Five Year Retrospective and Current Prevalence of Malaria in Bunkure Local Government Area of Kano State, Nigeria

Background: Malaria is one of the most severe public health problems worldwide, particularly in Africa, with Nigeria having the greatest number of cases. This study evaluated a five-year (2012-2016) retrospective and a current trend (August-December 2017) of malaria prevalence in Bunkure Local Government Area of Kano State, Nigeria. Methods:The retrospective review was conducted by extracting data on malaria cases from the Summary Record Book at Bunkure Primary Health Care Facility. In the current survey, a total of 400 participants were examined using peripheral blood sample obtained by venous puncture to estimate the current malaria prevalence. All data obtained were analyzed using SPSS version 20. Results:In the retrospective period, a total of 12,387 suspected malaria patients were diagnosed using Rapid Diagnostic Test kit, out of which 9,746 (78.7%) were positive for malaria. The infection was higher in females (45.27%) and in subjects above or equal to 5years of age. There was no significant difference in prevalence between the gender (P= 0.322) and the age groups (P = 0.630). Of the 400 participants examined, 193 were found positive formalaria,representing a prevalence rate of (48.3%), much lower than the prevalence rate in the retrospective period (78.7%). The higher prevalence of the infection was found in males (32.25%) and the age group between 5-12 years (14.25%). The difference in prevalence was statistically not significant between the genders (p =0.87) and the age groups (p = 0.142). Conclusion:Based on the findings of this study, there was a significant decline(P < 0.05) in trend of malaria prevalence in the study area, which may be attributed to the effectiveness of the ongoing control interventions in the locality. This study indicates the need for continuous monitoring of malaria prevalence using both microscopy and RDT for assessment of impact of malaria intervention in the area

Screening of C-kit gene mutation in acute myeloid leukaemia in northern India

Acute Myeloid Leukaemia [AML] is a cancer of blood-forming cells in bone marrow. C-kit gene is a Receptor Tyrosine Kinase class III [RTK] that is expressed by early hematopoietic progenitor cells and plays an important role in hematopoietic stem cell proliferation, differentiation and survival. It is known that c-kit is a proto-oncogene and the activating c-kit mutations are likely to contribute in the development of leukaemia in humans. Exon 11 of c-Kit gene is the frequent site for mutations in different kinds of tumours. In order to determine the frequency and prevalence of exon 11 mutations in 51 AML cases, we have done polymerase chain reaction-single-strand conformational polymorphism followed by direct DNA sequencing. The c-kit mutations in exon 11 were detected in 15.68% [8/51] in AML cases. We have detected totally ten missense mutations in eight AML cases those include Lys550Asn, Tyr568Ser, Ile571Leu, Tyr578Pro, Trp582Ser and Arg588Met and novel missense mutations at codons Ile563Lys and Val569Leu. Mutations at codons Ile571Leu and Trp582Ser was found in two independent cases. The presence of c-kit mutations in our study adds to investigative spectrum of AML cases. Since the c-kit mutations are seen in other malignancies, mutations in exon 11 of the c-kit gene might be involve in pathogenesis and represent useful predictive genetic marker in AML. Further studies in larger group of cases possibly will be required to determine the prognostic implications and to investigate how these mutations are co-related to the progression and pathogenesis of AML

[Relationship between mealtime glucose excursions and glycemic control in type 2 diabetes mellitus patients]

Monitoring glycemic status, as performed by patients and healthy care providers, is considered the cornerstone of diabetes care. Recent studies have shown that fasting plasma glucose [FPG] measurements alone do not provide an overall picture of disease prognosis and associated complications. This study was designed to evaluate the possibility of utilizing post-prandial glucose excursion test as a predictor of glycemic control during treatment with oral hypoglycemic agents in type 2 diabetes mellitus. This study was carried on 24 patients with type 2 diabetes mellitus ranked into good glycemic control group [12 patients] and poor glycemic control group [12 patients] according to the criteria of evaluation of FPG. Twelve healthy subjects were selected and served as controls for comparison of the studied parameters. Fasting levels of plasma glucose, C-peptide, glycated hemoglobin and post-prandial glucose excursion profile were measured. The results indicated that fasting plasma glucose [FPG] can not be used as only predictor for determining proper acute and chronic glycemic control during drug therapy of type 2 D.M. and post-prandial glucose excursion [PPGE] test was recommended as a more suitable procedure for diagnosis and treatment follow up of type 2 D.M. patients. PPGE test can be considered as a more convenient way to follow glycemic control status during treatment of type 2 DM

Study of the protective effect of melatonin against chlorpromazine-induced cholestasis in rats

As the liver is the predominant site of drug clearance, biotransformation and excretion, so drugs are considered as a frequent cause of liver injury ranging from asymptomatic elevation of liver enzymes activities to fulminant hepatic failure. Among these drugs are the chronically used phenothiazines psychotropic drugs like Chlorpromazine [CPZ] which known to produce cholestatic liver disease. Melatonin [MT] has been shown to reduce the toxicity and increase the efficacy of a large number of drugs whose side effects are well documented and provide protective effects in many organs, including liver, against many types of insult. Evaluation of the possible protective effect of orally administered melatonin against CPZ-induced liver injury in rats. The hepatoprotective effect of melatonin were studied through the treatment of rats with single dose [10 mg/Kg] orally, seven days before and during the period of CPZ treatment, and seven days after the induction of suspected hepatotoxicity. The parameters of oxidative stress, malondialdehyde [MDA] and glutathione [GSH] were evaluated in liver tissue homogenate. The activities of liver enzymes alaninaminotransferase [ALT] and aspartate aminotransferase [AST] in serum as indicator of liver injury, in addition to serum level of bilirubin [total and conjugated] were assessed. Analysis of data showed significant attenuation of oxidative stress parameter as evidenced by lowering MDA levels in tissue homogenate by melatonin while not affecting GSH levels. Serum activities of ALT, AST and serum bilirubin were normalized with both pre-treatment and post-treatment with melatonin. The data revealed that post-treatments with both saline and melatonin restore hepatic activity, however, melatonin showed significant reduction in ALT activity and bilirubin level than saline post-treatment. Additionally, the histologically evident damage in the liver has been improved. The presented data indicated that orally administered melatonin at pharmacological doses protects against CPZ-induced liver injury in rats

Evaluation of primary pulmonary malignancies in central Punjab, Pakistan

To study the clincopathological findings of Primary Pulmonary Malignancy in central Punjab, Pakistan. Three hundred patients of primary malignancies of the lung from Gulab Devi Chest Hospital and other hospital of Lahore were studied. The history of the Patients and their clinical findings were recorded. The sections of all the cases were stained with Haematoxyllin and eosin whereas all large cell carcinomas were stained with Alcian Blue-Periodic Acid- Schiff [AB-PAS] stain. There were 255 males and 45 females with a male to female ratio of 5.7:1. The age ranged from 10-90 years with a mean age of 54.17 +/- 3.46 years. Different tumors were significantly more [p<0.001] in males than in females. The mean age in squamous cell carcinomas cases was significantly high [P<0.001] as compared with adenocarcinoma. Small cell carcinoma cases had significantly low [P<0.02] mean age as compared with squamous cell carcinoma. The difference of mean age in cases of adenocarcinoma approached significant level [0.1>P>0.05] as compared with small cell carcinoma. The primary lung carcinoma is more common in males. Its prevalence is increasing in young ages

comparison of air way maintenance by cuffed oropheryngeal air way [COPA] and laryngeal mask air way [LMA] in spontaneously breathing adult patients

In this study total hundred patients wee included. Fifty [group I] were subjected to COPA device for airway maintenance and in other fifty [group II] LMA was used. In this study first attempt successful insertion rate in group I was 90% while in group II it was 94%. However statistical analysis showed no significant different in both groups. Regarding maneuvers needed to maintain smooth breathing in group I head tilt was used in 2%. It is significantly high in group I than in group II. Laboured breathing was seen in 6% in group I while 2% in group II. There was no significant difference in both groups. According to this study LMA is better in all respect as it is easier to insert and better fit in

Statistical analysis of astrocytic glioma

Fifty patients of both sexes of Astrocytic Glioma from Sheikh Zayed Hospital and Lahore General Hospital Lahore were included in this study. Ten normal brain tissues [control] were taken from accident cases. Out of 50 study cases there were 16 [32%] were low grade [I-II] Astrocytic Glioma and 34 [68%] were high grade Astrocytic Glioma. The male to female percentage was found out to be 26 [52%] and 24 [48%] respectively. Among the males, 11 [22%] were in grade I-II while 15 [30%] were in grade III-IV Astrocytic Glioma, while 5 [10%] females were in grade I-II and 19 [38%] were in grade No statistical sex difference was seen in the ratio of male and female who developed Astrocytic Glioma [P>0.05]. The ages of the patients ranged from 10 to 76 years with maximum number of cases in the age group 30-49 years. In this age group, 11 [22%] patients had grade I-II while 20 [40%] were in grade type of Astrocytic Glioma. The statistical difference of age in different groups was found to be highly significant, [P<0.01]. The most common presenting complaints were headache, vomiting, weakness of limbs, loss of orientation and giddiness. These were observed mainly in grade III-IV Astrocytic tumors. The complaints of difficulty in speech, papilloedema and fits were observed often with an almost equal ratio in all grades of Astrocytic Glioma. The loss of consciousness was observed only in Grade III-IV tumors. The most common site of Atstorcytic Glioma was Parietal lobe and Fronto-parietal lobe constituting 9 [18%] in grade I-II and 15 [30%] in grade HI-IV Astrocytic Gliomas, that is statistically significant, [P<0.05]. The most common site of Astrocytic Glioma was Parietal lobe, 17 out of 50 [7 in grade I-II and 10 in grade III-IV], while the second most common site of this tumor was Temproparietal region, [4 in grade I-II and 6 in grade III-IV]. There were 29 Astrocytic Gliomas in right lobe [10 in grade I-II, and 19 in grade III-IV], while 18 in left lobe [5 in grade I-II and 13 in grade III-IV]. This was statistically highly significant, [P<0.01]. High grade Astrocytic Glioma was also present in Thalamus, mid brain, and Interventricular septum

Treatment of Tibial Diaphyseal Fractures with Closed Flexible Intramedullary Ender Nails: 39 Fractures followed for a Period of Two to Seven Years

OBJECTIVE: To assess the efficacy of flexible intramedullary Ender nails for the treatment of tibial diaphyseal. MATERIALS AND METHODS: This is a retrospective review of patients treated with the Ender Nail for both open and closed tibial shaft fractures. Between January 1989 and December 1994, 43 fractures were treated with these nails. The configuration of each fracture was determined using the Orthopedic Trauma Association classification and the extent of soft tissue damage was assessed using the Gustilo and Anderson's classification. Four patients were excluded from the study due to inadequate follow-up. There were 27 closed and 12 open fractures. The average time to union in 34 out of 39 fractures was 17 weeks. Delayed union and malunion occurred in two patients each and superficial wound infection in 1 patient. Nonunion occurred in 5 fractures that were all located in the distal 1/3 of the tibial diaphysis. We attribute this high rate of non-union to a poor rotational control on the distal fragment by these nails. CONCLUSIONS: The Ender nails provide effective fixation for the OTA stable class of tibial fractures, where they produce good axial and rotational stability by virtue of their three-point fixation. Rotational and angular stability should be improved by a supplementary cast immobilization for fractures with unstable configuration and those located in the distal third of the diaphysis

Haplotypes of the beta-globin gene as prognostic factors in sickle-cell disease

We collaborated with researchers from Egypt, Syrian Arab Republic and Jordan in a study of patients with sickle-cell disease from those countries, and from various parts of Saudi Arabia, in order to investigate the influence of genetics on the clinical presentation of the disease, and to attempt to determine the origin of the sickle-cell gene in Arabs. Our results suggest that beta-globin gene haplotypes influence the clinical presentation of sickle-cell disease, and that there are at least two major foci for the origin of the sickle-cell gene, one in the eastern part of Saudi Arabia, and the other in the populations of North Africa and the north-western part of the Arabian peninsula

Piroxicam for postoperative analgesia

Analgesic effect of parenteral piroxicam in post operative pain was evaluated in 86 subjects undergoing general surgical operations in 1989-90. This drug gave satisfactory results in 75.6% of the patients. No untoward effects were noted except some local pain at the site of injection. The average time of onset of analgesia was 24.5 minutes with the duration of complete analgesia of 24 hours in 66% of the cases who had satisfactory results. We conclude that Piroxicam is a safe efficient and long acting drug for the post operative pain

Hepatic injuries due to blunt abdominal trauma

Sixty-six cases of blunt abdominal trauma have been studied in two years out of which 15 were with the liver injury. Commonest cause of injury had been due to the bamboos of the Donkey Carts and the Horse Carts struck against the motorcycle rider. Overall mortality due to liver injury has been 13.3%

Aetiological factors in breast cancer in Pakistani women

A preliminary report of 101 cases of breast cancer treated by the authors in 8 years is presented. Breast cancer occurs more commonly in low socio-economic group, in young females, in the women who had their first delivery earlier than general population and had late menopause, multiparous women suffer more often from the breast cancer in our study especially those women who breastfed their children more and for the longer period. The authors have postulated that our cancers in Pakistani women are different from the West, the a etiological factor might be the different genetic origin and having more prolactin receptors in Pakistani women with breast cancer