Prevalence of abnormal umbilical arterial Doppler indices in apparently normal pregnancies in Calabar.

Intrauterine growth restriction (IUGR) may occur in the presence of normal fetal growth parameters, with resultant unanticipated perinatal morbidity and mortality. Umbilical arterial Doppler evaluation determines the fetuses susceptible to compromise by detecting IUGR early enough for successful intervention measures to be implemented. This study was aimed at determining the prevalence of abnormal umbilical arterial Doppler indices (UADI) in apparently normal pregnancies and to assess its correlation with amniotic fluid index (AFI). In this prospective cross-sectional study, obstetric sonographic examination and UADI evaluation were done on 310 apparently normal pregnant women between 26 to 40 weeks within a 6-months period. Abnormal UADI had a prevalence of 10.3%. Educational level (P = 0.000) and employment status (P = 0.000) were significantly associated with abnormal UADI. Abnormal umbilical arterial resistivity index (RI) had a significant correlation with EFW (P = 0.000) and HC/AC (P = 0.000) but no significant relationship with AFI (P = 0.593). The prevalence of abnormal umbilical arterial Doppler indices was high in apparently normal pregnancies mostly among women with low socio-economic status, with no demonstrable association with AFI.

Large Uterine Fibroids in Pregnancy with Successful Caesarean Myomectomy.

Uterine fibroid is the commonest benign tumour of the female reproductive tract. It occurs in 20-40% of women, whereas the estimated incidence in pregnancy is 0.1-3.9%. Uterine fibroid in pregnancy is usually asymptomatic with complications occurring in 10-30% of cases. The first line of management is conservative with counselling for myomectomy after delivery. However, in the presence of intractable symptoms, both antepartum myomectomy and caesarean myomectomy have been reported to be successfully performed in carefully selected cases. We report a case of large subserous uterine fibroid in pregnancy that was referred to our centre at 14 weeks of gestation. She developed generalized body weakness, backache, and breathlessness at 27 weeks gestation. Thus, she was admitted and managed conservatively for eight weeks with significant relief of symptoms. She eventually had a caesarean myomectomy at 35 weeks of gestation; the outcome was a live female baby with a birth weight of 2.3 kg and a large subserous fibroid weighing 9.5 kg. We can therefore say that caesarean myomectomy can be safely performed in carefully selected cases.

The response to re-emergence of yellow fever in Nigeria, 2017.

Yellow fever (YF) is an acute viral hemorrhagic disease caused by the YF virus (arbovirus) which continues to cause severe morbidity and mortality in Africa. A case of YF was confirmed in Nigeria on the 12th of September 2017, 21 years after the last confirmed case. The patient belongs to a nomadic population with a history of low YF vaccination uptake, in the Ifelodun Local Government Area (LGA) of Kwara State, Nigeria. An active case search in Ifelodun and its five contiguous LGAs led to the listing of 55 additional suspect cases of YF within the period of the outbreak investigation between September 18 to October 6, 2017. The median age of cases was 15 years, and 54.4% were males. Of these, blood samples were collected from 30 cases; nine tested positive in laboratories in Nigeria and six were confirmed positive for YF by the WHO reference laboratory in the region; Institut Pasteur, Dakar. A rapid YF vaccination coverage assessment was carried out, resulting in a coverage of 46% in the LGAs, with 25% of cases able to produce their vaccination cards. All stages of the yellow fever vector, Aedes mosquito were identified in the area, with high larval indices (House and Breteau) observed. In response to the outbreak, YF surveillance was intensified across all States in Nigeria, as well as reactive vaccination and social mobilisation campaigns carried out in the affected LGAs in Kwara State. A state-wide YF preventive campaign was also initiated.

Evaluation of a Public Child Eye Health Tertiary Facility for Pediatric Cataract in Southern Nigeria I: Visual Acuity Outcome.

PURPOSE: A retrospective study of the outcome of congenital and developmental cataract surgery was conducted in a public child eye health tertiary facility in children <16 years of age in Southern Nigeria, as part of an evaluation. MATERIALS AND METHOD: Manual Small Incision Cataract Surgery with or without anterior vitrectomy was performed. The outcome measures were visual acuity (VA) and change (gain) in visual acuity. The age of the child at onset, duration of delay in presentation, ocular co-morbidity, non ocular co-morbidity, gender, and pre operative visual acuity were matched with postoperative visual acuity. A total of 66 children were studied for a period of six weeks following surgery. RESULTS: Forty eight (72.7%) children had bilateral congenital cataracts and 18 (27.3%) children had bilateral developmental cataracts. There were 38(57.6%) males and 28 (42.4%) females in the study. Thirty Five (53%) children had good visual outcome (normal vision range 6/6/ -6/18) post-operatively. The number of children with blindness (vision <3/60) decreased from 61 (92.4%) pre-operatively to 4 (6.1%) post-operatively. Post operative complication occurred in 6.8% of cases six week after surgery. Delayed presentation had an inverse relationship with change (gain) in visual acuity (r = - 0.342; p-value = 0.005). Pre-operative visual acuity had a positive relationship with post operative change (gain) in visual acuity (r = 0.618; p-value = 0.000). CONCLUSION: Predictors of change in visual acuity in our study were; delayed presentation and pre-operative VA. Cataract surgery in children showed clinical benefit.

Transforming Growth Factor-ß1 Induced Epithelial Mesenchymal Transition is blocked by a chemical antagonist of translation factor eIF4E.

The epithelial to mesenchymal transition (EMT) imparts disease-defining properties to epithelial cells in cancer and organ fibrosis. Prior studies identify EMT control points at the level of transcription and translation, and indicate that activation of translation initiation factor 4E (eIF4E) is involved in the mechanisms coordinating these two levels of control. Here we show that 4Ei-1, a specific chemical antagonist of the eIF4E-mRNA cap interaction, potently inhibits transforming growth factor beta 1 (TGF-ß1) mediated EMT in lung epithelial cells. Upon treatment with TGF-ß1, we observed a rapid recruitment of Snail1 mRNA into the actively translated polysome pool accompanied by accumulation of the EMT transcription factor Snail1 in the nucleus. 4Ei-1 blocks ribosome recruitment to the Snail1 transcript thereby preventing accumulation of the Snail1 protein in the nucleus. Our findings establish an obligatory role for upstream translational control of downstream Snail1-mediated transcriptional events in TGF-ß1 induced EMT, and provide proof of concept for efforts to pharmacologically modulate the eIF4E-cap interaction as a means to inhibit pathological EMT in the setting of cancer and organ fibrosis.

Organic cleanliness of the Mars Science Laboratory sample transfer chain.

One of the primary science goals of the Mars Science Laboratory (MSL) Rover, Curiosity, is the detection of organics in Mars rock and regolith. To achieve this, the Curiosity rover includes a robotic sampling system that acquires rock and regolith samples and delivers it to the Sample Analysis at Mars (SAM) instrument on board the rover. In order to provide confidence that any significant organics detection result was Martian and not terrestrial in origin, a requirement was levied on the flight system (i.e., all sources minus the SAM instrument) to impart no more than 36 parts per billion (ppb by weight) of total reduced carbon terrestrial contamination to any sample transferred to the SAM instrument. This very clean level was achieved by a combination of a rigorous contamination control program on the project, and then using the first collected samples for a "dilution cleaning" campaign of the sample chain prior to delivering a sample to the SAM instrument. Direct cleanliness assays of the sample-contacting and other Flight System surfaces during pre-launch processing were used as inputs to determine the number of dilution cleaning samples needed once on Mars, to enable delivery of suitably clean samples to the SAM experiment. Taking into account contaminant redistribution during launch thorough landing of the MSL on Mars, the amount of residue present on the sampling hardware prior to the time of first dilution cleaning sample acquisition was estimated to be 60 ng/cm(2) on exposed outer surfaces of the sampling hardware and 20 ng/cm(2) on internal sample contacting surfaces; residues consisting mainly of aliphatic hydrocarbons and esters. After three dilution cleaning samples, estimated in-sample contamination level for the first regolith sample delivered to the SAM instrument at the Gale Crater "Rocknest" site was bounded at ≤10 ppb total organic carbon. A Project decision to forego ejecting the dilution cleaning sample and instead transfer the first drill-acquired sample at the "John Klein" site to SAM resulted in an estimated level of terrestrial contamination of ≤430 ppb. The estimated terrestrial contamination for portions from the second drill-acquired sample, at Cumberland, was ≤69 ppb; the estimate for a future, third, drilled sample is ≤38 ppb. These levels are comparable in magnitude to the SAM instrument blanks at the nanomole level (as chlorohydrocarbon).

[Chronic abdominal pain and fever in an Ivoirian woman: Mycobacterium avium-intracellulare duodenitis in an AIDS patient in Abidjan, Cote d'Ivoire]. / Douleurs abdominales chroniques et fièvre chez une ivoirienne.

Duodenal infection by Mycobacterium avium-intracellulare is a common opportunistic disease in HIV-infected patients. Individuals with CD4 counts <50 cells/mm3 are at highest risk. The main symptoms are diarrhea, abdominal pain, weight loss, and fever. Endoscopic examination shows various abnormalities including disseminated nodules that may be yellowish, whitish, or pinkish in color. Other mucosal lesions may be found such as erosion, erythema, or friable edematous aspect. Since these findings are non-specific, it is important to obtain biopsy specimens for histological and microbiological examination. The most common histologic features are atrophic mucosa resembling Whipple's disease with strongly positive PAS staining. The presence of BARR in macrophages is typical of MAI. Diagnosis is based on identification of the bacteria using either conventional culture techniques or polymerase chain reaction (PCR). Differential diagnosis includes other gastrointestinal infections associated with AIDS, i.e., microsporidiosis, cryptosporidiosis, giardiosis, anguillulosis, CMV, and isoporosis. The course of the disease is usually unfavorable even with antibiotic treatment. The purpose of this report is to describe a case of duodenitis due to atypical mycobacterial infection in a 30-year-old woman who was seropositive for human immunodeficiency virus. She was hospitalized due to fever with deterioration of her general condition (more than 10% of body weight loss) and chronic abdominal pain with inflammation. Diagnosis of MAI was confirmed by biopsy and Ziehl-Neelsen coloration. The patient was treated with rifampicine, isoniazide, ethambutol, and pyrazinamide in association with stavudine, lamuvidine and efavirenz. Despite improvement of general condition, fever persisted and the patient died after 40 days of treatment.

[The influence of the hormonal replacement therapy on the amount and stability of the tear film among peri- and postmenopausal women]. / Wplyw hormonalnej terapii zastepczej na wydzielanie i stabilnosc filmu lzowego u kobiet w okresie okolo- i pomenopauzalnym.

PURPOSE: To estimate the amount of the tear-film and its stability among women treated due to endocrinological or gynecological indications with hormone replacement therapy. MATERIAL AND METHODS: 60 women treated with hormonal replacement therapy (HRT) were divided into 3 groups of examination: group 1 (20 women), treated with HRT after up to 1 year of menopausal symptoms, group 2 (20 women) treated with HRT between 1-5 years of menopausal symptoms, group 3 (20 women) treated with HRT after more than 5 years of menopausal symptoms. The secretion of the tear-film was measured using Schirmer I test and lisozyme test. The stability of the tear-film was measured with respect to the break-up time (BUT). The examinations were performed 3, 6, 12 months after HRT treatment. The values obtained before HRT treatment served as control. RESULTS: Before HRT treatment we observed significantly decreased tear secretion and lower stability in group 2 and group 3 as compared with group 1. We noticed the negative correlation between the secretion of the tear film as compared to age of examined women. HRT made the tear secretion significantly increased in group 2 and group 3 after 6, 12 and 3, 6, 12 months of HRT treatment respectively. We assessed a significant improvement of the tear film stability with respect to BUT in group 2 and 3 in all months of HRT treatment. We found significant correlation between modified Schirmer I test and lisozyme test (p < 0.001). CONCLUSION: The age and changes of the hormonal homeostasis have negative influence on the tear secretion, tear-film stability among peri and postmenopausal women. HRT treatment has beneficial influence on the tear film secretion and tear stabilization. Our results suggest that hormonal replacement therapy can be suitable for the treatment of the postmenopausal dry eye syndrome.

[The influence of the hormonal replacement therapy on conjunctival epithelium morphology among peri- and postmenopausal women]. / Wplyw hormonalnej terapii zastepczej na stan morfologiczny komórek nablonka spojówki u kobiet w okresie okolo- i pomenopauzalnym.

PURPOSE: To estimate the status of the conjunctival morphology among women treated due to endocrinological or gynecological indications with hormone replacement therapy. MATERIAL AND METHODS: 60 women treated with hormonal replacement therapy (HRT) were divided into three groups of examination: group 1 (20 women), treated with HRT after up to 1 year of menopausal symptoms, group 2 (20 women) treated with HRT between 1-5 years of menopausal symptoms, group 3 (20 women) treated with HRT after more than 5 years of menopausal symptoms. The morphology of the conjunctival epithelium was assessed by impressive cytology. The examinations were performed 3, 6, 12 months after HRT treatment. The values obtained before HRT treatment served as control. RESULTS: The preliminary examinations showed changes of the morphology of conjunctival epithelium in all groups. The longer duration of postmenopausal period, the more advanced morphological changes. In all groups of examinations the HRT has the beneficial influence on the state of conjunctival epithelium morphology. CONCLUSION: The age and changes of the hormonal homeostasis have negative influence on conjunctival epithelium morphology among peri- and postmenopausal women. HRT treatment has beneficial effect on the conjunctival epithelium morphology. Our results suggest that hormonal replacement therapy can be suitable for prevention and treatment of postmenopausal conjunctival changes.

[Clinical and morphological picture of retrobulbar optic neuritis]. / Obraz kliniczny i morfologiczny pozagalkowego zapalenia nerwu wzrokowego.

A case of unilateral retrobulbar neuritis was described. The patient, 43-year-old man died because of the extensive postinfarctional changes on the second day of the treatment. Retrobulbar part of the optic nerve and chiasma opticum were investigated. The microscopic pictures represent the correlations between morphological changes and their pressure on the neural fibres connected with visual disturbances.