Childhood trauma in Owerri (south eastern) Nigeria.

BACKGROUND: Childhood trauma is becoming a significant source of morbidity in many developing countries. Understanding the peculiar features of trauma in these areas is invaluable to the development of better preventive and treatment program. We aim to study the pattern and outcome of childhood trauma in southeastern Nigeria. METHODS: Evaluation of 1,642 children managed for trauma at the Federal Medical Centre, Owerri southeast Nigeria from January 1, 1999 to December 31st 2004. RESULTS: Nine hundred and forty-one children (57.3%) were boys and 701 (42.7%) were girls with a mean age of 8.7 years (range 3 months-15 years). Road traffic accidents (46.7%), falls (17.1%) and assaults (16.1%) were the commonest cause of trauma. The aetiology of trauma differed significantly in the different ages (P < 0.05). Laceration (61.1%), bruises (45.0%) and fractures (21.4%) comprised the predominant type of injury encountered among the children with 997 (60.7%) having multiple injuries. The mean time to hospital presentation was 2.7 days (range 30 minutes to 17 days). Eight hundred and one (48.8%) required admission while 841 (51.2%) were discharged from the emergency unit. Laparotomy (5.3%) and skin grafting (5.0%) were the main operative procedures. There were 41 deaths (2.5%), with 27 (65.9%) of these from severe head injury, 9 (21.9%) from chest injury, 3 (7.3%) from penetrating abdominal injury and 2 (4.9%) from burns. Twenty-nine (70.7%) of the deaths occurred within 96 hours of injury. CONCLUSION: There is appreciable variety of childhood trauma in our environment. Delay in presentation is a problem. Mortality can be minimized by preventive measures and improvement of emergency medical services.

Possible anti-atherogenic effect of kolaviron (a Garcinia kola seed extract) in hypercholesterolaemic rats.

1. The hypolipidaemic effect of kolaviron, a mixture of Garcinia biflavonoid 1 (GB1), Garcinia biflavonoid 2 (GB2) and kolaflavanone, used in the treatment of various ailments in southern Nigeria, was investigated in rats. The ability of Questran (Bristol-Myers Squibb, Hounslow, UK), a hypolipidaemic therapeutic drug, to attenuate hypercholesterolaemia in rats was also examined. 2. In order to assess the hypolipidaemic effect of this extract in experimental animals, thiobarbituric acid-reactive substances (TBARS), cholesterol, phospholipid, low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol and triglyceride levels were determined in the plasma and liver. 3. Cholesterol administered orally to rats at a dose of 30 mg/0.3 mL five times a week for 8 consecutive weeks resulted in a significant increase (P<0.001) in the relative weight of the heart of hypercholesterolaemic animals compared with control. However, cotreatment with kolaviron and Questran ameliorated the cholesterol-induced enlargement of the heart. Kolaviron (100 and 200 mg/kg) elicited 88.5 and 87.4% reductions, respectively, in plasma cholesterol levels of pretreated animals compared with the cholesterol-fed group. In addition, kolaviron produced a significant decrease (P<0.05) in post-mitochondrial fraction (PMF) cholesterol levels in treated animals compared with untreated hypercholesterolaemic animals. Similarly, Questran significantly decreased (P<0.05) the cholesterol-induced increase in plasma cholesterol levels compared with untreated hypercholesterolaemic animals. In addition, (100 and 200 mg/kg) significantly (P<0.05) decreased plasma LDL-C levels by over 70% in treated animals compared with untreated hypercholesterolaemic animals. Similarly, kolaviron significantly decreased (P<0.05) PMF LDL-C levels by over 60% in treated animals compared with untreated hypercholesterolaemic animals. 4. The significantly (P<0.05) higher values of plasma and PMF triglycerides obtained in cholesterol-fed animals compared with control animals were unaltered following cotreatment with kolaviron and Questran. In the present study, there was a significant decrease (P<0.05) in plasma formation of malondialdehyde in kolaviron- and Questran-treated animals compared with untreated hypercholesterolaemic animals. 5. The results of the present study demonstrate that kolaviron exerts a hypocholesterolaemic effect and reduces the relative weight of the heart in cholesterol-fed animals. This reduction and the favourable lipid profile indicate a possible anti-atherogenic property of the extract.

Serum vascular endothelial growth factor in patients with head and neck squamous cell carcinoma.

Vascular endothelial growth factor (VEGF) is a key pro-angiogenic cytokine expressed by most human tumours. Two isoforms, VEGF121 and VEGF165, are soluble and can be assayed in serum. Serum VEGF has been shown to be significantly raised in patients with solid tumours and shows some promise as a potentially useful tumour marker. Serum levels of VEGF were assayed in 52 patients with untreated head and neck squamous cell carcinoma (HNSCC) and 104 healthy controls. Serum VEGF is significantly raised in patients with HNSCC (P < 0.001), but there was no association with either tumour stage or specifically the presence of nodal metastases. Sixteen patients (31%) had a higher serum VEGF than 95th centile of controls, suggesting that serum VEGF measurement is of little practical use as an initial diagnostic tool. The finding that patients with HNSCC have significantly raised serum VEGF probably relates to enhanced platelet aggregation in these patients.