnosed with malaria, were concurrently infected by amoebiasis, 13 (5.20%) were infected by giardiasis, while 38 (15.2%) were infected by both giardiasis and amoebiasis. In all, 119 (47.60%) of the test population were concurrently infected by either one or both protozoan infections. The prevalence of giardiasis and mixed giardiasis/amoebiasis infections was significantly (p<.05) higher in the malaria-positive subjects than in the malaria-free group. However, the prevalence of amoebiasis in the malaria-positive group (27.6%) was lower than the prevalence (37.14%) in the malaria-negative control. It is concluded that a relatively high percentage of cases of childhood malaria in Nigeria is confounded by giardiasis and amoebiasis with severe implications for severity, duration and eventual outcome of illness.

Seroprevalence of Hepatitis B Surface Antigen and Liver Function Tests among Adolescents in Abakaliki, South eastern Nigeria

2009-11-04T12:36:06-06:00

Of the 385 apparently healthy adolescents, 191 (49.6%) males and 194 (50.4%) females (mean age, 15.6 ± 2.3 years) screened for hepatitis B surface antigen (HBsAg) using a third generation enzyme linked immunosorbent assay method, 15 (3.9%) were seropositive. Although, males and females did not differ significantly in HBsAg seropositivity (9 vs. 6; 95%CI -0.032-0.046) more infections were found in patients from lower- than middle-/or and upper- socioeconomic classes (p < 0.05). The major routes of HBV transmission in this population were unsafe injection (26.7%; 95%CI; -0.00-0.16), tribal marks/circumcision/scarification (13.3%; 95%CI; -0.02-0.13) and blood/blood products transfusions (6.7%; 95%CI; -0.12-0.4) while 53.3% (95%CI; 0.01-0.06) of HBV infections have no identifiable mode of transmission. Asymptomatic HBV infection among adolescents without proper identifiable risk factors or mode of acquisition calls for general surveillance, mass immunisation, and public health education to curtail the spread of the virus and its sequalae.

Gender Disparities In Mortality Among Medical Admissions Of A Tertiary Health Facility In Ilorin, Nigeria

2009-11-04T12:36:05-06:00

We retrospectively assessed sex-related differences in duration of hospital stay and mortality among medical admissions at the University of Ilorin Teaching Hospital (UITH), Nigeria between January 1996 and December, 2005. Seventeen thousand six hundred and fifty patients, consisting of 10,040 (56.9%) males and 7,610 (43.1%) females were admitted during the period under review. Of these, 4220 died which was made up of 2624 (62.2%) males and 1596 (37.8%) females with overall percentage mortality of 23.9%. Mortality rate was significantly higher (Chi2=62.5, p=0.0001) in males (26.1%) than in females (20.97%). The percentages of deaths due to Human Immunodeficiency Virus (HIV)/Tuberculosis (TB), neoplasms and haematological disorders were higher in females than in males (p=0.0001, 0.0001 and 0.0001 respectively). However, deaths from gastrointestinal system and liver, and endocrine system were higher in males (p=0.0001 and 0.02 respectively) than in females. We recommend gender specific community interventions for the control of HIV/AIDS, TB and liver diseases in the population studied.

Deforestation and Malaria in sub-Saharan Africa: an overview

2009-11-04T12:36:01-06:00

Malaria remains the most complex and overwhelming health problem in sub-Saharan Africa. The disease is compounded by the generally poor social, environmental and economic conditions in the region. Most sub-Saharan African countries are experiencing unprecedented rate of population growth which has led to uncontrolled and unsustainable exploitation of natural resources, especially the forests resources. Through the process of forest clearing, deforestation alters every element of local ecosystems such as microclimate, soil, and aquatic conditions, and most significantly, the ecology of local flora and fauna, including malaria vectors. Mosquitoes are highly sensitive to environmental changes because of deforestation: their survival, density, and distribution are dramatically influenced by small changes in environmental conditions, such as temperature, humidity, and the availability of suitable breeding sites. Changes in mosquito ecology and human behaviour patterns in deforested regions influence the transmission of malaria and deforestation has therefore been shown to increase the risk of malaria transmission in sub-Saharan. Because deforestation is a process that cannot be readily controlled for a variety of political and economic reasons, investigations and assessments of possible impacts of future deforestation will be crucial to minimize the ecological degradation caused by human activities and to control epidemics of malaria.

Urine colour as a rapid assessment indicator in evaluating the prevalence of Schistosoma haematobium infection in two endemic areas of Benue State-Nigeria.

2009-11-04T12:36:00-06:00

Schistosomiasis is a formidable public health problem, especially in sub-Saharan Africa where the majority of cases reside. In the context of having interest upon chemotherapy control, rapid, cheap and fast diagnostic tools and assay play an important role in assessing where treatment methods should be concentrated. We examined whether urine colour observation was correlated with intensity of infection in urinary schistosomiasis as measured by the gold-standard parasitological diagnosis. Using this tool and other proven field diagnostic (reagent strips), we examined 750 urine samples collected from school children and communities in two endemic areas of Benue State-Nigeria. Our findings demonstrate that urine colour observation was significantly associated with infection intensity (r = 0.72, p<.01). Given that parasitological examination is laborious, we showed that urine colour observation was significantly correlated with the indirect diagnosis method, Proteinuria (r = 0.75, p<.01) and Haematuria (0.52, p<.01) widely used at the present time. We suggest that urine colour observation may be useful for diagnostic purposes, and for monitoring and evaluating treatment programs over time. Furthermore, we recommend that additional research should be done to further elucidate the relationship between this technique and other diagnostic methods.

Factors Affecting on Child Survival in Bangladesh: Cox Proportional Hazards Model Analysis

2009-11-04T12:35:58-06:00

This paper focuses mainly on the impact of utilization of heath care services on child mortality, using data from the 2004 Bangladesh Demographic and Health survey (BDHS, 2004). The study elucidate that 1 in 11 children born in Bangladesh dies before reaching the fifth birthday, while 1 in 15 children dies before reaching the first birthday. A child’s risk of dying is highest during the first month of life. From relative hazards we found that child mortality is higher among mothers who do not take sufficient ANC and also not receive assistance from medically trained personnel. Mothers whose place of delivery is any hospital were reported less child mortality as against their opposite counterparts. The result suggests that certain socioeconomic factors like mothers and father’s education are related to reduce the child mortality risks. An increase of one moth in the duration of breastfeeding by mothers decreases the hazard risks of child mortality. The household infrastructure variables like household electricity and household assets index seems to have little insight relationship with child mortality. The mortality hazard is 1.32 times higher if there is no provision of electricity in the household. Child mortality was reported 0.72 and 0.53 times less among mothers whose household’s assets position is medium and higher than lower index.

Traditional Birth Attendants: Practices & Problems In Konduga Local Government Area Of Borno State; North Eastern Nigeria

2009-11-04T12:35:57-06:00

Background: Significant number of deliveries in the developing world takes place at home mostly conducted by traditional birth attendants. Some of their practices are harmful and contributes significantly to morbidity and mortality especially if untrained. This study was carried out to document harmful practices, training status and problems of the traditional birth attendants in Konduga Local Government Area of Borno State, North Eastern Nigeria.Methods: Data was collected based on a proforma questionnaire administered to traditional birth attendants by final year medical students supervised by consultant staff from departments of paediatrics and Community Medicine of the University of Maiduguri.Results: There were a total of 48 traditional birth attendants (TBAs) spread across the 5 districts of Konduga Local Government. Forty six (95.8%) were aged ≥ 35years with only 2 (4.2%) below age 35 years. Only 12 (25%) TBAs had some form of training while 36 (75%) did not have any form of training. All the trained TBAs sterilize their delivery kits before any delivery. Cord was severed using a new razor blade by 44 (91.7%) of the TBAs, 3 (6.3%) used bamboo or back of corn stick, while one (2.1%) used a pair of scissors. Various items used in securing the cord includes tie with thread 38 (79.2%), massage and application of warm or cold water before cutting 5 (10.4%), tie with string 3 (6.3%) and soak in dettol 2 (4.2%). Difficulties encountered by the TBAs during conduct of deliveries includes retained placenta 4 (8.3%), breech delivery 4 (8.3%), lack of facilities 2 (4.2%), obstruction 2 (4.2%), antenatal bleeding 1 (2.1%), all of the above 1 (2.1%) and none 34 (70.8%). When asked if they know of a child who have died as a result of stiffness during the cord care period, 23 (47.9%) said yes while 25 (52.1%) said no. Twenty five (52.1%) said it is not too common, 3 (6.3%) said it is common, only 1 (2.1%) said it is very common, while 19 (39.6%) said they have not seen or are not aware of the illness. Eleven (22.9%) of the TBAs saw about 1-2 cases of children dying of stiffness in the last one month, 2 (4.2%) saw 3 and above of such cases, while 35 (72.9%) said they have not seen any of such cases in the last one month.When asked what danger they think can result from not taking proper care of the cord, 18 (37.5%) said sickness /death, 14 (29.2%) said abdominal distention or perforation, 6 (12.5%) said stiffness, 5 (10.4%) said poor cord healing while 5 (10.4%) said they don’t know.Conclusion: In conclusion, there are few facilities and skilled attendants in Konduga Local Government Area to manage normal deliveries and diagnose, manage or refer obstetric and neonatal complications. There is therefore the need for training and retraining of TBAs on safe delivery and good cord care practices. The development of an effective referral system for referral of complicated deliveries and newborn problems needs serious consideration. This will go a long way in lowering the high maternal and neonatal mortality with subsequent lowering of perinatal mortality rates.

Epidemiological Survey of Cutaneous Leishmaniasis in Jos East L.G.A. Of Plateau State Nigeria.

2009-11-03T23:06:41-06:00

A house-to-house survey of the prevalence of leishmaniasis infection was carried out in Jos East Local Government Area of Plateau State, Nigeria, Cutaneous Lishmaniasis was diagnosed in 2.6% of a population of 703 inhabitants of the area. 18 inhabitants had the infection, which was considered to be native. 10 were males and 8 were females with age varying between 10 and 55. This area is a new focus of cutaneous leishmaniasis in Nigeria.

Antenatal Malaria Parasitaemia And Haemoglobin Profile Of Pregnant Mothers In Awka, Anambra State, Southeast Nigeria

2009-11-03T23:06:40-06:00

Three hundred and two women comprising 242 pregnant women attending antenatal clinic and 60 non pregnant women that served as control group, were tested for malaria parasites using Giemsa stained thick films. The haemoglobin concentration of the mothers were also tested and matched with their infection status. The findings show that malaria parasitaemia and intensity are dependent on pregnancy and parity of pregnancy (p < 0.05). It demonstrated that anaemia is a common feature of malaria infection, more severe during pregnancy especially in the first pregnancy. There was a downward gradation in the prevalence of low haemoglobin levels from primiparae to the control group in both infected and uninfected populations. Over 70% of primigravid mothers, 45% of the multiparae and only 22% of the control group recorded haemoglobin levels lower than the World Health Organization benchmark (11.0g/dl). Anaemia was therefore dependent on infection status, pregnancy status and parity of pregnancy (p <0.05). The effects of malaria and its clinical features (especially anaemia) on the mother and foetus was again re-stressed with emphasis on availability, affordability and sustainability of malaria control efforts especially for the most vulnerable populations. The study will be of immense value as a public health tool for planning, delivery, monitoring and evaluation of interventions.

Controlling Onchocerciasis: The Nigerian Experience

2009-11-03T23:06:37-06:00

Trend in the treatment of onchocerciasis in Nigeria was investigated by analyzing national treatment data (1991-2006). From 1991-1997 (the pre-APOC funding period) 2,392,554 people were treated on the average annually. During this 7-year period, the percentage national therapeutic coverage was very low but generally increased from 4% to 35% before dropping to 33% and then increased to 45% by 1997. The mean therapeutic coverage was 18%.A significantly increasing trend (P<0.01) reaching a maximum of 45% in 1997 was observed.For the APOC funding period (1998-2006) 17,250,485 people were treated on the average annually. During this 10-year period, the percentage national therapeutic coverage also generally increased from 55% to 77%. The mean therapeutic coverage for the treatment was 72% for the period 1998-2006. A significantly increasing trend (P<0.01) reaching a maximum of 77% in 2006 was observed.During the pre-APOC period (1991-1997) the lowest geographic coverage was 18% nationally and it increased to 78% in 1997 with a mean of 48%. The communities that were under treatment during the pre-APOC funding period (1991-1997) were 9535, while a total of 1933 communities were treated on the average annually.The communities that were under treatment during APOC funding period and commencement of CDTI (1998-2006) were 39803, while a total of 29882 communities were treated on the average annually. For the trend for the 17 years (1991-2006) in terms of therapeutic coverage the mean was 51% (95% CL=47.6-54.4). A significantly increasing trend (P<0.01) reaching a maximum of 77% in 2006 was observed. The objective of the study was to describe trends in the treatment of onchocerciasis in Nigeria over the past 16 years by analyzing national treatment data, which will provide background information that may be useful for targeting public health measures. We focused on therapeutic and geographic coverage of treatment.

Epidemiology of Malaria in Khorasan Razavi Province North-eastern of Iran within last 7 years (April 2001- March 2008)

2009-11-03T23:06:36-06:00

Malaria is a critical world health problem in recent years. Several factors have led for increasing its incidence such as wide use of insecticide and drug resistance. It still remains as a concern in Iran. It is under control in all parts except in three south-eastern provinces.Aim of the study: Khorasan Razavi is of the Iranian province that has lot immigrants each year. Therefore, epidemiological study of the malaria is necessary in non-endemic provinces.Methods: This research was a descriptive study to evaluate epidemiological status of the malaria within April 2001 till March 2008 using all patients’ data from whole of the province.Results: Total recorded cases were 945 within 7 years. The highest incidence was observed in 2001 and the lowest was in 2006. Plasmodium viovax was observed in 911 cases and 30 cases were P. falciparum. Mix species were in 4 cases. Malaria incidence had decreased since 2001. 34.6% of transmitted cases were local, 61% were transmitted from (other provinces) inside and outside the country, relapse cases were 5.4% and transmitted routs of the rest cases were unknown. The highest incidence was observed in 15 years old and higher and in men. Mashhad and Sarakhs cities had the highest rate.Conclusion: Prevented efforts must be continually taken in spite of decreasing rate of the malaria.

Prevalence and distribution of Tsetse fly (mainly Glossina palpalis palpalis and Glossina tachinoides) in BICOT Project area in Lafia Local Government of Nassarawa State,Nigeria – Implication for sustainable Agricultural development.

2009-11-03T23:06:36-06:00

A survey was conducted between May and June 2000 to study the prevalence and distribution of tsetse fly in the Biological Control of Tsetse fly project (BICOT) area. The project area covering approximately 1500km2 of land is located within Lafia Agricultural development project (now Nasarawa Agricultural development) in Lafia Local Government area of Nasarawa State, Nigeria. The area is regarded as one of the food basket of the nation due to its abundant crop and livestock resources, yet tsetse fly, which is one of the major constraints to effective utilization and the development of these resources, is found in the study area. Tsetse fly are vectors of African trypanosomes (that causes trypanosomosis) in humans and animals. Two major species of tsetse fly (Glossina) encountered during the study were Glossina palpalis palpalis and G. tachinoides. The total number of tsetse flies recorded was 466 comprising of 454 G.p.palpalis and 12 G.tachinoides. The distribution of tsetse flies in the study area as revealed by the result of this survey showed a high population of tsetse flies in Maisamari, Feferuwa,Ganye, Ehula, Bukankwato, Kurikiyo and Awuma areas. The economic importance of tsetse flies towards sustainable livestock and agricultural development, rural development, poverty alleviation, women and youth empowerment to mention a few cannot be overlooked. The author therefore wish to appeal to all stakeholders and decision makers to justify the decision of Heads of States and Governments of African Countries of July 2000 at the OAU Summit in Lome,Togo by coming up with sustainable measures of tsetse fly eradication from the continent of Africa.

Intestinal Parasites Distribution Among Inmates Of Owerri Prison

2009-11-03T23:06:33-06:00

Stool specimens from 260 inmates of Owerri prison were investigated for prevalence of intestinal parasites using direct wet preparation method and the formal–ether concentration technique. Of the 260 inmates examined, 200 (77.0%) were infected with the following intestinal parasites (in ascending order): Strongyloides stercoralis (0.4%), Taenia spp (0.8%), Schistosoma mansoni (0.8%), Trichuris trichiura (6.5%), Ascaris lumbricoides (10.8%), Entamoeba coli(11.9%), Hookworm(13.1%), Entamoeba histolytica(15.0%), Giadia lambia(17.7%). The combination of Hookworms / Entamoeba histolytica (3.8%) and Ascaris lumbricoides / Entamoeba histolytica (2.3%) dominated the cases of multiple infections. Inmates who were farmers and artisans had the highest infection rates (43.1% and 21.5% respectively) while those that were civil servants were the least infected (12.3%). The result was attributable to inadequate water supply, unsanitary defaecation methods and poor personal hygiene among the inmates. Periodic medical examination of the inmates and dramatic beef-up of sanitary facilities in Owerri prison is recommended.

Study on seroprevalence of visceral Leishmaniasis in stray dogs of Marand (East Azerbaijan) with indirect immuno-fluorescence antibody test (IFAT) and its health importance in 2007-2008

2009-11-03T23:06:32-06:00

This study was made to investigate the seroprevalence of zoonotic visceral Leishmaniasis (ZVL) among the stray dogs of Marand city and to find the possible relationship between to transmit of parasite from infected dogs to human beings. In this study blood sampling was made from 150 stray dogs for recognizing seroprevalence of visceral Leishmaniasis with indirect immuno fluorescence antibody test (IFAT). The serum was conjugated with anti leishmania infantom IgG antibodies and examined with fluorescent microscope. All the investigated dogs were reported to be seronegative, from the point of view of infection to visceral Leishmaniasis. In spite of that fact that four dogs were 1:64 regarding antibody titerbut taking into account the cut off degree, all of the dogs were negative. In this study the antibody titer in male dogs was more than that of female dogs, however, it was not statistically significant (p<.05). Considering the different animal reservoirs and various geographical animal conditions in this area and regarding the zooonotic parasite, controlling the animal reservoirs seems unavoidable and fighting against the vector sand fly and controlling plans are necessary.

A Review of Leishmaniasis in Eastern Africa

2009-11-03T23:06:32-06:00

ObjectiveThe review presents the epidemiology of leishmaniases in the Eastern Africa region. MethodsWe searched Pub Med and MEDLINE with several key words— namely, “leishmaniasis”; “cutaneous”, “diffuse cutaneous”, “mucosal”, and “visceral leishmaniasis”; “kala azar” and “post kala azar dermal leishmaniasis”—for recent clinical and basic science articles related to leishmaniasis in countries in the Eastern Africa region. ResultsPoverty, wars, conflicts and migration have significantly aggravated leishmaniases in Eastern Africa. Of particular concern is the increasing incidence of Leishmania-HIV co-infection in Ethiopia where 20–40% of the persons affected by visceral leishmaniasis are HIV-co-infected. Sudan has the highest prevalence rate of post kala-azar dermal leishmaniasis (PKDL) in the world, a skin complication of visceral leishmaniasis (VL) that mainly afflicts children below age ten. ConclusionIn view of its spread to previously non-endemic areas and an increase in imported cases, leishmaniasis in Eastern Africa should be considered a health emergency.

Impact Of Apolipoprotein E4 On Development And Cognitive Function In Giardia-Infected Children

2009-11-03T23:06:31-06:00

Parasitic worms have largely been over looked by medicine, but attitudes are changing with the realization that they can seriously affect child development and cognition while the treatment is easy and cheap. The aim of this study is to elucidate ApoE and neurodevelopment in Giardiasis patients and the role of ApoE isoforms in childhood cognition and infant development.The present study was performed on 75 Giardia-infected patients (1-9 years). All patients suffered from sole Giardia infection with normal blood pictures. They were subjected to anthropometric measurements, lipid profile, cognitive functioning, developmental assessments and determination of apolipoprotein E allelic forms.ApoE genotypes in the studied children were 5, 6, 2, 30, 18 and 14 for E2/2, E2/3, E2/4, E3/3, E3/4 and E4/4, respectively. There were no significant differences in the different genotypes regarding lipid profiles. There were also no significant differences regarding demographic and anthropometric measurement as well as cognitive function between ApoE4 carrier and non carrier, while highly significant differences were observed between ApoE4 carrier and non carrier regarding developmental assay, in children below 4 years.In conclusion, the ApoE4 isoforms have a protective role on cognitive development in children below 4 years suffered from sole Giardia infection. So, children with ApoE4 negative are advised to be treated and protected from any diarrheal disease.

Crepuscular Man-Biting Mosquitoes Of A Tropical Zoological Garden In Enugu, South-Eastern Nigeria

2009-11-03T23:06:29-06:00

Ovitraps and human baits methods were used in sampling crepuscular man-biting mosquitoes of the Zoological Garden Enugu which were studied between February and July 2005. Aedes aegypti, A. albopictus, A. luteocephalus, A. vittatus and A. africanus were among the mosquitoes identified in the Zoo. However, six of the 7 Aedes mosquitoes were members of the Stegomyia subgenus while A. comminsii belonged to the Aedimorphus subgenus. Approximately 6 and 3 out of every nine mosquitoes biting man per hour during the study period were A. albopictus and A. luteocephalus respectively. The other species had less than one mosquito bite per man per hour. Excepting Anopheles gambiae, these are mainly diurnal and outdoor biters, feeding mainly during dusk hours between 4.00 and 8.00pm local time which corresponds to the time many tourists visit the Zoo. Members of the Stegomyia subgenus identified have been implicated in various yellow fever (YF) epidemics in Nigeria. Their preponderance, as well as the presence of the monkey reservoir hosts of YF virus and other Arboviruses, may make this zoological garden uncomfortable for the tourists. Proper care must be taken to ensure that the Zoo environment is not a potential source of epidemics. All water containers should be covered to prevent mosquitoes breeding in them. Discarded vehicle tyre, broken utensils, tin cans, snail and coconut shells must be properly disposed. Intermittent fogging of the Zoo environment with Pyrethrin insecticide may reduce adult mosquito population and thereby fly-man contact.

Epidemiological And Biochemical Studies Of Human Lymphatic Filariasis And Associated Parasitoses In Oguta, Southeastern Nigeria

2009-11-03T23:06:27-06:00

Possible organ infections associated with human filariasis, helminthiasis and malaria in Oguta Local Government Area of Imo State, Southeastern Nigeria were investigated. Blood, urine and stool samples were collected in appropriate containers from 200 male and female respondents aged 31 – 85 years. Parasitological studies were carried out on blood samples for malaria and/or microfilariae parasites while stool samples were tested for the presence of some intestinal parasites. The study showed a prevalence of intestinal protozoa (Entamoeba histolytica), Wuchereria bancrofti and the intestinal helminthes Ascaris lumbricoides and Hookworms. Biochemical parameters of liver integrity were also studied across the various infection cohorts among the respondents. Results obtained show that these parasitic infections depressed the haematological parameters relative to ‘normal’ respondents. Comparative biochemical analyses showed significant (p<.05) differences in some liver function parameters obtained for infected respondents relative to those not infected. There was also a positive correlation between age brackets with highest filarial infection (with no malarial coinfection) and age groups with elevated markers of liver dysfunction. This study can be of immense diagnostic value in the clinical management of the filariases especially in malaria-endemic and resource-poor areas.

Prevalence and Pathology of Amoebotaenia sphenoides in free ranging chicken of Kashmir Valley.

2009-11-03T23:06:26-06:00

In the present study, a survey was carried out for a period of two years from Jan 2005 to Dec 2006 on the prevalence and pathology associated with the cestode Amoebotaenia sphenoides in a sample size of 478 birds collected from different localities of Kashmir valley, India. The overall prevalence rate of the cestode was found to be 6.69% (32/478) and annual occurrence rates of 6.8% (16/233) and 6.5% (16/245) were respectively reported for the 1st and 2nd years of study. Histopathological sections revealed the scolices burrowing deep into the mucosa and at the site of infection, the disintegration of epithelium and glands and infiltration of mononuclear cell was prominent.

Study of phylogenetic relationships between twelve species of cestoda parasites by using Internal transcribed spacer2 (ITS2) and 5.8S ribosomal genes

2009-11-03T23:06:22-06:00

Cestodes are parasitic flatworms causing disease of diverse nature in animals belongs to all the phyla including man. The phylogenetic status of the cestodes remains controversial for long time. In this contest a comparative study of common core secondary structure in the ribosomal internal transcribed spacer2 (ITS2) and 5.8SrDNA gene of 12 selected cestodes species from different hosts was carried out. Multiple sequence alignment and secondary structure analysis of ITS2 and 5.8S rDNA was performed to elucidate the phylogenetic relationships. This study reveals a phylogenetic relationship among the different species of cestodes from different hosts; with some of them support by compensatory changes, suggesting the significant role by ITS2 an RNA domain during ribosomal biogenesis. The sudy also shows that among the selected species Ligula and Digramma interrupta shows considerable similarity in all the selected parameters that both may belongs to one taxa.

Cattle production and marketing in Nigeria; the impact of diseases. A case study of Maiakuya, Assakio and Shinge cattle Markets in Lafia Local Government Area of Nasarawa State, Nigeria.

2009-11-03T23:06:21-06:00

Investigations were carried out in three major cattle markets in Lafia Local Government Area of Nasarawa State from January to September 2000 to evaluate the impact of animal diseases on cattle production and marketing. The study area are Maiakuya, Assakio and Shinge cattle markets. Cattle rearing and marketing constitute a major livestock enterprise in the study area, yet, diseases remain one of the major constraints hindering the growth of the enterprise. Structures questionnaires were administered to collect information on this study. In all, 200 questionnaires were administered out of which 185 were returned. Some of the issues addressed by the questionnaires includes; herd size, breed of cattle, knowledge and impact of diseases, fly problems, treatment of animals, benefit and cost of treatment, marketing and lucrative ness of cattle farming among others. The results showed that cattle owners in the study area are aware about the problems of animal diseases and the resultant effects on the productivity and profitability of their cattle. Trypanosomosis, worms infestations and skin diseases among others are some of the diseases mentioned. 148 (80%) of the respondents are familiar with tsetse fly and trypanosomosis problems with 58 (31.4%) and 72 (38.9%) rating trypanosomosis as No 1 and No 2 problems respectively. The results further revealed that treatment charges are expensive. 161 (87%) of the respondents held this view with insufficient Government owned veterinary clinics and high cost of drugs as some of the reasons advanced for this unhealthy situation. The objective of this study is to highlight the potentials and constraints of livestock production and marketing in the face of increasing demand for protein of animal origin for Nigerians and sub-Saharan populace in general.

The Toxicity Of Artesunate On Bone Develpments: The Wistar Rat Animal Model Of Malaria Treatment

2009-11-03T23:06:17-06:00

Artesunate is presently well acclaimed a potent anti-malaria, and hitherto, un-resisted by the malaria parasite plasmodium falciparum. Despite its beneficial effects, cases of toxicity had been reported in the off-springs of women that took the drug at pregnancy. Such effect is presently examined and observed on the fetal bones with the aim to find safe periods and dosages of administration of this promising anti-malaria drug.

Interspinous devices for lumbar stenosis – a review of the literature

2009-11-02T13:54:17-06:00

Interspinous process distraction devices are emerging as a treatment for lumbar spinal canal and foraminal stenosis. Lifetime risk is around 10%. The number of patients who could potentially benefit from such surgery is large and is projected to rise. A literature search was undertaken of relevant bibliographic databases, limited to four main languages. High level searching was performed using relevant web-based resources. . The literature review indicated that interspinous devices are effective, in the short term, in treating claudication related to spinal stenosis. There was however, a lack of medium and long-term outcome data, particularly with respect to durability of symptom relief and the risks of device migration or dislocation. There was also little published comparison against alternative conventional surgery. Interspinous devices are a promising new technology, the results of longer-term clinical follow-up studies are needed to define more clearly their role in the management of lumbar spinal stenosis.

Correlation between postoperative increment in disc height and improvement in vas score in PLIF operated cases of grade I and II degenerative and isthmic spondylolisthesis: A non –randomised prospective clinical trial

2009-11-02T13:54:11-06:00

Study designA prospective clinical trial of PLIF in grade I and II degenerative and isthmic spondylolisthesis was conducted in Mar2007-Aug2008Objective To assess the effect of PLIF for Restoration and maintenance of intervertebral disc height for indirect neural foraminal decompression and its consequences on the VAS scoreSummary of Background dataEarlier Literature is showing the safety and reliability of PLIF procedure in reducing the pain and claudication symptoms of degenerative spondylolisthesis by achieving reduction, and reducing the segmental instability by fusion. We studied the relationship of change in postoperative disc height to reduction in pain.Methods This study involved (n=14) patients.Inclusion criteria required the following:age of 30-70 years,symptomatic patient with disturbed ADL,single level L4/L5 or L5/S1 Grade I or grade II degenerative spondylolisthesis.Patients with osteoporosis,recent spondylodiscitis,subchondral sclerosis,visual and cognitive impairement, and all other types of spondylolisthesis were excluded. All the patients underwent short segment posterior fixation using CD2 or M8 instrumentation , laminectomy discectomy ,reduction and distraction of the involved vertebral space .In 57.1% (n=8) patients snugly fitted local bone chips were used while in 42..9%(n=6) patients Cage was used .Among Cage group, titanium cage was used in 4[28.5%] and PEEK cages in 2[14.2%] patient.In one patient unilateral PEEK cage was used. The mean follow-up period was 18 months.Results Among (n=14) patients,71.5%(n=10) were females and 28.5%(n=4) were males.71.5%(n=10) were having L4/L5 and 28.5%(n=4) L5/S1 spondylolisthesis.42.9%(n=6) were of grade I and 57.1%(n=8) were of grade II spondylolisthesisThere was a statistically significant correlation (p<.012 and p<.027) between the increment in disc height we achieved and the improvement in VAS score in both graft group and cage group. The increment in disc height and VAS score were significantly better in Cage group(2mm+- S.D visa-viz 7.2(88%) ) than the graft group(1.2mm+- S.D visa-viz 5(62%) . There was one case(7.1%) of superficial MRSA infection, one case(7.1%) of pedicle wall breakage(technical error) and two cases(14.2%) of loose rods.One patient with loose rod was reoperated while other is waiting for hardware removalConclusionMaintenance of disc height by structural graft is preffered over the non-structural graft.Using snugly fitted local bone chips avoids donor site morbidity besides yielding good fusion rates.

Minimizing the Risk of Retropharyngeal Hematoma After Anterior Cervical Spine Surgery: An 8-Point Checklist Before you Close

2009-11-02T13:54:10-06:00

Retropharyngeal hematoma with associated airway compromise is a feared and potentially catastrophic complication after anterior cervical spine surgery. The anterior approach to the cervical spine is commonly used for a variety of cervical spine diseases. This approach has been well described, as have been the potential complications. The most common reported complications include dysphagia, hematoma, and recurrent laryngeal nerve palsy. Meticulous surgical technique is always of paramount importance to minimize the risk of complications and maximize successful treatment outcomes. The authors propose a systematic evaluation method for the anterior cervical wound prior to closure to aid in minimizing the risk of airway compromise due to post-operative retropharyngeal hematoma. Described is an eight-point checklist of pertinent anatomic structures to evaluate for complete hemostasis prior to closing the surgical wound.