Outcome of childhood malignancies at the University of Port Harcourt Teaching Hospital: a call for implementation of palliative care

Background: Cancers in children are yet to be recognised as an important cause of childhood morbidity and mortality in developing countries where more than 70% of the world annual cases occur. Despite the limited resources and whatever the projected outcome, children with cancer need treatment, be it curative or palliative.Objectives: To determine outcome of cancers in children at the UPTH; identify factors that influence outcome, highlight the need for palliative care.Method: A retrospective study of cases of childhood malignancies admitted into Paediatric Oncology unit of UPTH over a two year period. Clinical profile of patients and outcome were analyzed using SPSS version 20.0.Results: Sixty cases were analysed: 35(58.3%) males, 25(41.7%) females giving a M:F ratio of 1.4:1. Under-fives constituted 55%. Twenty-seven (45%) patients presented within 4 weeks of onset of symptoms. Median duration of symptoms before presentation was 8 weeks while 36 (60%) had metastatic disease at diagnosis. Twenty patients (33.3%) defaulted with or without specific treatment. Mortality was recorded in 26(43.4%) of cases.Conclusion: There were more cases of cancer amongst under-fives with male preponderance. Late presentation, financial constraints and high default rate were contributory factors to poor outcome in most cases. Lack of palliative care left many families to face their sufferings.Keywords: Outcome, childhood malignancies, implementation, palliative car

Assessment of Workers’ Level of Exposure to Work-Related Musculoskeletal Discomfort in Dewatered Cassava Mash Sieving Process

This study was undertaken to assess the level of exposure of processors to work-related musculoskeletal disorder when using the locally developed traditional sieve in the sieving process. Quick ergonomic checklist (QEC)  involving the researcher’s and the processors’ assessment using the risk assessment checklist, was used in this assessment and data was obtained from a sample of one hundred and eight (108) processors randomly selected from three senatorial districts of Rivers State. Thirty-six processors from each zone comprising of 14 males and 22 females, were selected., and assessed on the bases of their back, shoulder/arm, wrist/hand and neck posture and frequency of movement during traditional sieving process. The result of the assessment showed that the highest risk of discomfort occurred at the region of the wrist/hand, followed by back, shoulder/arm, and neck. The posture used in the sieving process exposed the processors, not only to the discomfort of pain but also put them at high risk of musculoskeletal disorder at indicated by  a high level of percentage exposure of 66% QEC rating. The result indicated a need for immediate attention and change to an improved method that will reduce the discomfort on the body parts assessed. identified parts

Constraints on Omega_m and sigma_8 from weak lensing in RCS fields

We have analysed 53 square degrees of imaging data from the Red-Sequence Cluster Survey (RCS), and measured the excess correlations in the shapes of galaxies on scales out to ~1.5 degrees. We separate the signal into an ``E''- (lensing) and ``B''-mode (systematics), which allows us to study residual systematics. On scales larger than 10 arcminutes, we find no ``B''-mode. On smaller scales we find a small, but significant ``B''-mode. This signal is also present when we select a sample of bright galaxies. These galaxies are rather insensitive to observational distortions, and we therefore conclude that the oberved ``B''-mode is likely to be caused by intrinsic alignments. We therefore limit the cosmic shear analysis to galaxies with 22<R_C<24. We derive joint constraints on Omega_m and sigma_8, by marginalizing over Gamma, Omega_Lambda and the source redshift distribution, using different priors. We obtain a conservative constraint of $\sigma_8=0.45^{+0.09}_{-0.12} \Omega_m^{-0.55}$ (95% confidence). A better constraint is derived when we use Gaussian priors redshift distribution. For this choice of priors, we find $\sigma_8=(0.46^{+0.05}_{-0.07})\Omega_m^{-0.52}$ (95% confidence). Using our setof Gaussian priors, we find that we can place a lower bound on Gamma: Gamma>0.1+0.16\Omega_m$ (95% confidence). Comparison of the RCS results with three other recent cosmic shear measurements shows excellent agreement. The current weak lensing results are also in good agreement with CMB measurements, when we allow the reionization optical depth tau and the spectral index n_s to vary. We present a simple demonstration of how the weak lensing results can be used as a prior in the parameter estimation from CMB measurements to derive constraints on the reionization optical depth tau. (abridged)Comment: 9 pages, 6 figures, Accepted for publication in the Astrophysical Journa

Constraints on the Dark Matter Particle Mass from the Number of Milky Way Satellites

We have conducted N-body simulations of the growth of Milky Way-sized halos in cold and warm dark matter cosmologies. The number of dark matter satellites in our simulated Milky Ways decreases with decreasing mass of the dark matter particle. Assuming that the number of dark matter satellites exceeds or equals the number of observed satellites of the Milky Way we derive lower limits on the dark matter particle mass. We find with 95% confidence m_s > 13.3 keV for a sterile neutrino produced by the Dodelson and Widrow mechanism, m_s > 8.9 keV for the Shi and Fuller mechanism, m_s > 3.0 keV for the Higgs decay mechanism, and m_{WDM} > 2.3 keV for a thermal dark matter particle. The recent discovery of many new dark matter dominated satellites of the Milky Way in the Sloan Digital Sky Survey allows us to set lower limits comparable to constraints from the complementary methods of Lyman-alpha forest modeling and X-ray observations of the unresolved cosmic X-ray background and of dark matter halos from dwarf galaxy to cluster scales. Future surveys like LSST, DES, PanSTARRS, and SkyMapper have the potential to discover many more satellites and further improve constraints on the dark matter particle mass.Comment: 17 pages, 13 figures, replaced with final version published in Physical Review

Outcome of childhood malignancies at the University of Port Harcourt Teaching Hospital: a call for implementation of palliative care.

Background: Cancers in children are yet to be recognised as an important cause of childhood morbidity and mortality in developing countries where more than 70% of the world annual cases occur. Despite the limited resources and whatever the projected outcome, children with cancer need treatment, be it curative or palliative. Objectives: To determine outcome of cancers in children at the UPTH; identify factors that influence outcome, highlight the need for palliative care. Method: A retrospective study of cases of childhood malignancies admitted into Paediatric Oncology unit of UPTH over a two year period. Clinical profile of patients and outcome were analyzed using SPSS version 20.0. Results: Sixty cases were analysed: 35(58.3%) males, 25(41.7%) females giving a M:F ratio of 1.4:1. Under-fives constituted 55%. Twenty-seven (45%) patients presented within 4 weeks of onset of symptoms. Median duration of symptoms before presentation was 8 weeks while 36 (60%) had metastatic disease at diagnosis. Twenty patients (33.3%) defaulted with or without specific treatment. Mortality was recorded in 26(43.4%) of cases. Conclusion: There were more cases of cancer amongst under-fives with male preponderance. Late presentation, financial constraints and high default rate were contributory factors to poor outcome in most cases. Lack of palliative care left many families to face their sufferings

Maximum-Likelihood Comparisons of Tully-Fisher and Redshift Data: Constraints on Omega and Biasing

We compare Tully-Fisher (TF) data for 838 galaxies within cz=3000 km/sec from the Mark III catalog to the peculiar velocity and density fields predicted from the 1.2 Jy IRAS redshift survey. Our goal is to test the relation between the galaxy density and velocity fields predicted by gravitational instability theory and linear biasing, and thereby to estimate $\beta_I = \Omega^{0.6}/b_I,$ where $b_I$ is the linear bias parameter for IRAS galaxies. Adopting the IRAS velocity and density fields as a prior model, we maximize the likelihood of the raw TF observables, taking into account the full range of selection effects and properly treating triple-valued zones in the redshift-distance relation. Extensive tests with realistic simulated galaxy catalogs demonstrate that the method produces unbiased estimates of $\beta_I$ and its error. When we apply the method to the real data, we model the presence of a small but significant velocity quadrupole residual (~3.3% of Hubble flow), which we argue is due to density fluctuations incompletely sampled by IRAS. The method then yields a maximum likelihood estimate $\beta_I=0.49\pm 0.07$ (1-sigma error). We discuss the constraints on $\Omega$ and biasing that follow if we assume a COBE-normalized CDM power spectrum. Our model also yields the 1-D noise noise in the velocity field, including IRAS prediction errors, which we find to be be 125 +/- 20 km/sec.Comment: 53 pages, 20 encapsulated figures, two tables. Submitted to the Astrophysical Journal. Also available at http://astro.stanford.edu/jeff