Management of undescended testes: a comparative study in England and Africa

Objective The aim of our study was to determine the timing of referrals and the outcome of undescended testes (UDT) over a 4-year period in a tertiary centre in England, and to compare this with a similar centre in Nigeria. Background data Cryptorchidism is a recognized cause of infertility and a key risk factor for testicular malignancy. Current recommendations are that orchidopexy be performed between 12 and 18 months of age; however, there is no consensus on this.Materials and methods Data were obtained for orchidopexies performed between 2003 and 2007 from a tertiary referral centre in England. A standardized proforma was used to collect data into an Excel database, which was analysed and compared with data from a similar centre in Nigeria.Results Eighty-eight patients from a tertiary referral centre in England underwent surgery for UDT. Fifty-six (63.6%) patients were referred and 38 (43.2%) patients were operated on within 2 years of age. Doctors and health visitors accounted for 69 (78.5%) referrals to the tertiary centre. Data from Nigeria demonstrated that of the 61 cases, 13 (21%) patients presented and 11 (18%) patients were operated on by 24 months. Referral beyond 60 months of age in the English series was due to ascending testis, whereas in the Nigerian study, the delayed presentation was due to delayed referral from lack of knowledge of the condition.Conclusion In England and Nigeria, there is a lack of definitive guidelines relating to the appropriate age of referral of patients with UDT. A structured care pathway is needed to enable early detection and definitive management

Nutritional evaluation of some new maize varieties: Effects on growth performance and carcass traits of Albino rats

A study was carried out to ascertain the effects some new maize varieties: Obatanpa (OB), Opeaburoo (OP), Honampa (HO), Aseda (AS), Tintim (TT), Owanwa (OW) and Odomfo (OD) on the growth performance and carcass traits of albino rats. Aseda, Opeaburoo and Tintim are all white varieties and have been described as being moderately tolerant to drought and good for domestic purposes. Owanwa, Odomfo and Honampa on the other hand are all yellow varieties. The OW and OD varieties have a pro-vitamin A content of 6μg/g whilst HO has a pro-vitamin A content of 7μg/g. Obatanpa (OB) is a white and an open-pollinated Quality Protein Maize (QPM) variety grown widely by farmers in Ghana. Thirty-five weanling Wistar® rats with an average initial live weight of 36g were randomly allocated to seven isocaloric dietary treatments in a completely randomized design (CRD). There were five rats on each treatment, housed individually in plastic cages and each rat served as a replicate. Their growth performance was monitored for 28 days, after which the rats were euthanized and dissected to collect carcass data. The mean daily feed intakes and weight gains were similar (P>0.05) for the rats on the various dietary treatments. The feed conversion ratios (FCR) as well as feed cost per 100g weight gain were not significantly (P>0.05) influenced by the variety of maize in the diets. The abdominal fat colour score was affected by the dietary treatments with HO, OD and OW scoring 2 while treatments OB, OP, AS and TT scored 1. The carcass characteristics of all the albino rats on the seven dietary treatments were similar (P>0.05) except for empty gastrointestinal tract (GIT) weights which were higher (P<0.05) for HO and OD treatments. It was concluded that since the growth performance indicators were similar for all the dietary treatments, farmers can utilize any of these new varieties in their feeding operations but where enhanced carcass colour is desired HO, OD and OW could be the varieties of choice.Keywords: Carcass, carotene, colour, drought tolerance, maize, obatanpa, variety, yiel

Global Outward Foreign Direct Investment and Economic Growth Across Income Groups: The Mediating Effect of Home Country Institutions

Although some empirical studies have examined the direct impact of outward foreign direct investment (outward FDI) on economic growth, but the indirect role play by home country institutions in outward FDI-induced economic growth remain unexplored. To cover this research gap, this study examines the impact of outward FDI on economic growth mediated by home country institutions in global panel of 161 economies, divided into World Bank income clusters such as high, upper-middle, lower-middle, and low-income economies for the period 1998 to 2019. For empirical analysis, this study utilized the Cross-Sectionally Augmented ARDL (CS-ARDL) and the Common Correlated Effect Mean Group (CCEMG) techniques robust to numerous econometric problems. In low-income countries, results indicate that outward FDI internationalization activities have adverse effect on economic growth, and the impact of home country institutions in stimulating outward FDI-induced growth appears weak both in the short term and long-term. In the case of high income, upper-middle income and lower-middle income countries, finding highlights that the joint impact of outward FDI and home country institutions stimulate higher economic growth and accelerate economic integration into the global economy. These impacts were found to diminish moving from high to low-income countries, which suggests that home country institutional development and income economy level matters for outward FDI-induced growth effects. The study also discusses key implications for policy. © The Author(s) 2023.Ministry of Education and Science of the Russian Federation, MinobrnaukaThe author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: the Ministry of Science and Higher Education of the Russian Federation (Ural Federal University Program of Developing within the Priority-2030 Program)

Postmortem Examinations on Deceased Neonates: A Rarely Utilized Procedure in an African Referral Center

Postmortem examination remains the gold standard for the correct diagnosis of many diseases and for unraveling unexplained causes of death. This paper reports on the poor utilization of autopsy services and encourages parents/caregivers and practitioners to perform postmortem examinations on deceased neonates in sub-Saharan Africa. In a retrospective study, the records of 1093 neonates (653 males and 440 females, ratio 1.5:1) who died at the University of Benin Teaching Hospital and who were brought to the mortuary between 2006 and 2010 were reviewed to determine the utilization of and factors influencing postmortem examination. Sixty-two percent of the neonates died within the 1st week of life, and only 9 (0.8%) underwent a postmortem examination. Findings in the 9 postmortem studies performed on 7 males and 2 females provided additional information on the causes of death. The religious beliefs that neonates should not be subjected to postmortem study and beliefs that dead neonates are taboo and a punishment by the gods for past wrongdoings influenced 511 (46.8%) parents/caregivers to refuse postmortem analysis. The practitioners did not request postmortem study in 281 (25.7%) of the cases. The utilization of postmortem examination was marginal in this setting. We advocate the need for public enlightenment campaigns to modify the attitudes of parents/caregivers toward the postmortem study of deceased neonates. Policies should be formulated to mandate postmortem examinations of deceased neonates to enhance insight into neonatal disease, unravel unexplained causes of death, and improve the standard of neonatal care in this subregion.</jats:p

Les filles qui ont des organes génitaux ambigus dans une sous-région peu sensibilisée

Congenital aberrations of female children’s external genitalia are common worldwide with varied mode of presentation especially in regions with poor awareness. This prospective experience between July 2004 and June 2008 at two Nigerian healthcare facilities is on the mode of presentation and challenges of management of female children with ambiguous genitalia. Congenital adrenal hyperplasia (CAH) 19 (47.5%), female pseudohermaphroditism 20 (50%) and vaginal atresia 1 (2.5%) manifested as aberrations of external genitalia of 40 female children who presented between the ages of 3 months and 16 years (average 9 years). Cultural influence, lack of awareness, inadequate examination of external genitalia at birth and lack of diagnostic facilities resulted in late presentation and diagnosis with all the cases of CAH and pseudohermaphroditism raised as males. Five cases who developed female secondary sexual characteristics at puberty attempted suicide before presentation. Gender reassignment and feminizing genitoplasty were major challenges, but outcomes were encouraging (Afr J Reprod Health 2009; 13[4]:129-136).Les aberrations congénitales des organes génitaux externes chez les filles sont communes partout dans le monde, ayant des divers modes de présentation dans les régions qui sont peu sensibilisées. Cette expérience prospective entre juillet 2004 et juin 2008 dans deux établissements de santé est basée sur le mode de présentation et les défis du traitement des filles qui ont des organes génitaux ambigus. L’hyperplasie surrénale congénitale (HSC) 19 (47,5%) le pseudohermaphrodisme 20 (50%) et l’atrésie vaginale 1 (2,5%) se sont manifestées comme des aberrations des organes génitaux externes des 40 filles qui se sont présentées entre les ages de 3 mois et 16 ans (âge moyen – 9 ans). L’influence culturelle, le manque de conscience, l’insuffisance de l’examen des organes génitaux à la naissance et le manque des établissements d’analyses médicales ont abouti à la présentation et au diagnostic tardifs, ce qui fait que tous les cas de HSC et du pseudohermaphrodisme ont été élevé comme des mâles. Cinq cas qui ont développé des caractéristiques sexuelles secondaires féminines ayant atteint l’âge de puberté ont tenté de se suicider avant de se présenter. La réattribution de sexes et la génioplastie féminisante ont été des défis principaux, mais les résultats ont été encouragements (Afr J Reprod Health 2009; 13[4]: 129-136)

Bone Trephining for Osteoid Osteoma Excision: A Case Report

Osteoid osteomas may be treated medically or surgically; both have similar long-term outcomes. Nonetheless, only surgery allows complete excision of the lesion for histological analysis. Excessive removal of surrounding bone may destabilise and weaken the bony structure and predispose it to fractures. We describe a surgical technique using a bone graft trephine to enable precise lesion removal with minimal bone excision. </jats:p

Les filles qui ont des organes génitaux ambigus dans une sous-région peu sensibilisée

Congenital aberrations of female children’s external genitalia are common worldwide with varied mode of presentation especially in regions with poor awareness. This prospective experience between July 2004 and June 2008 at two Nigerian healthcare facilities is on the mode of presentation and challenges of management of female children with ambiguous genitalia. Congenital adrenal hyperplasia (CAH) 19 (47.5%), female pseudohermaphroditism 20 (50%) and vaginal atresia 1 (2.5%) manifested as aberrations of external genitalia of 40 female children who presented between the ages of 3 months and 16 years (average 9 years). Cultural influence, lack of awareness, inadequate examination of external genitalia at birth and lack of diagnostic facilities resulted in late presentation and diagnosis with all the cases of CAH and pseudohermaphroditism raised as males. Five cases who developed female secondary sexual characteristics at puberty attempted suicide before presentation. Gender reassignment and feminizing genitoplasty were major challenges, but outcomes were encouraging (Afr J Reprod Health 2009; 13[4]:129-136).Les aberrations congénitales des organes génitaux externes chez les filles sont communes partout dans le monde, ayant des divers modes de présentation dans les régions qui sont peu sensibilisées. Cette expérience prospective entre juillet 2004 et juin 2008 dans deux établissements de santé est basée sur le mode de présentation et les défis du traitement des filles qui ont des organes génitaux ambigus. L’hyperplasie surrénale congénitale (HSC) 19 (47,5%) le pseudohermaphrodisme 20 (50%) et l’atrésie vaginale 1 (2,5%) se sont manifestées comme des aberrations des organes génitaux externes des 40 filles qui se sont présentées entre les ages de 3 mois et 16 ans (âge moyen – 9 ans). L’influence culturelle, le manque de conscience, l’insuffisance de l’examen des organes génitaux à la naissance et le manque des établissements d’analyses médicales ont abouti à la présentation et au diagnostic tardifs, ce qui fait que tous les cas de HSC et du pseudohermaphrodisme ont été élevé comme des mâles. Cinq cas qui ont développé des caractéristiques sexuelles secondaires féminines ayant atteint l’âge de puberté ont tenté de se suicider avant de se présenter. La réattribution de sexes et la génioplastie féminisante ont été des défis principaux, mais les résultats ont été encouragements (Afr J Reprod Health 2009; 13[4]: 129-136)