RECURRENT HYDATIDIFORM MOLE COMPLICATED BY TOXIC GOITRE.

Hyperthyroidism complicates few pregnancies, in many cases due to Graves' disease, Gestational trophoblastic disease is a rare cause of hyperthyroidism in which high levels of hCG causes activation of the thyrotrophin receptor to stimulate supraphysiological secretion of thyroid hormone with or without thyroid gland enlargement Molar pregnancies are usually not recurrent, however, women with a previous hydatidiform mole (HM) are at higher risk of having a second mole than women from the general population. After a prior molar pregnancy, the risk of having a second one is 540 times that of the general population, however familial molar pregnancies are exceedingly rare. Here we present a case of recurrent HM complicated by a toxic goiter in a patient with family history of molar pregnancy&nbsp

The prevalence of hyperthyroidism at university of maiduguri teaching hospital (UMTH), Maiduguri.

Hyperthyroidism and hypothyroidism are the two common thyroid disorders but there is paucity of information on the prevalence of hyperthyroidism in Nigeria in general and in Northeast of Nigeria in particular. Objective: To determine the prevalence of hyperthyroidism at University of Maiduguri Teaching Hospital. Method: A retrospective study done over a period of one year that reviews the results of serum TSH, T4 and T4 from 203 patients. Results: Eighty-nine (43.8%) and 79 (38.9%) patients had elevated serum levels of T3 and T4 respectively (i.e. were hyperthyroid), 114 (56.2%) and 112 (55.2%) patients had normal serum levels of T3 and T4 respectively (i.e. were euthyroid) while 12 (5.9%) patients had low serum levels of T4 only (i.e. were hypothyroid). The female to male ratio of hyperthyroidism was 4 and 1[T3 — female 68 (35.4%), male — 17(89%); T 4— female 59 (30.7%), male 15(7.8%)]. Age —group from 25—34 years was the most frequent. (51 patients) and with the highest prevalence of hyperthyroidism [T4- 19(14.2%); T4 18(13.4%)].The study further revealed a decline in the prevalence of hyperthyroidism as age increased. The finding of high prevalence of low TSH (20.8%) against high prevalence of elevated T3 and T4 [89(44.1% and 79(38.9%) respectively] in this study could suggest that the hyperthyroidism in the studied patients could have been largely caused by Graves' disease. Conclusion: This study revealed that thyroid disorders are not uncommon in our environment and the finding of high prevalence of low TSH above high TSH, suggested that the hyperthyroidism discovered in our study may have been largely caused by Grave's disease. We recommend that more laboratory diagnostic centre should be established in our environment where thyroid disorders can be diagnosed

The assessment of patients' perception and satisfaction of radiology waiting time in university of maiduguri teaching hospital.

The patient is the most important person in the entire hospital setup and it is the duty of the health care personnel to give special attention to the management of patient to enhance effective service delivery.Waiting time is the total time from registration until consultation with healthcare personnel.It is an aspect of care that patients value most. Objective: The aim of this study was to evaluate Patients' perceived satisfaction with waiting time in Department of Radiology, University of Maiduguri Teaching Hospital, Borno State Nigeria. Method: The study was a cross-sectional prospective survey, that targeted patients who presented at the radiology department for HSG and IVU over the period of six months with a response rate of 70%, (n=70). The mean age of the participants was 33.6years. Data was collected using a 23 item self-completion questionnaire designed in line with the objectives of the study. Data were categorized into groups and analyzed using statistical package for social sciences version 16.0, where descriptive statistics such as the mean, percentages and frequencies were generated and tabulated. Pearson's correlation at p<0.01(2 tailed) was used to test for relationship Results: The results showed that 64.3%, (n=45) were female while 35.7%, (n=25) were male, out of these, 42.9% (n=30) were referred for HSG, and 57.1% (n=40) were for IVU. Among the patients referred for IVU, 37.5%, (n=15) were female, and 62.5%, (n=25) were male. Waiting time (before and after investigation) and satisfaction was found to be significant at (p<0.01 2-tailed), with the waiting time. Conclusion: Insufficient number of counter service staff (Receptionist) and insufficient number of Radiologist and Radiographers were some of the factors that affect patient's satisfaction with waiting time, as investigations and reports were delayed.&nbsp

Hyperbaric oxygen therapy for late radiation-induced tissue toxicity: Prospectively patient-reported outcome measures in breast cancer patients

__Introduction:__ This study examines patient reported outcome measures of women undergoing hyperbaric oxygen treatment (HBOT) after breast-conserving therapy. __Method:__ Included were 57 women treated with HBOT for late radiation-induced tissue toxicity (LRITT) referred in the period January 2014-December 2015. HBOT consisted of (on average) 47 sessions. In total, 80 min of 100 % O2 was administered under increased pressure of 2.4 ATA. Quality of life was assessed before and after treatment using the European Organization for Research and Treatment of Cancer (EORTC) QLQ-BR23, and a NRS pain score. __Results:__ Fifty-seven women were available for evaluation before and after treatment. Before HBOT, patients had severe complaints of pain in the arm/shoulder (46 %), swollen arm/hand (14 %), difficulty to raise arm or move it sideways (45 %), pain in the area of the affected breast (67 %), swollen area of the affected breast (45 %), oversensitivity of the affected breast (54 %), and skin problems on/in the area of the affected breast (32 %); post HBOT, severe complaints were still experienced in 17, 7, 22, 15, 13, 15, and 11 % of the women, respectively. Differences were all significant. The NRS pain score improved at least 1 point (range 0-10) in 81 % of the patients (p < 0.05). __Conclusion:__ In these breast cancer patients treated with HBOT for LRITT, the patient-reported outcomes were positive and improvements were observed. HBOT was a well-tolerated treatment for LRITT and its side-effects were both minimal and reversible

Early cancer detection among rural and urban californians

BACKGROUND: Since the stage of cancer detection generally predicts future mortality rates, a key cancer control strategy is to increase the proportion of cancers found in the early stage. This study compared stage of detection for members of rural and urban communities to determine whether disparities were present. METHODS: The California Cancer Registry (CCR), a total population based cancer registry, was used to examine the proportion of early stage presentation for patients with breast, melanoma, and colon cancer from 1988 to 2003. Cancer stage at time of detection for these cancers was compared for rural and urban areas. RESULTS: In patients with breast cancer, there were significantly more patients presenting at early stage in 2003 compared to 1988, but no difference in the percentage of patients presenting with early stage disease between rural and urban dwellers. There were no differences in incidence in early stage cancer incidence between these groups for melanoma patients, as well. In colorectal cancer in 1988, significantly more patients presented with early stage disease in the urban areas (42% vs 34%, p < 0.02). However, over time the rural patients were diagnosed with early stage disease with the same frequency in 2003 as 1988. CONCLUSION: This analysis demonstrates that people in rural and urban areas have their breast, melanoma or colorectal cancers diagnosed at similar stages. Health care administrators may take this information into account in future strategic planning

Functional kinomics establishes a critical node of volume-sensitive cation-Cl^- cotransporter regulation in the mammalian brain

This is the final version of the article. Available from the publisher via the DOI in this record.There is another record in ORE for this publication: http://hdl.handle.net/10871/33424Cell volume homeostasis requires the dynamically regulated transport of ions across the plasmalemma. While the ensemble of ion transport proteins involved in cell volume regulation is well established, the molecular coordinators of their activities remain poorly characterized. We utilized a functional kinomics approach including a kinome-wide siRNA-phosphoproteomic screen, a high-content kinase inhibitor screen, and a kinase trapping-Orbitrap mass spectroscopy screen to systematically identify essential kinase regulators of KCC3 Thr991/Thr1048 phosphorylation – a key signaling event in cell swelling-induced regulatory volume decrease (RVD). In the mammalian brain, we found the Cl−-sensitive WNK3-SPAK kinase complex, required for cell shrinkage-induced regulatory volume decrease (RVI) via the stimulatory phosphorylation of NKCC1 (Thr203/Thr207/Thr212), is also essential for the inhibitory phosphorylation of KCC3 (Thr991/Thr1048). This is mediated in vivo by an interaction between the CCT domain in SPAK and RFXV/I domains in WNK3 and NKCC1/KCC3. Accordingly, genetic or pharmacologic WNK3-SPAK inhibition prevents cell swelling in response to osmotic stress and ameliorates post-ischemic brain swelling through a simultaneous inhibition of NKCC1-mediated Cl− uptake and stimulation of KCC3-mediated Cl− extrusion. We conclude that WNK3-SPAK is an integral component of the long-sought “Cl−/volume-sensitive kinase” of the cation-Cl− cotransporters, and functions as a molecular rheostat of cell volume in the mammalian brain.We thank the excellent technical support of the MRC-Protein Phosphorylation and Ubiquitylation Unit (PPU) DNA Sequencing Service (coordinated by Nicholas Helps), the MRC-PPU tissue culture team (coordinated by Laura Fin), the Division of Signal Transduction Therapy (DSTT) antibody purification teams (coordinated by Hilary McLauchlan and James Hastie). We are grateful to the MRC PPU Proteomics facility (coordinated by David Campbell, Robert Gourlay and Joby Varghese). We thank for support the Medical Research Council (MC_UU_12016/2; DRA) and the pharmaceutical companies supporting the Division of Signal Transduction Therapy Unit (AstraZeneca, Boehringer-Ingelheim, GlaxoSmithKline, Merck KGaA, Janssen Pharmaceutica and Pfizer; DRA). We thank Thomas J. Jentsch (Max-Delbrück-Centrum für Molekulare Medizin) for providing the KCC1/3 double KO mice and his reading of this manuscript. We thank Nathaniel Grey (Harvard) for providing the kinase inhibitor library used in this study (NIH LINCS Program grant U54HL127365). This work was also supported by a Harvard-MIT Neuroscience Grant (to KTK/SJE)