Neuro-ophthalmic Manifestation Of Nasopharyngeal Carcinoma At Ilorin: A Five Year Review

Patients with Nasopharyngeal Carcinoma (NPC) may present with neuro-ophthalmic symptoms including visual loss. Involvement of the cranial nerves have been found to impact significantly on the individual\'s 5 year survival rate,whichmakes an early diagnosis of this condition of great importance in the management ofNPC. Aretrospective reviewof all patients with clinical and histological diagnosis of NPC over a five year period between 1999 and 2003was carried out. Information retrieved from the records include their age, symptoms and signs with emphases on neuro-ophthalmic at presentation. Data were analysed using SPSS statistical package. Twenty records out of the 23 patients with a diagnosis of NPC seen during this period were available for review.The age rangewas between 20 and 60years, theMeanwas 38.9years, SD11.62. Sixty percent of the patients had neuroophthalmic manifestation with symptoms such as ocular pain, double vision, loss of vision and eye protrusion and signs such as ophthalmoplegia, exposure keratopathy and proptosis in various combinations. Neuro-ophthalmic manifestations were commonly found among patients diagnosed as NPC at Ilorin. A high index of suspicion of NPC whenever a patient presents with neuro-ophthalmic signs and symptomis advocated. Keywords: Nasopharyngeal Carcinoma,Neuro-ophthalmic. Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 376-37

Travel burden and clinical presentation of retinoblastoma: analysis of 1024 patients from 43 African countries and 518 patients from 40 European countries

BACKGROUND: The travel distance from home to a treatment centre, which may impact the stage at diagnosis, has not been investigated for retinoblastoma, the most common childhood eye cancer. We aimed to investigate the travel burden and its impact on clinical presentation in a large sample of patients with retinoblastoma from Africa and Europe. METHODS: A cross-sectional analysis including 518 treatment-naïve patients with retinoblastoma residing in 40 European countries and 1024 treatment-naïve patients with retinoblastoma residing in 43 African countries. RESULTS: Capture rate was 42.2% of expected patients from Africa and 108.8% from Europe. African patients were older (95% CI -12.4 to -5.4, p<0.001), had fewer cases of familial retinoblastoma (95% CI 2.0 to 5.3, p<0.001) and presented with more advanced disease (95% CI 6.0 to 9.8, p<0.001); 43.4% and 15.4% of Africans had extraocular retinoblastoma and distant metastasis at the time of diagnosis, respectively, compared to 2.9% and 1.0% of the Europeans. To reach a retinoblastoma centre, European patients travelled 421.8 km compared to Africans who travelled 185.7 km (p<0.001). On regression analysis, lower-national income level, African residence and older age (p<0.001), but not travel distance (p=0.19), were risk factors for advanced disease. CONCLUSIONS: Fewer than half the expected number of patients with retinoblastoma presented to African referral centres in 2017, suggesting poor awareness or other barriers to access. Despite the relatively shorter distance travelled by African patients, they presented with later-stage disease. Health education about retinoblastoma is needed for carers and health workers in Africa in order to increase capture rate and promote early referral

Surface-modified polyacrylonitrile nanofibers as supports

Polyacrylonitrile nanofibers (PAN-nfs) are one of the most studied nanofibres because of their excellent characteristics, such as good mechanical strength, chemical resistance, and good thermal stability. Due to the easy dissolution in polar organic solvents, PAN-nfs are mostly produced via electrospinning technique. The electrospun PAN-nfs surfaces are relatively in-active and hydrophobic, and, therefore, hinder some potential applications; however, chemical surface modification reactions, such as amination, reduction, hydrolysis, and amidoximation, have been carried out on them. These reactions bring about functional groups, such as amine, hydroxyl, carboxylic, imine etc, to the surface PAN-nfs and invariably make their surfaces active and hydrophilic. The surface-modified PAN-nfs have been used as supports for organic compounds, enzymes, and antibodies in biological studies. They have also been used for immobilization of various organic ligands for adsorption of metal ions in water. Furthermore, because of their ability to complex metal ions, several surface-modified PAN-nfs have also been used as supports for transition metal catalysts in Fenton’s chemistry.IS

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Paediatric end-stage renal disease in a tertiary hospital in South West Nigeria

Background: Children and adolescents with end-stage renal disease (ESRD) in sub-Saharan Africa may have the worst outcomes globally. Barriers to management include late presentation, poor socioeconomic conditions, absence of medical insurance, limited diagnostic facilities and non-availability of chronic renal replacement therapy (RRT). Our study was to determine the incidence, aetiology, management and outcomes of paediatric ESRD in a tertiary hospital in Nigeria. Methods. A retrospective case review of paediatric ESRD at the University College Hospital Ibadan, Nigeria, over 8 years, from January 2005 to December 2012. Results: 53 patients (56.6% male), median age 11 (inter quartile range 8.5-12) years were studied. Mean annual incidence of ESRD in Ibadan for children aged 14 years and below was 4 per million age related population (PMARP) while for those aged 5-14 years it was 6.0 PMARP. Glomerulonephritis was the cause in 41 (77.4%) patients amongst whom, 29 had chronic glomerulonephritis and 12 had nephrotic syndrome. Congenital anomalies of the kidneys and urinary tract (CAKUT) accounted for 11 (21.2%) cases, posterior urethral valves being the most common. Acute haemodialysis, acute peritoneal dialysis or a combination of these were performed in 33 (62.3%), 6 (11.3%) and 4 (7.5%) patients respectively. Median survival was 47 days and in-hospital mortality was 59%. Conclusions: Incidence of paediatric ESRD in Ibadan is higher than previous reports from sub-Saharan Africa. Glomerulonephritis, and then CAKUT are the most common causes. Mortality is high, primarily due to lack of resources. Preventive nephrology and chronic RRT programmes are urgently needed