Sickle Cell Disease and H3Africa: Enhancing Genomic Research on Cardiovascular Diseases in African Patients.

Sickle cell disease (SCD) has a high prevalence in sub-Saharan Africa. There are several cardiovascular phenotypes in SCD that contribute to its morbidity and mortality. SCD is characterised by marked clinical variability, with genetic factors playing key modulating roles. Studies in Tanzania and Cameroon have reported that singlenucleotide polymorphisms in BCL11A and HBS1L-MYB loci and co-inheritance of alpha-thalassaemia impact on foetal haemoglobin levels and clinical severity. The prevalence of overt stroke among SCD patients in Cameroon (6.7%) and Nigeria (8.7%) suggests a higher burden than in high-income countries. There is also some evidence of high burden of kidney disease and pulmonary hypertension in SCD; however, the burden and genetics of these cardiovascular conditions have seldom been investigated in Africa. Several H3Africa projects are focused on cardiovascular diseases and present major opportunities to build genome-based research on existing SCD platforms in Africa to transform the health outcomes of patients

Applying the WHO ICD-MM classification system to maternal deaths in a tertiary hospital in Nigeria: A retrospective analysis from 2014–2018

Background Addressing the problem of maternal mortality in Nigeria requires proper identification of maternal deaths and their underlying causes in order to focus evidence-based interventions to decrease mortality and avert morbidity. Objectives The objective of the study was to classify maternal deaths that occurred at a Nigerian teaching hospital using the WHO International Classification of Diseases Maternal mortality (ICD-MM) tool. Methods This was a retrospective observational study of all maternal deaths that occurred in a tertiary Nigerian hospital from 1st January 2014 to 31st December,2018. The WHO ICD-MM classification system for maternal deaths was used to classify the type, group, and specific underlying cause of identified maternal deaths. Descriptive analysis was performed using Statistical Package for Social Sciences (SPSS). Categorical and continuous variables were summarized respectively as proportions and means (standard deviations). Results The institutional maternal mortality ratio was 831/100,000 live births. Maternal deaths occurred mainly amongst women aged 25–34 years;30(57.7%), without formal education; 22(42.3%), married;47(90.4%), unbooked;24(46.2%) and have delivered at least twice;34(65.4%). The leading causes of maternal death were hypertensive disorders in pregnancy, childbirth, and the puerperium (36.5%), obstetric haemorrhage (30.8%), and pregnancy related infections (17.3%). Application of the WHO ICD-MM resulted in reclassification of underlying cause for 3.8% of maternal deaths. Postpartum renal failure (25.0%), postpartum coagulation defects (17.3%) and puerperal sepsis (15.4%) were the leading final causes of death. Among maternal deaths, type 1, 2, and 3 delays were seen in 30(66.7%), 22(48.9%), and 6(13.3%), respectively. Conclusion Our institutional maternal mortality ratio remains high. Hypertensive disorders during pregnancy, childbirth, and the puerperium and obstetric haemorrhage are the leading causes of maternal deaths. Implementation of evidence-based interventions both at the hospital and community levels may help in tackling the identified underlying causes of maternal mortality in Nigeria

Imprint cytology of osteosarcoma of the jaw: a case report

Introduction. Osteosarcomas are highly malignant bone-forming neoplasms that account for about 20% of all sarcomas. In light of their aggressive behavior, early diagnosis is crucial for determining adequate treatment. Dental professionals may be the first to detect jaw osteosarcomas in their initial stages. The aim of this case report is to draw attention to the possibility of diagnosing this tumor based on clinical, radiographical and cytological characteristics before confirmation by histology. Case presentation. A 24-year-old Afro-Brazilian man presented with swelling and pain on the left side of the mandible in the region of the third molar (tooth 38). Radiography showed a poorly delimited intraosseous lesion with radiolucent and radiopaque areas. The cytological aspects were consistent with the diagnosis of osteosarcoma, which was confirmed by biopsy. Conclusion. Imprint cytology was found to be a reliable, rapid and easy complementary examination. An early diagnosis of osteosarcoma of the jaw is fundamental to the early determination of an adequate treatment. © 2009 Cabral et al; licensee BioMed Central Ltd

An Investigation of Potable Water Supply Problems in Akinima Community, Ahoada West Local Government Area of Rivers State, Nigeria

The Millennium Development Goals (MDGs) recognizes clean water as a major factor that determines development and promotes livelihood and human well-being, thus it set time-bound target for overcoming non –availability and non-potability of drinking water. A Scenario that is prevalent in developing countries including Nigeria. The aim of this paper is to investigate the potability of drinking water in Akinima Community, a rural community in Ahoada West Local Government Area (LGA) of Rivers State. The community like many other rural communities in Nigeria has no pipe-borne water supply. The major sources of drinking water are harvested rainwater, water from boreholes, and rivers. These sources are indentified to have varied problems of contamination and pollution, which range from high levels of chemical and microbiological contamination of harvested rainwater and rivers respectively, to saline intrusion into river water sources. Point sources and non-point sources of water contamination/pollution are common. With the current state of affairs meeting the MDGs target of “Halving, by 2015, the proportion of people without sustainable access to safe drinking water” is a mirage. The research design for the study is basically survey design and experimental design. The instruments used for investigation are questionnaire survey, face to face interview and observation. Experimentation was done in the laboratory to investigate physical, chemical and microbiological samples of drinking water from the households in Akinima community. Both primary and secondary data are applied for the study. The sample size is statistically determined using Taro Yamani’s formula for a finite population. The basic sampling unit (BSU) is the household. Sampling techniques applied are both systematic sampling and random sampling for selection of house-types and households respectively. Descriptive and inferential statistics are applied to investigate the data. Major findings revealed that the three major drinking water sources are not safe for drinking, because the values are significantly difference from the National Drinking Water Quantity Standard (NDWQS) 2007. The paper recommends the development of technologies that should harness rainwater harvesting and the introduction of active Civil Society Organization (CSOs) interventions/participation in rural water supply in Akinima Community among others

Blinding Bilateral Hyperviscosity Retinopathy in a 43-Year-Old Nigerian Male with Lymphoplasmacytic Lymphoma: A Case Report and Management Challenges

Lymphoplasmacytic lymphomas are rare and may present with uncommon and devastating symptoms. We report a case of a 43-year-old male who presented with bleeding gums and sudden onset of bilateral blindness but was not on anticoagulants and had no family history of bleeding disorder. He had bilateral hyperpigmented infraorbital skin lesions, visual acuities (VA) of hand motion in both eyes (blindness), round and sluggish pupils, and bilateral diffuse and extensive retinal haemorrhages obliterating the retinal details with central visual field defects. The optical coherence tomography revealed retinal haemorrhage, oedema, detachment, and diffuse photoreceptors damage. Investigations revealed elevated ESR and β2 microglobulin, monoclonal peak on serum protein electrophoresis, high IG with lambda restriction on serum, and urine immunofixation with increased lymphocytes and plasma cells in the bone marrow. A diagnosis of lymphoplasmacytic lymphoma complicated by blinding hyperviscosity retinopathy was made. In the absence of an aphaeresis machine, he received four cycles of manual exchange blood transfusion (EBT) and commenced with chlorambucil/prednisolone due to difficulty in obtaining blood for continued EBT. His general condition and VA has improved and he is stable for more than six months into treatment

Management of Giant Cell Tumour: A Nigerian Experience

Giant cell tumours (GCT) are the commonest bone tumours worldwide. It is rarely malignant but when it does it progresses to fibrosarcoma with high mortality. Otherwise it causes poor cosmesis, disability and pathological fractures. A total of 19 cases of histologically established Giant cell tumour of the bone were reviewed prospectively in a 5 year study. 14 cases were benign, 4 malignant and one was a malignant transformation. Lesions around the knee accounted for 42.2% of the cases, but the radius was the commonest single bone affected with 26.3%. Eleven patients had curettage, five of them had autogenous bone grafting while the remaining six had bone grafting and plate augmentation. One patient had fore-quarter amputation while seven had tumour resection. There was no recurrence recorded among those that had currretage and autogenous bone grafting. 33% of those that had curettage and bone cementing as well as 16.6% of those that had resection presented with recurrence. One patient died within 3 months of surgery due to metastasis to the lungs, liver and spleen. Mean follow up was 9.2 months (range of 2 to 60 months). With early presentation, curretage and bone grafting is often effective; late presentation however has an increased risk of recurrence due to soft tissue involvement, dearth of investigative tools and financial constraints. Nigerian Journal of Surgical Sciences Vol. 17 (2) 2007: pp. 91-9