Reversible effect of castration induced hypogonadism on the morphology of the left coronary arteries in adult male rabbits.

Hypogonadism is associated with an increased risk of coronary artery disease. This study sought to describe the histomorphology of the left coronary arteries of the adult male rabbit following orchiectomy and subsequent testosterone administration. We included 20 adult male rabbits, divided into a baseline group (n=2), an interventional group subjected to castration only (n=6), an intervention group subjected to castration followed by testosterone injection (n=6), and a control group (n=6). Key variables under investigation were serum testosterone levels, the intima-media thickness of coronary arteries, smooth muscle cell density, and adventitial collagen fiber density. The mean coronary arteries' intimal medial thickness was significantly higher in the castrated group than in controls (0.488 mm and 0.388 mm, respectively), while the testosterone-injected group had a mean of 0.440 mm. Mean smooth muscle cell density was significantly lower in the castrated rabbits vs. controls (26.96% and 47.80%, respectively), this observation being reversed with testosterone injection (47.53%). Mean adventitial collagen fiber density was significantly higher in the castrated group than in controls (66.6% and 36.1%, respectively), with a marginal difference after testosterone injection (65.2%). This study demonstrates that castration-induced hypogonadism causes morphological changes in the coronary arteries that are partly reversible using testosterone injections. These findings provide a morphological basis for understanding the role of testosterone in coronary arteries.

Changes in the structure of chorioamniotic membrane in patients with malaria in pregnancy.

INTRODUCTION: Malaria infection in pregnancy has adverse consequences for both fetal and maternal health. There is insufficient data on the effect malaria in pregnancy has on the structure of the chorioamniotic membrane. Our objective was to determine the structure of the chorioamniotic membrane in patients with malaria in pregnancy. METHODS: Specimens of the chorioamniotic membrane from 58 women with malaria in pregnancy and 58 women without malaria in pregnancy were used for this study. Biopsies of the fetal membranes were obtained immediately after delivery and processed for light microscopy. They were stained using H & E. Photomicrographs were taken for morphological analysis and statistical analyses were performed using Statistical Package for Social Sciences (SPSS, Version 23.0, Chicago, Illinois). The independent-sample t-test and odds ratios were used to compare the appropriate values between the two groups at a 95% confidence interval. RESULTS: Photomicrographs of the chorioamniotic membrane showed histological alterations, including a change of amniotic epithelium to columnar and stratified types, epithelial delamination, extensive fibrin deposition, and leukocyte infiltration in women with malaria in pregnancy. Statistical analysis found significant differences in epithelial type (p-value 0.001, ×2 = 17.9), epithelial denudation (p-value <0.001, ×2 = 19.4) and extensive fibrin deposition (p-value of 0.02 and ×2 = 7.5) between the study groups. DISCUSSION: This study has demonstrated histological alterations in the chorioamniotic membrane in association with malaria in pregnancy. Further studies may be conducted to characterize chorioamnionitis in malaria in pregnancy and associations with adverse pregnancy outcomes.

Policy and research frame of the coronavirus disease 2019 (COVID-19) pandemic: reflections on urban informality.

How has the informality of urban slums exposed a gap in policy formulation and research questions in the wake of the coronavirus disease 2019 (COVID-19) pandemic? This paper seeks to identify the appropriate questions and policy frame that would assist future researchers and policymakers on the subject of pandemics in densely populated urban settlements. The authors argue that the nexus between asking the appropriate questions and developing appropriate policy response measures during a pandemic can significantly impact the outcome of the response. The paper examines how the government of Kenya's response to the COVID-19 pandemic reveals a deep-rooted socio-economic and cultural inequality when "blanket" policies are adopted without taking into consideration the unique dynamics characterizing the society. The findings show that the effectiveness of implementing COVID-19 containment policies such as lockdowns, the cession of movement, working from home, distance learning, and social distancing are affected by other factors such as the nature of jobs, one's income levels, where someone lives, cultural beliefs, access to water, sanitation, internet, and medical facilities. This means that a significant number of people within the society experience a double tragedy from the pandemic and impact of government response measures. Yet most of the existing literature has focused on the causes, spread, and impact of the pandemic on health institutions, economies, and public health with little emphasis on the impact on policy measures especially on the vulnerable segments of the society. This paper, therefore, looks at the question of how the various public health intervention strategies disrupt or construct the livelihood of the already complex informal settlement. It provides policymakers and researchers with a number of questions that can frame policy and research during a pandemic with important consideration to urban informality.

How urban 'informality' can inform response to COVID-19: a research agenda for the future.

In the era of increasingly defined ontological insecurity and uncertainty driven by the ravages of COVID-19, urban informal settlement has emerged as a source of resilience. Indeed, the effects of a pandemic transcends its epidemiological characteristics to political economy and societal resilience. If resilience is the capacity of a system to adapt successfully to significant challenges that threaten the function or development of the human society, then ontological insecurity is about the lack of such capacity. Drawing on Keith Hartian's understanding of 'informality' of spaces, this policy brief attempts to identify and frame a research agenda for the future. The agenda would assist future researchers and policymakers provide responses that appropriately recognize groups and actors that define the urban informal space.

Assessment of knowledge on neonatal resuscitation amongst health care providers in Kenya.

INTRODUCTION: Competence in neonatal resuscitation, which represents the most urgent pediatric clinical situation, is critical in delivery rooms to ensure safety and health of newly born infants. The challenges experienced by health care providers during this procedure are unique due to different causes of cardio respiratory arrest. This study aimed at assessing the knowledge of health providers on neonatal resuscitation. METHODS: Data were gathered among 192 health providers drawn from all counties of Kenya. The clinicians were asked to complete questionnaires which were in two parts as; demographic information and assessment of their knowledge by different scenarios which were formatted in the multiple choice questions. Data were analyzed using SPSS version 15.0 for windows. The results are presented using tables. RESULTS: All the participants were aged 23 years and above with at least a certificate training. Most medical providers had heard of neonatal resuscitation (85.4%) with only 23 receiving formal training. The average duration of neonatal training was 3 hours with 50% having missed out on practical exposure. When asked on steps of resuscitation, only 68 (35.4%) of the participants scored above 85%. More than 70% of them considered their knowledge about neonatal resuscitation inadequate and blamed it on inadequate medical training programs. CONCLUSION: Health providers, as the key personnel in the management of neonatal resuscitation, in this survey seem to have inadequate training and knowledge on this subject. Increasing the duration and quality of formal training should be considered during the pre-service medical education to ensure acceptable neonatal outcome.