Serological Screening for Ante-Natal Toxoplasmosis in Maiduguri Municipal Council, Borno State, Nigeria

Toxoplasma gondii infection causes devastating defects including,  blindness, neurological impairment and mental retardation in congenitally infected children. Congenital infection occurs when a woman becomes infected during pregnancy; and the severity of the illness is related to the trimester period. This research was designed to evaluate the  seroprevalence of toxoplasmosis amongst pregnant women (n=90) using enzyme linked immunosorbent assay (ELISA) kit (Cortez Diagnostics Inc. USA). A structured questionnaire was used to collect socio-demographic data. A significant (x2 Cal 233.0/ x2 tab 124.1, p=0.01) overall prevalence of 22.2% (20/90) was obtained. Pregnant women within 25-29years had the highest prevalence of 33.3% (3/9); this was significant (x2 Cal 35.85/ x2 tab 9.21, p=0.01). An association between high levels of toxoplasma IgG and miscarriage was established in four of twenty five women who had suffered miscarriage (t cal 5.3/t tab 2.81, p=0.01). The results presented indicate that toxoplasmosis is a significant public health burden in the area of study, which requires drastic remedial measures.Key words: Toxoplasmosis, pregnant women, miscarriage, Nigeria L’infection de Toxoplasma gondii provoque des malformations dévastatrices, y compris, la cécité, des troubles neurologiques et un retard mental chez les enfants infectés congénitalement. L'infection congénitale se produit quand une femme est infectée au cours de la grossesse, et la gravité de la maladie est liée à la période de trimestre. Cette recherche a été conçue pour évaluer la séroprévalence de la toxoplasmose chez les femmes enceintes (n = 90) à l'aide de dosage immunoenzymatique (ELISA) (Cortez Diagnostics Inc. USA). Un questionnaire structuré a été utilisé pourrecueillir des données socio- démographiques. Une prévalence importante globale de 22,2 % (20/ 90) a été obtenu (p =0,01). Les femmes  enceintes dans les tranche d’âge25- 29 ans ont eu la plus forte prévalence de 33,3 % (3/9)qui était significative (p = 0,01). Une association entre des niveaux élevés de Toxoplasme IgG et fausse couche a été établie dans quatre des vingt-cinq femmes qui avaient subi une fausse couche (p = 0,01). Les résultats présentés indiquent que la toxoplasmose est un problème de santé publique dans cette localité, ce qui nécessite des mesures correctives drastiques.Mots clés: Toxoplasmose, femmes enceintes, fausses couches, Nigeria

Seroprevalence Survey of Rubella Antibodies among Pregnant Women in Maiduguri, Borno State, Nigeria

Rubella is a vaccine- preventable viral infection. Its etiologic agent, rubella virus was identified as a human teratogencapable of causing spectrum of birth defects described as congenital rubella syndrome (CRS) if the pregnant mother isinfected within the first trimester of pregnancy. A total of 90 pregnant women attending a secondary health carefacility in Maiduguri were screened for IgM and IgG antibodies using enzyme linked immunosorbent assay (ELISA)kit (Cortez Diagnostics Inc. USA). Of these, 37.8% (34/90) and 83.3% (75/90) were seropositive for anti-rubella IgM (x2Cal 5.1; p=0.05) and IgG respectively. Chi-square analysis (x2 Cal 38.38, p=0.05// x2 tab 31.41, p=0.05) revealed anassociation between miscarriage and IgG antibody level in twenty-one subjects. Pregnant women within 20-24yearshad the highest prevalence of 40% (36/90)( x2 Cal 4.22, p=0.05) : 44.4% (16/36) of them were seropositive for IgM (x2 Cal4.31, p=0.05). A marked surge in IgG antibody level, which tantamount acute infection, was observed in 15.6% (14/90)(x2 Cal 19.85, p=0.05) of the pregnant women. Pregnant women in the first trimester seropositive for anti-rubella IgMwere 36.4% (4/11), inferring that the fetuses of these women are susceptible to sequelae of rubella. This resulthighlights the consequence of rubella infection and confirms continuous circulation of rubella virus in the study area.There is need for vaccination of vulnerable population in order to ensure the control /elimination of rubella virus inNigeria.Key words: Rubella virus, teratogen, antibodies, Maiduguri La rubéole est une infection virale évitable par la vaccination. Son agent étiologique, virus de la rubéole a été identifiécomme un tératogène humain capable de provoquer le spectre de malformation congénitale décrite comme lesyndrome de rubéole congénitale (SRC) si la femme enceinte est infectée au cours du premier trimestre de lagrossesse. Au total, 90 femmes enceintes fréquentant un établissement de soins de santé secondaires à Maiduguri ontété dépistées pour le dosage des anticorps IgM et IgG à l'aide de kit immunoenzymatique (ELISA) (CortezDiagnostics Inc. USA). Parmi elles, 37,8% (34/90) et 83,3% (75/90) étaient séropositives respectivement pour lesanticorps anti-IgM (X2 Cal. 5,1, p=0,05) et IgG de la rubéole. L’analyse Chi-carré (X2 Cal. 38,38, p=0,05 /X2Tab. 31,41,p=0,05) a révélé une relation entre la fausse couche et le niveau d'anticorps IgG dans vingt-et-un sujets. Les femmesenceintes de 20 à 24 ans ont eu la plus forte prévalence de 40% (36/90) (X2 Cal. 4,22, p=0,05): 44,4% (16/36) d'entre ellesétaient séropositives pour les IgM (X2 Cal. 4,31, p=0,05). Une augmentation remarquable de taux d'anticorps IgG, équivalent à l’infection aiguë, a été observée chez 15,6% (14/90) (X2 Cal. 19,85, p=0,05) de femmes enceintes.Les femmesenceintes au premier trimestre, séropositives aux IgM anti-rubéole, ont été de 36,4% (4/11), déduisant que les foetus deces femmes sont sensibles aux séquelles de la rubéole. Ce résultat souligne la conséquence de la rubéole et confirme lacirculation continue du virus de la rubéole dans la zone d'étude. Il est nécessaire de vacciner la population vulnérableafin d'assurer le contrôle et/ou l’élimination du virus de la rubéole au Nigeria.Mots clés: virus de la rubéole, tératogènes, anticorps, MaiduguriArticle in English

Aberrant axillarybreast carcinoma: a case report andliterature review

Ectopic breast tissue (EBT) develops along the mammary line owing to incomplete embryologic regression of the mammary ridges. This includes supernumerary breasts and aberrant breast tissue, in which malignancy is rarely reported. The commonest site of ectopic breasts is at the axilla, and the subcutaneous axillary mass may pose a diagnostic challenge to theclinician. Case Report: We report the case of a 31 year old multiparous Nigerian woman who presented with a painless left axillary mass of two months' duration. The anatomical breasts were grossly and radiologically normal. A diagnosis of aberrant breast carcinoma in her left axilla was confirmed by tissue biopsy. She had wide local excision and left axillary dissection, followed by one course of cytotoxic chemotherapybeforeshe began radiotherapy. Conclusion: Malignancy of aberrant breast tissue is a rare entity. A high index of suspicion and a low threshold for biopsy of subcutaneous lesions in the periphery of the breast allows for early intervention and a better prognosis. Triple assessment with clinical, radiological and pathological assessment of lesions in the axilla or along the embryonic milk line can not be over-emphasized

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease

BACKGROUND: Patients with atherosclerotic vascular disease remain at high risk for cardiovascular events despite effective statin-based treatment of low-density lipoprotein (LDL) cholesterol levels. The inhibition of cholesteryl ester transfer protein (CETP) by anacetrapib reduces LDL cholesterol levels and increases high-density lipoprotein (HDL) cholesterol levels. However, trials of other CETP inhibitors have shown neutral or adverse effects on cardiovascular outcomes. METHODS: We conducted a randomized, double-blind, placebo-controlled trial involving 30,449 adults with atherosclerotic vascular disease who were receiving intensive atorvastatin therapy and who had a mean LDL cholesterol level of 61 mg per deciliter (1.58 mmol per liter), a mean non-HDL cholesterol level of 92 mg per deciliter (2.38 mmol per liter), and a mean HDL cholesterol level of 40 mg per deciliter (1.03 mmol per liter). The patients were assigned to receive either 100 mg of anacetrapib once daily (15,225 patients) or matching placebo (15,224 patients). The primary outcome was the first major coronary event, a composite of coronary death, myocardial infarction, or coronary revascularization. RESULTS: During the median follow-up period of 4.1 years, the primary outcome occurred in significantly fewer patients in the anacetrapib group than in the placebo group (1640 of 15,225 patients [10.8%] vs. 1803 of 15,224 patients [11.8%]; rate ratio, 0.91; 95% confidence interval, 0.85 to 0.97; P=0.004). The relative difference in risk was similar across multiple prespecified subgroups. At the trial midpoint, the mean level of HDL cholesterol was higher by 43 mg per deciliter (1.12 mmol per liter) in the anacetrapib group than in the placebo group (a relative difference of 104%), and the mean level of non-HDL cholesterol was lower by 17 mg per deciliter (0.44 mmol per liter), a relative difference of -18%. There were no significant between-group differences in the risk of death, cancer, or other serious adverse events. CONCLUSIONS: Among patients with atherosclerotic vascular disease who were receiving intensive statin therapy, the use of anacetrapib resulted in a lower incidence of major coronary events than the use of placebo. (Funded by Merck and others; Current Controlled Trials number, ISRCTN48678192 ; ClinicalTrials.gov number, NCT01252953 ; and EudraCT number, 2010-023467-18 .)

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

COMPLIANCE TOO DIABETIC MANAGEMENT AMONGST PATIENTS WITH DIABETES MELLITUS ATTENDING A GOVERNMENT HOSPITAL IN KANO, NORTHWESTERN NIGERIA

The physical, social, and economic burden of diabetes mellitus result mostly from the complications of the disease, which occur because of poor compliance to treatment. However, Physicians commonly ignore this important aspect of diabetic management. This study assessed patients' compliance to diabetic control measures using a combination of direct and indirect approaches. Objectives: The study aimed to assess diabetic patients’ compliance to management, as well as the Sociodemographic factors influencing their compliance. Methods: A cross sectional design was used to study 240 systematically selected diabetic patients from the diabetic clinic of a General Hospital. Subjects were interviewed using a semi-structured interviewer administered questioners, and data generated were analyzed using “Mini tab” 12.21 computer statistical software. Patients’ compliance was assessed using regularity of appointment visits, dietary control, regularity as drugs, modification of life style, and scored using a Likert scale. Results: More than one-third (37.1%) of the diabetic patients had good compliance to diabetic management, whereas 41.3% and 21.6% of them had moderate and poor compliance respectively. Compliance however varied for the different methods used to control the disease, with compliance to drug use being highest. The sex of the patients, their educational status, occupation, and their average monthly incomes were found to significantly influence the patients’ compliance to diabetic management. Conclusion: This study demonstrates that diabetic patients are being selective on the use of the disease control measures prescribed to them by their physicians.&nbsp

Evaluation of physical facilities and processing operations of major abattoirs in North-western states of Nigeria

The study was carried out to evaluate the physical facilities of four major abattoirs in North-western states of Nigeria these are: Mayanka abattoir in Kano, Kara abattoir in Sokoto, Zango abattoir Zaria and Kawo abattoir in Kaduna. The facilities of these abattoirs were evaluated based on their presence and functional status. Pictures were taken using digital camera to document conditions of the infrastructure and activities of the butchers. The present study showed that the basic components were in a deplorable state. The dilapidated conditions of the abattoirs were as a result of failure to enforce the use of standard facilities in carrying out abattoir operations and general maintenance in the understudied abattoirs. It was similarly observed that there was no proper record keeping, no formal ante-mortem and post-mortem meat inspection. Hygiene and sanitation were largely absent in these abattoirs. Diseases such as tuberculosis, contagious pleuropneumonia, fasciolosis and hydatidosis were most frequently encountered during the study. The results of focus-group interaction revealed that only 40% of butchers supported the use of standard  operating facilities during operation, while the remaining rejected the idea. It was concluded that all the major abattoirs in Kaduna, Kano and Sokoto states of North-western Nigeria were in a deplorable state and the dilapidated infrastructure could not support the production of safe and wholesome meat and meat products for human consumption.Keywords: Abattoir, Butcher, Meat, Physical facilities, Public health, Standard operating procedure

An audit of non-fatal assault injuries treated in Federal Medical Center(FMC), Nguru, North East Nigeria

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Vertical transmission of SARS-CoV-2 : a systematic review of systematic reviews

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