Echocardiographic Left Ventricular Hypertrophy and Geometric Patterns in Patients with Sickle Cell Anaemia.

BACKGROUND: Left ventricular hypertrophy (LVH) is a common complication in patients with sickle cell anaemia (SCA), and it has been associated with systolic and diastolic dysfunction, and sudden death. There is a wide variation in the reported prevalence of LVH in patients with SCA, partly due to the varying criteria applied, and the impact of small weight and body surface area (BSA) in SCA patients. We used four different criteria to determine echocardiographic LVH and geometric patterns in patients with steady-state SCA. Left ventricular hypertrophy was defined by LVM, LVM indexed to BSA, LVM indexed to height and LVM indexed to height2.7 using gender-specific reference values. Left ventricular geometry was determined using LVH and relative wall thickness. RESULTS: Eighty-two patients with steady-state SCA, aged 18years and above were studied from January 2018 to April 2018. The median [IQR] age of the patients was 23 [10] years. Forty-seven (57.3%) were females. The prevalence of LVH was highest when LVM was indexed to BSA (80.5%), followed by LVM indexed to height (73.2%). Comparable prevalences of 68.3% and 69.5% were observed using LVM and LVM indexed to height2.7, respectively. The prevalence of LVH was similar in males and females for all the criteria. CONCLUSION: The prevalence of LVH is high among patients with steady-state SCA irrespective of the criteria applied. The most prevalent geometric pattern was eccentric LVH. Indexing to BSA might result in over-estimation of LVH given the relatively small BSA in patients with SCA. Indexing to height 2.7 might give a more accurate estimate of LVH.

CONTEXTE: L'hypertrophie ventriculaire gauche (HVG) est une complication fréquente chez les patients atteints d'anémie falciforme (ACS), et elle a été associée à un dysfonctionnement systolique et diastolique, ainsi qu'à une mort subite. La prévalence de l'HVG chez les patients atteints d'anémie falciforme varie considérablement, en partie à cause des différents critères appliqués et de l'impact du petit poids et de la surface corporelle (BSA) des patients atteints d'anémie falciforme. Nous avons utilisé quatre critères différents pour déterminer l'HVG échocardiographique et les schémas géométriques chez les patients atteints d'ACS à l'état stable. L'hypertrophie ventriculaire gauche a été définie par la MVL, la MVL indexée sur la surface corporelle, la MVL indexée sur la taille et la MVL indexée sur la taille2,7 en utilisant des valeurs de référence spécifiques au sexe. La géométrie du ventricule gauche a été déterminée en utilisant l'HVG et l'épaisseur relative de la paroi. RÉSULTATS: Quatre-vingts deux patients atteints d'ACS à l'état stable, âgés de 18 ans et plus ont été étudiés de janvier 2018 à avril 2018. L'âge médian [IQR] des patients était de 23 [10] ans. Quarantesept (57,3 %) étaient des femmes. La prévalence de l'HVG était la plus élevée lorsque la MVL était indexée sur la BSA (80,5 %), suivie de la MVL indexée sur la taille (73,2 %). Une prévalence comparable de 68,3 % et 69,5 % a été observée en utilisant la MVL et la MVL indexée sur la taille2,7, respectivement. La prévalence de l'HVG est similaire chez les hommes et les femmes pour tous les critères. CONCLUSION: La prévalence de l'HVG est élevée chez les patients atteints d'ACS à l'état stable, quel que soit le critère appliqué. Le modèle géométrique le plus répandu est l'HVG excentrique. L'indexation à la BSA pourrait entraîner une surestimation de l'HVG étant donné la BSA relativement faible chez les patients atteints d'ACS. L'indexation à la taille 2,7 pourrait donner une estimation plus précise de l'HVG. Mots clés: Hypertrophie ventriculaire gauche; Géométrie ventriculaire gauche; Drépanocytose ; Échocardiographie.

Loss of helminth species diversity in the large hairy armadillo Chaetophractus villosus on the Tierra del Fuego Island, Argentina.

The aim of this work is to compare the taxonomic diversity of parasite species of the large hairy armadillo Chaetophractus villosus in its native range and in another recently introduced population (Tierra del Fuego island), and to evaluate whether the isolation of the latter determines a decrease in its parasitic diversity. Forty specimens from Buenos Aires and Tierra del Fuego Provinces were collected and examined for helminths. Eleven parasite species were found in the native population, and only one species was present in Tierra del Fuego (Trichohelix tuberculata). This may be explained because isolation and climatic conditions prevent encounters between potential host species and infective forms of parasites. Further sampling will be needed throughout the entire Patagonia steppe to confirm how the characteristic parasitic fauna of C. villosus behaves across the armadillo's southern distribution.

Epidemiology of armed robbery-related gunshot injuries in Maiduguri, Nigeria.

BACKGROUND AND OBJECTIVES: Gunshot Injuries used to be rare in Nigeria until the civil war of 1967-1970. Unfortunately, it has become very rampant recently. The objective of this paper is to look at the epidemiology of armed robbery-related gunshot injuries as seen in the University of Maiduguri Teaching Hospital over a five-year period. MATERIALS AND METHODS: Data on patients that presented with gunshot injuries within the study period (January 2002 to December 2006) were collected and analyzed retrospectively. RESULTS: We studied 129 patients with gunshot injuries that were managed during the study period. This comprises of 117 males and 12 females (M:F=9.8:1). Eighty four (65.1%) were young males between 20 and 40 years. One hundred and fifteen (89.2%) of the 129 victims were shot by armed robbers, the remaining 14 (10.8%) were shot under other circumstances not related to armed robbery. Analysis of the time of attack revealed 72% of victims were attacked at night. Over 80% of victims were shot along the highway. The anatomical sites of gunshot entry wound show the extremities having the highest of 46.1%. Ninety one (79.1%) victims were treated operatively while 16 (13.9%) were treated nonoperatively. CONCLUSION: Armed robbery is the motive behind most gunshot injuries in Nigeria. Most of these attacks are preventable if the government would support and motivate the security apparatus responsible. There is also need for the government to support the victims by shouldering their treatment and subsequent rehabilitation.

Chronic Kidney Disease amongst Sickle Cell Anaemia Patients at the University of Maiduguri Teaching Hospital, Northeastern Nigeria: A Study of Prevalence and Risk Factors.

BACKGROUND: Involvement of the kidneys in patients with sickle cell anaemia is a well recognised chronic complication. This study seeks to determine the prevalence of chronic kidney disease in patients with homozygous sickle cell disease (HbSS) and to identify risk factors associated with its development. METHODOLOGY: The subjects consisted of adolescents and adults with HbSS recruited sequentially from the adult haematology outpatient clinic and Daycare ward of the unit. Clinical variables including age at diagnosis of SCA, the frequency of vaso-occlusive crisis and transfusion therapy, as well as laboratory data including haematological profile and renal function tests were obtained. The glomerular filtration rate was estimated (eGFR) using the 'modification of diet in renal disease' (MDRD) formula. RESULTS: Two hundred and eighty-four HbSS patients were recruited. The prevalence of CKD amongst them was 38.9%. Further stratification of the patients based on eGFR showed that sixty-nine (26.8%) had hyperfiltration; 35 (13.6%) stage 1 CKD; 53 (20.6%) stage 2 CKD; 33 (12.8%) stage 3a CKD; 28 (10.9%) stage 3b CKD; 30 (11.7%) stage 4 CKD and 9 (3.5%) had end stage renal disease. There was significant association between eGFR and clinical parameters such as age (r -0.353, p=0.000), SBP (r -0.148, p= 0.021), DBP (r -0.213, p=0.001) and total number of blood received (r -0.276, p=0.000); and laboratory parameters such as PCV (r 0.371, p=0.000); urea ( r 0.527, p=000); creatinine (r 0.625, p=0.000) and uric acid ( r -0.419, p=0.000). CONCLUSIONS: The present study has revealed a high prevalence of CKD amongst patients with SCA in our region. Clinical and laboratory predictors of CKD using eGFR were identified to include age, SBP, number of units of blood transfusion, PCV, urea, creatinine and uric acid levels.

Intestinal parasites of Tolypeutes matacus, the most frequently consumed armadillo in the Chaco region.

The southern three-banded armadillo Tolypeutes matacus (Desmarest, 1804) is distributed from eastern Bolivia, south-west Brazil, the Gran Chaco of Paraguay and Argentina, and lives in areas with dry vegetation. This armadillo is one of the most frequently consumed species by people in this area. The objective of this work was test for zoonotic species among helminths in 12 intestinal tracts of T. matacus in a locality from the Argentinean Chaco (Chamical, La Rioja province). The parasites were studied with conventional parasite morphology and morphometrics, and prevalence, mean intensity and mean abundance were calculated for each species encountered. In the small intestine, seven species of nematodes and two species of cestodes were identified. In the large intestine, two species of nematodes were recorded. We did not find zoonotic species but have added new host records. This study in the Chaco region thus contributes to growing knowledge of the parasite fauna associated with armadillo species in this region.

Mites (Acari: Laelapidae) associated with sigmodontinae rodents in Entre Ríos Province, Argentina.

The richness, diversity, abundance and prevalence of mite species associated with sigmodontine rodents of different species in Entre Ríos province, Argentina are studied. Five of the six species of mites were reported for the first time in the study area. The richness and diversity of mites was higher on Oligoryzomys flavescens and O. delticola than on Akodon azarae. Androlaelaps rotundus was dominant and exhibited higher values of mean abundance and prevalence on A. azarae, Mysolaelaps microspinosus on O. flavescens and Gigantolaelaps mattogrossensis on O. delticola.