Pattern of Innervation of the Upper Gluteus Maximus Muscle: Implication in Prosthetic Hip Dislocation

Background: Dislocation is one of the most common complications after total hip arthroplasty. The posterolateral approach avoids disruption of the abductor mechanism but may denervate gluteus maximus as a basis for associated higher dislocation rates.Objective: To determine the pattern of innervation of gluteus maximusStudy design: Descriptive cross-sectional studyMaterials and methods: Twenty four cadavers for routine dissection in the Department of Human Anatomy, University of Nairobi were used. Having exposed the gluteus maximus, the muscle was transected close to its distal attachment and refl ected superiorly to expose the entry of the neurovascular structures into it from the greater sciatic foramen. The pattern of distribution of the inferior gluteal nerve to the muscle was noted and the left and right in the same cadaver comparedResults: In all the 48 cadaver sides, the inferior gluteal nerve exited the pelvis via the infra-piriformic compartment of the greater sciatic foramen. In majority (43, 89.6%) of gluteal regions this nerve funned out in multiple equal branches to the GM. Only one branch crossed the upper border of piriformis muscle. In 5 cases, this single branch that crossed theupper border of piriformis was a major trunk almost equal in size to theparent nerve. One such case was bilateral.Conclusion: A major branch of the inferior gluteal nerve to the upper partof GM, when present, could be injured in the posterior approaches to thehip to signifi cantly weaken the upper part of this muscle increasing therisk of prosthetic hip dislocation

Effect of parity on endometrial glands in gravid rabbits

The uterus undergoes intense remodeling in pregnancy and subsequent involution in the postpartum period. One of the anatomical changes that occur in the gravid endometrium is increased glandular density. Parity has been shown to be protective against certain endometrial pathologies probably as a result of retained changes that take place during pregnancy. The findings of the current study may help provide the anatomical basis for different traits noted as the parity rises. Nine rabbits, California white breed (oryctolagus cuniculus), were obtained from a private farmer. The subjects were grouped as follows; primiparous rabbits in group 1, Para 1 and Para 2-3 in group 2, and Para >4 in group 3. Once successfully mated, they were housed in pens, fed, and given adequate supply of water. On day 18 of pregnancy, the rabbits were sacrificed and uterus harvested en bloc. Five-millimeter specimens were obtained from the uterus and processed for light microscopy. Quantification of endometrial glands and their size was done using the computer program Image J. Endometrial gland density was noted to decrease with a rise in parity such that the percentage proportion in the primigravid rabbit was 45% compared to that of 34% and 37.5% in the biparous and multiparous groups respectively. The endometrial gland duct circumference also increased as the parity increased. The present study reveals that a high parity is characterized by fewer, wider endometrial glands.Key words: Endometrial glands, Parity, Gravidit

Anomalous origin of the ulnar nerve from the lateral cord of the brachial plexus: A case report

Background:  The ulnar nerve has been noted to bear variations as concerns its origin such as that of its communication with the median nerve via nerve branches and sharing of common sheath with the medial cutaneous nerve of the forearm. However, only a few studies have reported on the ulnar nerve receiving a communicating branch from the lateral cord. Case:  We report a case in which the ulnar nerve was noted to originate from branches of the lateral cord of the brachial plexus, during routine dissection. Discussion and conclusion:  This study adds data on such a rare scenario in a Kenyan setting.   French title: Origine anormale du nerf ulnaire du cordon lateral du plexus brachial : A propos d’un cas. Introduction: Des variations de l’origine du nerf ulnaire telles que celle de sa communication avec le nerf médian via des branches nerveuses et le partage de la gaine commune avec le nerf cutané médial de l'avant-bras ont été décrites. Cependant, seules quelques études ont rapporté que le nerf ulnaire recevait une branche communicante du faisceau latéral. Observation: Nous rapportons une observation dans laquelle le nerf ulnaire provenait des branches du cordon latéral du plexus brachial, lors d’une dissection de routine. Discussion et conclusion: Cette étude ajoute des données sur un scénario rare dans un contexte kenyan

Hibiscus extract mitigates salt induced carotid adventitial changes in rats

The tunica adventitia is an active vascular compartment that actively participates in modulation of vascular structure, function and pathophysiology. Adventitial thickness has recently been accepted as a surrogate marker of atherosclerosis. The effects of salt and chemicals that ameliorate those effects are important in understanding vascular structure, function and pathology. There are few studies on hibiscus and high salt induced vascular pathology. This study, therefore, investigated the effects of hibiscus on salt induced vascular changes on rat carotid artery. The experimental animals were divided into 3 groups of 8 animals each – (i) controls; (ii) high salt diet alone and (iii) high salt + hibiscus extract for a period of eight weeks. At ages 2, 5 and 8weeks 2 – 3 animals were sacrificed for study. They were anaesthetized with ether and perfused with formal saline. Specimens were then obtained from the middle of common carotid artery, fixed in 5% formaldehyde solution, processed routinely for paraffin embedding and 5-micron thick sections stained with Hematoxylin / Eosin and also with Mason’s Trichome/ Aniline blue. Adventitial thickness and volumetric densities of collagen were measured using morphometric techniques. High salt consumption induced statistically significant increase in adventitial thickness from 297.45μm at week 2 to 659.4μm in week 8. In hibiscus fed rats, this increase progressively reduced to 482.55μm in week 8. Volumetric density of collagen was 57% in high salt fed rats but reduced to 45.66% in hibiscus fed rats (p<0.001). The increase in tunica adventitial thickness and collagen density which is induced by high salt can be mitigated by hibiscus extract. This implies that hibiscus has potential to restore salt induced vascular injury. Further studies are recommended to refine the extract.Keywords: adventitial thickness, high salt, hibiscus, collagen, densit

A review of telocytes in cardiovascular tissue and their role in angiogenesis

Telocytes are interstitial cells characterized by small cell bodies with very long and slender processes extending from them. They are present in most tissues and are most commonly found in close association with nerves, smooth muscle and microvascular networks in tissue interstitial space. Telocytes maintain tissue homeostasis in various ways including modulation of electrical activity, regulation of stem cell proliferation and angiogenesis. The role of telocytes in blood vessels stems from a structural and functional coupling to vascular endothelial and smooth muscle cells. This review explores the distribution of telocytes in cardiovascular tissues, their mechanisms in angiogenesis and application of this property in tissue regeneration. The literature search was conducted on PubMedTM, Science directTM and African Journals Online databases as well as Google ScholarTM search engines. The keywords used in the literature search included ‘telocytes’, ‘cardiovascular telocytes’, ‘blood vessel’, ‘cardiac tissue’, ‘(neo-)angiogenesis’ and ‘tissue regeneration’. Articles which contained the keywords and relevant citations from their reference lists were included in the study. In conclusion, telocytes display close structural relationship with cardiovascular tissues. They play an angiogenesis inducing role which may be explored as a therapeutic target in tissue repair and regeneration. Keywords : cardiovascular telocytes, interstitial Cajal-like cell, regeneration, angiogenesi

Stereological Estimation and Zonal Distribution of the Hepatotoxic Effects of Doxorubicin on the Female Albino Rat (Rattus Norvegicus)

Background: Doxorubicin is an anti-neoplastic agent widely indicated for a variety of cancers. One of its adverse effects is hepatotoxicity which presents with hepatocyte necrosis, sinusoidal dilation, and fibrosis. However, there remains a dearth in the quantification and zonal distribution of this damage. Methods: Twenty-three adult female Wister albino rats were placed into baseline, control, and experimental group receiving 2.5mg/kg bodyweight Doxorubicin intra-peritoneally thrice weekly for 3-weeks. Rats were sacrificed on days 0, 7, 14 and 21 and livers harvested for processing. Masson’s Trichrome was used in staining 7 µm thick sections. Images were taken and analyzed via STEPanizer, and data entered into SPSS for analysis. Results: Rats treated with Doxorubicin had increased liver to body weight ratios from 5.00% at baseline to 6.15%, 6.69% and 7.56% on days 7, 14 and 21 (p=0.090). There was a decrease in hepatocyte densities from 51.88/mm2 to 48.61/mm2, 46.65/mm2 and 42.24/mm2 on day 7, 14 and 21 (p=0.779). Collagen fiber deposition increased from 0.12±0.06 cm3 to 0.47±0.55 cm3, 1.64±0.11 cm3 and 1.88±0.24 cm3 on days 7, 14 and 21 (p=0.009). Deposition was greatest periportally and least pericentrally. Volume of sinusoidal spaces increased from 5.46±0.50 cm3 to 5.49±0.15 cm3, 5.53±0.24 cm3 and 5.50±0.17 cm3 on days 7, 14 and 21 respectively (p=0.827).  Sinusoids were larger pericentrally than periportally. Conclusion: Doxorubicin administration is associated with an increase in volume density of fibrotic tissue and sinusoidal spaces but decrease in hepatocytes. The quantitative changes presented may facilitate histopathological grading of Doxorubicin-induced hepatotoxicity

A Risk-Score for Predicting the Presence of Treatable Sexually Transmitted Infections in Kenyan Women Planning Conception

Thesis (Master's)--University of Washington, 2020Treatable sexually transmitted infections (STI) disproportionately affect women’s reproductive health and contribute to poor neonatal outcomes. Because these infections are frequently asymptomatic, identifying women at higher risk of having STIs using risk scores may provide a cost-effective screening approach in regions where universal screening of pregnancy planners is not performed. The aim of this study was to determine the prevalence and correlates of Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis among Kenyan pregnancy planners, and to develop a risk score to identify those with a higher likelihood of current chlamydial infection. Kenyan women with fertility intent enrolled into a cohort study between April 2017 and March 2020 contributed data for this cross-sectional analysis. Logistic regression was used to estimate odds ratios of the association between demographic, behavioral, and clinical risk factors and prevalent STIs, both as a group, and for C. trachomatis alone. Based on the regression coefficients, prediction models were developed to identify women with increased likelihood of current C. trachomatis infection. The most common STI was C. trachomatis (51/691, 7.4%); N. gonorrhoeae (5/691, 0.5%), and T. vaginalis infections (6/687, 0.9%) were rare. The prevalence of any one or more of these STI was 60/688 (8.7%). Risk factors for any STI included age less than 25 (OR 2.41; 95%Cl: 0.69-8.48), partner’s age less than 25 (OR 17.22; 95%Cl: 3.74-79.24), Alcohol Use Disorders Identification Test (AUDIT) score ≥8 (OR 5.54; 95%Cl: 1.61-19.04), and bacterial vaginosis (BV) (OR 2.49; 95%Cl: 1.46-4.24). A risk score for predicting C.trachomatis infection, ranging from 0-6, derived from the participant’s age, AUDIT score, and BV status yielded an area under receiver operating curve (AUROC) of 0.78 (95%Cl: 0.72-0.84). Using a score cutoff of 0 versus ≥1, 478/691 (69.2%) were classified as higher-risk for C. trachomatis (sensitivity=98.0%, 95%Cl: 89.6-100.0; specificity=33.1%, 95%Cl: 29.5-36.9). At a higher cutoff of ≤2 versus ≥3, the risk score identified 31.8% of women as higher risk (sensitivity=70.6%, 95%Cl: 56.2-71.3, specificity=71.3%, 95%Cl: 67.7-74.5). Among women classified as higher risk by the risk scoring tool, the numbers needed to screen using nucleic acid amplification based tests (NAAT) testing to detect one C. trachomatis infection were 10.0 for the 0 versus ≥1 cutoff and 7.7 for the higher cutoff of ≤2 versus ≥3. This risk-scoring tool may be useful for identifying higher risk women for C. trachomatis screening among Kenyan pregnancy planners. Employing the tool could provide a cost-conscious approach for initiating species-specific testing for C. trachomatis infection

LIGHT MICROSCOPIC CHANGES IN THE VILLI HEIGHT OF THE SMALL INTESTINES OF LABORATORY RAT (RATTUS NORVEGICUS) FOLLOWING MEBENDAZOLE ADMINISTRATION; Pequeños cambios microscópicos observados en la altura del vello en el intestino delgado de la ratas de laboratorio (rattus norvegicus) después de la administración de mebendazole.

  Through tubulin degradation, mebendazole interferes with glucose uptake into intestinal cells and exhaustion of glycogen reserves leads to parasite death. When used in humans, the drug may mediate mucosal changes responsible for reported side effects including diarrhea. Earlier studies have shown changes to the goblet and crypt cells in mammalian intestines. Its effects on the intestinal villi height has not been determined. Forty laboratory rats were used; ten rats, for determination of baseline features whereas three experimental groups of five rats received 1.6ml of MBZ for three, eight, and thirty days respectively. Once sacrificed, the rats from the interventional and control groups were dissected to harvest 5mm sections from duodenum, jejunum and ileum. These were processed, sectioned and stained for light microscopy to demonstrate cryoarchitecture. The villi were measured and data represented in medians. Mann Whitney U test was done to check for differences between controls versus experimental groups at specific time points, Krus Kall Wallis test, for differences among experimental groups or control groups alone. Mebendazole administration was associated with initial reduction in the villi height. The lowest value recorded was after 3 days in the duodenum and 8 days in the jejunum/iluem, beyond which continued MBZ administration was associated with increase in villous height until day thirty. Findings of this study suggest that MBZ does not have effects on the villous height when used for prolonged periods. This explains why patients who use the drug for long-term periods tolerate it.   Mediante la degradación de la tubulina, el mebendazole (MBZ) interfiere con la entrada de glucosa a las células intestinales, y el agotamiento de las reservas de glucógeno causa la muerte de parásitos. Al ser utilizada en seres humanos, el medicamento puede fungir como intermediario de cambios en las mucosas que pueden causar efectos secundarios reportados, incluida la diarrea. Los estudios anteriores han demostrado cambios en los intestinos de mamíferos, los cuales afectan las células caliciformes y células en las criptas de Lieberkuhn. No se han determinado aún sus efectos en la altura del vello intestinal. Se utilizaron cuarenta ratas de laboratorio; diez ratas para determinar características básicas, mientras que tres grupos experimentales de cinco ratas recibieron 1.6 mL de MBZ por tres, ocho y treinta días, respectivamente. Una vez que fueron sacrificadas, las ratas de los grupos de intervención y de control fueron disecadas para obtener secciones de 5 mm de su duodeno, yeyuno e íleon. Estos segmentos fueron procesados, seccionados y entintados para microscopía de la luz, para determinar su arquitectura celular bajo congelación. Se midieron los vellos y se utilizaron las medias como datos. Se realizó la prueba de Mann-Whitney para determinar si existían diferencias entre los grupos de control y experimentales tratados por plazos específicos de tiempo, y se realizó la prueba de Kruskal-Wallis para identificar sólo las diferencias entre grupos experimentales y grupos de control. La administración de mebendazole estuvo asociada con la reducción inicial en la altura del vello. El valor registrado más bajo ocurrió después de 3 días en el duodeno, y 8 días en el yeyuno y el íleon. Después de este tiempo, la continuación de la administración de MBZ fue asociada con un aumento en la altura del vello hasta el día treinta. Los hallazgos de este estudio sugieren que el MBZ no surte efecto alguno en la altura del vello intestinal si se utiliza por plazos largos de tiempo. Esto explica por qué los pacientes que utilizan el medicamento a largo plazo llegan a tolerarlo