High Intensity Focused Ultrasound Treatment for Uterine Fibroid in a Nigerian Hospital: A Case Report and Review of Literature.

High intensity focused ultrasound (HIFU) is a non-invasive method of treating uterine fibroid that is based on the principle of using extracorporeal ultrasound to cause coagulative necrosis of uterine fibroid. While the technology has been used in other parts of the world, it is new in West Africa. The reported case was the first HIFU treatment of uterine fibroid in Nigeria. A 38-year-old woman was prepared for HIFU treatment of uterine fibroid. Abdomino-pelvic ultrasound scan, Magnetic Resonance Imaging (MRI) and pre-procedural bowel preparation were done. High intensity focused ultrasound (JC200) treatment was done under conscious sedation using average power of 400 Watts with total energy consumption of 278.0 Kilo Joules with total sonication time of 700 seconds. The patient was able to resume her daily activities one week post-HIFU procedure.

Ultrasons focalisés de haute intensité (HIFU)est une méthode non invasive de traitement des fibromes utérins à base sur le principe de l'utilisation d'ultrasons extracorporels pour provoquer nécrose coagulative du fibrome utérin. Alors que la technologie a été utilisé dans d'autres parties du monde, il est nouveau en Occident Afrique. Le cas signalé était le premier traitement HIFU de l'utérus fibrome au Nigeria. Une femme de 38 ans était préparée pour HIFU traitement du fibrome utérin. Échographie abdomino-pelvienne, Imagerie par résonance magnétique (IRM) et intestin pré-procéduralla préparation a été faite. Ultrasons focalisés de haute intensité (JC200) le traitement a été effectué sous sédation consciente en utilisant puissance moyenne de 400 Watts avec une consommation totale d'énergie de278,0 kilojoules avec un temps de sonication total de 700 secondes. Le patiente a pu reprendre ses activités quotidiennes une semaine après la procédure de HIFU.

Prevalence and distribution of cervical high-risk human papillomavirus infection in a rural community of Edo State, Nigeria

Background: Human papillomaviruses (HPVs) are non-enveloped, double-stranded DNA viruses and most women in the world are probably infected with at least one type of the virus during their sexual life. Oncogenic HPVs are predominantly sexually-transmitted pathogens and several high-risk types are associated with nearly all cases of cervical cancer worldwide. In view of paucity of data on the prevalence and distribution of various high risk HPV subtypes, this study was carried out to provide evidence based local data for cervical cancer preventive programs within this region. Methodology: This was a descriptive cross-sectional study involving 145 consenting women living in Ugbegun rural community of Edo central senatorial district, Edo State, Nigeria. Informed consent of each participant was obtained and socio-demographic information collected through interviewer-administered collection tool. Cervical swab sample was collected using the female cervical cell collection kit for HPV DNA testing. HPV DNA was detected by the Hybribio 21 HPV Geno array test kit which uses polymerase chain reaction (PCR) amplification and flow through hybridization assay. Summary statistics were presented as mean, standard deviation, median, frequency and proportions as appropriate using the Statistical Package for the Social Sciences (SPSS) version 22.0. Association of sociodemographic characteristics of the women with HPV prevalence was done using the 't' test, with p value less than 0.5 considered statistical significance. Results: Twenty four of the 145 women tested positive, giving HPV prevalence of 16.6%. Six HPV serotypes were detected; types 16, 18, 35, 45, 52 and 58. HPV types 16 and 18 were most frequent, contributing 54.2%, and coinfection occurred in 29.2%. HPV-positive women had significantly higher mean number of life time sexual partners (p=0.046) and mean parity (p=0.0001) compared to HPV-negative women. The mean age of the women (p=0.710), mean age at menarche (p=0.570) and mean age at coitarche (p=0.940) were not significantly associated with prevalence of HPV Conclusion: This study showed predominance of oncogenic cervical HPV types 16 and 18 within this sub region of rural Nigeria. Strengthening reproductive and sexual education in both males and females with focus on HPV vaccination, delaying sexual activities and reduction in number of child birth are strategies which could prevent high risk HPV infection and cervical cancer in rural communities

Tuberculosis: current trends in diagnosis and treatment.

Among communicable diseases, tuberculosis (TB) is the second leading cause of death worldwide, killing nearly 2 million people each year. It is estimated that about one-third of the world population are infected with TB (2 billion people) and about 10% of this figure will progress to disease state. Most cases are in the less-developed countries of the world. Tuberculosis incidence has been on the increase in Africa, mainly as a result of the burden of HIV infection. Definitive diagnosis of tuberculosis remains based on culture for Mycobacterium tuberculosis, but rapid diagnosis of infectious tuberculosis by simple sputum smear for acid fast bacilli remains an important tool, as more rapid molecular techniques are being developed. Treatment with several drugs for 6 months or more can cure more than 95% of patients. Direct observation of treatment, a component of the recommended five-element DOTS strategy, is judged to be the standard of care by most authorities. Currently only a third of cases worldwide are treated using this approach. There may be need to modify the treatment modalities especially with the choice of drugs and duration of therapy when TB infection occurs in special situation like pregnancy, liver disease, renal failure or even in coexistence with HlV/AIDS or the drug resistant state.

The validity of haematuria in the community diagnosis of urinary schistosomiasis infections.

The validity and reliability of haematuria when used as screening criteria in community diagnosis of urinary schistosomiasis is presented. Between May and July, 1998, 1173 persons were screened for haematuria and examined for the presence of eggs of Schistosoma haematobium in their urine from all participating households in the Ozitem area of Bende Local Government Area, Abia State, Nigeria. Haematuria showed a sensitivity rate of 41.0% and specificity of 82.0% when used to identify cases of urinary schistosomiasis. Some factors that influenced the validity of haematuria as a diagnostic criterion are discussed. The use of haematuria amongst subjects in the first twenty years of their life is recommended.

Validity of leopard skin manifestation in community diagnosis of human onchocerciasis infection.

The validity and reliability of onchocercal leopard skin (LS) when used as a screening criteria in community diagnosis of human onchocerciasis is reported. Between March and May, 1991, 1,302 persons were skin snipped and examined for LS from all households in Mballa, Isuochi in Isuikwuato L.G.A. of Abia State, Nigeria. Leopard skin showed a sensitivity rate of 30% and a specificity of 76.5% when used to identify cases of onchocerciasis. Some factors that influenced validity of leopard skin as diagnostic criterion are discussed. The use of two or more manifestations jointly as indicators of onchocercal infection is recommended.

The role of neutrophils in acute and chronic inflammation in rats.

The effect of neutropenia on acute and chronic inflammatory oedema in rats was assessed using histamine, carrageenan and Freund's complete adjuvant as inducers. Neutropenia (about 85% reduction in peripheral blood neutrophil count) was induced with intraperitoneal administration of 2.5 mg/kg methotrexate for three consecutive days. Acute paw oedemas induced with carrageenan and Freund's complete adjuvant, but not that induced by histamine, were significantly decreased in neutropenic animals compared with controls. In adjuvant-induced chronic knee swelling (Adjuvant arthritis), neutropenia produced small, statistically non-significant, suppressive effect. In contrast, it significantly suppressed adjuvant-induced chronic paw swelling, although suppression was observed only in the late phase component of the swelling. The results suggest that neutrophils are involved in certain acute and chronic inflammatory responses but not in others.