Survey of urologists on clients’ demand for screening for prostate cancer in Nigeria

Objective: The aim of this article is to document the experience of urologists on clients’ demand for prostate cancer screening among Nigerians.Materials and Methods: The study is a cross-sectional evaluation of the urologists that attended the Fourteenth Annual Meeting and the Scientific Conference of the Nigerian Association of Urological Surgeons. A structured questionnaire was used to assess the estimated workload of the respondents, with reference to prostate cancer management, the stage proportion at the time of diagnosis, and the proportion of patients requesting for CaP screening. The data was analyzed using the SPSS version 15 statistical software.Results: Twenty-two respondents completed and returned the questionnaire and formed the basis of further analysis. About 76.9% of the consultant urologists were also lecturers in their respective universities. They were all actively practicing and a majority of them, 76.9%, had up to 10 years experience as practicing urologists. The majority of the respondents managed between one and fifteen new patients with CaP every month, with 36.4% of them managing more than 15 new patients on an average every month. About 95.4% of all the patients seen by the respondents were diagnosed with advanced stages of the disease, while the remaining ones were incidental findings. About one half of the respondents attended to clients seeking for advice on CaP ‘often’ or ‘very often,’ while 40.9% attended to them ‘occasionally,’ with a mean of 4.67 clients seeking advice per month. The majority of respondents, 20 (22); 90.9%, were ‘not aware’ of any national guideline on CaP screening.Conclusions: A majority of practitioners affirmed that patients with prostate cancer present late. The mean number of patients requesting for screening for prostate cancer per month, per respondent, for CaP, is still low. It is the authors’ belief that the trend may not change until there is an appropriate effort at health education, to enlighten the populace

Effect of n-3 and n-6 fatty acid supplementation on fetal, gestation and parturition in pregnant Sprague Dawley rats

The aim of this study was to evaluate the effect of different ratio of n-6:n-3 on gestation and parturition as well as to determine the hormone concentration on plasma of the pregnant rats. At the end of the trial period, blood plasma was collected and analysed for progesterone, estradiol and prostaglandin F2α hormone (PGF2α) concentrations, and fatty acids profile. The results indicated that the group with a very low ratio of n-6:n3 fatty acids (diet 1) showed increased concentration of progesterone in the plasma (P<0.05), while the group with high ratio of n6:n3 fatty acids (diet 3) with high arachidonic acid (AA) showed significantly (P<0.05) increased concentration of estradiol and PGF2α in the plasma. The n-3 polyunsaturated fatty acids (PUFA) in plasma of diet 1 group were significantly (P<0.05) higher than the other treatment diet groups. The total n-6 PUFA was significantly higher (P<0.05) in diet 3 group as compared to diet 1 group. In contrast, the number of implanted embryos was significantly lower (P<0.05) in the diet 3 group at 15 days of gestation, while, the litter size were significantly lower in the diet 2 group and diet 3 group by 4.57 and 1.00 folds respectively, as compared to the control group (diet 4). In conclusion, for the rat with very low ratio on diet 1, the n-6:n-3 ratio satisfied the requirement for the growth of mother and fetuses but was inadequate for the normal process of parturition, probably through inadequate production of the prostaglandins involved.Key words: n-6:n-3, plasma fatty acids, progesterone, estradiol, prostaglandin production, pregnant rat

Effect of dietary n-6 to n-3 polyunsaturated fatty acid ratio on prostaglandin plasma levels and genes expression peroxisome proliferator-activated receptor (PPAR) in pregnant Sprague Dawley rats

The peroxisome proliferator-activated receptors (PPARs) are a family of nuclear transcription factors thought to act as receptors for polyunsaturated fatty acids and to reduce production of series 2 prostaglandins (PG). The objective of this study was to investigate the effect of different ratio n-6:n-3 on the PPAR expression of rats endometrial tissue. The findings obtained from this study showed significant induction of PPARδ mRNA levels in endomatral cells treatment 1:1 group by 1.38 fold compared with the PPARδ mRNA levels in endomatral cells treatment 30:1 group. This induction was due to the cellular demands for prostaglandin were high in the endometrial cells when cells were treated with high ratio n6:n3 on 30:1 group, thus, resulting in an increase in both prostaglandin PGE2 and PGF2α production by induction of PPARδ genes. On the other hand, treatment 1:1 group and control group of endometrial cells did not show any significant changes in mRNA level of PPARδ, compared with treatment ratio n6:n3 on 6:1 group and treatment high ratio n6:n3 on 30:1 group of the endometrial cells. These findings show that inhibition of uterine PGF2α synthesis by n-3 fatty acids may depend on the amount of n-6 fatty acids reaching the target tissue. In conclusion, PPARδ function in the response of rat endometrium to long chain n-6:n3 polyunsaturated fatty acids.Key words: Polyunsaturated fatty acid, gene expression, peroxisome proliferator-activated receptor, prostaglandin, pregnancy rat

Perineo-penile Degloving Exposure in Quartey's Urethroplasty: A Preliminary Report

Objective: To present a technique of stricture exposure in Quartey's urethroplasty. Methods: A retrospective analysis of case files of seven patients that underwent perineo-penile degloving (PPD) exposure for Quartey's urethroplasty was done and formed the basis of this communication.The perineo-penile degloving exposure involves a midline perineal incision to expose the bulbar urethral and a circumcising incision to deglove the penis which is later delivered to the perineum through the retro-scrotal tunnel. The urethroplasty is then done in a single operation field. Results: Seven patients with long segment urethra stricture were repaired using PPD exposure during the study period. The age ranged from 35 to 70 years with a mean of 48.6±11.1 years. The peno-bulbar site was involved in six (85.7%) of the patients. The mean intra-operative length of the stricture is 7.6±1.5cm. All the patients had Quartey's flap for their reconstruction under spinal anaesthesia with mean operation time of 3.16±0.50 hours (range 2.30 – 4.00 hours). They all had ventral on-lay repair except for one patient who had tubularization of the flap and anastomosis. Three of the patients had excellent short-term outcome. However, one patient developed slight distal penile skin necrosis, two patients had perineal wound infection and one patient could not void despite patent urethra postoperatively. Of the patients, only one had extravasation of contrast on pericatheter urethrogram which warranted leaving the urethral catheter for one more week. The mean follow-up period was 8.3±4.5 months with a range of 3 to 14 months. There has being no evidence of recurrence clinically or urodynamically thus far. Conclusion: PPD is convenient and allows tension-free, water-tight reconstruction in a single operation field with a comparable short-term outcome. Key words: urethral stricture, Quartey's urethroplasty, perineo-penile degloving, exposure

Juvenile Dermatomyositis in a Nigerian Girl: a Case Report.

A case of Juvenile dermatomyositis (JDM) in a 10 year old Nigerian girl is herein reported to discuss some of the features of the disease and challenges in management of such a rare but crippling autoimmune vasculopathy of childhood. She was referred to the University of Maiduguri Teaching Hospital (UMTH) with an eight-month history of recur rent fever, abdominal pain, and a four-month history of body rash and inability to walk or sit. Muscle biopsy and clinical findings consistent with JDM were found. Her condition improved with steroids, cytotoxic therapy and physiotherapy. Some invest igat ion and t reatment modalities could not be accessed for the benefit of the patient. Although, the outcome of patients with JDM has improved with the discovery of steroids, the disease is shown to have a variable course, with attendant social and financial implications especially to the immediate family

Leaf epidermal studies of four species of Chlorophytum Ker- Gawl in Nigeria

Studies of the foliar epidermal morphology in four species of Chlorophytum; C. orchidastrum , C. bichetii , C. stenopetalum and C. macrophyllum revealed the presence of stomata on both sides of the leaves(amphistomatic stomata distribution). In C. orchidastrum, few stomata are present on the adaxial surfaces. Stomata type has no diagnostic importance as all the species studied have tetracytic stomata. Stomata index (<10%) on the adaxial surface in C. orchidastrum easily distinguished the species from others. In C. bichetii and C. macrophyllum stomata index (<50%) was recorded while stomata index (>50%) was recorded for C. stenopetalum on the adaxial surface. Stomata index on the abaxial surface also shows that fewer stomata occur in C. macrophyllum compared with C. stenopetalum. The studies also revealed smooth leaf margin for C. orchidastrum. Papillea out growth were observed on the leaf margin of C. stenopetalum and C. macrophyllum, Papillea projections were however more pronounced in C. bichetii. Leaf epidermal character is hereby indicated as an important tool in delimiting species in the genus Chlorophytum

Microbiological Quality of some Expired Drugs in Sokoto Metropolis, Nigeria

Twenty eight samples of expired drugs were obtained from different medical stores including Sokoto State Medical Store in Sokoto Metropolis. The drugs included paracetamol, vitamin C (Ascorbic acid), Phenergan (promethazine), Chloroquine (A 4–aminoquinoline acid), flagyl (metronidazole), folic acid (Pteroylglutamic acid), tablets and vitamin A injection (Retinol). The tablets were ground into powder using sterile pestle and mortar. Powder of each tablet (0.2g) and 0.2ml vitamin A injection was dispensed into 9ml sterile nutrient broth. After incubation for 24 hours, a loopful from the growth was subcultured into nutrient agar and malt extract agar plates. The nutrient agar plates were incubated at 37oC for 24 hours and the Malt Extract plates were incubated at 26oC for 3-7 days After incubation, the organisms were identified using a combination of microscopy and biochemical tests. For each drug, the procedure was repeated four times. The frequency of occurrence of each organism was determined and found to be: Aspergillus niger 28(60%); Aspergillus flavus 28(32%); Penicillium spp. 28(14%); Scopulariopsis spp. 28(7%); Neurospora spp. 28(7%); Mucor sp. 28(4%); Enterococcus avium 28(35%); Staphylococcus aureus 28(29%); Enteococcus gallinarum 28(25%); Staphylococcus epidermidi, 28(17%); Enterococcus durans 28(14%) and Staphylococcus saccharolyticus 28(14%). The results demonstrated the involvement of pathogenic microorganisms; therefore, expired drugs should not be consumed no matter how neat they may appear

Effect of Neem Extracts (Azadirachta indica) on Bacteria Isolated from Adult Mouth

The antibacterial activity of the bark, Leaf, Seed and fruit extracts of Azadirachta indica (neem) on bacteria isolated from adult mouth was carried out using agar- well diffusion method. The test bacteria were isolated from patients attending Usmanu Danfodiyo University Teaching Hospital, Sokoto. The bark and leaf extracts showed antibacterial activity against all the test bacteria used. The zone of inhibition increased with increase in concentrations of the extracts. The seed and fruit extracts showed antibacterial activity only at higher concentrations. The results, therefore, confirm the traditional use of neem in maintaining oral hygiene