Effect of hemoglobin polymorphism on performance traits in indigenous chicken genotypes in Nigeria.

The effect of hemoglobin polymorphism on performance traits in Nigerian indigenous chicken types was investigated in this research. The chickens were obtained through the pure mating of the sire and dam of each population of frizzle feathered, normal feathered, and naked neck chickens to produce F1 offsprings. One hundred fifty-five chicks (37 frizzle, 79 normal, and 39 naked neck) were measured for body weight (g), breast girth (cm), and tibia length (cm). At 20 weeks, 5 mL of blood was collected from the wing vein of each chicken into heparinized tubes and labeled according to its tag number for electrophoresis. The electrophoresis procedures outlined by RIKEN BRC (2006) was used. 0.6 µl of undiluted blood constituent was taken. The prepared buffer (Tris 10.91 g, EDTA 0.60 g, boric acid 3.10 g) at pH 8.5 was used for the gel preparation. The cellulose acetate membrane was used as a supporting medium. The electrophoresis was carried out at a voltage of 150 V for about 50 min at a temperature of 4 °C. The migration of the genotype was from cathode (-) to anode (+). Each bird was scored as either fast (AA), midway (AB), or slow (BB) according to the mobility on the cellulose acetate paper for hemoglobin. Data were analyzed using statistical analysis system (SAS 2002), and significant means were separated using Tukey's Honestly Significant Difference. Hardy Weinberg's equation was used to calculate genotypic and allelic frequencies and tested using chi-square (χ2). Hemoglobin had three polymorphic forms viz AA, AB, and BB. The genotypic frequencies of hemoglobin (HbAA, HbAB, and HbBB) were 49, 56, and 50, respectively, while the allelic frequencies were 0.50 for both HbA and HbB. The effect of the polymorphic forms on body weight (g), breast girth (cm), and tibia length (cm) showed that the AA had significantly higher (P < 0.05) body weight (g) than AB and BB (1296.43 g, 1029.59 g, and 884.46 g, respectively). The AA was also higher (P < 0.05) than the AB and BB for breast girth (cm) and tibia length (cm). Heterozygotes adapted and survived better than the homozygotes. The effect of the polymorphic forms of hemoglobin on body weight (g), breast girth (cm), and tibia length (cm) showed that it could be used for body weight selection.

Molecular characteristics and prognostic features of breast cancer in Nigerian compared with UK women.

Although breast cancer (BC) incidence is lower in African-American women compared with White-American, in African countries such as Nigeria, BC is a common disease. Nigerian women have a higher risk for early-onset, with a high mortality rate from BC, prompting speculation that risk factors could be genetic and the molecular portrait of these tumours are different to those of western women. In this study, 308 BC samples from Nigerian women with complete clinical history and tumour characteristics were included and compared with a large series of BC from the UK as a control group. Immunoprofile of these tumours was characterised using a panel of 11 biomarkers of known relevance to BC. The immunoprofile and patients' outcome were compared with tumour grade-matched UK control group. Nigerian women presenting with BC were more frequently premenopausal, and their tumours were characterised by large primary tumour size, high tumour grade, advanced lymph node stage, and a higher rate of vascular invasion compared with UK women. In the grade-matched groups, Nigerian BC showed over representation of triple-negative and basal phenotypes and BRCA1 deficiency BC compared with UK women, but no difference was found regarding HER2 expression between the two series. Nigerian women showed significantly poorer outcome after development of BC compared with UK women. This study demonstrates that there are possible genetic and molecular differences between an indigenous Black population and a UK-based series. The basal-like, triple negative and BRCA1 dysfunction groups of tumours identified in this study may have implications in the development of screening programs and therapies for African patients and families that are likely to have a BRCA1 dysfunction, basal like and triple negative.

TENS for surgical stabilisation of acetabular fracture in the skeletally immature: A novel technique.

BACKGROUND: Acetabular fractures in childhood are rare and the literature is scarce to describe a standard protocol in surgical management of these injuries. As the patient is still growing, it warrants a detailed assessment with a sound surgical plan if operative intervention is deemed necessary to prevent late complications. Throughout literature, most fixation rely on using pins, screws, plates or combination of the three which require large surgical exposure and risk of secondary physeal injury, hence we come up with a method of using the Titanium Elastic Nail System (TENS) to overcome this issue. We describe a novel technique in managing acetabular fractures in this group of patients using the TENS. METHOD: An 8 year old girl with a diagnosis of right anterior column posterior hemitransverse acetabular fracture was fixed with 3 TENS for supra-acetabular, anterior column and posterior column fragments. Surgery was performed in a minimally invasive manner. No drilling was performed during the surgery and implant insertion is done manually. RESULTS: Advantages of this procedure include minimally invasive surgery with smaller wounds, minimal intraoperative bleeding and theoretically reduces the risk of premature fusion of the triradiate cartilage. Patient is allowed early rehabilitation with this method. CONCLUSION: This novel method provides an alternative to traditional usage of wires, pins, plates and screws as is described in most literature. However, it requires the surgeon to appreciate that the safe corridors for the implant are much narrower than adults. We recommend this technique for fractures that are deemed suitable for intramedullary fixation and further research in the future will be needed.

The use of drains in thyroid surgery.

OBJECTIVE: To evaluate the necessity and benefits of the use of drains and their limitations in thyroidectomy and assess their relationship with cost of surgery and hospital stay. METHODS: We conducted a prospective randomised study on 67 patients divided into two groups. A consisted of 35 patients with drain and B, 32 patients without drain between January 2005 and June 2007. All had subtotal thyroidectomy and the technique and method of closure were the same. No anticoagulant was used and the clotting profiles were within normal range in the two groups. RESULTS: The sixty seven patients recruited for the study were made up of 60 females (89.6%) and 7 males (10.4%). The mean age for group A was 50.14 +/- 10.7 years, group B was 51.97 +/- 9.5 years. The P value for the mean ages of the two groups is 0.464 (p=0.05,t=3.98).There was no blood transfusion. Three patients developed features of respiratory obstruction (respiratory distress and stridor) -the first 2, one from each group was as a result of laryngeal oedema from trauma of difficult intubation. The third was from group B, as a result of hemorrhage and haematoma collection (she was one of the controlled thyrotoxic patients). Two patients (5.7%) developed wound infections in group A, which increased morbidity, hospital bill and prolonged hospital stay as compared to group B. The highest volume of drainage of 35ml was from a woman with a big goiter (120g). Average drainage was 17.7 +/- 6.9ml. CONCLUSION: The use of drains is not necessary in all cases of thyroidectomy but for cases with large cavity post extraction and copious oozing in vascular glands. Some of the limitations to the use of drains are infections, this can prolong hospital stay and thereby increase hospital bill.

General and regional anaesthesia for thyroidectomy in rural/semi-urban Nigerian centres.

OBJECTIVE: To evaluate the feasibility and benefits of regional anaesthesia (RA) for thyroidectomy in rural/semi-urban centres. DESIGN: A prospective study. SETTINGS: Missionary Hospital Saki, Nigeria and Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. SUBJECTS: One hundred and seventy five patients with goitre. RESULTS: The average time for the anaesthetists to put patients to sleep was 4.06 +/- 1.02 minutes, while it took 17.8 +/- 2.9 minutes to give the regional block. Post operative laryngeal complications in RA group were very minimal, while in general anaesthesia (GA) group, there were significant complications in 32 (36%) patients laryngeal oedema 15 (17%), erosions in 10 (11%) and ulcer in seven (8%). Cost of surgery in GA was thrice as much as in RA group. Thirty one (35%) with GA had steam inhalation for sore throat. It was possible to converse (laryngeal nerve monitoring) with the patient during operation but not possible with GA group. There was early discharge of patients in RA group. CONCLUSION: Regional/local anaesthesia is feasible for some cases of thyroidectomy with a lot of advantages and specifically allows surgeons to converse with the patients during operation-direct laryngeal and other nerve monitoring. Despite advancement in cuff design a lot of lesions still occur from endotracheal intubations.

Multiple embolisations in rheumatic heart disease: a case report.

BACKGROUND: Though systemic thromboembolism is not an infrequent complication of rheumatic valvular disease, multiple embolic phenomena are rare. OBJECTIVE: To present a patient with rheumatic heart disease associated with multiple embolic complications. CASE REPORT: A 44-year-old lady with rheumatic valvular disease and atrial fibrillation defaulted anticoagulant medication, and subsequently presented with acute chest pain, acute left ventricular failure, focal neurological deficit and gangrenous lower limb extremities. Electrocardiography showed atrial fibrillation and an old anteroseptal myocardial infarction. Echocardiography showed multiple valvular lesions and multiple thrombi in the left atrium. Computed tomogram scan demonstrated a large infarct involving the region supplied by the right middle cerebral artery. Bilateral above knee amputation was performed. Recovery from neurological deficit was complete. She had, during a 4-year follow-up and anticoagulation remained free of new clinically evident embolic complications. Serial echocardiography however showed that the atrial clots had persisted and presumably fibrosed. CONCLUSION: Multiple systemic thromboembolisms are serious complication of atrial fibrillation of valvular aetiology, and their prevention requires continuous anticoagulation.

Street dust heavy metal pollution implication on human health in Nicosia, North Cyprus.

The consequence of carcinogenic and non-carcinogenic health risks of the heavy metal concentrations in street dust of North Cyprus is yet to be reported. This study is aimed at investigating the concentration of six different heavy metals' concentration explicitly: As, Cu, Zn, Ni, Cr, and Pb, along leading highways in Nicosia. The result obtained was analyzed using an X-ray fluorescent machine. Multivariate and statistical methods were applied for the data analysis using xlstat MS-excel; furthermore, index of geo-accumulation (Igeo) and human health risk assessment using exposure pathways as defined by United State Environmental Protection Agency (USEPA) pollution mode were also used for level assessment and health risk implications. The average (M ± SD) concentrations of the metals in the dust are as follows: As (17.48 ± 1.53 mg/kg), Cu (51.86 ± 8.60 mg/kg), Cr (321.14 ± 8.20 mg/kg), Pb (35.62 ± 8.54 mg/kg), Ni (64.79 ± 8.72 mg/kg), and Zn (136.13 ± 30.85 mg/kg). Variation coefficient, Vc, and principle component analysis (PCA) suggested that As, Cr, Ni, and Pb have same source of pollution emission from both natural and anthropogenic activities, Zn from traffic emission while Cu from natural source. However, the result was compared with other nearby towns bordering North Cyprus; all the metal shows similar pattern of pollution with the exception of Cr which is 5 and 11 times higher than street dust of Amman (Jordan) and Tokat (Turkey), respectively. Additionally, Igeo result has the following decreasing order: Zn > Cr > Pb > Ni > Cu > As and also revealed that the As, Cu, and Ni have originated from natural source. Cr has mix source: one from traffic and the other one from atmospheric deposition. Also, Pb is emitted from industrial pollution, whereas 80% of Zn are from traffic-related emissions. The non-carcinogenic health risk (hazard quotient (HQ) and hazard index (HI)) follows the order Cr > As>Ni > Pb > Zn > Cu for children and adults. It is found that the HI of As, Cu, Ni, Pb, and Zn is less one; hence, the street dust does not exhibit non-carcinogenic health risk. But that of Cr content is greater than one, with HI values of Cr 1.44E+02 and 1.55E+01 for children and adults, respectively. The result for carcinogenic health risk (total cancer risk (TCR)) has the following order: Pb (1.42E-05) > Cr (4.81E-09) > (Ni 1.35E-09) > As (1.96E-10). With all the values less than threshed hole limit of TCR ≥ 10-4, street dust does not possess carcinogenic health risk for the entire values of six heavy metals considered in this work.

Rectal carcinoma in a nine-year-old Nigerian male child: case report.

Carcinoma of the colon and rectum are rare in children and under the age of 40 years. A case of coro-rectal carcinoma in a nine-year-old Nigerian male child is reported. Family history was significant in the patient, it revealed that his father died three years earlier because of chronic diarrhoea and mucoid stool with associated on and off constipation and one of his elder brothers died eight years ago of colonic cancer at the age of twenty years. Exploratory laparotomy was done for the patient which revealed fixed rectosigmoid tumour with metastases to the liver, omentum and small intestine and ascites was also found. Hartmann's procedure with sigmoid colostomy was performed and the tumour was resected. Histological report of the biopsy specimen was consistent with poorly differentiated adeno-carcinoma. To the best of our knowledge, the youngest patient recorded in the literature is seven years old, which is younger than our patient, but this is still the youngest in our records.

Surgical complications from local herbal practitioners: report of five cases.

Over a 12-month period, five patients (out of a total of 72) with serious complications resulting from use of herbs by traditional healers were seen at the surgical unit of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. The age range was one and a half to five years with a mean age of 23.4 +/- SD years and a male to female ratio of 3:2. All the cases were misdiagnosed and mismanaged and ended up with various complications. Such as penile amputations, digital necrosis, upper and lower limb gangrene as well a severe sepsis among others. Ignorance, cultural beliefs and attitudes, delusion, poverty and inaccessibility to orthodox medical practice were some of the factors responsible for the patronage of traditional healers.

Thermal injuries in under-4-year-old children: the Lesotho experience.

The Queen Elizabeth II Hospital is the apex of the health care services in the Kingdom of Lesotho but has no designated burns unit. A review of patients managed during a 5-year period was done to document our experience so as to show what can be achieved even without a standard burns unit. We reviewed the clinical course of children who were admitted for care of acute thermal injuries during a 5-year period, May 1997 to April, 2002 inclusive. All were treated in the children surgical ward in accordance with a protocol of care emphasizing urgent care of shock, accurate fluid therapy, open wound care and early enteral feeding. Ninety-eight children (51 males and 47 females) aged 4 months to 43 months (mean 21.66 +/- 11.30 months) were admitted on account of acute thermal injuries during the study period. The injuries included scalding (46%) involving predominantly the upper part of the body and full thickness burns (87%). Skin grafting was needed in 82% of the patients. The common complications were infection, fluid imbalance, respiratory problems, and contracture deformities. The mean duration of hospital stay was 40 +/- 4.43 days and the case fatality rate was 9%. The case fatality rate in this series is considered high and could be improved if there were a well staffed specialized burns unit.

Basic trauma life support: knowledge of medical students.

BACKGROUND: The first hour of management (golden hour) of any trauma patient might be the determining factor if he/she will survive. The first contact most patients have in an emergency room is with a young medical graduate. The knowledge of basic trauma life support (BTLS) by all doctors therefore becomes important. AIMS AND OBJECTIVES: This study set out to assess how much knowledge medical students had about BTLS in their final year compared with their knowledge at the beginning of clinical postings. METHOD: A cross-sectional study of fourth and sixth (final) year medical students to evaluate their knowledge of BTLS using a test of 30 questions under examination conditions. One hundred and twenty-three fourth year students were given a test after a lecture on the care of injured patients. The same test was administered on 41 sixth year students without prior lecture on day of test, having had a similar lecture 2 years before. Data analysis was performed using the SPSS 11.0 for Windows statistical software and EPI INFO version 6.04. RESULT: Mean scores were 25.8 +/- SD1.91 for the 4th year students and 21.0 +/- SD2.93 for the 6th year students. There was a statistically significant difference between scores of the 4th year and the 6th year (P < 0.000001). CONCLUSION: Knowledge was imparted in the 4th year but was forgotten by the 6th year. It is essential that courses in BTLS be given periodically to all medical graduates and all personnel involved in care of the traumatised patient.

Case Report: Acute Limb Ischaemia and Gangrene associated with Peripartum Cardiomyopathy.

UNLABELLED: Thromboembolic complications are frequent in patients with peripartum cardiomyopathy (PPCM). Peripheral artery occlusions are however rare. This case report describes a 30-year-old grand multiparous woman with PPCM complicated by acute lower limb ischaemia and gangrene. This followed left intraventricular thrombi despite maintenance of sinus rhythm. We suspect that the thrombosis is caused by the hypercoagulable state of peripartum period, ventricular dilatation and hypokinesis. The impacts of economic and sociocultural factors in the management of this rare complication of PPCM in a resource depleted nation are highlighted. KEYWORDS: peripartum cardiomyopathy, limb ischaemia.

The effect of improving maternity services in a secondary facility, Zaria, Nigeria. The Zaria PMM Team.

PRELIMINARY STUDIES: Facility review at the secondary hospital in Makarfi revealed a lack of drugs and skilled personnel and delays in treating and referring women with obstetric complications. INTERVENTIONS: In 1994, maternity facilities were renovated, a revolving drug fund was introduced, midwives were trained and an ambulance was restored to service. Attempts to secure a physician with skills in treating obstetric emergencies were unsuccessful. Prior to these activities, obstetric services at the referral hospital were improved. Community interventions focused on improving utilization by women with complications. RESULTS: Between 1990 and 1995, substantial increases occurred in antenatal attendance (2517 to 5565 per year) and deliveries (325 to 1952 per year). The number of women with complications seeking care at this facility, however, dropped from 85 in 1990 to 28 in 1995. Referrals to higher level facilities increased from four in 1990 to 17 in 1995. COSTS: The cost of the interventions was approximately US $32,000. Ninety-eight percent was paid by the government and 2% by PMM. CONCLUSIONS: Improving the quality of maternity services can increase utilization by women with uncomplicated pregnancies. However, utilization of emergency services appears to be influenced by other factors, such as the ability to treat obstetric complications and prevailing economic conditions.

Reproductive outcome following abdominal metroplasty.

OBJECTIVE: To evaluate pregnancy outcome following uterine unification procedures in patients with uterine anomalies. METHODS: A retrospective survey included all abdominal metroplasty procedures performed on 43 patients at the American University of Beirut Medical Center between January 1, 1974 and December 31, 1991. Age at metroplasty, type of anomaly and surgical procedures, as well as preoperative and postoperative reproductive performance were all recorded. RESULTS: Forty (93%) out of 43 patients who underwent metroplasty had postoperative live births compared with five (12%) prior to surgery. The fetal wastage rate dropped from 93% pre- to 16% postoperatively. All seven patients with a history of primary infertility conceived and had live births. CONCLUSION: Our data suggest a remarkable improvement following abdominal metroplasty in patients with both typical and uncharacteristic preoperative reproductive performance.

Giant cervical polyp. A case report.

BACKGROUND: Very large cervical polyps are rarely reported. CASE: A giant cervical polyp, 17 x 10 x 5 cm, protruded through the vaginal introitus in a 27-year-old, sexually inactive woman. CONCLUSION: Although carcinomatous change occurs in 1.7% of cervical polyps, malignant degeneration did not occur in the six reported cases. Thus, biopsy of these tumors before excision may not be necessary.

Methods of assessing spinal radiographs in scoliosis are functions of its geometry.

The most important feature of scoliosis is the lateral curvature of the spine. It can be treated either conservatively or by surgery; however, treatment choice depends mainly on curve progression which is determined by frequent curve assessment. This is a review of methods of curve measurement and proof of the relationship between them.

Cardiac hydatid cyst in a child.

Presentation of hydatid disease is uncommon in children, and cardiac hydatid cyst is rare at any age. The authors discuss a pediatric patient with cardiac hydatid cyst in the posterior wall of the left ventricle. The cyst was diagnosed by two-dimensional echocardiography and by serology. A 3 month course of mebendazole therapy was only partially effective. The patient remains asymptomatic 2 years after diagnosis. HYDATID DISEASE is endemic in the Middle East. In a study from a surgical hospital in eastern Libya, the disease accounted for 0.89 percent of all hospital admissions. The echinococcus cyst grows very slowly and unless located in a critical anatomic site, it takes many years to evolve. Consequently, presentation in pediatric patients is distinctly uncommon. In an epidemiologic study from Benghazi, only 11.7 percent of patients were under 10 years old. Cardiac hydatid disease is rare at any age, accounting for less than 2 percent of all hydatid disease. Since the introduction of two-dimensional echocardiography, more cases are being diagnosed. All the reports in the recent literature are in adult patients. We report here, however, a cardiac hydatid cyst in the left ventricular wall in a child.

Humeroulnar synostosis: case report.

This is a report of a case of humeroulnar synostosis at the right elbow of a native Nigerian girl in whose family there is no history of genetic/hereditary diseases. This defect was not associated with any other deformity. This is a rare defect that has never been mentioned in literature. By excluding any causes, this case has been proved to be a failure of differentiation that is one of the major categories in the classification of congenital limb defects by Alfred B. Swanson.

Tropical idiopathic lower limb gangrene: case report.

Tropical idiopathic lower limb gangrene is a rare disease. It was first described by Gelfand amongst the indigenous inhabitants of present day Zimbabwe. It is a bilateral and simultaneous gangrene of both lower extremities due to no obvious cause and usually seen in men during the second and fourth decade of life. The onset is always sudden and the first sign is oedema of both feet accompanied by pain. The patients are usually people who have been previously healthy. This is a report of a clinical variant of the disease.