Bone marrow trephine biopsy: still a vital diagnostic tool in the 21th century.

Trephine biopsy is an indispensable diagnostic tool in the 21th century, even though the technique has an ancient origin, its value in developing countries is still innovative. The outcome of the marrow biopsy reports are determined by many factors, which includes detailed patient clinical information, inter departmental alliance, personnel practical knowledge and technical skill. However, molecular studies on the biopsy tissues are highly necessary and that can enhance diagnostic accuracy and also aid in personalized treatment. Method: The present review is based on a comprehensive Medline literature search and multidisplinary clinical experiences of the authors'. Result: Trepanning is still new in developing countries despite its importance, these has been highlighted especially on molecular ancillary studies and quality. Conclusion: We reviewed articles on trephine biopsy and its challenges to reemphasize its usefulness as a fundamental diagnostic tool in this era. Re-examination of the reality of the test to meet the standard is what is required

Bone marrow invasion by aspergillus specie in a sickle cell trait patient with invasive aspergillosis: a fatal case in association with disseminated intravascular coagulation

Invasive aspergillosis has been predominantly associated with pulmonary infection, particularly amongst immunocompromised individuals. Extrapulmonary infections with Aspergillus specie have been reported rarely irrespective of immune status. Risk factors for invasive aspergillosis include prolonged and severe neutropenia, haematopoietic stem cell and solid organ transplantation, advanced AIDS, and chronic granulomatous disease. The most frequently involved specie is Aspergillus fumigatus that constitutes over 90% of cases, followed by Aspergillus flavus, usually associated with a primary skin infection. Haematogenous spread to the bone causing osteomyelitis is the commonest form of disseminated aspergillosis and a surprisingly high proportion of these patients have no immunosuppression. We present a rare case of bone marrow invasion by Aspergillusspp. in a 3-year-old patient with sickle cell trait and chronic Aspergillosis. Case report: A 3-year-old patient with sickle cell trait was brought to the paediatric unit with recurrent diarrhoea, abdominal distention, weight loss and persistent cough. The child was severely wasted with generalised peripheral lymphadenopathy. She had marked respiratory distress and hepatosplenomegaly but no demonstrable ascites. Haematologic examination revealed leukaemoid reaction (leukocyte count of 44.0 x 10 /L) with monocytosis (10%) and thrombocytopenia (platelet count of 97,000/mm ); no blast cells were seen on blood film. The bone marrow was hypercellular with a myeloid/erythroid ratio of 20:1, consistent with infection. Bone Marrow culture yielded Aspergillus spp. and other results of sepsis work up were negative. Conclusion: Cases of extrapulmonary invasive aspergillosis have been reported rarely in both immunocompetent and immunocompromised patients. Haematogenous spread to the bone is the commonest form of disseminated disease

Maternal and fetal determinants of perinatal transmission of HIV among HIV positive mothers attending ANC at a northern Nigerian tertiary health institution

Objective: To ascertain the major determinants of perinatal transmission of HIV among HIV positive women attending ANC and delivery at the University of Maiduguri Teaching Hospital, Maiduguri.Patients and methods: A prospective case control study of 52 HIV positive pregnant women who were attending ANC and delivery at university of Maiduguri Teaching Hospital (UMTH) was carried out. Known HIV positive mothers sent from the adult HIV clinic and those found during ANC HIV screening and diagnosis using rapid tests were recruited, while Fetal diagnosis of HIV was done using polymerase chain reaction (PCR) technique at 6 and/or at 12 weeks of birth age. Socio demographic and obstetrics history were obtained and analyzed using SPSS version 11 and test of significance was carried out using chi square tests.Results: Of the 52 women that were found to be HIV positive, the perinatal transmission rate was 11.5%. Elective caesarean section (ELCS) was offered to 11(21.2%) and all the babies delivered through ELCS were negative for HIV. Advanced maternal age (X2 =33.53 P <0.001), Low CD4 count (X2 =15.58 P =0.016), high maternal viral load (X2 =21.85 P =0.005), prematurity (X2 = 9.872 P= 0.007), low birth weight (X2 = 63.80 P < 0.001) and birth asphyxia(X2 = 24.149 P< 0.001) were the major determinants of perinatal transmission of HIV infection in this study.Conclusion: The perinatal transmission of HIV is high. Prompt identification of both maternal and fetal risks' factors and Effective interventions aim at minimizing the impact of these factors before or during pregnancy will help to lower some of the preventable determinants of perinatal transmission.Recommendations: A prenatal and antenatal risks reduction strategy should be advocated. All effort should be geared toward identifying those positive and minimized or modify risks factors through behavior change, prompt initiation of treatment and prophylaxis for those found positive with a view to reduce the incidence of perinatal transmission.Key Words: perinatal transmission, HIV, maternal, fetal determinants, Maidugur

Two decades of neuroscience publication trends in Africa.

Neuroscience research in Africa remains sparse. Devising new policies to boost Africa's neuroscience landscape is imperative, but these must be based on accurate data on research outputs which is largely lacking. Such data must reflect the heterogeneity of research environments across the continent's 54 countries. Here, we analyse neuroscience publications affiliated with African institutions between 1996 and 2017. Of 12,326 PubMed indexed publications, 5,219 show clear evidence that the work was performed in Africa and led by African-based researchers - on average ~5 per country and year. From here, we extract information on journals and citations, funding, international coauthorships and techniques used. For reference, we also extract the same metrics from 220 randomly selected publications each from the UK, USA, Australia, Japan and Brazil. Our dataset provides insights into the current state of African neuroscience research in a global context

The involvement of tau in nucleolar transcription and the stress response

Tau is known for its pathological role in neurodegenerative diseases, including Alzheimer’s disease (AD) and other tauopathies. Tau is found in many subcellular compartments such as the cytosol and the nucleus. Although its normal role in microtubule binding is well established, its nuclear role is still unclear. Here, we reveal that tau localises to the nucleolus in undifferentiated and differentiated neuroblastoma cells (SHSY5Y), where it associates with TIP5, a key player in heterochromatin stability and ribosomal DNA (rDNA) transcriptional repression. Immunogold labelling on human brain sample confirms the physiological relevance of this finding by showing tau within the nucleolus colocalises with TIP5. Depletion of tau results in an increase in rDNA transcription with an associated decrease in heterochromatin and DNA methylation, suggesting that under normal conditions tau is involved in silencing of the rDNA. Cellular stress induced by glutamate causes nucleolar stress associated with the redistribution of nucleolar non-phosphorylated tau, in a similar manner to fibrillarin, and nuclear upsurge of phosphorylated tau (Thr231) which doesn’t colocalise with fibrillarin or nucleolar tau. This suggests that stress may impact on different nuclear tau species. In addition to involvement in rDNA transcription, nucleolar non-phosphorylated tau also undergoes stress-induced redistribution similar to many nucleolar protein

Health seeking behaviour of infertile women in Gombe, north eastern Nigeria

Context: Health seeking behaviour of infertile women is an area that has received scant attention in our environment.Objective: To document the health seeking behaviour of infertile women in Gombe, Northeastern Nigeria.Study Design, Setting and Subjects: This is a cross sectional study of infertile women seen at the gynaecological clinic of the Federal Medical Centre Gombe from January 2005 to December 2005. A total of 119 infertile women were interviewed.Results: They were aged 22-40 with a mean of 27.81+4.727years. The majority, 85(71.4%) were in their second and third decades. Only 37 (31.1%) had living children. Most, 69(58%) had post-secondary education with 32(26.9%) being non literate. The parity ranged from 0-2 with a mean of 0.50 + 0.535. Majority, 68 (57.1%) were Muslims while Christians made up 51(42.9%). Almost 40% sought for care more than three years after being unable to conceive with only 27(22.7%) being cared for by specialists. Sixty five (55%) had previously visited an orthodox health institution, while 60(50.4%) used traditional medication. Most of the traditional healers visited were herbalists (18.5%) native doctors (16.8%) and marabout's (10.1%). Most of those childless were Muslims (X2=23.615, P=0.000). The Muslims also tended to seek help later than their Christian counterparts (X2=49.132, P=0.000). Health seeking behaviour is significantly influenced by education (X2=2.747, P=0.000). Parity significantly influenced health seeking behaviour with the parous more likely to delay seeking help (X2=71.457, P=0.000).Conclusion: Delay in seeking care and patronage of traditional healers and non specialist tend to procrastinate arrival to appropriate health facility.Key words: health seeking behaviour, infertility, women, Gomb

Caesarean delivery at the Federal Medical Center Gombe: A 3-year experience

No Abstract

The prevalence of hookworm infection among patients attending Sunni Private Clinic, Maiduguri, Nigeria

This study was conducted using the moist-filter paper-strip-faecal smear method for larval culture to determine the prevalence of hookworm infections among patients attending Sunni Private Clinic, Maiduguri. A total of 60 patients were examined out of which 27 (45.0%) were infected. Fifteen (55.6%) had Necator americanus, while 12(44.4%) had Ancylostoma duodenale (p>0.05). Male patients were more infected (52.0%) compared to the females with (40.0%) (p>0.05). Age groups of < 20 years were significantly (p20 years with (29.4%). The mean ± SD packed cell volume values (PCV %) for male and female patients were 34.5 ± 7.8 and 30.0 ± 2.8 respectively, while for the ages 20 years were 31.0 ± 1.4 and 35.0 ± 7.1 respectively. These findings are discussed with reference to the improvement of sanitary conditions and health education programme of the metropolitan communities

Sexual Assault against Female Nigerian Students

Sexual assault is a common social disorder among students in our tertiary institutions. This study ascertains the extent and effect of sexual assault among Nigerian students. Two hundred and Sixty Eight structured questionnaires were distributed to randomly selected students in 4 tertiary institutions, information on socio demography, sexual history and consequences of their exposure were obtained for analysis and interpretation. Thirty seven (13.8%) of the respondents were sexually assaulted as a student and 19 (7.1%) were assaulted by their lecturers and fellow students, Younger age at coitarche, history of forced coitarche, marriage, coitarche with relations and unknown persons, significantly influenced subsequent risks of sexual assault. Improve security, moral behaviours enforcing dress code and stiffer penalties were suggested ways to prevent sexual assault among the students. Sexual assault is still a common finding in our institutions; effort should be made by all stake holders to prevent this social embarrassment (Afr. J. Reprod. Health 2010; 14[3]: 189-193).Key words: Sexual assault, female, students, Nigeria, tertiary institutions

Prevalence of Preinvasive Lesions of the Cervix in Maiduguri, North-Eastern Nigeria

Cervical cancer is the leading cause of cancer related mortality in developing countries. The lack of routine cytological screening in developing countries is mainly responsible for this unacceptably high mortality. Early detection of pre-invasive disease has reduced mortality from invasive cancer in developed countries. The opportunistic screening services offered in most of the developing countries is unlikely to have a similar effect. To determine the prevalence of pre-invasive lesions of the cervix. A 15year review of Papanicolau smear for cervical cytology carried out from January 1993 to December 2007. Of the 2082 cervical cytology reports, 162 smears showed cervical intraepithelial neoplasia (CIN), thus giving 7.8% as the prevalence of CIN. Cervical intraepithelial neoplasia 1 (CIN1) was seen in 87 (53.7%), CIN 11 in 56 (34.6%), and CIN 111 in 19 (11.7%). Invasive cervical cancer was suspected in 13 (0.6%) of the 2082 slides reviewed. One hundred and sixty six (7.9%) of the smears were unsatisfactory. The utilization of cervical cancer screening in Maiduguri is abysmally low. There is the need for increase awareness and utilization of Papanicolaou smear. Reasons for the low patronage need to be found so that appropriate measures are put in place to improve coverage