Assessment of age-related bone loss in normal South African women by means of the Hologic QDR 1000 system

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Polyarteritis nodosa presenting as a bladder outlet obstruction

Polyarteritis nodosa (PAN) of the urinary tract is rare. An unusual case of systemic PAN involving the bladder neck is described. A 27-year-old man, with known diastolic hypertension diagnosed 2 years earlier, was admitted with chronic urinary obstruction complicated by hydronephrosis. He had symptoms of myalgia and weight loss, was afebrile but had an elevated erythrocyte sedimentation rate and acute-on-chronic renal impairment. All virological and serological tests including hepatitis B and anti-neutrophil cytoplasmic antibody were negative. A computed tomography scan of the brain revealed small-vessel disease. A bladder neck mass was visualised on cystoscopy. Histological examination of this demonstrated a medium-sized necrotising vasculitis with small-vessel fibrinoid necrosis suggestive of PAN. At least six of the American College of Rheumatology criteria for PAN were met. The patient was treated with pulses of intravenous cyclophosphamide and oral corticosteroids with a good clinical response

African League Against Rheumatism (AFLAR) preliminary recommendations on the management of rheumatic diseases during the COVID-19 pandemic

Objectives To develop recommendations for the management of rheumatic and musculoskeletal diseases (RMDs) during the COVID-19 pandemic. Method A task force comprising of 25 rheumatologists from the 5 regions of the continent was formed and operated through a hub-and-spoke model with a central working committee (CWC) and 4 subgroups. The subgroups championed separate scopes of the clinical questions and formulated preliminary statements of recommendations which were processed centrally in the CWC. The CWC and each subgroup met by several virtual meetings, and two rounds of voting were conducted on the drafted statements of recommendations. Votes were online-delivered and recommendations were pruned down according to predefined criteria. Each statement was rated between 1 and 9 with 1–3, 4–6 and 7–9 representing disagreement, uncertainty and agreement, respectively. The levels of agreement on the statements were stratified as low, moderate or high according to the spread of votes. A statement was retired if it had a mean vote below 7 or a ‘low’ level of agreement. Results A total of 126 initial statements of recommendations were drafted, and these were reduced to 22 after the two rounds of voting. Conclusions The preliminary statements of recommendations will serve to guide the clinical practice of rheumatology across Africa amidst the changing practices and uncertainties in the current era of COVID-19. It is recognized that further updates to the recommendations will be needed as more evidence emerges

FRAX-based fracture probabilities in South Africa

Summary The hip fracture rates in South Africa were used to create ethnic-specific FRAX® models to facilitate fracture risk assessment. Introduction The aim of this study was to develop FRAX models to compute the 10-year probability of hip fracture and major osteoporotic fracture and assess their potential clinical application. Methods Age- and sex-specific incidence of hip fracture and national mortality rates were incorporated into a FRAX model for the White, Black African, Coloured and Indian population of South Africa. Age-specific 10-year probabilities of a major osteoporotic fracture were calculated in women to determine fracture probabilities at a femoral neck T score of -2.5 SD, or those equivalent to a woman with a prior fragility fracture. Fracture probabilities were compared with those from selected countries. Results Probabilities were consistently higher in Indian than in Coloured men and women, in turn, higher than in Black South Africans. For White South Africans, probabilities were lower than in Indians at young ages up to the age of about 80 years. When a BMD T score of −2.5 SD was used as an intervention threshold, FRAX probabilities in women age 50 years were approximately 2-fold higher than in women of the same age but with an average BMD and no risk factors. The increment in risk associated with the BMD threshold decreased progressively with age such that, at the age of 80 years or more, a T score of −2.5 SD was no longer a risk factor. Probabilities equivalent to women with a previous fracture rose with age and identified women at increased risk at all ages. Conclusions These FRAX models should enhance accuracy of determining fracture probability amongst the South African population and help guide decisions about treatment

Corticosteroid therapy and bone mass - comparison of rheumatoid arthritis and systemic lupus erythematosus

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Effect of varieties on growth components and dry matter yield of Lablab purpureus (L) sweet in the semi-arid region of Nigeria

Two years field trials were conducted in Maiduguri the Borno State Capital Nigeria to evaluate the effect of varieties on growth components and dry matter yield of three lablab varieties Lablab purpureus (L) sweet (white, black and brown). The experiment was laid in a randomized complete block design. Growth components were determined at 4, 6, 8, 10 and 12 weeks after planting and dry matter yield was determined at 12 weeks after planting in 2014 and 2015 cropping season. Results revealed that there was significant (P<0.05) difference between plant heights with the highest plant height (100.44cm) being for white variety in week 10 of 2014. There was no significant (P>0.05) difference recorded in leaf height in throughout the study period. There was no significant difference in dry matter yield however, highest yield of 28.10 t/ha was recorded for Brown lablab variety in 2014 compared to other varieties. From this study, it can be concluded that varietal difference has significantly affected the growth components and dry matter of three lablab varieties. The varieties of lablab investigated can be used as forage legumes which can improve animal performance and productivity.Keyword: Lablab varieties, dry matter yield, plant height, leaf numbe

Pomegranate peels as versatile adsorbents for water purification: Application of box–behnken design as a methodological optimization approach

Pomegranate peels (PGP) were tested as a green adsorbent for the removal of Ni(II) from contaminated water samples. Both raw (RPG), and char/burnt peels (BPG) were tested. A multivariate analysis approach, Box–Behnken (BB) design was executed to augment the efficiency of BPG as adsorbent. Three factors were considered thereof; contact time (CT), adsorbent dose (AD), and heavy metal concentration (HMC). The percentage of heavy metal removal was the designated response (Y). Main effects plot together with analysis of variance (ANOVA) were used to decide on the substantial factors. Obtained results showed that AD was the most significant linear factor, while the interaction between AD*HMC was the most influential two‐way interaction. Contour and response surface plots were used to study the factorial interactions and optimize the response. Desirability function was used to find the best factorial combination for maximum removal of Ni(II). Efficacies of both adsorbents were compared and BPG was more effectual achieving 99.99% removal of Ni(II). Surface morphology was characterized using FTIR, BET, SEM, and EDX analyses. Results indicated that functional groups such as hydroxyl, amino, carboxylic acid are available on surface of PGP and might be responsible for the adsorption process. © 2019 American Institute of Chemical Engineers Environ Prog, 38: e13223, 2019This work was made possible by UREP award [UREP 20-116-1-020] from the Qatar National Research Fund (a member of The Qatar Foundation). The statements made herein are solely the responsibility of the authors.Scopu