Tissue correlation of nitrite in plant parts of cassava (manihot esculenta crantz) and nitrosamine toxicity in wistar rat

Aim: This study was designed to determine the correlation in nitrite content of cassava (Manihot esculenta Crantz) as present in the various parts (roots, stems and leaves) and the possible hepatotoxicity when Wistar rats are exposed to N-nitrosamine precursors. Methods: Cassava cultivar used for this experiment was collected from International Institute of Tropical Agriculture, Ibadan, Nigeria (IITA). Various parts (Roots, Stems and Leaves) was weighed and homogenized separately. The homogenate was filtered to get clear solution and nitrite content therein was analyzed. Thirty Wistar rats divided into three groups, classified into; Group 1, Group 2 and Group 3 were used for the in-vivo experiment. The urine nitrite content and serum biomarkers of toxicity namely; Serum alanine transaminase (ALT), aspartate transaminase (AST), alkalin phosphatase (ALP) and gamma-glutamyl transferase (GGT) was estimated and the histopathological changes in the liver was examined in order to evaluate the extent of toxicity. Results: The nitrite levels in the roots, stems and leaves of these cassava cultivars were estimated as follows: roots; 110.8±23.7 μg/50 g, stems; 14.4±17.7 μg/30 g and leaves; 112.0±30.4 μg/5 g. The nitrite correlations between the roots and leaves is r = 0.97, correlations between the roots and stems is r = 0.65 while the correlations between the stems and leaves is r = 0.63. Urinalysis test carried out shows urine is the major sources of excretion of N-nitrosamines from the system. Both Group II and Group III animals had a significant increase in ALT, AST, ALP and GGT levels in t he serum. Histopathology study of liver is in agreement with these results. Conclusion: This study shows that there was a correlation in nitrite levels between the roots and leaves of cassava and the level of toxicity found in the liver of rat administer with N-nitrosamine precursors (DMA.HCL and NaNO2)

Autoimmune Hemolytic Anemia in HIV-infected Patients: A Hospital Based Study

Background: The prevalence of anemia in HIV/ AIDS patients is high, with a multitude of possible etiologies; autoimmune hemolytic anemia (AIHA) in HIV/AIDS patients has been associated with a poor prognosis when treated with red cell transfusion. Our aim was to demonstrate the frequency of AIHA in a cohort of adult Nigerian HIV/AIDS patients and to see if the presence or not of AIHA is related to the severity of the disease with regards to the CD4 counts and the presence or absence of opportunistic infections. Method: Ninety- eight adult patients with HIV infection were screened for the presence of AIHA using the packed cell volume (PCV), direct antiglobulin test (DAT) and reticulocyte count (RC). Results: The frequency of AIHA was 3.06%, 36.74% of our study population were anemic; 11.22% had a positive DAT. Mean RC was 2.22 +/- 0.90 for all the patients. There was no statistically significant difference in the PCV of patients that had positive and negative DAT. There was no correlation between the presence of AIHA, use of ART, presence of opportunistic infections or CD4 counts. Conclusion: We conclude that in spite of the low frequency of AIHA in HIV/AIDS patients, the fact that most patients will respond to standard treatment makes it imperative to screen HIV/AIDS patients with anemia for the presence of AIHA. Again since HIV/AIDS patients with AIHA may have a fatal reaction to red cell transfusion, we suggest that anemic patients with HIV/AIDS in non-emergency situations be screened for the presence of AIHA before receiving red cell transfusions when indicated.Culture g\ue9n\ue9rale: Il y a trop de fr\ue9quence d'an\ue9mie parmi les malades sero-positifs ou les malades atteints de sida, souvent accompagne d'un grand nombres d'aetiologies: an\ue9mie haemolylique autoimmuno (AHAI) parmi les malades sero-positifs est directement lie a une mauvaise pronostic, surtout quand on fait le traitement avec une transformation du globule rouge. Notre objectif est de d\ue9montrer la fr\ue9quence de (AHAI) parmi un nombre d'adultes nig\ue9rians sero-positifs ou qui sont atteints du sida. C'est aussi de v\ue9rifier si la pr\ue9sence ou l'absence de (AHAI) est lie directement lie a la gravite de la maladie, de la maladie surtout quand il s'agit de la num\ue9ration CD4 et de la pr\ue9sence ou absence des infections opportunistic. Modalit\ue9: \uc0 l'aide de l'analyse directe antiglobulin (ADA) et la num\ue9ration r\ue9ticulocyte (NR) et le packed cell volume (PCV) ; quatre-vingt-dix-huit malades sero-positifs, ont pass\ue9 un test de d\ue9pistage pour v\ue9rifier la pr\ue9sence de (AHAI) R\ue9sultat: La fr\ue9quence de (AHAI) \ue9tait 3.06%, 36.74% de notre population \ue9tait an\ue9mique ; 11.22% \ue9tait positif de l'analyse antiglobulin.Pour la num\ue9ration reticulocy, la moyenne \ue9tait 2.22+-0.90 pour tous les malades, on n'a trouv\ue9 aucune diff\ue9rence qui est statistiquement significatif parmi les malades positif de (ADA) et n\ue9gatif de (ADA). Il n y avait aucun rapport entre la pr\ue9sence de AHAI, l'emploi de ART, pr\ue9sence des opportunistic ou la num\ue9ration CD4. Conclusion: Pour conclure, il faut souligner que, malgr\ue9 la basse fr\ue9quence de AHAI dans les malades atteint du sida ou sero-positifs, tous les sero-positifs avec an\ue9mie doivent passer un test de d\ue9pistage, puisqu'il est \ue9vident que la plupart des malades r\ue9agissent positivement au traitement.Et en plus,nous proposons que d\ue9sormais, avant la transfusion du globule rouge, tous les malades sero-positifs ou du sida, passent un test de d\ue9pistage afin de d\ue9terminer la pr\ue9sence de AHAI car parfois la prise de cette transfusion peut aboutir \ue0 la mort

Cervical dysplasia and cancer and the use of hormonal contraceptives in Jamaican women

<p>Abstract</p> <p>Background</p> <p>This study was conducted to determine whether use of hormonal contraceptives is associated with cervical dysplasia and cancer in a population where there is widespread use of hormonal contraception and the rates of cervical cancer remain high at 27.5/100,000.</p> <p>Methods</p> <p>A case-control study was conducted among women visiting the colposcopy and gynaelogical clinics at a tertiary referral hospital. Two hundred and thirty six cases CIN I (72), II (59), III (54), cancer (51) and 102 controls, consented and were interviewed on use of contraceptives using a structured questionnaire. Logistic regression was used to determine odds ratios (ORs) and 95% confidence intervals (CIs) associated with use of hormonal contraception in cases and controls and in low and high risk cases. Recruitment was carried out from 2001–2002.</p> <p>Results</p> <p>Contraceptives used were: oral contraceptives – 35%, injections (depot medroxy progesterone acetate (Depo-provera) – 10%, Intrauterine devices – 2%, combinations of these and tubal ligation – 30%. 23% reported use of 'other' methods, barrier contraceptives or no form of contraception. Barrier contraceptive use was not significantly different between cases and controls. Current and/or past exposure to hormonal contraceptives (HC) by use of the pill or injection, alone or in combination with other methods was significantly higher in the cases. In multivariate analysis with age and number of sexual partners as co-variates, use of hormonal contraception was associated both with disease, [OR, 1.92 (CI 1.11, 3.34; p = 0.02] and severity of the disease [OR, 2.22 (CI 1.05, 4.66) p = 0.036]. When parity and alcohol consumption were added to the model, hormonal contraception was no longer significant. The significant association with high risk disease was retained when the model was controlled for age and number of sexual partners. Depo-provera use (with age and number of sexual partners as covariates) was also associated with disease [OR, 2.43 (CI 1.39, 4.57), p = 0.006] and severity of disease [OR 2.51 (1.11, 5.64) p = 0.027]. With parity and alcohol added to this model, depo-provera use retained significance. Exposure to HC > 4 years conferred more risk for disease and severity of disease.</p> <p>Conclusion</p> <p>Hormonal contraception did confer some risk of dysplasia and women using HC should therefore be encouraged to do regular Pap smear screening.</p

Comparisons of high-risk cervical HPV infections in Caribbean and US populations

<p>Abstract</p> <p>Background</p> <p>Disparities in cervical cancer incidence and mortality rates exist among women of African ancestry (African-American, African-Caribbean and African). Persistent cervical infection with Human papillomavirus (HPV) is associated with cervical dysplasia and if untreated, could potentially progress to invasive cervical cancer. Very few studies have been conducted to examine the true prevalence of HPV infection in this population. Comparisons of cervical HPV infection and the type-specific distribution of HPV were performed between cancer-free Caribbean and US women.</p> <p>Results</p> <p>The Caribbean population consisted of 212 women from Tobago and 99 women from Jamaica. The US population tested, consisted of 82 women from Pittsburgh. The majority of the US subjects was Caucasian, 74% (61/82) while 12% (10/82) and 13% (11/82) were African-American or other ethnic groups, respectively. The age-adjusted prevalence of any HPV infection among women from Tobago was 35%, while for Jamaica, it was 81% (p < 0.0001). The age-adjusted prevalence of HPV infection for Caribbean subjects was not statistically significantly different from the US (any HPV: 47% vs. 39%, p > 0.1; high-risk HPVs: 27% vs. 25%, p > 0.1); no difference was observed between US-Blacks and Jamaicans (any HPV: 92% vs. 81%, p > 0.1; high-risk HPV: 50% vs. 53%, p > 0.1). However, US-Whites had a lower age-adjusted prevalence of HPV infections compared to Jamaican subjects (any HPV: 29% vs. 81%, p < 0.0001; high-risk HPV: 20% vs. 53%, p < 0.001). Subjects from Jamaica, Tobago, and US-Blacks had a higher proportion of high-risk HPV infections (Tobago: 20%, Jamaica: 58%, US-Blacks: 40%) compared to US-Whites (15%). Similar observations were made for the presence of infections with multiple high-risk HPV types (Tobago: 12%, Jamaica: 43%, US-Blacks: 30%, US-Whites: 8%). Although we observed similar prevalence of HPV16 infections among Caribbean and US-White women, there was a distinct distribution of high-risk HPV types when comparisons were made between the ethnic groups.</p> <p>Conclusion</p> <p>The higher prevalence of cervical HPV infections and multiple high-risk infections in Caribbean and US-Black women may contribute to the high incidence and prevalence of cervical cancer in these populations. Evaluation of a larger sample size is currently ongoing to confirm the distinct distribution of HPV types between ethnic groups.</p

Evaluation of Current Knowledge, Awareness and Practice of Spirometry among Hospital -based Nigerian Doctors

<p>Abstract</p> <p>Background</p> <p>Spirometry is a cost-effective diagnostic tool for evaluation of lung function and for case-finding in a resource-limited setting. The acceptance of this test depends on the awareness of its indications and the ability to interpret the results. No studies have assessed the knowledge of spirometry among Nigerian doctors. The aim of this study was to evaluate the current knowledge, awareness and practice of spirometry among hospital-based Nigerian doctors.</p> <p>Methods</p> <p>We carried out a cross-sectional survey among 321 doctors working in Nigerian hospitals between March 2008 and June 2008. Information on knowledge, awareness, practice of and barriers to spirometry were obtained using a pre-tested, self-administered structured questionnaire and the data were then analysed.</p> <p>Results</p> <p>Of the 321 doctors that participated, 108 (33.6%) reported that they have good knowledge of spirometry. One hundred and ninety-five (60.7%) were aware of the importance of spirometry in aiding the diagnosis of respiratory diseases; 213(66.4%) were aware of the importance of spirometry in determining the severity of diseases. Medical school was the most common source of knowledge on spirometry (64.5%). Eighty-one (25.2%) doctors reported having a spirometer in their hospitals. Doctors having access to a spirometer used it more frequently for aiding the diagnosis of COPD (40.7% vs.27.5%) and for monitoring of asthma (18.5% vs.11.3%) than those without access to a spirometer. The doctors working in University Teaching Hospitals and Federal Medical Centres (FMC) (22.4% vs. 4.5%) and those having access to a spirometer (40.7 vs.11.3%) were very confident of interpreting spirometry results compared to those working in District and General Hospitals and without access to a spirometer. Irrespective of access to a spirometer or the type of hospital they were employed in, doctors reported that unavailability of a spirometer was the greatest barrier to its use (62.5%) followed by lack of awareness about its usefulness (17.2%).</p> <p>Conclusion</p> <p>The knowledge and practice of spirometry were poor among hospital-based Nigerian doctors because of unavailability of spirometers in most hospitals. These findings have implications for further evaluation, planning and management of patient care in respiratory disease. Spirometers should be made available in all hospitals, and the knowledge of spirometry should be improved among doctors.</p

One and a half million hematopoietic stem cell transplants: continuous and differential improvement in worldwide access with the use of non-identical family donors

The Worldwide Network of Blood and Marrow Transplantation (WBMT) pursues the mission of promoting hematopoietic cell transplantation (HCT) for instance by evaluating activities through member societies, national registries and individual centers. In 2016, 82,718 first HCT were reported by 1,662 HCT teams in 86 of the 195 World Health Organization member states representing a global increase of 6.2% in autologous HCT and 7.0% in allogeneic HCT and bringing the total to 1,298,897 procedures. Assuming a frequency of 84,000/year, 1.5 million HCT were performed by 2019 since 1957. Slightly more autologous (53.5%) than allogeneic and more related (53.6%) than unrelated HCT were reported. A remarkable increase was noted in haploidentical related HCT for leukemias and lymphoproliferative diseases, but even more in non-malignant diseases. Transplant rates (TR; HCT/10 million population) varied according to region reaching 560.8 in North America, 438.5 in Europe, 76.7 in Latin America, 53.6 in South East Asia/Western Pacific (SEA/WPR) and 27.8 in African/East Mediterranean (AFR/EMR). Interestingly, haploidentical TR amounted to 32% in SEA/WPR and 26% in Latin America, but only 14% in Europe and EMR and 4.9% in North America of all allogeneic HCT. HCT team density (teams/10 million population) was highest in Europe (7.7) followed by North America (6.0), SEA/WPR (1.9), Latin America (1.6) and AFR/EMR (0.4). HCT are increasing steadily worldwide with narrowing gaps between regions and greater increase in allogeneic compared to autologous activity. While related HCT is rising, largely due to increase in haploidentical HCT, unrelated HCT is plateauing and cord blood HCT is in decline

Narrowing the gap for hematopoietic stem cell transplantation in the East-Mediterranean/African region: comparison with global HSCT indications and trends.

Hematopoietic Stem Cell Transplantation (HSCT) activity was evaluated in the African (AFR)/EMRO region and compared to the global activity for the years 2006-2013. Data were obtained from 1570 teams in the 6 WHO continental regions. Of these, 29 (1.85%) of all teams were active in 12 of the 68 AFR/EMRO countries. They reported 2.331 (3.3%) of the worldwide 71.036 HSCT, and a transplant rate of 32.8 (TR; HSCT/10 million inhabitants; worldwide 128.5). This reflects still the lowest regional TR despite an increase of 90% since 2006. HSCT activity in AFR/EMRO countries was characterized by a higher use of allogeneic compared to autologous HSCT, an almost exclusive use of family donors, including haploidentical family donors. These findings contrast with the prevalence of autologous over allogeneic HSCT, and a higher frequency of unrelated HSCT in other parts of the world. Of note, the increase by 200% in HSCT for hemoglobinopathies from 2006 to 2013 (72 per year) in the AFR/EMRO region. This reflects the specific role of HSCT for these disease categories with high prevalence and incidence in the AFR/EMRO region. This report provides information for the competent authorities to foster adequate infrastructure. It urges transplant organization to optimize their cooperation

Iterative approximation of split feasibility problem in real Hilbert spaces

In this paper, we propose an iterative algorithm for finding solution of split feasibilty problem involving a λ−strictly pseudo-nonspreading map and asymptotically nonexpansive semigroupsin two real Hilbert spaces. We prove weak and strong convergence theorems using the sequence obtained from the proposed algorithm. Finally, we applied our result to solve a monotoneinclusion problem and present a numerical example to support our result.&nbsp

Presence of lupus anticoagulant in an asymptomatic Nigerian

Background:The lupus anticoagulant (LA) is one of the antiphospholipid antibodies (aPL), which prolong phospholipid- dependent coagulation tests by interfering with coagulation reactions that depend on protein - phospholipid complexes in vitro. Method:A 25 year old \'healthy\' male Nigerian was screened for the presence of any coagulation abnormality using the KCT, PT and platelet count; after volunteering for his plasma to be used in the preparation of normal pooled plasma in a study. Results: He was discovered to have a prolonged KCT, PT and normal platelet count. Based on the prolonged KCT his plasma was subjected to mixing studies with various concentration of normal pooled plasma; the KCT index was calculated and a curve was plotted. His KCT index was 1.6 and the curve convex in the left axis suggesting the presence of LA. His past medical history and physical examination were not remarkable.Three months after the initial study, a repeat KCT index was 1.4 and the subject asymptomatic. Conclusion: From literature review this is the first report of LA in an asymptomatic adult Nigerian; the importance of this finding is discussed. African Health Sciences Vol. 7 (3) 2007: pp. 182-18