Histological Study of Lumbosacral Spinal Cord of Mice Embryos who’s Mothers were Administered Retinoic Acid

The usefulness of retinoic acid (RA) in reproduction, embryonic and fetal development, growth and tissue maintenance has been established. Excess/low consumption of RA by pregnant rat also leads to congenital malformations affecting the musculoskeletal system and nervous system. The aim of this study was to investigate the histological changes of the lumbosacral spinal cord in mice embryos whose mothers were administered RA on day 8 post coitum (dpc). Twenty pregnant albino mice were divided into two groups of 10 each. The experimental group received a single dose (70mg/kg) of RA dissolved in vegetable oil by gastrointestinal route, delivered by gavage on gestational day 8, while the control group received only vegetable oil by the same route on gestational day 8. The animals were all sacrificed on gestational day 14 and their embryos harvested and studied. Gross malformations were observed around the lumbosacral region. Microscopic observations revealed reduction in left and right anterior horn thickness (diameter) of the lumbosacral spinal cord region of experimental group (0.01885mm ± 0.00045mm and 0.01872mm ± 0.00054mm) against control (0.02015mm ± 0.00065mm and 0.02002mm ± 0.00054mm) P<0.05. Quantification of left and right lumbosacral anterior horn cell density revealed reduction in cell density of experimental group (354.4 ±4.77493 and 351.6 ± 6.542) P<0.05 against control (366.0 ± 6.245 and 366.4 ± 7.056). This study showed that one dose of 70mg/kg RA administered through the gastrointestinal route by gavage to pregnant mice on 8dpc caused neural tube defect such as spina bifida occluta, reduction in embryonic neural cell proliferation, reduction of lumbosacral anterior grey horn density and thickness. Key Words: Administration, Embryonic, Gestational, Malformation, Spina bifida

Meta-analysis of factors affecting prevalence estimates of HIV-associated neurocognitive disorder in sub-Saharan Africa

Successful treatment of HIV with anti-retroviral therapy (ART) is resulting in more people living with HIV-associated neurocognitive disorder (HAND). In sub-Saharan Africa, this calls for strategic planning and judicious allocation of scarce resources, which requires an accurate estimate of the prevalence of HAND. Estimates of the prevalence of HAND in sub-Saharan Africa vary greatly, between 18.8% and 88.3%. This variability may be explained by factors such as different diagnostic approach, neuromedical examination, ART status, sampling method, substance abuse, assessors’ qualification, depression and outcome measure. Different methods of diagnosing HAND, different outcome measures and non-random sampling techniques make it almost impossible to accurately estimate the prevalence of HAND in subSaharan Africa, often resulting in overestimation of the burden of disease. Consumers of health research should consider certain study characteristics and exercise appropriate caution when interpreting burden of disease in sub-Saharan Africa, especially when pursuing policy shift. Underestimating the prevalence of HAND will certainly affect the capacity and speed of containment, while overestimating will draw unnecessary attention and result in the misallocation of scarce resources. Significance: • The high prevalence of HAND in sub-Saharan Africa as estimated in this review calls for further research on the impact of HAND on activities of daily living and putative therapeutic modalities. • We highlight which study characteristics should be critically checked when using prevalence estimates for the purpose of health policy and distribution of scarce resources in sub-Saharan Africa. • By favouring certain factors, this review will guide HIV health researchers in which techniques should be used to estimate the burden of HAND. These factors may also apply to estimating the burden of other diseases in sub-Saharan Africa.University of Pretoria.https://sajs.co.zaPhysiotherap

A qualitative study exploring healthcare workers’ lived experiences of the impacts of COVID-19 policies and guidelines on maternal and reproductive healthcare services in the United Kingdom

INTRODUCTION During the COVID-19 pandemic, pregnant women were regarded as vulnerable to poor health outcomes if infected with the SARS-CoV-2 (COVID-19) virus. To protect the United Kingdom’s (UK) National Health Service (NHS) and pregnant patients, strict infection control policies and regulations were implemented. This study aimed to understand the impact of the COVID-19 policies and guidelines on maternal and reproductive health services during the pandemic from the experiences of healthcare workers (HCWs) caring for these patients. METHODS This qualitative study involved HCWs from the United Kingdom Research study into Ethnicity and COVID-19 outcomes in Healthcare workers (UK-REACH) project. Semi-structured interviews and focus groups were conducted online or by telephone with 44 diverse HCWs. Transcripts were thematically analyzed following Braun and Clarke’s principles of qualitative analysis. RESULTS Three key themes were identified during analysis. First, infection control policies impacted appointment availability, resulting in many cancellations and delays to treatment. Telemedicine was also used extensively to reduce risks from face-to-face consultations, disadvantaging patients from minoritized ethnicities. Secondly, staff shortages and redeployments reduced availability of consultations, appointments, and sonography scans. Finally, staff and patients reported challenges accessing timely, reliable and accurate information and guidance. CONCLUSIONS COVID-19 demonstrated how a global health crisis can impact maternal and reproductive health services, leading to reduced service quality and surgical delays due to staff redeployment policies. Our findings underscore the implications of policy and future health crises preparedness. This includes tailored infection control policies, addressing elective surgery backlogs early and improved dissemination of relevant vaccine information

Hunger, waiting time and transport costs: Time to confront challenges to ART adherence in Africa

International audienceAdherence levels in Africa have been found to be better than those in the US. However around one out of four ART users fail to achieve optimal adherence, risking drug resistance and negative treatment outcomes. A high demand for 2nd line treatments (currently ten times more expensive than 1st line ART) undermines the sustainability of African ART programs. There is an urgent need to identify context-specific constraints to adherence and implement interventions to address them. We used rapid appraisals (involving mainly qualitative methods) to find out why and when people do not adhere to ART in Uganda, Tanzania and Botswana. Multidisciplinary teams of researchers and local health professionals conducted the studies, involving a total of 54 semi-structured interviews with health workers, 73 semi-structured interviews with ART users and other key informants, 34 focus group discussions, and 218 exit interviews with ART users. All the facilities studied in Botswana, Tanzania and Uganda provide ARVs free of charge, but ART users report other related costs (e.g. transport expenditures, registration and user fees at the private health facilities, and lost wages due to long waiting times) as main obstacles to optimal adherence. Side effects and hunger in the initial treatment phase are an added concern. We further found that ART users find it hard to take their drugs when they are among people to whom they have not disclosed their HIV status, such as co-workers and friends. The research teams recommend that (i) health care workers inform patients better about adverse effects; (ii) ART programmes provide transport and food support to patients who are too poor to pay; (iii) recurrent costs to users be reduced by providing three-months, rather than the one-month refills once optimal adherence levels have been achieved; and (iv) pharmacists play an important role in this follow-up care

The prevalence and long-term health effects of Long Covid among hospitalised and non-hospitalised populations: A systematic review and meta-analysis

BACKGROUND: The aim of this study was to systematically synthesise the global evidence on the prevalence of persistent symptoms in a general post COVID-19 population. METHODS: A systematic literature search was conducted using multiple electronic databases (MEDLINE and The Cochrane Library, Scopus, CINAHL, and medRxiv) until January 2022. Studies with at least 100 people with confirmed or self-reported COVID-19 symptoms at ≥28 days following infection onset were included. Patient-reported outcome measures and clinical investigations were both assessed. Results were analysed descriptively, and meta-analyses were conducted to derive prevalence estimates. This study was pre-registered (PROSPERO-ID: CRD42021238247). FINDINGS: 194 studies totalling 735,006 participants were included, with five studies conducted in those <18 years of age. Most studies were conducted in Europe (n = 106) or Asia (n = 49), and the time to follow-up ranged from ≥28 days to 387 days. 122 studies reported data on hospitalised patients, 18 on non-hospitalised, and 54 on hospitalised and non-hospitalised combined (mixed). On average, at least 45% of COVID-19 survivors, regardless of hospitalisation status, went on to experience at least one unresolved symptom (mean follow-up 126 days). Fatigue was frequently reported across hospitalised (28.4%; 95% CI 24.7%-32.5%), non-hospitalised (34.8%; 95% CI 17.6%-57.2%), and mixed (25.2%; 95% CI 17.7%-34.6%) cohorts. Amongst the hospitalised cohort, abnormal CT patterns/x-rays were frequently reported (45.3%; 95% CI 35.3%-55.7%), alongside ground glass opacification (41.1%; 95% CI 25.7%-58.5%), and impaired diffusion capacity for carbon monoxide (31.7%; 95% CI 25.8%-3.2%). INTERPRETATION: Our work shows that 45% of COVID-19 survivors, regardless of hospitalisation status, were experiencing a range of unresolved symptoms at ∼ 4 months. Current understanding is limited by heterogeneous study design, follow-up durations, and measurement methods. Definition of subtypes of Long Covid is unclear, subsequently hampering effective treatment/management strategies. FUNDING: No funding

Lower limb amputationa: Study of indications in hospitals in South Eastern Nigeria

No Abstract

Unusual formation of the median nerve at the level of the distal half of the arm

Median nerve is one of the terminal branches of the brachial plexus associated with several variations most of which are reported in the literature. Some of these variations include abnormal communications with other nerves such as musculocutaneous and ulnar nerves, splitting of the nerve, penetration of the nerve by other vessels such as brachial artery, variations with the areas of innervation of the nerve and also with the number roots forming this nerve. This study reported the formation of the median nerve at an unusually low level in the arm. This unusual level of formation was compared with standard course of this nerve as described in the anatomy  literature and atlases

Anthropometric study on the effect of social scale on adiposity blood pressure of married Igbo woman in Nigeria

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The influence of age on lipid profile among women taking hormonal contraceptives

Family planning clinic and women at large, in Port Harcourt, Rivers State, have adopted the administration of hormonal contraceptives to cub incessant occurrence of unplanned pregnancies among women within the reproduction age. This study was carried out to evaluate the effect of hormonal contraceptives (Medroxyprogesterone acetate or Norethisterone oenanthate) on lipid profile of premenopausal women at different age groups. Total cholesterol (TC), Triglycerides (TG), High.Density LipoproteinCholesterol (HDL-C) and Low Density Lipoprotein Cholesterol (LDL-C), of both women who were users and non-users of hormonal contraceptives at different age groups (16-25, 26-35, and 36-45 years of age) wereestimated using enzymatic method. There were raised levels of TG, TC, HDL-C and reduced level of LDL-C among women taking hormonal contraceptives. The increase levels of TC and HDL-C in women within the age range of 26-35 years was significant (p.0.05). The result obtained suggested that the use of hormonal contraceptives do not impose any cardiovascular risk among these women in all age groups, rather, a beneficial effect. Women within the age range of 26-35 years by this study, had effect that is more beneficial because they had significantly high levels of TC and HDL-C, and reduced Castelli risk index I and II (TC/HDL-C andLDL-C/HDL-C respectively)