Molecular screening of S769N mutation for PFATPASE in subjects with plasmodiasis in Owo

Background: The emergence and spread of drug-resistant Plasmodium falciparum is a major problem of public health concern. Due to the high incidence of parasite resistance to antimalarial drugs, artemisinin-based combination therapies (ACTs) have now replaced those failing drugs in order to combat the growing drug resistance.Aim: This study is undertaken to detect resistant strains of P. falciparum to artemisinin in infected human blood in Owo.Methods: A total of 1000 participants took part in the study. Falciparum malaria was confirmed by microscopic examination of Giemsastained blood samples from patients who presented with fever at Federal Medical Centre, Owo, Ondo state, Nigeria. Molecular methods were employed to detect a marker of resistance of P. falciparum to artemisinins: Parasite DNA was extracted from patient blood using Tris-EDTA buffer-based extraction method. Amplification was carried out by Nested Polymerase Chain Reaction followed by Restriction Fragment Length Polymorphisms (PCR/RFLP) for the detection of falciparum sarco/endoplasmic reticulum calcium dependent ATPase (SERCA) PfATPase6 gene mutation.Results: The result showed that resistant PfATPase6 gene which codes for artemisinin resistance was not present in the population studied.Conclusion: Since there was no resistant gene detected in the population studied, it could be said that artemisinin resistance has not yet developed in this area and subsequent monitoring of resistance pattern to artemisinin based therapy is advised in order to detect and prevent its spread.Keywords: Artemisinin, pfATPase, falciparum malaria, S769N mutation, polymorphism, drug resistanc

A Comparative Analysis of Ganglion Cell Complex Parameters in Nigerian Negroes with Glaucoma and Macular Disease

Aim: To evaluate the differences between ganglion cell complex (GCC) of primary open angle glaucoma and ocular disorders affecting the macula.Methods and Materials: Forty-seven patients diagnosed with primary open angle glaucoma and 27 patients with macular diseases of different aetiology were enrolled in this pilot study. All patients underwent direct GCC analysis with the optical coherence tomographic scan, using the Optovue Fourier Domain RTVue-version. A comparison of the average GCC thickness, focal loss volume (FLV) and the global loss volume (GLV) of thetwo groups was made.Results: A total of 74 pairs of eyes were included in the study. This comprised 48 males and 26 females with a mean age of 53.8 ± 11.3 among glaucoma patients and 59.8 ± 9.8 among patients with macular disease. Eyes with macular disease (33.3%) and eyes with glaucoma(42.6%) had abnormal average GCC parameters. However, the mean average GCC value was significantly higher in eyes with macular disease (87.50 ± 20.73) when compared with eyes with glaucoma (76.55± 12.51) (p=0.01). A significantly higher percentage of eyes with macular disease (43.3%) had GLV values within normal range when compared with eyes with glaucoma (21.3%) (p=0.03). Abnormal FLV values were seen in both eyes with macular disease (83.3%) and eyes with glaucoma (80.9%) but the differences were not of statistical significance (p= 0.24).Conclusion: This pilot study demonstrated abnormal OCT GCC values in eyes with glaucoma as well as in eyes with macular disease. However, eyes with macular disease had significantly higher mean average GCC parameters but GLV parameters that were within normal values.Key words: glaucoma, macular disease, ganglion cell comple

Transpupillary Thermotherapy for Classic Subfoveal Choroidal Neovascularization: A case report

Aim: To report a case of successful treatment of a classic subfoveal choroidal neovascularization with a transpupillary thermotherapy protocol. Case Report: A 67-year old pensioner presented with a sixmonth history of reduced vision in both eyes. He had been previously diagnosed with primary open angle glaucoma. After anterior and posterior segment examination and fundus fluorescein angiography were done, a diagnosis of a classic subfoveal choroidal neovascularization secondary to exudative age-related macular degeneration OS with bilateral cataracts and primary open angle glaucoma OU was made. Complete resolution of the choroidal neovascular membrane was achieved with transpupillary thermotherapy. Keywords: transpupillary thermotherapy, age-related macular degeneration, subfoveal choroidal neovasularization, fundus fluorescein angiographyNigerian Journal of Opthalmology Vol. 15 (2) 2007: pp. 49-5

Combined Cataract and Glaucoma Surgery: An assessment of 68 eyes in an eye hospital in Lagos, Nigeria

Objective: To assess the best corrected visual acuity and average intraocular pressure at 6 months and one (1) year in patients with cataracts in glaucoma that had combined trabeculectomy and cataract surgery with lens implantation. Methods: A retrospective review of the case notes of patients who underwent combined glaucoma and cataract surgery with lens implantation in a private eye centre, The Eye Foundation Hospital, was carried out, using the following parameters: age, pre-operative intraocular pressure (IOP), post-operative intraocular pressure preoperative and postoperative visual acuity, the number of preoperative antiglaucoma medications, and the number of postoperative antiglaucoma medications at one (1) year or more. Results: 68 eyes of 67 patients were assessed during the study. Thirty-one (44.93%) had preoperative visual acuity (VA) of light perception (LP) -6/60 (very poor). At 6 months post operatively, 50 patients were followed up, 40% (n=20) had a visual acuity of 6/12-6/5 (very good). At one year, 37 patients followed up, of those, 48.65% (n=18) maintained a visual acuity of 6/12-6/5(very good). Mean preoperative intraocular pressure was 18.96 ± 7.38mmHg. At 6 months, mean IOP was 11.77± 3.61mmHg; one (1) year postoperatively IOP was 13.93 ± 3.21mmHg. There was a statistically significant improvement in VA (

Essential oils from the leaves of six medicinal palnts of Nigeria

The chemistry of Cassia siamea L., C. occidentalis L. (Fabaceae), Cnestis ferruginea Vahl ex DC (Connaraceae), Anthocleista djalonensis A. Chev (Loganiaceae), Solanum torvum Swartz and S. erianthum G. Don (Solanaceae) volatiles grown in Nigeria have been studied. The essential oils were obtained by hydrodistillation and analyzed by GC and GC-MS. The main compounds of C. siamea were (E)-geranyl acetone (5.8%), 1-octen-3-ol (5.8%), linalool (7.8%), iso-italicene (15.4%) and (E)-β-damascenone (11.0%). On the other hand, C. occidentalis consisted mainly of (E)-geranyl acetone (8.0%), hexahydrofarnesylacetone (24.0%) and (E)-phytol acetate (40.7%). The oil of C. ferruginea was comprised mainly of (E)-geranyl acetone (13.7%), (E)-α-ionone (9.5%), phytol (5.8%), pentadecanal (6.1%) and 1-octen-3-ol (5.5%). The main compounds of A. djalonensis were α-humulene (31.9%), β-caryophyllene (17.8%), humulene epoxide II (12.7%) and caryophyllene oxide (5.9%). The main volatiles of S. torvum were (E)-phytol acetate (38.7%), pentadecanal (25.3%) and (E)-geranyl acetone (5.0%). Apart from methyl salicylate (4.5%), tetradecanal (2.2%), 2-pentyl furan (1.8%), hexahydrofarnesylacetone (1.6%) and hexadecanal (1.1%), all other compounds were either present in trace quantity or in amounts less than 1%. On the other hand, α-humulene (46.6%) and β-caryophyllene (20.6%) were the compounds occurring in higher quantities in S. erianthum. The volatile oil contents of Cassia siamea, Cnestis ferruginea, Anthocleista djalonensis and Solanum torvum are being reported for the first tim

Ciliary Body Tumour Occurring in a Nigerian - A case report

Objective: To report the rare case of a 33-year-old female Nigerian who presented to our retina clinic with a chronic total retinal detachment and visual acuity of no light perception in her left eye. Re-attachment surgery in the eyewas not attempted as prognosis for return of vision was poor. She was later noted to harbor a progressively enlarging ciliarybody mass in the inferotemporal quadrant. Method: An observational case report was performed, withdocumentation of findings as patient was seen in the clinic.Conclusion: This is the first report of a ciliary body mass lesionin a Nigerian. The ciliary body mass could be a ciliary melanoma (ciliary body lesion being rarer than a choroidal mass) but other benign differential diagnoses must be borne in mind. Enucleation and histological assessment of the specimen will give the definitive diagnosis. Difficulties with patientacceptance of enucleating a non seeing eye though harboring a potentially harmful disease still abound in our environment

Glomerular disease and acute kidney injury in Sudan: Demographics, histological diagnosis and outcome

Background. Acute kidney injury (AKI) is a relatively common clinical condition, associated with high rates of mortality. Although there is extensive literature on the nature and consequence of AKI in the developed world, much less is known in the developing world and more specifically in sub-Saharan Africa (SSA).Objectives. To describe the demographics, histological diagnosis and clinical course of patients presenting with AKI to a single centre in Sudan.Methods. Retrospective data were collected on 100 consecutive patients with AKI and an active urinary sediment, who underwent diagnostic native percutaneous renal biopsy.Results. The mean (standard deviation) age of those biopsied was 33.6 (14.1) years of age, with a preponderance (58%) of females. The most common clinical  indications for biopsy were AKI associated with haematuria and proteinuria (72%), AKI and proteinuria (22.5%) or AKI and haematuria (5%). The frequencies of the most common primary glomerulonephritides (GN) were focal segmental GN (15%) and mesangiocapillary GN (8%). Lupus nephritis was the most frequent secondary GN associated with AKI (31%) and the most common overall histological diagnosis. Peak creatinine, but not oliguria, at presentation predicted likelihood of remaining dialysis-dependent. Age at presentation but not baseline renal function by  estimated glomerular filtration rate (eGFR), was associated with the likelihood of having residual chronic kidney disease following an episode of AKI.Conclusions. The data suggested differences in the pattern of intrinsic  renal/glomerular disease leading to AKI to those published and mainly derived from the developed world and patients in SSA

Treatment Outcomes among Human Immunodeficiency Virus and Tuberculosis Co-Infected Pregnant Women in Resource Poor Settings of South-western Nigeria

The complex interactions between Human Immunodeficiency Virus (HIV) and Tuberculosis (TB) infections may be magnified, in the presence of another potentially stressful condition like pregnancy. Though co-infection among pregnant women is rare, treatment outcomes may depend on accessibility to comprehensive treatment modalities. The objective of this study is to determine treatment outcomes among pregnant HIV and TB co-infected pregnant women in Lagos, South-western Nigeria. This retrospective, analytical study was carried out among ninety four (94) eligible pregnant women co-infected with HIV and TB at selected health-care facilities in Lagos state between January, 2008 and December, 2009. A standard checklist for data collection was used and analysis was carried out using the EPI info software. Mean age of respondents was 30.8 (±3.9) years. Sixteen (17.1%) TB cases were clinically diagnosed for tuberculosis. Among tuberculosis cases identified through sputum microscopy, 60(63.8%) were acid fast bacilli (AFB) positive and 21(22.3%) were identified in the first trimester. The mean percentage adherence to anti-retroviral drugs was 95.9% (±5.3). None of the participant smoked cigarette. Seventy three {73 (77.7%)} had contact with TB infected or suspected person in the last three months. Treatment outcome in mother showed that 74(78.7%) were cured, 8(8.5%) relapsed while 12 (12.8%) had treatment failures. Among the babies, 83(88.3%) were born alive. Women with both poor adherence (<90%) and with positive TB contact, but neither factor alone, were half-fold less likely to be cured compared with women with both good adherence (>95%) and no TB contact (OR=0.59, CI=0.45-0.95 and p=0.014). Cure rate was substantially lower in this study. This calls for extra strategies such as routine TB screening in antenatal clinics, strict adherence to national guidelines in the treatment of HIV/TB co-infections, focused antenatal care and comprehensive Prevention of Mother to Child Transmission (PMTCT) care and treatment

Anterior Hyaloidal Fibrovascular Proliferation (AHFVP) in a Diabetic after Cataract Extraction, Resulting in Hyphaema and Vitreous Haemorrhage during YAG Laser Capsulotomy

Aim: To report a rare case of anterior hyaloidal fibrovascular proliferation (AHFVP) which occurred after cataract surgery on a non-vitrectomized diabetic eye. This complication resulted in vitreous haemorrhage and hyphaema following a YAG laser capsulotomy procedure.Method: A case report of a patient managed at the above eyedepartment. Clinical records as indicated in the patient’s case note were reported.Conclusion: Anterior hyaloidal fibrovascular proliferation is a complication which an eye surgeon should bear in mind when attending to diabetic eyes after cataract surgery. The potential danger of vitreous haemorrhage following YAG laser capsulotomy should also be borne in mind, as more centres inthe country aspire to acquire a YAG laser machine to performcapsulotomy

Outcome of Lens-Sparing Vitrectomy for Infantile Post-Traumatic Amblyogenic Vitreous Haemorrhage: A case report

The visual outcome after bilateral lens-sparing 3-port pars planavitrectomy in a case of post-traumatic vitreous haemorrhagein an infant is reported. Although it is possible to perform avitrectomy procedure via a pars plana approach in infantswithout compromise to the lens for the treatment ofamblyogenic vitreous opacity, such as vitreous haemorrhage,the visual outcome could be poor in cases associated withtrauma owing to possible structural damage to the macular,the optic nerve and other more posterior visual pathway