Evaluation of image quality and radiation dose in computed tomography urography following tube voltage optimisation.

INTRODUCTION: Computed tomography urography (CTU) comprehensively evaluates the urinary tract. However, the procedure is associated with a high radiation dose due to multiple scan series and therefore requires optimisation. The study performed CTU protocol optimisation based on a reduction in tube voltage (kV) using quality assurance (QA) phantom and clinical images and evaluated image quality and radiation dose. METHODS: The study was prospectively conducted on patients referred for CTU. The patients were grouped into A and B and were scanned with the standard protocol, a protocol used for the routine CTU at the CT centre before optimisation, and optimised protocol, a protocol with reduced kV respectively. The protocols were first tried on a quality assurance (QA) phantom before being applied to patients, and image quality was assessed based on signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR). In addition, the clinical images were assessed based on the visibility of the anatomical criteria for CT images by five observers with >5 years of experience. The data were analysed using both visual grading characteristic (VGC) curves and statistical package for social sciences (SPSS) version 22.0. RESULTS: The dose was significantly lower in the optimised protocol with a 10 % reduction in both volume computed tomography dose index and (CTDIvol) and dose length product (DLP) for the phantom images, and a 26 % reduction in CTDIvol and 28 % in DLP for the clinical images. However, there was no significant difference in image quality noted between the standard and optimised protocols based on the quantitative and qualitative image quality evaluation using both the QA phantom and clinical images. CONCLUSION: The findings revealed a significant dose reduction in the optimised protocol. Further, image quality in standard and optimised protocols did not differ significantly based on quantitative and qualitative methods. IMPLICATION FOR PRACTICE: kV optimisation in contrast-enhanced procedures provides dose reduction and should be encouraged in the medical imaging departments.

Prevalence and risk estimates of Cryptosporidium oocysts infection associated with consumption of raw-eaten vegetables in Maiduguri metropolis LGAs, Northeast Nigeria.

Cryptosporidium is one of the most important protozoan parasitic pathogens, and it is a common cause of diarrhoea in humans, domestic animals, and wild vertebrates and has serious public health threats. A cross-sectional study was designed to determine the prevalence of Cryptosporidium oocysts in raw-eaten vegetables in Maiduguri Metropolitan Council (MMC) and Jere Local Government Areas (LGAs). A total of 400 samples were collected from four (4) different locations, namely Tashan Bama, Gomboru, and Monday Markets (n = 100), while fifty (n = 50) each from 202-Vegetable-Vendors and Unimaid Commercials. A total of 16 visits were conducted in all the sampling areas (twenty-five samples per visit). The Cryptosporidium oocysts were detected using the Modified Ziehl-Neelsen Staining Technique. The locations, sources, and types of raw-eaten vegetables were also assessed. The oocysts were confirmed (100×) as bright pink spherules. Data generated were analyzed using IBM-SPSS V23.0, and p ≤ 0.05 was considered significant. Out of the total samples (n = 400) analyzed, cabbage appeared to have the highest number of 10 (12.5%) of Cryptosporidium oocysts detected, while Tomato and garden egg had 9 (11.3%) and 1 (1.2%), respectively. There was a statistically significant association (χ2 = 12.5, P = 0.014) between the presence of Cryptosporidium oocysts in raw-eaten vegetables and vegetable types. Among the sources of the vegetables sampled, Alau had the highest number of Cryptosporidium oocysts, 15 (12.5%), followed by Kilari-Abdullahi and Zabarmari sources with 4 (10.0%) and 4 (5.0%), respectively. However, Jetete appeared to have the least number 2 (2.5%) of oocysts, and there was a statistically significant association (χ2= 10.4, P = 0.034) between the presence of Cryptosporidium oocysts and the sources of vegetables and fruits. The study concludes that the raw-eaten vegetables sampled from Maiduguri Metropolis were contaminated with Cryptosporidium oocysts. The study recommends that all raw-eaten vegetables should be from cleaned sources and washed before consumption. Consumers should be enlightened on the hygienic measures in the food chain in line with the Hazard Analysis and Critical Control Points (HACCP) principles.

Risk Factors and Pattern of Lower Limb Deep Venous Thrombosis in Gombe, North-Eastern Nigeria.

BACKGROUND: Deep venous thrombosis (DVT) is one of most common causes of morbidity and mortality among hospitalized patients. Many risk factors ranging from inherited to acquired are associated with increased risk of DVT. AIMS: The aim of the study was to review the pattern and risk factors of DVTs in Gombe. METHODS: This study was a retrospective review of Doppler ultrasound confirmed lower limb DVT that were managed in the Department of Haematology, Federal Teaching Hospital Gombe, North-eastern Nigeria over a 4-year period (January 2018 to December 2021). Data obtained was analyzed using SPSS version 28. RESULTS: Ninety (90) patients were seen and managed during the study period, most were females, (56.7%; n =51) with an age range of 18 to 92 years and mean of 47.3±17.8 years. Young adults (18-45 years) were in the majority (n=45; 50%), followed by the middle aged (46-60 years) (n=28; 31.1%) and then elderly (>60 years) (n=17; 18.9%). Twenty-five patients (27.8%) had proximal DVT, thirteen (14.4%) distal while 49 (57.8%) had extensive DVT. The most affected side is the left lower limb (64.4%; n=58). Most of the patients had provoked DVT (n=65; 72%) with immobilization, recent surgery, bone fracture and stroke as the leading provoking factors. Among those with provoked DVT, young adults were the majority (n=34; 38%), followed by those in the middle-aged group (n=21; 23%) and then the elderly (n=10; 8%). CONCLUSION: Our study showed the preponderance of left sided DVT and the majority of the cases were provoked affecting young adults.

CONTEXTE: La thrombose veineuse profonde (TVP) est l'une des causes les plus courantes de morbidité et de mortalité chez les patients hospitalisés. De nombreux facteurs de risque, qu'ils soient héréditaires ou acquis, sont associés à un risque accru de thrombose veineuse profonde. OBJECTIFS: L'objectif de l'étude était d'examiner les caractéristiques et les facteurs de risque de la TVP à Gombe. MÉTHODES: Cette étude était un examen rétrospectif des TVP des membres inférieurs confirmées par échographie Doppler qui ont été prises en charge dans le département d'hématologie de l'hôpital universitaire fédéral de Gombe, au nord-est du Nigéria, sur une période de 4 ans (janvier 2018 à décembre 2021). Les données obtenues ont été analysées à l'aide de SPSS version 28. RÉSULTATS: Quatre-vingt-dix (90) patients ont été vus et pris en charge au cours de la période d'étude, dont la plupart étaient des femmes, (56,7% ; n =51) avec une tranche d'âge de 18 à 92 ans et une moyenne de 47,3±17,8 ans. Les jeunes adultes (18­45 ans) étaient majoritaires (n=45 ; 50%), suivis par les personnes d'âge moyen (46­ 60 ans) (n=28 ; 31.1%) et les personnes âgées (>60 ans) (n=17 ; 18.9%). Vingt-cinq patients (27,8 %) présentaient une TVP proximale, treize (14,4 %) une TVP distale et 49 (57,8 %) une TVP étendue. Le côté le plus touché est le membre inférieur gauche (64,4% ; n=58). La plupart des patients présentaient une TVP provoquée (n=65 ; 72%), l'immobilisation, une intervention chirurgicale récente, une fracture osseuse et un accident vasculaire cérébral étant les principaux facteurs de provocation. Parmi les patients présentant une TVP provoquée, les jeunes adultes étaient majoritaires (n=34 ; 38%), suivis du groupe d'âge moyen (n=21 ; 23%) et des personnes âgées (n=10 ; 8%). CONCLUSION: Notre étude a montré la prépondérance de la TVP du côté gauche et la majorité des cas ont été provoqués en affectant les jeunes adultes. Mots-clés: Thrombose veineuse profonde, Schéma, Gombe, Facteurs de risque.

Studies on intra-ocular vaccination of adult cattle with reduced dose Brucella abortus strain-19 vaccine.

Brucella abortus vaccines play a central role in bovine brucellosis control with tremendous success worldwide for decades. The study was aimed to evaluate the efficacy of reduced dose (5.0 × 10 9 cfu) of S19 vaccine in adult cattle and its shedding in the milk of vaccinated cattle using molecular techniques. The OIE recommended tests (RBPT, SAT, and iELISA) for brucellosis screening in cattle were used. Seronegative cattle (n = 90) of different age groups (young, old heifers & milking cows, n = 30 each) were selected for the vaccine trials. Antibody titers were recorded at 7th, 21st, 30th, 60th, 90th and 120th days post-vaccination (DPV) to monitor the immune responses following vaccination and at 150th, 180th, 210th and 240th DPB following booster-dose to an intraocular group. The humoral immune responses observed by RBPT and ELISA, proved that antibody titers persisted in s/c group compared to the i/o group in all categories. The IFN-γ stimulation (CMI) due to reduced dose vaccination was noticed early as 30th in all groups and declined after 90th DPV, with higher IFN-γ stimulation among the s/c group. The Bcsp31 and IS711 targeted PCR detected the presence of Brucella DNA in milk samples (n = 120) from the vaccinated cows (n = 30) and confirmed by qPCR (TaqMan assay) at 30th, 60th, 90th and 120th DPV. A Significant number, 70% (7/10) was detected in s/c by qPCR. BCSP31 sequence was deposited at NCBI GenBank (accession no. MK881173-6). PCR and qPCR techniques could provide a reliable diagnosis of brucellosis from milk. The intraocular route remains the safer route for vaccinating adult cattle than subcutaneous.

Epidemiology of bovine brucellosis in Hisar, India: identification of risk factors and assessment of knowledge, attitudes, and practices among livestock owners.

Brucellosis caused by facultative intracellular bacteria, Brucella, remains a global threat to both animal and human health. In this study we aimed to identify potential risk factors of bovine brucellosis and to assess the knowledge, attitudes, and practices (KAPs) of livestock keepers in Hisar, India. A standardized questionnaire was used to collate information regarding potential risk factors of bovine brucellosis and livestock owners' KAPs. A total of 127 livestock keepers were involved. Serum samples from their animals (n = 635) were tested for the presence of antibodies against Brucella by Rose Bengal Plate Test (RBPT) and indirect enzyme-linked immunosorbent assay (iELISA). Out of these, 78 (61.4%) of the herds had at least one seropositive animal, and 302 (47.6%) of the cattle were seropositive. Univariate and multivariate analysis revealed significant associations between intensive farm type (OR = 4.6; 95% CI, 1.6-16.7; P = 0.009), hygienic disposal of aborted fetuses (OR = 0.3; 95% CI, 0.08-0.9; P = 0.04) and herd seropositivity for brucellosis. The majority, 96 (75.6%) of the respondents, were males aged 18-50, and 82 (64.6%) owned a small-backyard farm. Only 51 (40.2%) of the participants knew about brucellosis; out of them, 54.9% (28/51) could not identify clinical signs of brucellosis. Six (11.8%) participants indicated abortion as the most noticeable clinical sign, and 45.1% indicated that consumption of raw milk is associated with high risk of contracting brucellosis. A large proportion of respondents confirmed that milk from their animals was regularly consumed (86.6%) and sold (59.8%) to other people. These results suggest that bovine brucellosis is endemic in Haryana, where Brucella-contaminated milk is likely being regularly sold. Brucellosis control efforts in Haryana should include education programs to raise awareness of the disease and means to control it in cattle and to prevent zoonotic transmission.

Genomic analyses in African populations identify novel risk loci for cleft palate.

Orofacial clefts are common developmental disorders that pose significant clinical, economical and psychological problems. We conducted genome-wide association analyses for cleft palate only (CPO) and cleft lip with or without palate (CL/P) with ~17 million markers in sub-Saharan Africans. After replication and combined analyses, we identified novel loci for CPO at or near genome-wide significance on chromosomes 2 (near CTNNA2) and 19 (near SULT2A1). In situ hybridization of Sult2a1 in mice showed expression of SULT2A1 in mesenchymal cells in palate, palatal rugae and palatal epithelium in the fused palate. The previously reported 8q24 was the most significant locus for CL/P in our study, and we replicated several previously reported loci including PAX7 and VAX1.

Identification of paternal uniparental disomy on chromosome 22 and a de novo deletion on chromosome 18 in individuals with orofacial clefts.

BACKGROUND: Orofacial clefts are the most common malformations of the head and neck region. Genetic and environmental factors have been implicated in the etiology of these traits. METHODS: We recently conducted genotyping of individuals from the African population using the multiethnic genotyping array (MEGA) to identify common genetic variation associated with nonsyndromic orofacial clefts. The data cleaning of this dataset allowed for screening of annotated sex versus genetic sex, confirmation of identify by descent and identification of large chromosomal anomalies. RESULTS: We identified the first reported orofacial cleft case associated with paternal uniparental disomy (patUPD) on chromosome 22. We also identified a de novo deletion on chromosome 18. In addition to chromosomal anomalies, we identified cases with molecular karyotypes suggesting Klinefelter syndrome, Turner syndrome and Triple X syndrome. CONCLUSION: Observations from our study support the need for genetic testing when clinically indicated in order to exclude chromosomal anomalies associated with clefting. The identification of these chromosomal anomalies and sex aneuploidies is important in genetic counseling for families that are at risk. Clinicians should share any identified genetic findings and place them in context for the families during routine clinical visits and evaluations.

Effect of co-doping of sodium on the thermoluminescence dosimetry properties of copper-doped zinc lithium borate glass system.

The effect of sodium as a co-dopant on the thermoluminescence (TL) properties of copper-doped zinc lithium borate (ZLB: Cu) subjected to Co-60 gamma radiation is reported in this study. TL intensity is enhanced with the introduction of sodium in ZLB: Cu. The obtained glow curve is simple with a single peak. The annealing procedure and the best heating rate for the proposed thermoluminescent dosimeter (TLD) are established, and the phosphor is reusable. The TL response within the dose range of 0.5-1000Gy is investigated. The results show that the thermal fading behaviour is improved significantly.

Rituximab as a single agent in the management of adult patients with haemophilia A and inhibitors: marked reduction in inhibitor level and clinical improvement in bleeding but failure to eradicate the inhibitor.

Management of patients with severe haemophilia A who develop inhibitors is difficult and expensive. Standard treatment of this complication is immune tolerance induction (ITI) therapy, but is successful in only 60-80% of the patients. Failure of ITI results in a higher risk of morbidity and mortality. We used rituximab, an anti-CD20 antibody, in three patients with severe haemophilia A and inhibitors. Two patients with high-titre inhibitors had marked reduction in the inhibitor level; the third patient with low-titre inhibitor had a disappearance of the inhibitor. All patients improved clinically, with fewer bleeding episodes and a better quality of life. Inhibitor level increased with time in these patients, but the clinical benefit continued in two patients with high-titre inhibitors initially, after a follow-up of 48 and 22 months. One of the patients with concomitant human immunodeficiency virus (HIV) infection and a very low CD4 lymphocyte count developed severe truncal herpes zoster after the third weekly dose of rituximab. Caution is required in such patients, and we recommend avoiding rituximab use in HIV-infected patients with very low CD4 lymphocyte count. In conclusion, rituximab is useful in reducing the inhibitor level with clinical benefit in patients with severe haemophilia A and inhibitors, but it cannot eradicate the inhibitors for long periods with the currently used protocol of up to five doses.