Wandering spleen: A common presentation of an uncommon anomaly

Background: With the advent of real time ultrasonography of the abdomen, the spleen is no longer an inaccessible organ. Wandering spleen is a rare entity with only less than 500 cases reported so far. Method: This case report presents a 16-year- old Nigerian girl admitted in a medical centre but referred for ultrasonography on account of a clinical history of lower abdominal tenderness. Result: Ultrasonography examination revealed that the spleen was not found in its normal anatomical position. However, a well defined acoustic signature of the spleen was seen in the pelvis. Conclusion: Ultrasonography which is far cheaper than magnetic resonance imaging (MRI) and computed tomography (CT) is a valuable diagnostic aid in this conditio

Hysterosalpingographic Findings in Patients with Infertility in South Eastern Nigeria

Hysterosalpingography (HSG) is still an integral part of gynecological evaluation of infertile couple and its value has not been underestimated in modern gynecological practice, especially in developing countries.The study aims to evaluate the findings at HSG in patients presenting with infertility at the Ebonyi State University Teaching Hospital,Abakaliki, Southeastern Nigeria. A retrospective analysis of 100 consecutive HSG results of patients presenting with infertility was done between January 2005-April 2008. Their clinical records and radiological findings were analyzed for demographic data, and cervical, uterine and tubal, pathology.The commonest age group was between 25 -34 years. Sixty-five percent presented with secondary infertility while 35% presented with secondary infertility. Hysterosalpingographic findings were abnormal in 80% of patients(primary infertility 20% and secondary infertility 60%). Bilateral tubal blockage and bilateral fimbrial adhesion were the commonest tubal factor abnormalities while intracavitary mass impression and cervical synechia were the commonest findings for uterine and cervical factor abnormalities respectively. Tubal blockage and tubal factor infertilityare still common among infertile couples. This may probably be due to chronic pelvic inflammatory disease or pelvic infection following sexually transmitted infections, mismanaged pregnancies and septic abortions, as most of the patients presented with secondary infertility. Measures to prevent the occurrence of these infections are highlighted.Keywords: Hysterosalpingography, Infertility, Abakaliki, Southeastern Nigeria

Quantifying previous SARS-CoV-2 infection through mixture modelling of antibody levels.

As countries decide on vaccination strategies and how to ease movement restrictions, estimating the proportion of the population previously infected with SARS-CoV-2 is important for predicting the future burden of COVID-19. This proportion is usually estimated from serosurvey data in two steps: first the proportion above a threshold antibody level is calculated, then the crude estimate is adjusted using external estimates of sensitivity and specificity. A drawback of this approach is that the PCR-confirmed cases used to estimate the sensitivity of the threshold may not be representative of cases in the wider population-e.g., they may be more recently infected and more severely symptomatic. Mixture modelling offers an alternative approach that does not require external data from PCR-confirmed cases. Here we illustrate the bias in the standard threshold-based approach by comparing both approaches using data from several Kenyan serosurveys. We show that the mixture model analysis produces estimates of previous infection that are often substantially higher than the standard threshold analysis

The global impact of non-communicable diseases on macro-economic productivity: a systematic review

© 2015, The Author(s). Non-communicable diseases (NCDs) have large economic impact at multiple levels. To systematically review the literature investigating the economic impact of NCDs [including coronary heart disease (CHD), stroke, type 2 diabetes mellitus (DM), cancer (lung, colon, cervical and breast), chronic obstructive pulmonary disease (COPD) and chronic kidney disease (CKD)] on macro-economic productivity. Systematic search, up to November 6th 2014, of medical databases (Medline, Embase and Google Scholar) without language restrictions. To identify additional publications, we searched the reference lists of retrieved studies and contacted authors in the field. Randomized controlled trials, cohort, case–control, cross-sectional, ecological studies and modelling studies carried out in adults (>18 years old) were included. Two independent reviewers performed all abstract and full text selection. Disagreements were resolved through consensus or consulting a third reviewer. Two independent reviewers extracted data using a predesigned data collection form. Main outcome measure was the impact of the selected NCDs on productivity, measured in DALYs, productivity costs, and labor market participation, including unemployment, return to work and sick leave. From 4542 references, 126 studies met the inclusion criteria, many of which focused on the impact of more than one NCD on productivity. Breast cancer was the most common (n = 45), followed by stroke (n = 31), COPD (n = 24), colon cancer (n = 24), DM (n = 22), lung cancer (n = 16), CVD (n = 15), cervical cancer (n = 7) and CKD (n = 2). Four studies were from the WHO African Region, 52 from the European Region, 53 from the Region of the Americas and 16 from the Western Pacific Region, one from the Eastern Mediterranean Region and none from South East Asia. We found large regional differences in DALYs attributable to NCDs but especially for cervical and lung cancer. Productivity losses in the USA ranged from 88 million US dollars (USD) for COPD to 20.9 billion USD for colon cancer. CHD costs the Australian economy 13.2 billion USD per year. People with DM, COPD and survivors of breast and especially lung cancer are at a higher risk of reduced labor market participation. Overall NCDs generate a large impact on macro-economic productivity in most WHO regions irrespective of continent and income. The absolute global impact in terms of dollars and DALYs remains an elusive challenge due to the wide heterogeneity in the included studies as well as limited information from low- and middle-income countries.WHO; Nestle´ Nutrition (Nestec Ltd.); Metagenics Inc.; and AX

Juvenile rheumatoid arthritis in an 8 year old girl: a case report

No Abstract. Ebonyi Medical Journal Vol. 5 (2) 2006: pp. 73-7

Radiological evaluation of an infertile couple

Objective: To determine the level of awareness, knowledge and attitude of secondary school students in Owerri to HIV/AIDS. Methods: Semi-structured questionnaires were administered to six hundred randomly selected secondary school students from four secondary schools and the results were analyzed. Results: There was no significant difference in results from both sexes. All the students were aware of the disease. Viral aetiology was mentioned by 77.2% of all the students while 74.8% and 85.4% mentioned mother- to- child transmission and sexual intercourse respectively as modes of transmission. Blood transfusion and sharing of needles and syringes were mentioned by 92.8 % and 96.4% of the students respectively. Only 58.1% knew about the condom as a method of prevention. The students demonstrated a poor attitude to HIV/AIDS positive patients as 78.2% would not employ them while 10.6% want them isolated and 36.8% would avoid them. Mass media ;television ( (32.4% ) , radio ( 23.5%)) and health sources ( 26,1% ) were the major means of information. Conclusion: Because of the deficiencies in knowledge and the poor attitude of the students, these highlighted areas should be emphasized in media adverts. The introduction of reproductive health studies in secondary school curricula may also help in addressing these identified deficiencies. Keywords: Knowledge, Awareness, Attitude, HIV/AIDS, AdolescentsPort Harcourt Medical Journal Vol. 2 (3) 2008: pp. 233-23

Sonographic evaluation of cervical length changes during normal pregnancy

This study was aimed to establish reference values of cervical length in normal pregnancy. We studied a cross-sectional sample of 144 pregnant women by transabdominal sonography. The inclusion criteria were sonographic confirmation of gestational age, the absence of any risk factors for preterm birth, and uncomplicated pregnancy. Cervical length was measured in a straight line. Height, age and weight of patients were also obtained. There was a relationship between gestational age and cervical length, which could be described with a linear regression (R = 0.44;

Wandering spleen: A common presentation of an uncommon anomaly

Background: With the advent of real time ultrasonography of the abdomen, the spleen is no longer an inaccessible organ. Wandering spleen is a rare entity with only less than 500 cases reported so far. Method: This case report presents a 16-year- old Nigerian girl admitted in a medical centre but referred for ultrasonography on account of a clinical history of lower abdominal tenderness. Result: Ultrasonography examination revealed that the spleen was not found in its normal anatomical position. However, a well defined acoustic signature of the spleen was seen in the pelvis. Conclusion: Ultrasonography which is far cheaper than magnetic resonance imaging (MRI) and computed tomography (CT) is a valuable diagnostic aid in this condition

Guidelines for the management of HIV/AIDS in infants and older children in Lagos University Teaching Hospital

No abstract Nigerian Quarterly Journal of Hospital Medicine Vol. 13(1-2): 8-1

Impaired recruitment of HHT-1 mononuclear cells to the ischaemic heart is due to an altered CXCR4/CD26 balance

Aims Mononuclear cells (MNCs) from patients with hereditary haemorrhagic telangiectasia type 1 (HHT1), a genetic disorder caused by mutations in endoglin, show a reduced ability to home to infarcted mouse myocardium. Stromal cell-derived factor-1a (SDF-1 alpha) and the chemokine receptor CXCR4 are crucial for homing and negatively influenced by CD26. The aim of this study was to gain insight into the impaired homing of HHT1-MNCs. Methods and results CXCR4 and CD26 expression on MNCs was determined by flow cytometry. Transwell migration to SDF-1 alpha was used to analyse in vitro migration. Experimentally induced myocardial infarction in mice, followed by tail vein injection of MNCs, was applied to study homing in vivo. HHT1-MNCs expressed elevated levels of CXCR4, but this was counterbalanced by high levels of CD26, resulting in decreased migration towards an SDF-1 alpha gradient in vitro. Migration was enhanced by inhibiting CD26 with Diprotin-A. While MNCs from healthy controls responded to transforming growth factor-beta stimulation by increasing CXCR4 and lowering CD26 expression levels, HHT1-MNCs did not react as efficiently: in particular, CD26 expression remained high. Inhibiting CD26 on MNCs increased the homing of human cells into the infarcted mouse heart. Interestingly, the defect in homing of HHT1-MNCs was restored by pre-incubating the HHT1-MNCs with Diprotin-A before injection into the tail vein. Conclusion We show that a decreased homing of HHT1-MNCs is caused by an impaired ability of the cells to respond to SDF-1 alpha. Our results suggest that modulating CD26 levels using inhibitors like Diprotin-A can restore homing in cases where increased expression of CD26 contributes to the underlying pathological mechanism.Signal transduction in aging related disease