Induced Membrane Technique of Masquelet; A Viable Option in Treatment of Post-Trauma Segmental Bone Loss: A Case Report.

In trauma and orthopaedic practice, the management of segmental bone loss constitutes a major challenge to the surgeon. Several methods have been employed in bone reconstruction with varying objectives depending on the size of the defect in question. A gap of not more than 2cm may benefit from acute docking and fixation, 4cm gap can be managed by non-vascularized structural or non-structural graft with fixation. Gaps of more than 4cm can be managed by numerous options which include allograft, vascularized structural graft and distraction osteogenesis with either linear rail system (LRS) or Ilizarov device. Masquelet technique of induced membrane formation is used to bridge a gap of more than 5cm and up to 25cm using bone cement as a spacer in first stage and use of autologous cancellous bone graft in the second stage.

En traumatologie et en orthopédie, la prise en charge de la perte osseuse segmentaire constitue un défi majeur pour la chirurgien. Plusieurs méthodes ont été employées dans la reconstruction d'os avec des objectifs variables en fonction de la taille du défaut en question. Un écart de pas plus de 2 cm peut en bénéficier de l'amarrage et de la fixation aigus, un écart de 4 cm peut être géré par structurelle non vascularisée ou greffe non structurelle avec fixation. Les espaces de plus de 4 cm peuvent être gérés par de nombreux options qui incluent allogreffe, greffe structurelle vascularisée et ostéogenèse par distraction avec l'un ou l'autre des systèmes de rails linéaires (LRS) ou appareil Ilizarov. Technique de Masquelet d'induit la formation de la membrane est utilisée pour combler un espace de plus de 5 cm et jusqu'à 25 cm en utilisant du ciment osseux comme espaceur dans la première étape et l'utilisation d'une greffe d'os spongieux autologue dans la deuxième étape. Mots clés: Défaut osseux segmentaire, ostéogenèse par distraction, technique de membrane induite, espaceur de ciment osseux.

Peripheral Gangrene and Extremity Amputations - Painful Preventable Sequelae of Meningococcal Septicaemia: Case Series Reports.

Extremity gangrene is a fairly common pathology, which complicates systemic vascular and endocrine diseases. Most often, it is encountered in diseases like uncontrolled Diabetes Mellitus, presenting as diabetic foot gangrene, severe peripheral arteriosclerosis with gangrene of the extremity complicating severe uncontrolled systemic hypertension and meningococcal septicaemia with peripheral gangrene. It also occurs in some cases of snake bite as well as frost bite (in regions with extreme cold weather conditions). Some of them present as monolateral extremity gangrene. However, others present as bilateral symmetrical peripheral gangrene (SPG) characterized by bilateral extremity ischaemia resulting in gangrene in which there is no major vascular occlusive disease. There is disseminated intravascular coagulation with the gangrene being considered as a cutaneous marker and some of the patients that survive ultimately require amputation of the affected limb(s) in the severe cases. The mild cases end up losing some of the digits or just exfoliation of the dead cutaneous layer. The effects are generally more severe in the lower limbs than in upper limbs. Notable among these are some of those complicating meningococcal sepsis resulting from peripheral intravascular coagulation. We present here, five patients who presented with varying degrees of peripheral gangrene during an epidemic of meningitis and the treatments that were carried out depending on the severity of their cases.

Socioecology of the Canine Population in the Province of El Jadida, Morocco.

Understanding the socioecology of domestic dog populations is essential for effective disease control, especially canine rabies. In Morocco, since 1986, the control efforts and plans put in place by the government have failed to eradicate this disease; this is because the management of the canine population was not taken into account during the establishment of these plans. It is against the background that this study was designed to estimate the dog population and determine its socioecological characteristics, as well as investigate the attitude of the inhabitants towards the dogs. A stratified random sampling was conducted using a structured questionnaire from May to December 2016. A total of 1931 households were interviewed, comprising 27.4% in urban areas and 72.6% in rural areas. A total of 3719 dogs were counted alongside a human population of 11302 for a dog : human ratio of 1 : 2.42 in rural areas and 1 : 46.58 in urban areas. The majority of dogs (92%) in rural areas were not vaccinated against rabies. In urban areas, about 88.5% were vaccinated against rabies. In addition, 78.5% of dogs in rural areas were free roaming, with more than 53% of births being abandoned by their owners, resulting in a large stray and feral dog population and increasing the potential for continued transmission of rabies virus. There was strong association between breed and rabies vaccination (p<0.05) and confinement with body condition score.

Heme mediated STAT3 activation in severe malaria.

BACKGROUND: The mortality of severe malaria [cerebral malaria (CM), severe malaria anemia (SMA), acute lung injury (ALI) and acute respiratory distress syndrome (ARDS)] remains high despite the availability associated with adequate treatments. Recent studies in our laboratory and others have revealed a hitherto unknown correlation between chemokine CXCL10/CXCR3, Heme/HO-1 and STAT3 and cerebral malaria severity and mortality. Although Heme/HO-1 and CXCL10/CXCR3 interactions are directly involved in the pathogenesis of CM and fatal disease, the mechanism dictating how Heme/HO-1 and CXCL10/CXCR3 are expressed and regulated under these conditions is still unknown. We therefore tested the hypothesis that these factors share common signaling pathways and may be mutually regulated. METHODS: We first clarified the roles of Heme/HO-1, CXCL10/CXCR3 and STAT3 in CM pathogenesis utilizing a well established experimental cerebral malaria mouse (ECM, P. berghei ANKA) model. Then, we further determined the mechanisms how STAT3 regulates HO-1 and CXCL10 as well as mutual regulation among them in CRL-2581, a murine endothelial cell line. RESULTS: The results demonstrate that (1) STAT3 is activated by P. berghei ANKA (PBA) infection in vivo and Heme in vitro. (2) Heme up-regulates HO-1 and CXCL10 production through STAT3 pathway, and regulates CXCL10 at the transcriptional level in vitro. (3) HO-1 transcription is positively regulated by CXCL10. (4) HO-1 regulates STAT3 signaling. CONCLUSION: Our data indicate that Heme/HO-1, CXCL10/CXCR3 and STAT3 molecules as well as related signaling pathways play very important roles in the pathogenesis of severe malaria. We conclude that these factors are mutually regulated and provide new opportunities to develop potential novel therapeutic targets that could be used to supplement traditional prophylactics and treatments for malaria and improve clinical outcomes while reducing malaria mortality. Our ultimate goal is to develop novel therapies targeting Heme or CXCL10-related biological signaling molecules associated with development of fatal malaria.

Prevalence of urinary schistosomiasis in school-aged children in Langai, Plateau State: pre- and post-intervention.

BACKGROUND: Schistosomiasis poses a public health challenges, but for several reasons it is not considered a priority in national and local health policies and programmes. The objective of this study was to determine the effect of health education and drug treatment on the prevalence of Urinary Schistosomiasis among school-aged children in Langai community of Plateau state. METHODS: Two hundred and eighteen children (218) subjects who were selected by multi-staged sampling methods were administered semi-structured questionnaires and their urine samples were assayed for S. haematobium ova using the sedimentation method before and after drug treatment with Praziquantel tablets RESULTS: Pre-intervention, fourteen (14) respondent had urinary Schistosomiasis, giving a prevalence of 6.4% with males (64.3%) having the higher prevalence both pre- and post-intervention. Six weeks after intervention, prevalence had reduced to 0.9%, giving a cure rate of about 92%. Of the 22 respondents (10.1%) who had ever noticed 'blood in their urine', only 6 (27.3%) had Schistosoma ova present in their urine samples at the time of the study. CONCLUSION: It was concluded that drug treatment with Praziquantel, especially when combined with Health Education was effective in reducing the prevalence of Urinary Schistosomiasis among school-aged children in Langai Community of Plateau State.

Home treatment of malaria, amongst under fives presenting with fever in PHC facilities in Jos North LGA of Plateau State.

BACKGROUND: Malaria is one of the major causes of morbidity and mortality in Nigeria. It accounts for 30-50% of morbidity generally and 25% of mortality among under fives. Over the counter treatment of malaria is practiced in almost every household in Nigeria. Therefore this study was carried out to determine the pattern of Home treatment of Malaria amongst under fives seen at PHC facilities in Jos, Plateau State. Nigeria METHODS: A cross-sectional descriptive study design was adopted. Data were generated from 260 systematically selected under fives using interviewer administered structured questionnaires. The informants were their mothers who brought them to PHC facilities with the history of fever. RESULTS: One hundred and fifty nine (57.3%) of the 260 were positive for malaria parasite. One hundred and thirty five (51.9%) did not take any Antimalarial before presentation. Eighty seven (33.5%) took chloroquine, nine (3.5%) had chloroquine with paracetamol, fourteen (5.4%) had nivaquine, nine (3.5%) took paracetamol alone and six (2.3%) were given a combination of orthodox and traditional medicines. Only 21.6% of the mothers gave correct dosage of the Antimalarial. There was no statistically significant relationship between home treatment and parasitaemia among the under fives. CONCLUSION: Home treatment of malaria is a strategy that if properly done will reduce the morbidity and mortality of malaria but this study showed that the knowledge of home treatment of malaria was poor and even when done was not completed because of unavailability of pre-packaged antimalaria.

The impact of advocacy and community mobilization on the utilization of health services at the Comprehensive Health Centre, Gindiri

Primary Health Care facilities provide promotive; preventive; curative and rehabilitative services to a community. They may be well built and equipped with adequate resources but grossly underutilized due to several factors. Health records at the Comprehensive Health Centre Gindiri for 2005 were compared with those of 2007 after a well-coordinated advocacy and mobilization programme in that community. The results show that the total out patient attendance in 2007 increased by 220.6 when compared to that of 2005. 293 patients were admitted into the wards in 2005 compared to 813 in 2007(277). There was no surgery carried out in the whole of 2005; whereas in 2007 there were 98 surgeries. Advocacy and community mobilization could be important factors in the utilization of primary health services

The uptake and release of benzo[a]pyrene and benzo[e]pyrene in vitro by Syrian hamster embryo cells as a function of serum concentration.

A quantitative study on the in vitro uptake of benzo[a]pyrene (B[a]P) and benzo[e]pyrene (B[e]P) by Syrian hamster embryo cells and the induction of sister chromatid exchange (SCE) has been carried out. The amounts of B[a]P and B[e]P taken up by the cells decreases as does the induction of SCEs by B[a]P when the concentration of serum in the culture medium increases. It appears that serum prevents (B[a]P or B[e]P uptake. We have observed no significant differences between the two hydrocarbons regarding uptake by cells; chromatographic results show however that B[a]P is metabolized by these cells, while B[e]P is not. Our results suggest that serum inhibits B[a]P and B[e]P uptake and hence decreases the number of SCEs.