Late third trimester ultrasound diagnosis of duodenal atresia - the importance of detailed prenatal ultrasound screening

Duodenal atresia (DA) is the commonest type of congenital small bowel obstruction usually presenting in the neonatal period. About half of fetuses with duodenal atresia have other associated anomalies, and these associations often contribute to morbidity and mortality. DA can be fatal unless promptly diagnosed and treated surgically. In experienced hands and in countries where prenatal ultrasound screening for anomalies is routine, DA can be confidently diagnosed prenatally, which can help in reducing the perinatal morbidity and mortality associated with diagnosis after delivery.We report a case of DA diagnosed by ultrasonography at 36 weeks gestation in a 34 year old multiparous woman in a hospital where targeted prenatal ultrasound screening for fetal anomalies was recently introduced, and reviewed relevant literatureKeywords: Prenatal Ultrasound screening, Duodenal Atresi

Prevalence of prenatal ultrasound diagnosed single umbilical artery in a cohort with associated congenital malformations

Introduction: Single umbilical artery (SUA), a developmental abnormality of the umbilical cord occurs following primary agenesis or secondary atrophy of one of the arteries. It occurs in 0.08%–2% of pregnancies and associated with intrauterine growth restriction, preterm delivery, stillbirth, and congenital anomalies. Usually, the attending midwife or doctor determines the number of umbilical arteries at delivery. However, with the advent of prenatal ultrasound screening, the umbilical cord vessels can be determined as early as 14 weeks prenatally. The study aimed at determining the prevalence of SUA in University College Hospital (UCH), Nigeria, with associated anomaly (ies).Materials and Methods: This is a prospective cohort study of 989 fetuses who had detailed anomaly scan over 4 years at the ultrasound unit of the antenatal clinic, UCH.Results: Sixty‑two fetuses had various anomalies, of which three had SUA, and these cohorts were followed up. The prevalence of SUA was 0.3% in both singleton and multiple gestations. Other anomalies detected with SUA include abnormal‑shaped head, hypoplastic cerebellum, bilateral renal pyelectasis, bilateral ventriculomegaly, cavum septum defect, and ventricular septal defect.Conclusion: SUA is more common in twin gestations than in singletons, and if found in a fetus, it is a high risk for other anomalies which must be determined prenatally.Keywords: Congenital anomalies; prenatal; prevalence; single umbilical arter

Pattern of Midface Trauma with Associated Concomitant Injuries in a Nigerian Referral Centre

Aim: The aim of this study was to determine the pattern of midface trauma with associated concomitant injuries seen in our environment. Methodology: This was a prospective analysis of trauma patients with midfacial injuries presenting at a referral center in South West Nigeria. In addition to socio‑demographic data, the following information was also obtained: Mechanism of injuries, type of midfacial injuries, concomitant/associated injuries and treatment. Results: A total of 101 patients with midfacial injuries were involved. They were made up of 85 males and 16 females. The 20‑29 year age group was mostly affected (44.6%) and the most common cause of midface injuries was road traffic accident (91.1%). The zygoma was fractured more than any other midfacial bone (46.0%). A total of 144 associated injuries were recorded among these patients, head and ocular injuries accounted for 49 (34%) and 35 (24.3%) respectively. The patients were mostly treated conservatively or by closed reduction. Conclusion: The rate of head and ocular injuries among patients with midfacial injury was high. Knowledge of these associated injuries provides useful strategies for patient care and prevention of further complications. A multidisciplinary approach is important for optimum management of these patients.Keywords: Concomitant injuries, midface trauma, multidisciplinary car

Trends of oral cancer in University College Hospital, Ibadan, Nigeria

Objective: The aim of this study was to describe the trend and recent pattern of oral cancer in the University College Hospital, Ibadan, Nigeria. Method: A retrospective analysis of all cases of oral cancer (excluding lymphoid cancers) documented in the records of the Departments of Oral and Maxillofacial Surgery and Pathology, University College Hospital (UCH), Ibadan, from the year 1983 to 2007 was done. The analysis of the data collected was compared with three earlier studies in this same centre and the published literature in general. Result: Over the 25-year-period a total 450 cases of oral cancer were recorded. More than half of the cases were squamous cell carcinomas (SCC) and 58.0% of these occurred in the palate which was the commonest site. Compared with previous studies, the male to female ratio of 1.4:1 revealed a higher number of females, and more patients were recorded in the first and tenth decades of life. Conclusion: The trends in oral cancer prevalence in UCH, Ibadan, show that oral SCC, still occurs commonly in the palate in our environment, and constituted the bulk of oral cancer. In addition, more females and patients within the extremes of age are being increasingly affected. There is before a need for more investigations into the possible aetiological factors in our environment in order to offer a preventive approach to the management of the disease

In-silico and in-vivo comparative evaluation of the cardioprotective potential of Yellow turmeric and White turmeric in Mn-induced cardiac oxidative stress

Introduction The effect of the ethanol extracts of Curcuma longa Linn (yellow turmeric) and Curcuma zedoaria Rosc (white turmeric) on cardiac oxidative stress in rats exposed to manganese was evaluated in this study. Methods We divided 60 Wistar rats into 12 groups (n = 5) with some administered different concentrations of yellow or white turmeric extract. The animals except the control groups were exposed to manganese on days 1,3, and 7. All the animals were sacrificed on the 8th day and the hearts were harvested for biochemical assays. Ferric-reducing antioxidant power (FRAP) and the levels of cardiac superoxide dismutase, reduced glutathione, nitric oxide, and lipid peroxidation in rats were determined. Additionally, in silico studies were performed to further compare the cardioprotective potential of the two species of turmeric. Results The results showed that rats treated with manganese alone had decreased levels of FRAP, superoxide dismutase, and glutathione but increased levels of nitric oxide and lipid peroxidation were observed. The Mn-induced oxidative stress was ameliorated in animals co-treated with yellow or white turmeric. The yellow turmeric showed better activity than white turmeric. In the in-silico evaluation, phytocompounds from yellow turmeric had higher binding energy against Nuclear factor erythroid 2-related factor 2 (NRF2) protein than the ones from white turmeric. Bioactive compounds from white turmeric did not violate any of Lipinski's rules of five or three, despite having lower binding energy. Conclusion These findings suggest that ethanol extract of yellow and white turmeric may have the potential to ameliorate manganese-induced cardiac oxidative stress

Bilateral Transverse Facial Cleft as an Isolated Deformity

Transverse facial clefts are rare deformities, these mostly occur as part of syndromes such as facial dysostosis and branchial arch syndrome. This is a report of a case of isolated, asyndromic bilateral facial cleft seen at a semi-urban specialist hospital. Congenital facial defects remain sources of mental and social stress to the families. Infanticide, perhaps a thing of the past in the developed world may still be practiced in cases of congenital deformities in the developing countries, hence the need for early involvement of social workers and clinical psychologist in management.Facials fendus transverse sont des d\ue9formit\ue9s rares, le plus souvent, ils arrivent comme une partie des syndromes tels que facial dysostose et syndrome branchial arch. Il s'agit d'un rapport d'un cas isol\ue9, facial fendu asyndromique bilat\ue9rial vu dans un h\uf4pital specialiste semi-urban. D\ue9fauts facials cong\ue9nitaux est toujours les sources du stress social et mental pour des familles. L'enfanticide, peut-\ueatre une chose du pass\ue9 dans le monde d\ue9velopp\ue9 pourrait \ueatre en pratique dans les cas des d\ue9formit\ue9s cong\ue9nitales dans les pays en voie de d\ue9veloppement, donc, le besoin pour une participation pr\ue9coce des ouvriers social et psychologiste clinique dans la prise en charge

Comparative antioxidant activity, total phenol and total flavonoid contents of two Nigerian ocimum species

Antioxidants are compounds which act as a major defense against oxidative stress caused by free radicals. In this study, a comparative evaluation of the antioxidant properties, phenolic and flavonoid contents of the methanolic extracts of Ocimum gratissimum Linn and Ocimum canum Sims was carried out. Crude extracts of both plants were obtained by maceration of powdered plant materials in methanol (80%) for 24hrs. The phenolic and flavonoid contents were determined using standard methods while the antioxidant capacities were evaluated using six different in vitro radical scavenging assays: total antioxidant potential, reductive potential, I, 1-diphenyl-2-picryl-hydrazyl (DPPH) free radical scavenging, lipid peroxidation inhibition, hydroxyl radical and nitric oxide scavenging activity. The total phenolic content in O. gratissimum and O. canum were found to be 32.66 ± 6.21 and 17.19 ± 2.54 mg GAE/g dw while total flavonoid content gave 1.94 ± 0.23 and 0.67 ± 0.01 mg QUE/g dw, respectively. Both extracts had effective reductive potential as well as exhibited strong total antioxidant capacity with increasing concentration of extract. Comparatively, O. gratissimum exhibited a significantly (p < 0.05) higher capacity to quench the DPPH free radical with IC50 value of 26.01 ± 3.2 µg/ml than O. canum, which has an IC50 value of 60.45 ± 5.22 µg/m. O. gratissimum also significantly inhibited membrane lipid peroxidation and hydroxyl radical formation with IC50 of 99.37 ± 8.56 µg/ml and 465.33 ± 21.62 µg/ml, respectively while O. canum correspondingly gave IC50 values of 447.5 ± 35.61 µg/ml and 868.16 ± 43.05 µg/ml. In the nitric oxide scavenging activity, however, O. canum showed a stronger inhibitory effect than O. gratissimum as indicated by their IC50 values of 277.22 ± 15.09 µg/ml and 731 ± 56.99 µg/ml, respectively. These activities are however several folds lower than those of butylated hydroxyl toluene (BHT), ascorbic acid and quercetin used as antioxidant standards. The results demonstrate that O. gratissimum has greater antioxidant capacity than O. canum because of its relatively higher radical scavenging activity in all antiradical tests carried out except the nitric acid scavenging test and higher contents of flavonoid and phenolic compounds. O. gratissimum is therefore more beneficial therapeutically than O. canum since it provides better defense against free radical induced oxidative stress, and this attribute probably explains its relative preference in ethnomedicine for both culinary and medicinal purposes amongst the Ocimum species widely cultivated in South Western Nigeria

Team approach concept in management of oro-facial clefts: a survey of Nigerian practitioners

<p>Abstract</p> <p>Background</p> <p>Cleft palate craniofacial teams have evolved across the globe in the last 20 years in compliance with the interdisciplinary concept of management of oro-facial clefts. An interdisciplinary care allows a coordinated treatment protocol for the patient. The objective of this study was to evaluate oro-facial cleft care in Nigeria with particular emphasis on the compliance of the practitioners to the team approach concept.</p> <p>Methods</p> <p>A snapshot survey was conducted among specialists that attended the Pan African Congress on Cleft Lip and Palate, at the International Institute of Tropical Agriculture, Nigeria in February 2007.</p> <p>Result</p> <p>Sixty three respondents successfully completed and returned the questionnaire for analysis. Mean age of respondents was 43.5 years and the range was 38–62 years.</p> <p>Male to female ratio was 2.7:1. Oral and Maxillofacial Surgeons and Plastic Surgeons constituted the majority of respondents (38.1% and 22.2%) respectively. Only 47.6% (n = 30) of the specialists belonged to cleft teams. Majority of Oral and Maxillofacial Surgeons and Plastic Surgeons belonged to cleft teams (70% and 63.3% respectively) while speech pathologists and orthodontists were less represented (20% and 36.7% respectively) in teams.</p> <p>Conclusion</p> <p>Findings from this study suggests that interdisciplinary care for the cleft patient does not appear to have been fully embraced in Nigeria. This may be a result of several reasons ranging from non availability of the requisite specialists, the relatively young age of cleft care practice in this part of the world to the poor state of infrastructure.</p

MODULATION OF KEY BIOCHEMICAL MARKERS RELEVANT TO STROKE BY ANTIARIS AFRICANA LEAF EXTRACT FOLLOWING CEREBRAL ISCHEMIA/REPERFUSION INJURY

Background: Oxidative stress plays a significant role in stroke pathogenesis. Hence, plants rich in antioxidant phytochemicals have been suggested as effective remedies for prevention and treatment of stroke and other neurological diseases. Antiaris africana Engl. (Moraceae) is traditionally used for the management of brain-related problems but there is paucity of data on its anti-stroke potential. Materials and Methods: Ischemia/reperfusion injury was induced by a 30 min bilateral common carotid artery occlusion/ 2 h reperfusion (BCCAO/R) in the brain of male Wistar rats. A sham-operated group which was not subjected to BCCAO/R and a group subjected to BCCAO/R without treatment with MEA served as controls. The ameliorative effect of 14 days of pretreatment with 50 mg/kg or 100 mg/kg A. africana methanol leaf extract (MEA) on BCCAO/R-mediated alterations to key markers of oxidative stress (malondialdehyde, reduced glutathione, xanthine oxidase, superoxide dismutase, catalase and glutathione peroxidase) and neurochemical disturbances and excitotoxicity (myeloperoxidase, glutamine synthetase, Na+/K+ ATPase, acetylcholinesterase and tyrosine hydroxylase), was evaluated and compared with the effect produced by treatment with 20 mg/kg quercetin as a reference standard. Results: Results show that pretreatment with MEA significantly mitigated or reversed BCCAO/R-induced changes in the level or activity of the evaluated biochemical markers of oxidative stress, neurochemical dysfunction and excitotoxicity compared with the BCCAO/R untreated control group (p < 0.05). The effect produced by 100 mg/kg MEA was similar to that of the reference standard, quercetin. Conclusion: These results revealed the neuroprotective potential of A. africana in stroke and other ischemia-related pathologies. Key words: brain ischemia

Antifungal, anti-inflammatory and cytotoxicity activities of three varieties of Labisia pumila benth : from microwave obtained extracts.

Background: Labisia pumila, locally known as Kacip Fatimah, is a forest-floor plant that has tremendous potential in the herbal industry. It is one of the five herbal plants identified by the government as one of the national key economic areas to be developed for commercial purposes. There are three varieties of L. pumila namely, L. pumila var. pumila, L. pumila var. alata and L. pumila var. lanceolata and each has its own use.Methods: The leaves and roots of the three varieties of L. pumila Benth. were extracted using microwave assisted extraction (MAE). Antifungal activity of all plant extracts were characterized against Fusarium sp., Candida sp. and Mucor using the agar diffusion disc. Anti-inflammatory assays were performed using NO production by macrophage RAW 264.7 cell lines induced by LPS/IFN-g and cytotoxic activity was determined using several cancer cell lines and one normal cell line.Results: The overall result demonstrated that leaf and root extracts of all three varieties of L. pumila exhibited moderate to appreciable antifungal activity against Fusarium sp., Candida sp. and Mucor compared to streptomycin used as positive control. Leaf and root extracts of all varieties significantly decreased NO release. However, the root extracts showed higher activity compared to the leaf extracts. Cytotoxic activity against MCF-7, MDA-MB-231 and Chang cell lines were observed with all extracts.Conclusions: These findings suggest the potential use of L. pumila Benth. as a natural medicine and indicated the possible application of this medicinal plant such anti inflammatory activity and cytotoxic agents