Correlation of clinical data, anatomical site and disease stage in colorectal cancer

Objective: To evaluate the colorectal cancer clinical data with respect to the anatomical location and stage of disease. Design: Retrospective observational study. Setting: Kenyatta National Hospital (KNH), Nairobi, Kenya. Subjects: Two hundred and fifty three tumours were categorised as right colonic (RCC), left colonic (LCC) and rectal (RC) lesions. The distribution of symptoms (rectal bleeding, tenesmus, change in bowel habits, abdominal pain, intestinal obstruction, rectal mass), anaemia, transfusion requirement, and the Dukes\' stages were compared for right colon, left colon and rectal tumours. Results: There were 54 RCC, 59 LCC, 140 RC lesions. Patient delay from onset of symptom(s) to presentation was a mean of 26.6 ± 43, 20 ± 25 and 33.7 ± 42 weeks for right, left and rectal lesions respectively (p = 0.092). The proportion of patients presenting with rectal bleeding was 21%, 44% and 79% for RCC, LCC and RC lesions, respectively. The prevalence of intestinal obstruction was 14.8%, 27.1% and 43.6% in right, left and rectal lesions, respectively. The haemoglobin levels were significantly lower for right sided lesions (p = 0.05 for right colon/rectum pair; p = 0.059 for right colon/ left colon pair). The sites of the lesions had no relationship to the stage of disease at presentation. Conclusion: In patients with colorectal cancer, the duration of symptoms was prolonged irrespective of the anatomical sub-sites. Symptoms were evenly distributed across the anatomical regions except for bleeding and obstruction which predominated in rectal and left colon cancers respectively. This underlines the need for early investigations in patients with rectal bleeding, change of bowel habit, intestinal obstruction and anaemia. East African Medical Journla Vol. 85 (6) 2008: pp. 259-26

Fractional Statistics in terms of the r-Generalized Fibonacci Sequences

We develop the basis of the two dimensional generalized quantum statistical systems by using results on $r$-generalized Fibonacci sequences. According to the spin value $s$ of the 2d-quasiparticles, we distinguish four classes of quantum statistical systems indexed by $s=0,1/2:mod(1)$, $s=1/M:mod(1)$, $s=n/M:mod(1)$ and $0\leq s\leq 1:mod(1)$. For quantum gases of quasiparticles with $s=1/M:mod(1)$, $M\geq 2,$, we show that the statistical weights densities $\rho_M$ are given by the integer hierarchies of Fibonacci sequences. This is a remarkable result which envelopes naturally the Fermi and Bose statistics and may be thought of as an alternative way to the Haldane interpolating statistical method.Comment: Late

Activité hypoglycémique de l’extrait aqueux d’Ajuga iva L. schreber chez les rats diabétiques induite par l’alloxane

Ajuga iva (L) schreber est utilisé en médecine traditionnelle dans le traitement du diabète. Le but de cette étude était d'évaluer l'activité l'hypoglycémique de l'extrait aqueux de la partie aérienne de cette plante sur un modèle animal. L’extrait a été préparé dans de l'eau bouillante et le filtrat aqueux a été lyophilisé et conservé. A iva est une plante capable d’induire une hypoglycémie chez les rats diabétiques. Alloxane a été administré en dose unique (150 mg poids corporel / kg) par injection intra-péritonéal. Des rats femelles Wistar (n = 30) pesant 200 ± 2g divisés en 5 groupes, ont reçu des doses différentes (0,05 g/mL, 0,10 g/mL, 0,15 g/mL) par voie orale. Cette opération est répétée tous les jours pendant 3 semaines. La glycémie a été déterminée par la méthode enzymatique colorimétrique par spectrophotométrie. Seul l’extrait aqueux à forte dose a diminuée le taux du glucose sanguins de 62, 96±7, 30% comparativement au groupe control. Dans la présente étude, le potentiel hypoglycémiant de A iva est démontré chez le rat. Ces résultats confirment l'utilisation de cette plante comme antidiabétique.Mots-clés : Ajuga iva, extrait aqueux, alloxane, activité hypoglycémique, diabète.Hypoglycemic Activity of the aqueous extract of Ajuga iva L. in diabetic rats induced by alloxanAjuga iva (L) schreber is used in traditional medicine in the treatment of diabetes, The purpose of this study was to evaluate hypoglycemic effect of the aqueous extract of aerial parts of this plant on animal model. The extract was prepared in boiling water and the aqueous filtrate was lyophilized and conserved. A iva is a plant capable of inducing hypoglycemia in diabetic rats. Alloxan was administered as a single dose (150 mg body weight / kg) injection intaperitoneal injection. Female Wistar rats (n = 30) weighing 200 ± 2g divided into 5 groups received different doses (0.05 GML-1, 0.10 GML-1, 0.15 g / mL) by oral route. This is repeated every day for three weeks. Blood glucose was determined by the enzymatic and colorimetric method by spectrophotometry. Only the aqueous extract high dose rate decreased blood glucose of 62, 96 ± 7, 30% compared with the control group. In the present study, the hypoglycemic potential of the A iva was demonstrated in rats. These results give support to the traditional use of this plant as antidiabetic herbal medicine.Keywords : Ajuga iva L, aqueous extract, alloxan, diabetes, hypoglycemic activity

Comparing Strategies to Prevent Stroke and Ischemic Heart Disease in the Tunisian Population: Markov Modeling Approach Using a Comprehensive Sensitivity Analysis Algorithm.

Background. Mathematical models offer the potential to analyze and compare the effectiveness of very different interventions to prevent future cardiovascular disease. We developed a comprehensive Markov model to assess the impact of three interventions to reduce ischemic heart diseases (IHD) and stroke deaths: (i) improved medical treatments in acute phase, (ii) secondary prevention by increasing the uptake of statins, (iii) primary prevention using health promotion to reduce dietary salt consumption. Methods. We developed and validated a Markov model for the Tunisian population aged 35–94 years old over a 20-year time horizon. We compared the impact of specific treatments for stroke, lifestyle, and primary prevention on both IHD and stroke deaths. We then undertook extensive sensitivity analyses using both a probabilistic multivariate approach and simple linear regression (metamodeling). Results. The model forecast a dramatic mortality rise, with 111,134 IHD and stroke deaths (95% CI 106567 to 115048) predicted in 2025 in Tunisia. The salt reduction offered the potentially most powerful preventive intervention that might reduce IHD and stroke deaths by 27% (−30240 [−30580 to −29900]) compared with 1% for medical strategies and 3% for secondary prevention. The metamodeling highlighted that the initial development of a minor stroke substantially increased the subsequent probability of a fatal stroke or IHD death. Conclusions. The primary prevention of cardiovascular disease via a reduction in dietary salt consumption appeared much more effective than secondary or tertiary prevention approaches. Our simple but comprehensive model offers a potentially attractive methodological approach that might now be extended and replicated in other contexts and populations

Étude comparative de l’activité antispasmodique de l’extrait aqueux d’Ajuga iva L. et de l’ibuprofène chez les souris

Ajuga iva (L.) Schreber, utilisé dans la pharmacopée traditionnelle, pour des troubles gastro-intestinaux, le diabète et comme  hypocholestérolémiante. L’étude pharmacologique de l’extrait aqueux d’Ajuga iva (Lamiaceae) a été effectuée à l’aide de modèles animaux. L’évaluation de l’activité analgésique, montre que l’extrait aqueux à 0,4g/ L de cette plante induit une diminution du nombre de crampes abdominales dans le test de writhing provoqué par l’acide acétique à 1% Ajuga iva a un effet analgésique plus efficace que celui de l’ibuprofène, en effet ce dernier provoque une inhibition de la douleur de 77,53±3,80 % et celui de ,l’extrait aqueux d’Ajuga iva de 85,39±4,29 % pour la même concentration (200mg/kg). L’extrait aqueux d’Ajuga iva a des propriétés analgésiques qui justifient son usage traditionnel. Les effets  thérapeutiques sont induits par divers composés révélés lors du tri phyto chimique de cette plante (alcaloïdes, flavonoïdes, polyphénols, saponosides, et tanins catéchiques) qui constituent la base scientifique de l’utilisation thérapeutique traditionnelle de la plante étudiée.Mots- clés : Ajuga iva L., extrait aqueux, effet analgésique, ibuprofène, writhing test

African Traditional Cultural Values and Beliefs: A Driving Force to Natural Resource Management: A Study of Makonde District, Mashonaland West Province, Zimbabwe

Natural resources in Africa are in jeopardy of depletion as a result of increasing demographic pressure and  climate change. Sustainability of the natural resource base can be achieved through adoption of traditional cultural values and beliefs. This research was conducted in Makonde District, Mashonaland West Province of Zimbabwe. The research is qualitative in nature and employs the empirical case study research design through adopting the descriptive approach to data. The research involved description of knowledge, behaviors, perceptions and attitudes of the people in the Makonde District on cultural values and beliefs for the sustainable management of natural resources. The results of the study indicate that cultural norms and values such as totems, taboos, traditional ceremonies, and the formation of the old age group committees as well as the role of the spirit mediums have an impact of the conservation of natural resources namely tree species, water resources, forests, minerals and some sacred groves in Makonde district. Therefore, we recommend that traditional leaders should be a vital cog whenever natural resources management policy is crafted by central government. We also recommend cultural values and belief should be integrated into the development plans of the country. Keywords: natural  resources management, cultural values, beliefs, sustainabilit

Young patients with colorectal cancer at a tertiary hospital in Kenya, 1993–2005

BACKGROUND: The onset of colorectal cancer appears to be two to three decades earlier in developing countries. Data on whether colorectal cancer in the young has worse prognosis than in older patients is conflicting. METHOD: Clinical charts of 70 patients ≤40 years old were reviewed to determine clinical and pathological patterns and treatment outcomes. Their data were compared with a larger group of older patients treated between 1993-2005 at Kenyatta National Hospital in Nairobi, Kenya. RESULTS: The data retrieval was highest for sub-site distribution and lowest for pathology information. Patients ≤ 40 years of age comprised 27.3% of all colorectal cancer cases treated over the study period. There were 41 males (58.6%) and 29 (41.4%) females patients. The most common symptoms were abdominal pain (76.9%), change in bowel habit (71.4%) and rectal bleeding (54.3%). The mean duration of symptoms was 24.6 ± 30 months. The rate of advanced colorectal disease (Duke C and D) was 73.5%. Mean follow-up time was 5.8 months with median survival of only 6.9 months. The Duke staging, histology, symptom duration, locations of tumours, follow-up and the complication rates were similar for young and older patients. CONCLUSION: Younger patients form a significant proportion of colorectal cancer burden. Both the clinico-pathological characteristics and treatment outcome correspond to older individuals. It is suggested that the concluded colorectal symptoms in younger patients should also be aggressively evaluated including early endoscopy. A prospective follow-up study of patients with the disease will unravel the true survival picture

Anatomical variations of the carotid arteries in adult Kenyans

Objective: To describe the topography and anatomical variations of the carotid arteries among Kenyans. Design: A descriptive cross-sectional study. Setting: Department of Human Anatomy, University of Nairobi. Subjects: Eighty carotid arteries of forty cadavers were dissected. Results: The bifurcation of the commonest carotid artery was high (above the reference points) in 63.8% of vessels and the external carotid was antero-lateral to the internal carotid artery in 30% of the vessels. A linguo-facial trunk was the most common variation of the external carotid artery. The origin of the right common carotid artery was high and low in 10% and 2.6% of vessels respectively. Conclusion: The carotid arteries show important variability and thus emphasise caution for clinicians during surgical procedures in the neck. East African Medical Journla Vol. 85 (5) 2008: pp. 244-24