Investigation of natural radionuclides and radiation shielding potential of some commonly used building materials in Northwestern Nigeria.

This study assessed the gamma-ray shielding potential of clay, sand, gypsum and kaolin commonly used as a building material in Northwestern, Nigeria. The radiological status of the samples was first evaluated by determining the activity concentrations of 238U, 232Th and 40K using NaI (Tl) detector after which elemental composition and mass density were determined using Neutron Activation Analytical Technique. After which the mass attenuation coefficients (MAC), linear attenuation coefficients (LAC), half value layer (HVL), tenth value layer (TVL), and effective atomic number (Zeff) were determined experimentally and theoretically using standard point sources of 137Cs and 60Co photon peaks (0.662 and 1.332, 1.173) MeV and Py-MLBUF software. The activity concentrations were found to range from 51 to 59 Bq kg-1 with a mean value of 59 Bq kg-1 for 238U, 24 to 27 Bq kg-1 with a mean value of 29 Bq kg-1 for 232Th, and 219 to 247 Bq kg-1 with a mean value of 247 Bq kg-1 for 40K which were about within the world recommended values of 33, 45 and 420 Bq kg-1 respectively. The results of the elemental compositions show that Si, Al, K, Fe, and Ba in clay and sand samples have concentrations in the range of 36.83-78.48%, 1.92-26.05%, 6.33-21.96%, 2.39-19.09%, and 0.09-1.44%, respectively, while in kaolin and gypsum, results revealed that Si, Al, K, Fe, and Ca range between 0.34 and 65.52%, 1.14-35.82%, 0.00-12.12%, 0.00-5.77%, and 0.00-96.6%, respectively. However, the concentrations of other elements such as Mg, Ti, Mn, Zn, Na, and Ba varied significantly with the samples. The results showed that clay has an average density of 1.96 g/cm3, sand has 2.32 g/cm3, kaolin has 2.63 g/cm3, and gypsum has the highest density with a value of 2.66 g/cm3 compared to other samples. During the measurements, a thallium-activated sodium-iodide NaI (TI) detector was used. A narrow beam transmission geometry condition was adopted for the measurements to ensure minimal scattered radiation. Absorption and attenuation of gamma beams as a function of sample thickness against gamma energy generally exhibit an increasing gamma ray behaviour as the sample thickness increases from 1 to 3 cm. The results showed that the gypsum, kaolin, sand, and clay were capable of attenuating 63.5%, 61.5%, 58.4%, and 44.2 of gamma-ray photons of energy 0.662 MeV at 3 cm thickness %, respectively, and 40.6%, 32.9%, 30.6%, and 27.3% of gamma energy 1.332 MeV at 3 cm thickness, respectively. The results showed that MAC, LAC, and Zeff of all the samples decreased with an increase in photon energy, while those of HVL and TVL increased. The experimental results for all the gamma-ray shielding parameters were found to be in good agreement with the theoretical values obtained using Py-MLBUF. The results have shown that all the samples have similar photon attenuation behaviours; however, gypsum has the best shielding potential than kaolin and this is attributed due to its highest density value.

Community cervical cancer screening and precancer risk in women living with HIV in Jos Nigeria.

BACKGROUND: High HIV prevalence, and lack of organized screening for the indigent population receiving care and treatment within HIV clinics in low-resource settings increases cervical cancer incidence. We sought to determine predictors of cervical precancer in women living with HIV and receiving cervical cancer screening in Jos, Nigeria. METHODS: A cross-sectional study of women living with HIV and receiving care and treatment in adult HIV/AIDS clinics in Jos-Metropolis, Nigeria between June 2020 and April 2023. Ethical approvals were obtained from the ethics committee in Jos, Nigeria and Northwestern University IRB, USA. Informed consent was obtained from eligible participants, and data on socio-demographics, cancer risk factors, and cytology reports were collected. The outcome variables were cervical precancer lesions. The independent variables were prior Pap smear status, socio-demographics, income, educational, and other reproductive health factors. Descriptive statistics was done to obtain means ± sd, frequencies, and percentages for the variables. Univariate and bivariate analyses were done to determine predictors of cervical dysplasia. Analyses were performed using R software. RESULTS: Of 957 women screened, 570 were living with HIV and 566 women had cytology report and were included in the final analysis. The mean age was 45.08 ± 8.89 years and 81.6% had no prior evidence of Pap test (under-screened). Prevalence of cervical dysplasia was 24% (mild and severe dysplasia were 12.9% and 11.1%, respectively). Age above 45 years (aOR = 3.48, p = 0.009), postmenopausal status (aOR = 7.69, p = 0.000), and women with no history of prior IUCD use (aOR = 5.94, p = 0.0001), were predictors for severe dysplasia. Women who had history of STI (aOR = 0.17, p = 0.000), prior use of IUCD (aOR = 0.32, p = 0.004), prior use of condom (aOR = 2.50, p = 0.003) and had co-morbidities (aOR = 0.46, p = 0.009) were more likely to have had a Pap test in the past. CONCLUSIONS: The majority of indigent women receiving care at HIV clinics had their first Pap test screening, and lack of organized screening among older and post-menopausal women with HIV, puts women at a higher risk of developing severe cervical precancer lesions.

RARE PRESENTATION OF FLORID VULVA WARTS - A CASE REPORT AND REVIEW OF LITERATURE.

Background: Condyloma acuminata is an extremely common cutaneous sexually transmitted disease often diagnosed clinically, on the basis of its warty, cauliflower, and verrucous appearance. It is caused by the "low risk" Human papillomavirus types 6 and 11 in 90 percent of cases. The immune system plays a critical role in determining the course of viral infection, with immune-suppression and advanced age increasing the risk for long term wart persistence. Treatment options include the use of a wide variety of topical medications as well as surgical excision by cauterisation. Patient: A rare case of florid vulvar warts in a 21-year old nulliparous immuno-competent woman is presented and the literature reviewed. She had a 7-month history of progressive vulva swelling with associated itching, contact bleeding, and malodorous discharge. It measured about 14 × 10 cm in dimensions, occupying the posterior two-thirds of the labia majora and minora and obliterating the posterior commissure. Intervention: There was no positive response to Podophyllin application, however, it was eventually excised and histologic analysis excluded malignancy. Conclusion: Florid vulvar warts though rare in immune-competent patients, could occur. Patients with persistent and recurrent infection often require surgical procedures as was performed in our patient with the possibility of speedy recovery and restoration of normal anatomy and cosmesis.

Eukaryotic initiation factor 4E-binding protein 1 (4E-BP1): a master regulator of mRNA translation involved in tumorigenesis.

Protein synthesis activity is abnormally enhanced in cancer cells to support their uncontrolled growth. However, this process needs to be tightly restricted under metabolic stress-a condition often found within the tumor microenvironment-to preserve cell viability. mTORC1 is critical to link protein synthesis activity to nutrient and oxygen levels, in part by controlling the 4E-BP1-eIF4E axis. Whereas mTORC1 and eIF4E are known pro-tumorigenic factors, whose expression or activity is increased in numerous cancers, the role of 4E-BP1 in cancer is not yet definitive. On the one hand, 4E-BP1 has tumor suppressor activity by inhibiting eIF4E and, thus, blocking mRNA translation and proliferation. This is corroborated by elevated levels of phosphorylated and hence inactive 4E-BP1, which are detected in various cancers. On the other hand, 4E-BP1 has pro-tumorigenic functions as it promotes tumor adaptation to metabolic and genotoxic stress by selectively enhancing or preventing the translation of specific transcripts. Here we describe the molecular and cellular functions of 4E-BP1 and highlight the distinct roles of 4E-BP1 in cancer depending on the microenvironmental context of the tumor.

Total abdominal hysterectomy for benign gynaecological conditions at a University Teaching Hospital in Nigeria.

BACKGROUND: Hysterectomy is one of the most commonly performed major gynaecological procedures in women. Total abdominal hysterectomy (TAH) for benign disorders is commonly performed in Jos University Teaching Hospital and this study aimed at ascertaining its frequency in relation to other major gynaecological operations, demographic features of the patients, indications and safety of the procedure in this institution. MATERIALS AND METHODS: A retrospective descriptive study of consecutive patients who had elective total abdominal hysterectomy performed for various benign indications during the study period from January 2001 to December 2008 was conducted. Data extracted from the case files included age, parity, presenting symptoms, indications for the surgery, intraoperative findings and post-operative complications. Data was analysed with 2008 EPI-info version 3.5.1. RESULTS: Total abdominal hysterectomy accounted for 18.2% of all major gynaecological operations. Majority of the women were in their fifth decade of life (65.9%) and parity of five and above (46.4%). The most common indications were uterine fibroid with or without menorrhagia (60.6%) and cervical intraepithelial neoplasia (27.0%). Post-operative morbidity was recorded in 40 (17.7%) of cases. Post-operative wound infection (52.5%) and fever (30.0%) accounted for the majority of the complications. There was no mortality. CONCLUSIONS: Total abdominal hysterectomy for benign conditions is relatively common and safe in this centre. The review of the antibiotic regimes for chemoprophylaxis may help in reducing the post-operative infection rate associated with the operation.

Substance abuse among antenatal patients at jos university teaching hospital, north central Nigeria.

BACKGROUND: Substance use in this country, among pregnant women, is a recent phenomenon as our women embrace western culture. More worrisome is the current finding showing no 'safe' level of alcohol exposure for possible adverse effect or harm to the developing child to occur. AIMS AND OBJECTIVES: To determine what substances are used and the prevalence of substance use among pregnant women attending the antenatal clinic of the Jos University Teaching Hospital, Jos, Northcentral Nigeria. DESIGN: Cross-sectional study. SETTING: Jos University Teaching Hospital. RESULTS: A total of 557 women were administered the pre-tested questionnaire. The mean age was 29.1 years, with a range of 15 to 48 years. The prevalence rate of substance used among the pregnant women was 43.8%. In all, 244 of the 557 women were taking one substance or the other. About 61.9% of the women abuse Kolanuts. There was no significant difference in the age group between those who sue it and those who do not (p-value 0.7411). Other substances were chlorpheniramine 10.6%, alcohol 8.6%, diazepam 4.5% and promethazine 2.5%, cigarettes/tobacco 2.9%, phenobarbitone 2.9%, cocaine 2.5%, codeine 2.0%, and marijuana 1.6%. A significant number 22.8% admit to using other substances in pregnancy. The commonest reason given for substance use is to control nausea and vomiting of early pregnancy. CONCLUSION: Nigerian pregnant women use and abuse a wide variety of substances and drugs during pregnancy just as their counterparts in the developed world. The high prevalence observed in this study was largely due to the consumption of locally available substances.

Ectopic pregnancy in Jos Northern Nigeria: prevalence and impact on subsequent fertility.

BACKGROUND: Ectopic pregnancy remains a major gynaecological problem in contemporary gynaecological practice. Not only do women die from this disease, but also of greater clinical importance is the indirect morbidity of poor fertility prognosis and adverse outcome in subsequent pregnancies. We were interested in documenting the prevalence of ectopic pregnancy and its impact on subsequent fertility. METHODOLOGY: This retrospective descriptive study was done at the Jos University Teaching Hospital. The case notes of all patients who had tubal ectopic pregnancy managed in JUTH between January 1997 and December 2000 were retrieved. Subsequent fertility and reproductive outcome were assessed among women who reported back for follow up fora minimum period of twelve months post surgery. The data was analyzed using frequencies. RESULTS: During the study period, January 1997 and December 2000 a total of 168 ectopic pregnancies were managed and 9,638 deliveries occurred during the same period. This gives a prevalence rate of 1.74%. Of the 168 cases of ectopics, 130 case records containing relevant information were retrieved (77.4%) and this constituted the sample population for the study. Majority (53.8%) of the women were between 20 and 29 years. Majority of the women were either nulliparous or primiparous (23.8% and 20.0% respectively). Tubal rupture occurred in 86.9% of the women at the time of laparotomy. Total salpingectomy was the surgical modality in 77.7% of the cases. The right fallopian tube was affected in 66.2% and the left 33.8% of the cases. The contralateral fallopian tube was grossly normal in 73.1% of cases. Of the 64 women who were followed up for a minimum of 12 months, 40.6% achieved viable intra uterine pregnancies, 6.3% had a repeat ectopic pregnancy in the contra lateral tube and 53.1% were unable to achieve pregnancy. CONCLUSION: Ectopic pregnancy is prevalent in our environment affecting mainly young women of low parity who desire future pregnancies. The subsequent impact on future fertility of these women could be improved if efforts are focused on early diagnosis to prevent tubal rupture. Early diagnosis prior to rupture offers opportunity for medical management and conservative surgical procedures that are proven to improve future fertility prognosis.

Underutilization of vaginal hysterectomy and its impact on residency training.

BACKGROUND: The advantages of vaginal hysterectomy over abdominal hysterectomy include lower morbidity, shorter hospital stay, and reduced cost to the patient. It is, therefore, important to pass the required skill for vaginal hysterectomy unto trainees. OBJECTIVE: To determine the proportion of vaginal hysterectomies done in a residency training institution in Nigeria and its possible impact on the proficiency of future gynaecologists in performing the procedure. METHODS: A chart review was done on all documented cases of hysterectomies for benign gynaecological conditions done in Jos University Teaching Hospital, over a four-year period (January 2002 to December 2005). Case files of patients who had hysterectomy during the study period were retrieved and the relevant information obtained for analysis of frequencies and percentages. RESULTS: A total of 94 hysterectomies for benign gynaecological conditions were done during the study period. Nine (10%) vaginal hysterectomies were done. All the vaginal hysterectomies performed were for uterovaginal prolapse by consultants. However, 45 (53%) of the abdominal hysterectomies were performed by consultants and 40 (47%) by residents. CONCLUSION: This study suggests that residents exposure and training on the act of vaginal hysterectomy is inadequate. This has potential implications on future gynaecologist proficiency to perform this method of surgery that has documented advantages and better outcome for patients.

The impact of HIV/AIDS epidemic on the choice of specialties among medical students and house officers in Jos, Nigeria.

BACKGROUND: HIV/AIDS is a scourge that has seriously compromised the lives of millions of people, especially those living in sub-Saharan Africa. With continued high prevalence, there is a high risk of healthcare workers, especially those in the surgical specialties, acquiring the infection. This study was done to investigate the impact of HIV on the choice of surgical specialties in a training institution located in Jos, north-central Nigeria. We hypothesized that the awareness of the risk of acquiring infections associated with surgical practice has no significant impact on the choice of surgical specialties among final-year medical students and house officers at our institution. METHOD: A cross-sectional questionnaire based survey was conducted on final-year medical students and house officers during their training in Jos University Teaching Hospital (JUTH), Jos. Two hundred questionnaires were randomly distributed to final year medical students and house officers who volunteered to participate in the survey. The completed questionnaires were returned to the researchers and information obtained was analyzed using Epi info 3.3. RESULTS: Of the 200 questionnaires distributed, 135 with relevant information were returned for analysis, giving a response rate of 67.5%. Of these respondents, 96.3% said they planned to specialize after their basic medical training and the majority of these (97.8%) were aware of the increased risk associated with surgical specialties, with 83.7% acknowledging the transmission of HIV and hepatitis B as being the greatest risk. About 53.0% of the respondents said they planned to pursue surgical specialties. Fifty three percent (53.3%) and sixteen percent (16.3%) based their choice of specialty on job satisfaction and favourable work schedule respectively. The knowledge of the risk of acquiring HIV/AIDS affected choice of specialty in only 21% of the respondents. CONCLUSION: The awareness of most recently graduated medical doctors and final-year medical students of the risk of acquiring HIV in surgical specialties seems to have not deterred them from wanting to pursue surgical specialties. We recommend improvements in the work environment and adherence to universal precautions to reduce the risk of transmission of HIV and other infections to surgeons practicing in the region.

A role for the homeobox protein Distal-less 3 in the activation of the glycoprotein hormone alpha subunit gene in choriocarcinoma cells.

Synthesis and secretion of chorionic gonadotropin in trophoblast cells of the placenta is required for establishment of early pregnancy in primates. Chorionic gonadotropin is a heterodimeric glycoprotein hormone consisting of alpha and beta subunits. Regulation of the alpha subunit gene within the placenta requires an array of cis elements within the 5'-flanking region of the promoter. Within this array of elements, the junctional regulatory element (JRE) putatively binds a placental-specific transcription factor. The aim of our studies was to determine the identity and role of the transcriptional regulator that binds to the JRE in choriocarcinoma cells (JEG3 cells). Mutations within the JRE resulted in reduction in basal expression of an alpha subunit reporter gene, suggesting that the JRE binding factor was necessary for full basal activity. Using electrophoretic mobility shift assays, we determined that the JRE was capable of serving as a homeobox factor-binding site. The homeobox factor, Distal-less 3 (Dlx 3) was found to be expressed in JEG3 cells and in the trophoblast layer of human chorionic villus but not in a gonadotrope cell line that also expresses the alpha subunit gene. Electrophoretic mobility shift assays revealed that recombinant Dlx 3 could bind specifically to the JRE and endogenous Dlx 3 was present in JRE/JEG3 nuclear protein complexes. Overexpression of Dlx 3 resulted in activation of an alpha subunit reporter gene. A JRE mutation resulted in attenuated activation of the alpha subunit reporter via an adjacent cis element, suggesting that JRE/Dlx 3 interactions may facilitate regulation of the alpha subunit gene at sites immediately upstream of the JRE. Our studies support the conclusion that Dlx 3 is a placental-specific transcriptional regulator that binds to the JRE and contributes to expression of the alpha subunit gene in cells of trophoblast origin.