Recurrence of Malignant Pleural Effusion Following Pleurodesis: Is There a Difference Between Use of Povidone-Iodine or Cyclophosphamide?

Background: Malignant pleural effusion is associated with poor quality of life. The success of pleurodesis varies with different agents, with talc being the most effective. It is however not available in Nigeria. This study aimed to determine the efficacy of povidone iodine and cyclophosphamide, the two commonly available agents for pleurodesisMethods: A prospective simple randomized enrollment of consecutive patients with malignant pleural effusion over a five year period (2008- 2012).Results: Thirty four patients were analyzed with a M:F ratio of 1:2.4. Breast cancer was responsible for almost half (47.1%) of the effusions. Although the povidone iodine group was slightly younger both groups were similar. There was no difference in the effusion recurrence for both groups. Age, duration of symptoms and cancer type were not predictors of recurrence of effusion following pleurodesis.Conclusions: Both agents are readily available and perform well with minimal side effects. However, povidone iodine being cheaper may be a more affordable alternative.Key Words: Malignant effusion, Pleurodesis, Povidone-iodine, Cyclophosphamid

Malaria parasitaemia among blood donors in Ilorin, Nigeria

Background: The prevalence of malaria parasitaemia among blood donors in Ilorin has not been documented. In this study, we determined the prevalence of malaria parasitaemia among blood donors in Ilorin, as well as, the sociodemographic and other factors associated with it.Method: This was a hospital- based cross sectional study involving 308 consenting blood donors. The sociodemographic characteristics of participants as well as blood donation history were obtained using structured questionnaires specifically designed for this purpose. Giemsastained thick and thin blood films to identify malaria parasites were performed using standard method. ABO blood grouping and haemoglobin electrophoresis tests were also done using standard methods.Results: The prevalence of malaria parasitaemia among blood donors in Ilorin was 27.3%. The parasite species found were more of Plasmodium falciparum(85.7%) than Plasmodium malariae(14.3%) . There was no age or sex difference in malaria parasitaemia. (p-value of 0.8 and 0.32 respectively). A greater proportion of blood group O individuals had malaria parasitaemia than groups A and B but this difference was not significant (p-value = 0.13). There was also no significant difference among haemoglobin genotypes.Conclusion: The prevalence of malaria parasites among blood donors in Ilorin is considerably high and lack of routine screening of blood puts recipients at risk. We recommend that routine screening for malaria parasites be commenced in our blood banks. Treatment of donor blood with riboflavin and UV light to inactivate malaria parasites and other infectious pathogens before they are transfused to patients may also be considered in our blood banks.Key words: malaria, parasitaemia, blood donors, Nigeri

Reference values of haematological parameters of healthy adults in the north central zone of Nigeria

Background: Haematological parameters differ from one population to another due to several factors. To determine the clinical implication of the blood parameters of an individual in the state of health or disease, we need to have the knowledge of the normal reference range for that locality.Objectives: To determine the reference values of haematological parameters of apparently healthy adults in Ilorin.Design: A descriptive cross sectional study.Setting: Ilorin, North Central zone of NigeriaSubjects: Nine hundred and ten (443 males and 467 females) randomly selected normal, HIV negative individuals aged 18-65 yearsResults: The red blood cell count, Haemoglobin concentration, PCV and MCHC were significantly higher among males than females while the platelet count, total WBC count and absolute neutrophil count were significantly higher in females than in males. There was however no significant gender difference in the values of MCV, MCH and absolute lymphocyte count. The normal reference values obtained in this study were notably different from those that are used currently in the hospital.Conclusion: The normal reference value obtained in this study was notable different from those that are currently used in the hospital. These findings will have clinical implications regarding the adjustment of our current reference values and definitely add value to the management of patients in this part of the country

Selective AKR1C3 inhibitors do not recapitulate the anti-leukaemic activities of the pan-AKR1C inhibitor medroxyprogesterone acetate

Background: We and others have identified the aldo-keto reductase AKR1C3 as a potential drug target in prostate cancer, breast cancer and leukaemia. As a consequence, significant effort is being invested in the development of AKR1C3-selective inhibitors. Methods: We report the screening of an in-house drug library to identify known drugs that selectively inhibit AKR1C3 over the closely related isoforms AKR1C1, 1C2 and 1C4. This screen initially identified tetracycline as a potential AKR1C3-selective inhibitor. However, mass spectrometry and nuclear magnetic resonance studies identified that the active agent was a novel breakdown product (4-methyl(de-dimethylamine)-tetracycline (4-MDDT)). Results: We demonstrate that, although 4-MDDT enters AML cells and inhibits their AKR1C3 activity, it does not recapitulate the anti-leukaemic actions of the pan-AKR1C inhibitor medroxyprogesterone acetate (MPA). Screens of the NCI diversity set and an independently curated small-molecule library identified several additional AKR1C3-selective inhibitors, none of which had the expected anti-leukaemic activity. However, a pan AKR1C, also identified in the NCI diversity set faithfully recapitulated the actions of MPA. Conclusions: In summary, we have identified a novel tetracycline-derived product that provides an excellent lead structure with proven drug-like qualities for the development of AKR1C3 inhibitors. However, our findings suggest that, at least in leukaemia, selective inhibition of AKR1C3 is insufficient to elicit an anticancer effect and that multiple AKR1C inhibition may be required

Management of peripheral facial nerve palsy

Peripheral facial nerve palsy (FNP) may (secondary FNP) or may not have a detectable cause (Bell’s palsy). Three quarters of peripheral FNP are primary and one quarter secondary. The most prevalent causes of secondary FNP are systemic viral infections, trauma, surgery, diabetes, local infections, tumor, immunological disorders, or drugs. The diagnosis of FNP relies upon the presence of typical symptoms and signs, blood chemical investigations, cerebro-spinal-fluid-investigations, X-ray of the scull and mastoid, cerebral MRI, or nerve conduction studies. Bell’s palsy may be diagnosed after exclusion of all secondary causes, but causes of secondary FNP and Bell’s palsy may coexist. Treatment of secondary FNP is based on the therapy of the underlying disorder. Treatment of Bell’s palsy is controversial due to the lack of large, randomized, controlled, prospective studies. There are indications that steroids or antiviral agents are beneficial but also studies, which show no beneficial effect. Additional measures include eye protection, physiotherapy, acupuncture, botulinum toxin, or possibly surgery. Prognosis of Bell’s palsy is fair with complete recovery in about 80% of the cases, 15% experience some kind of permanent nerve damage and 5% remain with severe sequelae