Barriers to Adoption of Family Planning among Women in Eastern Democratic Republic of Congo

The objectives of this survey were to identify women’s level of KAP toward FP; identify possible barriers to using FP; determine pregnancy spacing pattern; and ascertain the level of FP promotion by health workers. This was a 2-weeks cross-sectional survey at all maternity units in Butembo of post-partum women. 572 women were interviewed. FP knowledge was high (76%), perception good (80%). Majority used traditional methods (65%), mostly Calendar method (72%). Barriers to using modern FP included lack ofknowledge, fear of side effects, religious considerations and husband opposition. Unmet need for spacing and limiting was high (21 & 31%).For majority (56%), pregnancy spacing met WHO’s Healthy Timing and Spacing of Pregnancy recommendations. Promotion of FP was poor (42%). Training of health workers, advocating modern contraception, improving FP services in all public health facilities and promoting FP on each contact of women is highly recommended in this city (Afr J Reprod Health 2011; 15[1]: 69-77)

High levels of microRNA-21 in the stroma of colorectal cancers predict short disease-free survival in stage II colon cancer patients

Approximately 25% of all patients with stage II colorectal cancer will experience recurrent disease and subsequently die within 5 years. MicroRNA-21 (miR-21) is upregulated in several cancer types and has been associated with survival in colon cancer. In the present study we developed a robust in situ hybridization assay using high-affinity Locked Nucleic Acid (LNA) probes that specifically detect miR-21 in formalin-fixed paraffin embedded (FFPE) tissue samples. The expression of miR-21 was analyzed by in situ hybridization on 130 stage II colon and 67 stage II rectal cancer specimens. The miR-21 signal was revealed as a blue chromogenic reaction, predominantly observed in fibroblast-like cells located in the stromal compartment of the tumors. The expression levels were measured using image analysis. The miR-21 signal was determined as the total blue area (TB), or the area fraction relative to the nuclear density (TBR) obtained using a red nuclear stain. High TBR (and TB) estimates of miR-21 expression correlated significantly with shorter disease-free survival (p = 0.004, HR = 1.28, 95% CI: 1.06–1.55) in the stage II colon cancer patient group, whereas no significant correlation with disease-free survival was observed in the stage II rectal cancer group. In multivariate analysis both TB and TBR estimates were independent of other clinical parameters (age, gender, total leukocyte count, K-RAS mutational status and MSI). We conclude that miR-21 is primarily a stromal microRNA, which when measured by image analysis identifies a subgroup of stage II colon cancer patients with short disease-free survival

European clinical guidelines for Tourette syndrome and other tic disorders. Part II: pharmacological treatment

To develop a European guideline on pharmacologic treatment of Tourette syndrome (TS) the available literature was thoroughly screened and extensively discussed by a working group of the European Society for the Study of Tourette syndrome (ESSTS). Although there are many more studies on pharmacotherapy of TS than on behavioral treatment options, only a limited number of studies meets rigorous quality criteria. Therefore, we have devised a two-stage approach. First, we present the highest level of evidence by reporting the findings of existing Cochrane reviews in this field. Subsequently, we provide the first comprehensive overview of all reports on pharmacological treatment options for TS through a MEDLINE, PubMed, and EMBASE search for all studies that document the effect of pharmacological treatment of TS and other tic disorders between 1970 and November 2010. We present a summary of the current consensus on pharmacological treatment options for TS in Europe to guide the clinician in daily practice. This summary is, however, rather a status quo of a clinically helpful but merely low evidence guideline, mainly driven by expert experience and opinion, since rigorous experimental studies are scarce

Obstetric Hysterectomy in Rural Democratic Republic of the Congo: An Analysis of 40 Cases at Katwa Hospital

The objective of this study was to determine the incidence, indication, and outcome of obstetric hysterectomy at an Eastern DRC rural hospital. This was a seven year retrospective study. The incidence was 0.28%. Mean age and parity of patients was 35.8 and 7 respectively. Trend to have Obstetric Hysterectomy increased with an age of = 35 years and parity of = 5. The main indications were Post-Partum Hemorrhage (PPH) (40%) and Ruptured Uterus (27.5%). Maternal mortality was 5% compared to 0.18% for Caesarean practiced at the same study period; and perinatal mortality 35.5%. Most indications could be avoided by improvement of Obstetric care.Keywords: Obstetric hysterectomy, Katwa, DRC.African Journal of Reproductive Health Vol. 12 (1) 2008: pp. 60-6