Frequency and Pattern of Gynecological Cancers in Federal Teaching Hospital, Abakaliki, Nigeria

Background: Gynecological cancers are common and are among the leading causes of cancer‑related deaths worldwide. Aim: The objective of this study was to determine the pattern and relative frequencies of gynecological cancers as seen at the Federal Teaching Hospital, Abakaliki, Nigeria. Materials and Methods: A 2‑year retrospective study of female genital tract malignancies was conducted at the Federal Teaching Hospital, Abakaliki. The case notes of patients admitted for female genital tract malignancy between January 1, 2012 and December 31, 2013 were retrieved from the ward admissions and discharge books and the operating theater record books. The data were analyzed using Statistical Package for Social Science (SPSS), IBM SPSS statistics Version 20, IBM incorporation and licensors 1989,2011 New York USA and the results expressed in descriptive statistics by simple percentages. Result: A total of 1,178 women were seen during the study period, while 99 were found to have gynecological malignancy. The proportion of gynecological malignancies was 8.4%. Majority of the patients were in the 5th and 6th decades of life, most (60.6%) had cervical cancer, followed by ovarian cancer (19.2%), endometrial cancer (10.1%) vulva cancer (7.1%), and the least was choriocarcinoma (3.0%). Tumors of fallopian tube and vagina were not seen during the study period. Majority of the patients presented late and the common presentation was vaginal bleeding. Conclusion: Despite the preventable nature of cancer of cervix, it remained the most common female genital tract malignancy in Abakaliki, southeast Nigeria. Education and public enlightenment on the importance of routine screening and treatment of premalignant lesions of the cervix are necessary tools to reduce the incidence and mortality of cervical cancer.KEY WORDS: Abakaliki, cancer, frequency, gynecologic, gynecological cancer, Nigeria, patter

Prevalence and Parasite Density of Asymptomatic Malaria Parasitemia among Unbooked Paturients at Abakaliki, Nigeria

Background: Malaria in pregnancy has contributed significantly to maternal morbidity and mortality in our environment.Aim: This study was aimed at determining the prevalence, and parasite density of asymptomatic malaria parasitemia among unbooked paturients at Federal Teaching Hospital Abakaliki. Subjects and Methods: This was a prospective cross‑sectional study conducted in the labor ward complex of the Federal Teaching Hospital Abakaliki over a period of three months from March to May 2012. Two hundred and fifty unbooked women presenting in labor at term and willing to participate were consecutively recruited. A structured data collection sheet was administered to each parturient. Thick and thin blood films were prepared for quantification and speciation of parasitemia respectively. Results: A total of 250 unbooked parturients participated in the study. The mean age of the parturients was 28.2 (7.2) years. One hundred and seven 107/250 (42.8%) were primigravid, 111/250 (44.4%) were between para 1‑4 while 32/250 (12.8%) were para 5 and above. Majority of the parturients 236/250 (95.2%) were of low socio‑economic class. The prevalence of asymptomatic malaria parasitemia was 77.6%. Asymptomatic malaria parasitemia was most prevalent among paturients of social class 5 (24/32 (75%) and primigravid paturients (93/107 (86.9%)) and the association of asymptomatic malaria parasitemia with parity (χ2 = 10.8, P = 0.01) and social class (χ2 = 10.88, P = 0.02) was statistically significant. Conclusion: There was high prevalence of asymptomatic malaria parasitemia in the study. Preconceptional care and early antenatal booking are advocated with emphasis on prevention of malaria infestation through health education and effective use of insecticide treated nets and intermittent prophylaxis therapy for malaria during pregnancy.Keywords: Asymptomatic malaria parasitemia, Nigeria, prevalence, unbooked paturient

Correlating low energy impact damage with changes in modal parameters: diagnosis tools and FE validation

This paper presents a basic experimental technique and simplified FE based models for the detection, localization and quantification of impact damage in composite beams around the BVID level. Detection of damage is carried out by shift in modal parameters. Localization of damage is done by a topology optimization tool which showed that correct damage locations can be found rather efficiently for low-level damage. The novelty of this paper is that we develop an All In One (AIO) package dedicated to impact identification by modal analysis. The damaged zones in the FE models are updated by reducing the most sensitive material property in order to improve the experimental/numerical correlation of the frequency response functions. These approximate damage models(in term of equivalent rigidity) give us a simple degradation factor that can serve as a warning regarding structure safety

Holographic and Wilsonian Renormalization Groups

We develop parallels between the holographic renormalization group in the bulk and the Wilsonian renormalization group in the dual field theory. Our philosophy differs from most previous work on the holographic RG; the most notable feature is the key role of multi-trace operators. We work out the forms of various single- and double-trace flows. The key question, `what cutoff on the field theory corresponds to a radial cutoff in the bulk?' is left unanswered, but by sharpening the analogy between the two sides we identify possible directions.Comment: 31 pages, 3 figures. v2: Minor clarifications. Added reference

Stakeholder narratives on trypanosomiasis, their effect on policy and the scope for One Health

Background This paper explores the framings of trypanosomiasis, a widespread and potentially fatal zoonotic disease transmitted by tsetse flies (Glossina species) affecting both humans and livestock. This is a country case study focusing on the political economy of knowledge in Zambia. It is a pertinent time to examine this issue as human population growth and other factors have led to migration into tsetse-inhabited areas with little historical influence from livestock. Disease transmission in new human-wildlife interfaces such as these is a greater risk, and opinions on the best way to manage this are deeply divided. Methods A qualitative case study method was used to examine the narratives on trypanosomiasis in the Zambian policy context through a series of key informant interviews. Interviewees included key actors from international organisations, research organisations and local activists from a variety of perspectives acknowledging the need to explore the relationships between the human, animal and environmental sectors. Principal Findings Diverse framings are held by key actors looking from, variously, the perspectives of wildlife and environmental protection, agricultural development, poverty alleviation, and veterinary and public health. From these viewpoints, four narratives about trypanosomiasis policy were identified, focused around four different beliefs: that trypanosomiasis is protecting the environment, is causing poverty, is not a major problem, and finally, that it is a Zambian rather than international issue to contend with. Within these narratives there are also conflicting views on the best control methods to use and different reasoning behind the pathways of response. These are based on apparently incompatible priorities of people, land, animals, the economy and the environment. The extent to which a One Health approach has been embraced and the potential usefulness of this as a way of reconciling the aims of these framings and narratives is considered throughout the paper. Conclusions/Significance While there has historically been a lack of One Health working in this context, the complex, interacting factors that impact the disease show the need for cross-sector, interdisciplinary decision making to stop rival narratives leading to competing actions. Additional recommendations include implementing: surveillance to assess under-reporting of disease and consequential under-estimation of disease risk; evidence-based decision making; increased and structurally managed funding across countries; and focus on interactions between disease drivers, disease incidence at the community level, and poverty and equity impacts

Synergies for Improving Oil Palm Production and Forest Conservation in Floodplain Landscapes

Lowland tropical forests are increasingly threatened with conversion to oil palm as global demand and high profit drives crop expansion throughout the world’s tropical regions. Yet, landscapes are not homogeneous and regional constraints dictate land suitability for this crop. We conducted a regional study to investigate spatial and economic components of forest conversion to oil palm within a tropical floodplain in the Lower Kinabatangan, Sabah, Malaysian Borneo. The Kinabatangan ecosystem harbours significant biodiversity with globally threatened species but has suffered forest loss and fragmentation. We mapped the oil palm and forested landscapes (using object-based-image analysis, classification and regression tree analysis and on-screen digitising of high-resolution imagery) and undertook economic modelling. Within the study region (520,269 ha), 250,617 ha is cultivated with oil palm with 77% having high Net-Present-Value (NPV) estimates ($413/ha?yr–$637/ha?yr); but 20.5% is under-producing. In fact 6.3% (15,810 ha) of oil palm is commercially redundant (with negative NPV of $-299/ha?yr-$-65/ha?yr) due to palm mortality from flood inundation. These areas would have been important riparian or flooded forest types. Moreover, 30,173 ha of unprotected forest remain and despite its value for connectivity and biodiversity 64% is allocated for future oil palm. However, we estimate that at minimum 54% of these forests are unsuitable for this crop due to inundation events. If conversion to oil palm occurs, we predict a further 16,207 ha will become commercially redundant. This means that over 32,000 ha of forest within the floodplain would have been converted for little or no financial gain yet with significant cost to the ecosystem. Our findings have globally relevant implications for similar floodplain landscapes undergoing forest transformation to agriculture such as oil palm. Understanding landscape level constraints to this crop, and transferring these into policy and practice, may provide conservation and economic opportunities within these seemingly high opportunity cost landscapes

Trends in healthcare utilization among older Americans with colorectal cancer: A retrospective database analysis

<p>Abstract</p> <p>Background</p> <p>Analyses of utilization trends (cost drivers) allow us to understand changes in colorectal cancer (CRC) costs over time, better predict future costs, identify changes in the use of specific types of care (eg, hospice), and provide inputs for cost-effectiveness models. This retrospective cohort study evaluated healthcare resource use among US Medicare beneficiaries diagnosed with CRC between 1992 and 2002.</p> <p>Methods</p> <p>Cohorts included patients aged 66+ newly diagnosed with adenocarcinoma of the colon (n = 52,371) or rectum (n = 18,619) between 1992 and 2002 and matched patients from the general Medicare population, followed until death or December 31, 2005. Demographic and clinical characteristics were evaluated by cancer subsite. Resource use, including the percentage that used each type of resource, number of hospitalizations, and number of hospital and skilled nursing facility days, was evaluated by stage and subsite. The number of office, outpatient, and inpatient visits per person-year was calculated for each cohort, and was described by year of service, subsite, and treatment phase. Hospice use rates in the last year of life were calculated by year of service, stage, and subsite for CRC patients who died of CRC.</p> <p>Results</p> <p>CRC patients (mean age: 77.3 years; 44.9% male) used more resources than controls in every category (<it>P </it>< .001), with the largest differences seen in hospital days and home health use. Most resource use (except hospice) remained relatively steady over time. The initial phase was the most resource intense in terms of office and outpatient visits. Hospice use among patients who died of CRC increased from 20.0% in 1992 to 70.5% in 2004, and age-related differences appear to have evened out in later years.</p> <p>Conclusion</p> <p>Use of hospice care among CRC decedents increased substantially over the study period, while other resource use remained generally steady. Our findings may be useful for understanding CRC cost drivers, tracking trends, and forecasting resource needs for CRC patients in the future.</p

Stressor- and Corticotropin releasing Factor-induced Reinstatement and Active Stress-related Behavioral Responses are Augmented Following Long-access Cocaine Self-administration by Rats

Rationale Stressful events during periods of drug abstinence likely contribute to relapse in cocaine-dependent individuals. Excessive cocaine use may increase susceptibility to stressor-induced relapse through alterations in brain corticotropin-releasing factor (CRF) responsiveness. Objectives This study examined stressor- and CRF-induced cocaine seeking and other stress-related behaviors in rats with different histories of cocaine self-administration (SA). Materials and methods Rats self-administered cocaine under short-access (ShA; 2 h daily) or long-access (LgA; 6 h daily) conditions for 14 days or were provided access to saline and were tested for reinstatement by a stressor (electric footshock), cocaine or an icv injection of CRF and for behavioral responsiveness on the elevated plus maze, in a novel environment and in the light–dark box after a 14- to 17-day extinction/withdrawal period. Results LgA rats showed escalating patterns of cocaine SA and were more susceptible to reinstatement by cocaine, EFS, or icv CRF than ShA rats. Overall, cocaine SA increased activity in the center field of a novel environment, on the open arms of the elevated plus maze, and in the light compartment of a light–dark box. In most cases, the effects of cocaine SA were dependent on the pattern/amount of cocaine intake with statistically significant differences from saline self-administering controls only observed in LgA rats. Conclusions When examined after several weeks of extinction/ withdrawal, cocaine SA promotes a more active pattern of behavior during times of stress that is associated with a heightened susceptibility to stressor-induced cocaine-seeking behavior and may be the consequence of augmented CRF regulation of addiction-related neurocircuitry

Disparities and risks of sexually transmissible infections among men who have sex with men in China: a meta-analysis and data synthesis.

BACKGROUND: Sexually transmitted infections (STIs), including Hepatitis B and C virus, are emerging public health risks in China, especially among men who have sex with men (MSM). This study aims to assess the magnitude and risks of STIs among Chinese MSM. METHODS: Chinese and English peer-reviewed articles were searched in five electronic databases from January 2000 to February 2013. Pooled prevalence estimates for each STI infection were calculated using meta-analysis. Infection risks of STIs in MSM, HIV-positive MSM and male sex workers (MSW) were obtained. This review followed the PRISMA guidelines and was registered in PROSPERO. RESULTS: Eighty-eight articles (11 in English and 77 in Chinese) investigating 35,203 MSM in 28 provinces were included in this review. The prevalence levels of STIs among MSM were 6.3% (95% CI: 3.5-11.0%) for chlamydia, 1.5% (0.7-2.9%) for genital wart, 1.9% (1.3-2.7%) for gonorrhoea, 8.9% (7.8-10.2%) for hepatitis B (HBV), 1.2% (1.0-1.6%) for hepatitis C (HCV), 66.3% (57.4-74.1%) for human papillomavirus (HPV), 10.6% (6.2-17.6%) for herpes simplex virus (HSV-2) and 4.3% (3.2-5.8%) for Ureaplasma urealyticum. HIV-positive MSM have consistently higher odds of all these infections than the broader MSM population. As a subgroup of MSM, MSW were 2.5 (1.4-4.7), 5.7 (2.7-12.3), and 2.2 (1.4-3.7) times more likely to be infected with chlamydia, gonorrhoea and HCV than the broader MSM population, respectively. CONCLUSION: Prevalence levels of STIs among MSW were significantly higher than the broader MSM population. Co-infection of HIV and STIs were prevalent among Chinese MSM. Integration of HIV and STIs healthcare and surveillance systems is essential in providing effective HIV/STIs preventive measures and treatments. TRIAL REGISTRATION: PROSPERO NO: CRD42013003721