Botulinum toxin as adjunct therapy in surgical management of a periprosthetic scapular spine fracture: a case report

Six months after undergoing reverse total shoulder arthroplasty (RSA) a 73-year-old woman sustained a periprosthetic scapular spine fracture following a fall. She was treated with open reduction and internal fixation (ORIF), followed by botulinum toxin injection into the deltoid muscle to temporarily minimize strain at the fracture. Fracture union was achieved by three months, with excellent clinical function more than one year following fracture fixation and full resolution of deltoid function. Scapular spine fracture following RSA can be treated with ORIF and temporary deltoid paralysis using botulinum toxin in the immediate postoperative period to safely support fracture healing.

Safe duration of silicon catheter replacement in urological patients

Objectives: This study compared the infection rates, degree of encrustation, symptoms, and complications in patients regarding the duration of urethral catheterisation (three weeks, six weeks, and eight weeks). Design: A cross-sectional study with stratified simple random sampling Setting: Urology Unit, Korle Bu Teaching Hospital Participants: One hundred and thirty-seven male patients with long-term urinary catheters Interventions: Participants were grouped into 3 weeks, 6 weeks, and 8 weeks duration of catheter replacementsPrimary outcomes measures: Symptoms due to the urinary catheters, urinalysis, urine and catheter tip cultures, sensitivity, and catheter encrustations were assessed. Results: Eighty-six patients had a primary diagnosis of benign prostatic hyperplasia (BPH), 35 had urethral strictures,13 had prostate cancer, two had BPH and urethral strictures, and one participant had bladder cancer. There was no difference in the symptoms the participants in the different groups experienced due to the urinary catheters (p > 0.05). The frequency of occurrence of complications (pyuria, p = 0.784; blocked catheter, p=0.097; urethral bleeding, p=0.148; epididymo-orchitis, p=0.769 and bladder spasms, p=1.000) showed no differences in the three groups. There was no statistical difference in the urinalysis for the three groups (p>0.05) and the degree of encrustations (3 weeks: 0.03 ± 0.06, 6 weeks: 0.11±0.27 and eight weeks: 0.12 ±0.27) with p=0.065. Conclusions: In this study, the duration of urinary catheterisation using silicone Foley's catheters did not influence the complication and symptom rates; hence silicon catheters can be placed in situ for up to 8 weeks before replacement instead of the traditional three-weekly change.

Patient treatment cost of oral diseases in Ghana

Objectives: To estimate patient treatment cost of oral diseases in Ghana Design: A cross-sectional study design using cost-of-illness analysis was employed Setting: The study was conducted at the dental unit of the University of Ghana Hospital, Legon Participants: About185 patients attending the dental unit of the hospital were selected Interventions: None Main outcome measures: Direct medical and non-medical costs, indirect costs, and intangible costs of treatment of oral conditions Results: The estimated average cost of treatment for oral diseases was US$ 35.75. The total cost was US$ 6,614.11, with the direct and indirect costs constituting 94.5% and 5.5%, respectively of the total cost. Direct medical costs constituted 86.9%, while direct non-medical costs constituted 13.1% of the total direct cost. The richer socio-economic group had the highest cost per quintile, with a mean of US$ 46.69. The intangible cost described was highest for pain (47.1%), followed by difficulty in eating (40.8%) and sleeping (34.6%) for both men and women. Conclusion: The costs of oral diseases are huge and cannot be overlooked. Oral diseases also pose significant productivity losses to patients

Mortality Rate and Ten Years Survival of Elderly Patients Treated with Total Hip Arthroplasty for Femoral Neck Fractures

@#Introduction: Mortality following traumatic femoral neck fractures in the elderly (age >60 years) is influenced by many factors. Addressing some of them may reduce the mortality rate thus improving patient survival and quality of life. Materials and methods: This study was a retrospective research using data collected from Hospital Sultanah Bahiyah, Kedah between the years 2008-2018. We measured outcomes such as age, gender, hospital stay, default rate, ambulation post-surgery, American Society of Anaesthesiologists score (ASA) and surgical timing in correlation with mortality rate and 10-year survival of elderly patients treated with Total Hip Arthroplasty for femoral neck fractures in this centre. Results: A total of 291 traumatic femoral neck fractures aged above 60 years post total hip arthroplasty performed were included. There was higher number of female (n =233) compared to male (n=53) Estimated 10 years survival from Kaplan Meier was 42.88% (95% CI: 33.15, 52.54). One year mortality rate in our study was found to be 18.9%. The average time to event was 7.1 years (95% CI:33.15, 52.24) with a mean age group of 75. Discussion: Total hip arthroplasty patients not ambulating after surgery had a 4.2 times higher hazard ratio compared to ambulators. Those with pre-existing systemic disease (ASA III and IV) were found to have the highest hazard ratio, almost five times that of healthy patients, after adjusting for confounding factors. Delay of more than seven days to surgery was found to be a significant factor in 10-year survival with a hazard ratio of 3.8, compared to surgery performed earlier. Conclusion: Delay of more than 7 days to surgery in 10 years survival was significant with high hazard ratio. It is a predictor factor for survival in 10 years. A larger sample size with a prospective design is required to confirm our findings regarding “unacceptable surgical timing” for femoral neck fractures in patients above 60 years of age.

Effects of Highly Active Antiretroviral Treatment on Liver and Kidney Functions

Aim:This study assesses the effects of HAART on liver and renal functions in HIV infected individuals on HAART.Study Design:Cross sectional study.Place and Methods:This study was conducted in Tamale, Ghana from August, 2015 to November 2017. Original Research Article Methodology:A total of 300 HIV infected participants with ages ranging from 19 to 79 years who have been administered with HAART for at least 6 months were recruited. Pre-HAART administration (baseline) demographic and clinical information, with initial liver and renal function test results were retrieved from the medical records of the participants present at the ART center. Post HAART administration blood sample (5mLs) was taken from each participant into a gel separated vacutainer tube, allowed to clot and spun at 3000rpm for 3 minutes to produce serum. The product (serum) was used for liver and renal function test analysis using a fully automated chemistry analyser (Vital Scientific Selectra Flexor XL). Results: Of the study population, 72% were administered with AZT/3TC/EFV, 13% with AZT/3TC/NVP, 6.7% with TDF/3TC/LPV/r and TDF/3TC/NVP, 1% with AZT/3TC/EFV while 0.7% were administered with TDF/FTC/EFV. The following parameters were significantly increased post HAART administration; ALT (25.53 ± 16.90 to 30.87 ± 19.28 U/L), ALP (163.7 ± 141.0 to 215.2 ± 143.4 U/L), GGT (37.27 ± 25.21 to 53.19 ± 41.71 U/L), Total protein (73.97 ± 17.08 to 82.31 ± 11.62 g/L), Albumin (38.02 ±9.331 to 41.01 ± 7.471 g/L), Globulin 38.02 ± 15.71 to 42.79 ± 25.20 (g/L). There were however significant reductions in Total bilirubin (12.13 ± 10.85 to 9.434 ± 4.560 μmol/L), Direct bilirubin (6.616 ± 5.770 to 4.184 ± 2.806 μmol/L), (Creatinine 73.19 ±36.13 to 63.14 ± 27.14 μmol/L) and Urea (3.515 ± 2.552 to 3.011±1.274 mmol/L).Conclusion: HAART improves renal function, induces elevation in liver enzymes, stimulates the production of plasma proteins and reduces serum bilirubin concentration

Effects of Highly Active Antiretroviral Treatment on Complete Blood Count Parameters

Aim:This study assesses the effects of HAART on complete blood count parameters among HIV infected participants.Study Design:Case control study. Place and Methods:This study was conducted inTamale, Ghana from August, 2016to December,2017. Methodology:A total of 300 HIV infected participants with ages ranging from 19–79 years, administered with HAART for at least 6 months were recruited. Pre-HAART administration (baseline) demographic andclinical information, with initial full blood count results were retrieved from the medical records of the participants. Post HAART administration blood sample (5mLs) was taken from each participant into an EDTA vacutainer tube andcomplete blood count (CBC) performed usingURIT 5250 haematology analyser.Participants transfused with blood overthe last 4 months were excluded from the study.Results: The study recorded significant decreases in WBCand Neutrophil (%)post HAART administration. Lymphocyte (%),Haemoglobin, Haematocrit, MCV, MCHC, RDW-SD were all significantly higher post HAART administration. Total Platelets count, MPV, PDW-SD, PCT and P-LCR were significantly lower post-HAART administration.A comparison of the effects of EFV and NVP administered with AZT/3TC backbone yielded the following results. The NVP group recorded a significantly higher HCT compared with the EFV group (p-0.0073). A significantly higher mean PCT, MPV, P-LCR,PLCC, PDW-SD were recorded in the EFV group comparedto the NVP group respectively.Conclusion: The administration of HAART is associated with significant improvements in erythroid and lymphoid lineages, reduce anaemia, improves immunity and general patient well-being. NVP improve erythroid cell indices while EFV ameliorate platelet indices. HAART regimen should be chosen based on the pre-HAART laboratory tests conducted on the individual

Effect of Watermelon Rind (Citrullus lanatus) Addition on the Functional, Pasting and Microbiological Quality of Sorghum Based Mumu

The effect of watermelon rind powder addition on the functional, pasting and microbiological quality of Sorghum based mumu was evaluated. Sorghum-based mumu was prepared from composite flours of 85:15, 75:15, 70:15 and 65:15% roasted sorghum flour and roasted partially defatted groundnut flour respectively and included with 0, 10, 15 and 20% watermelon rind powder respectively which were known as sample A, B, C and D accordingly. Subsequently, the functional, pasting properties and microbial quality was assessed. Functional properties values; Bulk density (0.89 to 0.80mg/100g), reconstitution index (4.99 to 4.89) and swelling index (2.35 to 2.20) decreased significantly (p < 0.05) with increase in watermelon powder addition while water absorption (10.36 to 10.97g/g), oil absorption (10.33 to 10.79) and foam capacities (12.46 to 13.85%) increased with increase in watermelon rind powder. The pasting properties; peak (302.22 to 292.44 RVU), trough (156.44 to 150.00 RVU) and Final viscosities (412.69 to 400.76RVU), and breakdown (149.95 to 140.59RVU) decreased significantly (p < 0.05) with increased in watermelon rind powder while setback viscosity (101.05 to 115.59RVU), pasting temperature (59.32 to 62.02oC) and pasting time (4.93 to 5.13mins) increased. Microbial analysis revealed the following ranges: Total viable count, 0.5x102 to1.0x102 cfu/g, fungi count of 6.1x101- 9.9x101 cfu/g and no coliform was detected. Overall, addition of watermelon rind powder showed good functional, pasting and microbiological qualities of sorghum based mumu.

The Perception of Residents of Makurdi, Benue State, Nigeria about the Veterinary Profession

Veterinary medicine is the medical science that is concerned with the diagnosis, treatment, prevention and control of diseases, disorders and injuries of animals. A questionnaire-based study was conducted to investigate the perception of Nigerians resident in Makurdi city about the veterinary profession. Makurdi city, located in Central Nigeria, was divided into 10 sub-study areas for the purpose of the survey. Exactly 965 questionnaires were administered randomly to respondents in the study areas and collected immediately they were completed. Data obtained from the study was collated and analyzed using Chi square (statistical package for social sciences, SPSS) and values of P<0.05 were significant. Majority of the respondents (n=936 or 96.99 %) confirmed they had prior knowledge about the identity of a veterinary doctor before the study. Most respondents (P<0.05) strongly agreed that veterinary doctors usually receive more standard professional training than animal scientists. Half of the respondents (n=485 or 50.2%) (P<0.05) strongly agreed that veterinary and human medicine are complimentary in the disease control strategy plan of any nation. Majority of the respondents (P<0.05) either strongly agreed or agreed that ranches should be established for rearing livestock in Nigeria to prevent frequent farmer-herdsmen clashes that have been on the increase in recent times. The significance of these findings and the implication on the development of the livestock industry in Nigeria are discussed.

An elderly man with gastric cancer, Saint's triad and Heyde's syndrome / Un anciano con cáncer gástrico, tríada de Saint y síndrome de Heyde

This case study describes a 71-year-old man with signet-ring cell gastric adenocarcinoma and malignant sigmoidal polyp; and typical features of Saint's triad and Heyde syndrome. He had digestive bleeding, two types of hernia, diverticulosis, arterial hypertension, malignant polyp, and antecedent of smoking, lung tuberculosis, and surgical correction of aortic valve stenosis. There is a hypothetical inverse relationship between herniosis and development of malignancy; however, the patient herein described presented gastric and sigmoidal cancers. Gastrointestinal malignancies are sometimes associated with paraneoplastic entities, isolated or manifested as syndromes, but neither Saint's triad or Heyde syndrome have been included. This patient persisted clinically stable during the preoperative period, but suddenly died; Trousseau's syndrome would be the most probable mechanism of sudden death in this setting. Case reports can stimulate further studies to get additional knowledge about unusual entities.

Este estudio de caso describe un hombre de 71 años de edad, con adenocarcinoma gástrico con células en anillo de sello y un pólipo maligno sigmoideo; y características típicas de la tríada de Saint y del síndrome de Heyde. Tuvo una hemorragia digestiva, dos tipos de hernias, divertículos, hipertensión arterial, y pólipo maligno; con antecedente de tabaquismo, tuberculosis pulmonar, y corrección quirúrgica de estenosis de la válvula aórtica. Hay una hipotética relación inversa entre hernioses y el desarrollo de malignidades; sin embargo, el paciente que se describe en el presente documento presentó cánceres gástrico y sigmoideo. Neoplasias gastrointestinales se asocian a veces con entidades para neoplásicas aisladas o manifiestan síndromes, pero ni la tríada de Saint ni el síndrome de Heyde se ha incluido. Este paciente persistió clínicamente estable durante el período preoperatorio, pero de repente murió; síndrome de Trousseau sería el mecanismo más probable de muerte súbita en esta situación. Los informes de casos pueden estimular más estudios para obtener un conocimiento adicional sobre esas entidades inusuales.

Local Anesthetic Used for Dental Treatment in Children- Systematic Review.

Aims: To analyse the existing literature on the effectiveness of various injectable amide local anaesthetic agents for children undergoing routine dental treatment. Design: A systematic search was carried out for the databases of PubMed, Central, LILACS, Science direct, Metapress and SIGLE to identify clinical trials published on the effectiveness of injectable amide local anaesthetic agents in dental journals from the inception of the databases up to July 2015. Results: The systematic search gave nine studies. Four of out seven studies found articaine to more effective. No significant difference in anaesthetic effectiveness of the agents were found in seven studies. One study reported significant difference in the anaesthetic effectiveness in favour to articaine. Two studies reported articaine to have longer duration of action. Conclusion: With the available evidence, this review may suggest that articaine is an effective amide anesthetic agent. Lignocaine is most effective at 2% concentration. Prilocaine and mepivacaine show comparable effectiveness. As eight of the studies have high risk of bias, there is a greater need for well-designed randomized controlled studies to be conducted to assess effectiveness of various injectable amide local anaesthetics to be used in children for routine dental treatment.

Generalización e inferencia: un acercamiento a su compresión desde tres enfoques / Generalization and inference: an understanding based on three approaches

Se trata de una reflexión que busca poner en discusión los diferentes significados que pueden adquirir los conceptos de generalización e inferencia, de acuerdo con el enfoque o perspectiva desde el cual se pretendan utilizar. Para este propósito, en primer lugar, se pone en consideración la importancia y el uso que se ha dado a estos conceptos en el campo de la epidemiología clásica-moderna, especialmente para definir asuntos de validez interna y externa y para la formulación de hipótesis. Seguidamente, se presentan las principales argumentaciones que al respecto defiende Clifford Geertz desde su perspectiva epistemológica de la etnografía interpretativista y de acuerdo con su concepción teórica de la cultura. Posteriormente, se presentan las ideas que sustenta Juan Samaja desde su enfoque epistemológico y metodológico para la investigación en salud, abogando principalmente por el razonamiento abductivo, y no sólo el inductivo y el deductivo que han sido privilegiados en los estudios lógicos. Por último se presenta una discusión y unas conclusiones destacando que en estas tres perspectivas la salud pública tiene una oportunidad para enriquecer sus procesos de generación de nuevo conocimiento y para comprender de mejor manera las condiciones de salud y de bienestar colectivo.

This paper is a reflection which seeks to stimulate discussion and debate concerning the different meanings that the concepts of generalization and inference can take on, based on the approach or perspective that is being employed. For this purpose the importance and usage which has been accorded to these concepts within the field of classic-modern epidemiology is taken into consideration, especially in order to define internal and external validity issues and to formulate hypotheses. Next the main arguments are presented and are defended by Clifford Geertz from his epistemological perspective of interpretive ethnography and based on his theoretical conception of culture. Subsequently the ideas maintained by Juan Samaja are presented from his epistemological and methodological approach for research into health, advocating primarily for abductive reasoning, and not simply inductive and deductive, which have until now been privileged in logic studies. Finally a discussion and conclusions are presented, highlighting that from these three perspectives public health has the opportunity to expand its new knowledge generation processes and to better understand the conditions for good collective health and wellbeing.

The Role of Coconut Oil on Pentylenetetrazole Induced Convulsion in Rats: An Electroencephalogram Study.

Aim: This study was carried out to investigate the role of coconut oil on pentylenetetrazole (PTZ) induced convulsant activity in Wistar rats using the laboratory model. Convulsant activity was achieved by injection of PTZ. Study Design: The rats were divided into five groups. Group 1 served as control and received distilled water orally. Group2 was a reference group and received only PTZ. The remaining three groups (3, 4 and 5) were test groups and rats were given oral administration of coconut oil at doses of 2, 4 and 5.3 ml/kg for 21 days. Methodology: 25 rats weighing between 125 and 200g were used. 30 minutes after the last administration of coconut oil after 21 days, a convulsive dose of PTZ was given intraperitoneally. Electroencephalogram (EEG) readings of the rats were then taken using an EEG machine and electrodes placed on the head of the rats recorded the waves produced on the scalp of the rats. The frequencies of the waves recorded were analyzed and compared for all groups. Result: The frequency of EEG readings produced during convulsion that was caused by the PTZ in the rats were reduced for the rats that received coconut oil. There was a significant decrease in the mean frequency of EEG of rats that received 2, 4 and 5.3 ml/kg coconut oil ( which had frequencies of 13Hz, 14.6Hz and 14. 4Hz, respectively) when compared with the reference group that received only PTZ which had a mean frequency of 16Hz. Coconut oil significantly reduced the frequency produced by PTZ. The result also shows that the lower dose group had the most appreciable decline in convulsive activity returning the frequency of electroencephalogram waves recorded to 13Hz same as the control group. Conclusion: The result suggests that coconut oil given at a moderate dose has anticonvulsant effect and will cause an increase in weight. These findings supports reports that ketogenic diet could help reduce convulsant activities and epileptic seizures.

Clinicopathologic features of non-small cell lung cancer in India and correlation with epidermal growth factor receptor mutational status.

INTRODUCTION: We performed retrospective analysis of 106 patients with lung cancer for which formalin‑fixed paraffin‑embedded tissues was available. Their epidermal growth factor receptor (EGFR) mutation status and treatment outcomes are described. MATERIALS AND METHODS: All patients with confirmed non–small cell lung cancer (NSCLC) during Jan 2008 to Dec 2010 were included. EGFR sequencing was performed with ABI PRISM 310 genetic analyzer. RESULTS: Forty‑two (39.6%) patients had mutation in one of the four exons characterized. Patients whose EGFR mutational status was not available at presentation before the start of treatment were started on chemotherapy, n = 46 (43.39%). If EGFR mutational analysis was available and mutations were present, the patients were started on either upfront tyrosine kinase inhibitor (TKI), n = 15 (14.15%) or if on chemotherapy arm were allowed to finish six cycles and then start with maintenance TKIs, n = 26 (24.52%). The median progression free survival for patients with and without mutations was 11 months (95% CI,7-14) and 9 months (95% CI,7-10) respectively. A median PFS of 14 months (95%CI, 12-16) was seen in the mutation‑positive group that received both chemotherapy followed by switch maintenance with TKIs versus 8 months (95%CI, 7-8 months) in the group that received only TKI. CONCLUSION: The prevalence of EGFR mutations in this population of NSCLC patients was 39.6% with exon 19 mutation being the most common. The observed benefit of addition of chemotherapy over TKI in EGFR mutation‑positive group raises the question, can we offer the therapy of chemotherapy–TKI combination to EGFR mutation‑positive lung cancer patients as shown in the present study.

Alopecia areata of dental origin in a child.

Alopecia areata (AA) is a chronic inflammatory disease that involves the hair follicle. Current evidence indicates that hair follicle inflammation in AA is caused by a T-cell-mediated autoimmune mechanism occurring in genetically predisposed individuals. AA has a reported incidence of 0.1%-0.2%, with a lifetime risk of 1.7%. It has also been found that AA accounts for roughly 2% of new dermatology outpatient cases in the US and the UK, 3.8% of cases in China and 6.7% of cases in Kuwait. Pediatric AA constitutes approximately 20% of all AA cases. AA affects males and females equally. The most common site to be affected is the scalp (90%). The face, eyebrows, eyelashes, beard, underarm hair, and pubic hair may be affected and, sometimes, even the entire body. AA requires combined therapy, involving topical or intralesional corticosteroids, immune therapy with diphenylcyclopropenone, and even psychotherapy. In some cases, treatment consists of simply eliminating the dental infectious process. This case report describes AA of dental origin in a 9-year-old girl, which resolved after management of the dental problem.

Calidad del agua para consumo humano en el departamento del Tolima / The quality of water for human consumption in the Tolima department, Colombia

OBJETIVO: describir la calidad del agua para consumo humano en áreas urbanas del departamento del Tolima y su relación con la incidencia notificada de Hepatitis A, Enfermedad Diarreica Aguda (eda) e indicadores sociales. METODOLOGIA: estudio observacional descriptivo ecológico transversal, que utiliza bases de datos del Sistema de Vigilancia de la Calidad del Agua Potable (sivicap) y el Sistema de Vigilancia en Salud Pública (SIVIGILA) de 2010. Se obtuvo media, mediana, desviación estándar, proporción de incidencia notificada de municipios del Tolima (n=47), se empleó Anova de una vía y análisis de correlación. RESULTADOS: el 63,83% de los municipios del Tolima presentaron agua no potable. En la categoría de inviable sanitariamente se clasificaron los municipios: Ataco, Cajamarca, Planadas, Rovira, Valle de San Juan y Villarrica. El 27,7% de los municipios evidenciaron resultados con coliformes. No se encontró asociación estadística entre la incidencia de las enfermedades trazadoras y la calidad del agua; se encontró relación estadísticamente significativa entre la cobertura de acueducto, alcantarillado, nivel educativo y calidad del agua. DISCUSION: es necesario el mejoramiento de la calidad del agua, ampliando cobertura de servicios, la notificación epidemiológica y la promoción de buenas prácticas higiénico–sanitarias.

OBJECTIVE: to describe the quality of drinking water in urban areas of the Tolima department and its relationship to the reported incidence of hepatitis A, acute diarrheal disease and social indicators. METHODOLOGY: descriptive observational study using cross–sectional ecological databases (sivicap) and (SIVIGILA) 2010. It was mean, median, standard deviation, proportion of reported incidence of municipalities of Tolima (n = 47), we used one–way anova and correlation analysis. RESULTS: 63.83% of the municipalities of Tolima had potable water. In the category of sanitary non–viable municipalities were classified: Ataco, Cajamarca, Planadas, Rovira, Valle de San Juan, and Villarrica. 27.7% of the municipalities showed coliform results. No association was found between the incidence of the diseases and water quality, statistically significant relationship was found between the coverage of water supply, sewerage, education and water quality. DISCUSSION: it is necessary to improve water quality, expanding service coverage, epidemiological reporting and promotion of good hygienic practices.

Caracterización de los tiempos de atención y de mujeres con cáncer de mama que asistieron a un hospital de tercer nivel, 2005-2009 / Characterization of service times and of women with breast cancer who attended in a hospital, 2005–2009

Objetivos: caracterizar el perfil sociodemográfico y clínico de mujeres con cáncer de mama tratadas en la Unidad Oncológica del Hospital Federico Lleras Acosta de Ibagué entre 2005 y 2009, e identificar tiempos de atención. Metodología: estudio descriptivo retrospectivo con selección de 308 historias clínicas, recolección de variables en un instrumento elaborado y análisis estadístico con el programa spss. Resultados: predominante el grupo de 45 a 64 años, casadas, provenientes de zonas urbanas, edad promedio de menarquia de 13 años, al menos 3 gestas y postmenopáusicas. El tipo histológico canalicular infiltrante fue el más frecuente, así como el estadio IIIB. La mastectomía radical modificada fue la elección quirúrgica predominante, al igual que la quimioterapia pre y postoperatoria y la radioterapia postoperatoria. En los tiempos de atención se evidenciaron demoras en el ingreso e inicio del tratamiento. Conclusión: un bajo porcentaje de carcinoma in situ y mayor proporción de estadio IV respecto a países desarrollados. Una alta proporción de abandono en controles postratamiento y fallas en seguimiento de casos, así como los hallazgos en tiempos de atención plantean la necesidad de correctivos institucionales para mejorar la calidad del servicio de salud en cáncer de mama.

Objectives: to characterize the clinical and sociodemographic profiles of women with breast cancer treated at the Oncology Unit of the Federico Lleras Acosta Hospital in Ibagué, Colombia between 2005 and 2009, and to identify service times. Methodology: a retrospective descriptive study in which 308 records were selected. Variables were collected using an instrument developed by the authors. The statistical analysis was conducted using the SPSS software. Results: the predominant age group was 45 to 64 years old. Additionally, 57.8% of these women were married. Similarly, most of them were from urban areas. The average age of menarche was 13 years. Half of the participants had been pregnant at least 3 times, and most of them were in the postmenopausal stage of their lives. The most frequent histological type was the infiltrating ductal one, as well as stage IIIB. The predominant surgical choices were modified radical mastectomy, pre- and post-operative chemotherapy, and postoperative radiotherapy. As for service times, there were delays in the admission to the oncology unit and treatment initiation. Conclusion: there was a low rate of carcinoma in situ and a high proportionof stage IV carcinoma in comparison to other studies fromdeveloped countries. The high rates of abandonment in posttreatment follow-up, the shortcomings in case monitoring,and the findings concerning service times suggest the needfor institutional corrective measures in order to improve thequality of the healthcare service in breast cancer patients.

Psychosocial burden of sickle cell disease on the family, Nigeria

Background: Sickle Cell Disease (SCD); the most common genetic disorder amongst Black people; poses a significant psychosocial burden on the sufferers; the caregivers and their families. Objective and methods: From 01 January 2011 to 30 September 2011 the caregivers of children with SCD treated at the Paediatric Haematology Clinic of the University Teaching Hospital in Ado-Ekiti; Nigeria; were included in a study; using a structured questionnaire and a validated; culture-relevant disease burden interview to assess the psychosocial burden of SCD on these caregivers. Three main objective psychosocial domains and some subjective domains; including the caregivers' coping ability were assessed. Results: A total of 225 caregivers; consisting of 202 mothers (89.8); 15 grandmothers (6.7) and 8 fathers (3.6) were studied. In 53.3of the families; the care of children with SCD adversely affected the provision of their basic needs; with 73.3of the caregivers stating that time spent caring for the child made them lose income or financial benefits; 19.6of the caregivers had to take out loans to meet the expenditure of the patient's illness. Caring for children with SCD reportedly made 42.2of the caregivers neglect other family members. In addition; 14.2of the families experienced moderate to severe disruption in their day-to-day interactions within the family to the extent that 12.4frequently quarrelled due to the child's illness. Conclusion: Caregivers are faced with enormous financial; interpersonal and psychological problems. Social support should be available to alleviate caregivers' and/or family members' burdens

La reducción del sueño como factor de riesgo para obesidad / Sleep deprivation as a risk factor for obesity

Nocturnal sleep patterns may be a contributing factor for the epidemic of obesity. Epidemiologic ana experimental studies have reported that sleep restriction is an independent risk factor for weight gain and obesity. Moreover, sleep restriction is significantly associated with incidence and prevalence of obesity and several non-transmissible chronic diseases. Experimental sleep restriction is related to altered plasma leptin and ghrelin concentrations. Both hormones are directly related to appetite and satiety mechanisms. Also, a higher activity of the orexin/hypocretin system has been reported, as well as changes in glucose metabolism and autonomic nervous system. Some studies indicate that these endocrine changes could be associated with a higher diurnal food intake and preference for energy- dense foods. All these changes could result in a positive energy balance, leading to weight gain and a higher obesity risk in the long-term. The present article summarizes the epidemiologic and experimental evidence related to sleep deprivation and higher obesity risk. The possible mechanisms are highlighted.

Anti-ulcerogenic and proton pump (H+, K+ ATPase) inhibitory activity of Kolaviron from Garcinia kola Heckel in rodents.

Anti-ulcer potential and proton pump inhibitory activity of kolaviron (KV) isolated from Garcinia kola Heckel has been evaluated using different ulcer models. Cold-restraint (CRU), aspirin (ASP), alcohol (AL), pyloric ligation (PL) induced gastric ulcer models were used to assess  anti-ulcerogenic activity of KV in rats. Effects of KV on gastric juice for free and total acidity, peptic activity and mucin secretion were also evaluated. The H+, K+-ATPase activity was assayed in gastric microsomes, spectrophotometrically. Results of this study showed that KV (200 mg/kg) reduced the incidence of ulcers in CRU (69.0%), PL (67.6%), ASP (68.6%) and AL (51.5%). Reductions were also observed in free acidity (32.6%), total acidity (56.2%) and peptic activity (35.4%) with increase in mucin secretion by 40.1%. KV inhibited the H+,K+-ATPase activity with IC50 of 43.8 g/ml compared with omeprazole with IC50 of 32.3 g/ml. KV showed both cyto-protective and anti-secretory potentials against peptic ulcer models, and a proton pump inhibitory activity. KV may emerge as a potent anti-ulcer compound.