Comparison of absolute neutrophil to CD4 lymphocyte values as a marker of immunosuppression in cancer patients on cytotoxic chemotherapy

Background: The absolute neutrophil count (ANC) is currently used to assess immune status of patients on cytotoxic therapy. The CD4 lymphocytes have also been shown to be of importance in protection against opportunistic infections. In people of African descent a low baseline ANC has been recorded and the currently accepted neutropaenic threshold may not be appropriate.Objective: This study was aimed at comparing the change in ANC to CD4 lymphocyte count in adult cancer patients following chemotherapy.Patients and methods: Eighty chemotherapy-naive patients with various malignancies had their ANC and CD4 lymphocyte counts done at days 0 and 12 of the first cycle of various chemotherapeutic regimens. The paired sample t-test was done to assess the significance between these values. Socio-demographic data was obtained using questionnaires.Results: ANC and CD4 pre-chemotherapy differed significantly from their post-chemotherapy values (p=0.001) for both parameters). The CD4 count showed significant reduction in patients with Non-Hodgkin’s lymphoma (p=0.043), colorectal carcinoma (p=0.037) and other malignancies (p=0.030), while the ANC did not. Patients who had received COPP for Hodgkin’s lymphoma also had significant CD4 depletion (p=0.037).Conclusion: The CD4 lymphocyte count may be a more suitable parameter than ANC, for monitoring immuno-depletion in cancer patients on cytotoxic chemotherapy. Further studies are required to validate these findings, especially in the Negroid population.Keywords: cancer, chemotherapy, immunosuppression, absolute neutrophil count, CD4 lymphocyte

THE RELATIONSHIP BETWEEN CHILD SEXUAL, PHYSICAL, PSYCHOLOGICAL, EMOTIONAL AND RITUALISTIC ABUSE AMONG HIGH SCHOOL STUDENTS IN THE NORTHERN PROVINCE, SOUTH AFRICA

This study is an investigation into the relationship between child sexual, physical, psychological, emotional and ritualistic abuse among high school students in the Northern Province (South Africa). Gender and urban-rural differences are also examined in relation to child sexual abuse. The method of secondary data analysis was used to analyse the same data used by Madu and Peltzer (1998, 2000) and Madu, Peltzer and Mashego (1998). Logistic Regression Analysis shows that among all the participants child sexual abuse correlates positively with psychological and emotional forms of child abuse. No gender correlated significantly with child sexual abuse. Chi-Square analysis for village-urban difference shows that child sexual abuse occurs more often in the urban areas than in the villages. The authors conclude that mental health workers and social workers should take note of the above relationship in planning preventive and therapeutic strategies for victims of child abuse in the area

Avascular necrosis in sickle cell (homozygous S) patients: Predictive clinical and laboratory indices

Background: Pathogenetic mechanism as well as laboratory and clinical correlates of osteonecrosis in sickle cell have not been fully investigated. The aim of this study is to investigate the predictive value of the steady state white cell and platelet count as well as the frequency of bone pain crisis per annum to detect sickle cell patients who will eventually develop avascular necrosis (AVN).Patients and Methods: A 5 year retrospective analysis of 122 homozygous S (HbSS) patients, aged 6‑49 years (mean age 24.7 ± 7 years), out of which 16 patients (13.1%) had developed AVN within the years under review.Results: The prevalence of AVN in sickle cell patients was determined to be 13.1 per 1000. The steady state white cell count, platelet count, frequency of bone pain crisis and hematocrit, was compared in patients that develop AVN and those who had not over the period. Only the steady state platelet count was found to differ significantly (P = 0.011) between these two patient groups and to correlate positively (Pearson correlation coefficient = −0.251) with development of AVN. The hematocrit, white cell count, and frequency of bone pain crisis were found neither to differ significantly nor correlate with the development of AVN.Conclusion: In conclusion, patients with a raised steady state platelet count may have a higher tendency to develop AVN and may require closer orthopedic review and prophylactic intervention.Key words: Avascular necrosis, homozygous S, platelet count, sickle cell anemia, white cell coun

Prevalence and associations of symptomatic renal papillary necrosis in sickle cell anemia patients in South‑Eastern Nigeria

Aim: To assess the prevalence and associations of symptomatic renal papillary necrosis (RPN) in sickle cell anemia patients.Patients and Methods: The case notes of homozygous hemoglobin (Hb) S patients diagnosed with RPN were retrospectively assessed. Diagnosis was based on microscopic hematuria and positive ultrasound findings. Their steady state diastolic blood pressure, Hb, leukocyte count, platelet count, serum direct bilirubin, and aspartate transaminase, were obtained by automated analyzers. These were evaluated for any relationship with the occurrence of RPN.Results: Two hundred and twenty patients were assessed aged 6–55 years with a median age of 24 years. The prevalence of symptomatic RPN was found to be 2.3%. RPN was positively associated with the female gender (Chi‑square P value 0.001), but not with any other clinical or laboratory variable. However, other predictors of disease severity were positively associated with RPN such as age, diastolic blood pressure 0.180 (P = 0.016), serum aspartate transaminase, serum bilirubin 0.145 (0.027), Hb, and leukocyte count − 0.155 (P = 0.003).Conclusion: The prevalence of symptomatic RPN is low in this group of homozygous S patients and occurs more commonly in females. Improvement in care for these patients will reduce these chronic complications.Keywords: Female gender, microscopic hematuria, renal papillary necrosis, sickle cell anemi

APPRAISAL OF THE FACTORS OF RURAL-URBAN MIGRATION IN SOUTHEASTERN NIGERIA

 This study highlighted the pattern, and examined the factors of rural-urban migration in Southeastern Nigeria. The primary data for this study was generated through questionnaire surveys and key informant interviews. A total of 225 rural-urban migrants were administered with the questionnaire across the five states, five urban areas and fifteen rural Local Government Areas covered by this study. The data generated from the fieldwork were analyzed with descriptive statistics, analysis of variance, and principal component analysis. Results of the study show that over 70percent of the migrants are males while over 80percent of them are also single or married. The analysis of variance shows that while some factors vary significantly across the study area in determining rural-urban migration, others do not. The principal component analysis reduced the factors to thirteen underlying components that together account for 68.95percent of the cumulative variance in the determinants of migration. These underlying components include migrating to look for job, to join spouse, and to further education. Based on the results of the study, recommendations such as the establishment of skills acquisition centers and provision of social infrastructures in the rural areas are made. KEYWORDS: Appraisal; Factors; Migration; Rural-urban; Southeastern Nigeria

Development of a Small Scale Okro Slicing Machine

The technique of slicing Okro using kitchen knife often exposes users to the danger of knife cut and the output of the technique has been found to be low due to the drudgery involved in the process. It was in recognition of the need to reduce drudgery, injury and associated rigors to the user and to enhance quality, hygiene and efficiency in Okro processing that the research of developing a suitable Okro slicing machine was initiated. A simple motorized device was developed for slicing okra using locally available materials which include: bearings, shaft, pulleys, electric motor, cutting blade, rail, bolts and nuts. The slicing mechanism was based on the high shear stress that is generated when a blade edge is brought into contact with fibrous material causing the blade to move in rotary motion and to the direction of the applied force. After coupling and testing the machine, results obtained showed that it takes 3 seconds to slice one Okro using machine while in the case of manual slicing, it takes 8.22 seconds. The device has a slicing efficiency of 66.67%.  The machine has shown to enhance processing of okra in small scale industry application. The machine therefore is of great importance to the industries within the country and beyond where preservation of Okro in sliced and dried form is important

Creative Accounting around Contemporaneous Involuntary Bank Mergers and Acquisitions, and Non-Routine Board Changes

Thispaper examines the magnitude and direction of creative accounting following contemporaneousmergers and acquisitions consummated under duress, and abnormal corporate boardchanges taking evidence from Nigeria. But most importantly, the paper determineswhether any likely resultant abnormal accrual following corporate acquisitions canbe unconsciously normalized by ‘big bath’ accounting players following contemporaneousnon-routine board leader replacement. Evidence has shown that following acquisitions,mangers can engage in income-increasing management on one hand. On the other hand,new CEOs can give earnings a ‘big’ downward ‘bath’ blaming their predecessors forthe poor performance while pursuing personal contractual performance benefit. Hence,within extensive researches already carried out on the impacts of acquisitions andboard replacement on creative accounting, there remains unanswered question of theextent of accrual manipulation when the two events occur simultaneously. Drawingheavily from Jones and Dechow models in estimating normal accrual, normal cash flowfrom operations and both discretionary accrual and cash flow, we report consistentwith extant literatures, that under consolidation duress, the victim firms engagein a significant discretionary income-increasing manipulation. Our study also confirmsthat significant downward accrual management follows corporate board changes inNigeria. However, the board changes that follow consolidation restructuring limitthe persistence of the abnormal accrual in the end. We find that the ‘Big bath’accounting players reverse although unconsciously a significant proportion of theupward managed accrual from opportunistic perspective. The ratio of pre consolidationaccrual hiking to post-consolidation board changes reversal is 3:2, which indicates67% normalization for stock based acquisitions. For cash based acquisitions however,the reversal is much lower. Our findings suggest that where abnormal earnings ishighly suspected following involuntary acquisitions, board restructuring that willlead to new managers could help in correcting or reversing significant proportionof the accrual abnormality. Keywords: Discretionary Accounting,Consolidations, Earnings management, Mergers and acquisitions, Accrua

Heteroatom and side chain effects on the optical and photophysical properties: ultrafast and nonlinear spectroscopy of new Naphtho[1,2-b:5,6-b ']difuran donor polymers

The photophysical and electronic properties of four novel conjugated donor polymers were investigated to understand the influence of heteroatoms (based on the first two member chalcogens) in the polymer backbone. The side chains were varied as well to evaluate the effect of polymer solubility on the photophysical properties. The donor–acceptor polymer structure is based on naptho[1,2-b:5,6-b′]difuran as the donor moiety, and either 3,6-di(furan-2-yl)-1,4-diketopyrrolo[3,4-c]pyrrole or 3,6-di(thiophen-2-yl)-1,4-diketopyrrolo[3,4-c]pyrrole as the acceptor moiety. Steady-state absorption studies showed that the polymers with the furan moiety in the backbone displayed a favorable tendency of capturing more solar photons when used in a photovoltaic device. This is observed experimentally by the higher extinction coefficient in the visible and near-infrared regions of these polymers relative to that of their thiophene counterparts. The excitonic lifetimes were monitored using ultrafast dynamics, and the results obtained show that the type of heteroatom π-linker used in the backbone affects the decay dynamics. Furthermore, the side chain also plays a role in determining the fluorescence decay time. Quantum chemical simulations were performed to describe the absorption energies and transition characters. Two-photon absorption cross sections (TPA-δ) were analyzed with the simulations, illustrating the planarity of the backbone in relation to its torsional angles. Because of the planarity in the molecular backbone, the polymer with the furan π-linker showed a higher TPA-δ relative to that of its thiophene counterpart. This suggests that the furan compound will display higher charge transfer (CT) tendencies in comparison to those of their thiophene analogues. The pump–probe transient absorption technique was employed to probe the nonemissive states (including the CT state) of the polymers, and unique activities were captured at 500 and 750 nm for all of the studied compounds. Target and global analyses were performed to understand the dynamics of each peak and deduce the number of components responsible for the transient behavior observed respectively. The results obtained suggest that the furan π-linker component of a donor and acceptor moiety in a conjugated polymer might be a more suitable candidate compared with its more popular chalcogenic counterpart, thiophene, for use as donor materials in bulk heterojunction photovoltaic devices.Support for this investigation is provided by the National Science Foundation (DMR-1709005) Polymers (TGIII) and (DMR 1410088/1640297) Polymers (MJE). (DMR-1709005 - National Science Foundation; DMR 1410088/1640297 - National Science Foundation)Accepted manuscrip

Epidemiological pattern of rape cases managed at a regional hospital in South Africa

Background: South Africa has one of the highest incidences of rape globally. Understanding the epidemiological pattern of rape is needed to inform the design of effective intervention programmes for rape prevention and management of alleged rape cases. Aims: To investigate important epidemiological patterns associated with rape in Kimberly, Northern Cape Province, South Africa. Setting: The Robert Mangaliso Sobukwe Hospital (RMSH) forensic unit. Methods: A descriptive, retrospective cross-sectional clinical audit of rape cases. Results: The majority (93.3%) of the alleged rape victims were women, with a mean age (SD) of 21.6 years (11.3); the male population made up 6.7% of the cases, with a mean age (SD) of 10.5 years (6.9). The highest incidence of alleged rape in the male population was seen in the age group ≤ 16 years (81.8%) and for women 17–30 years (50.3%). Most of the incidents occurred at the perpetrators’ homes (42.7%); on the days Fridays (14.6%), Saturdays (29.9%) and Sundays (23.2%); at night up to midnight 20:00–23:59 (32.9%) (p = 0.01) and involved threats of violence (55.5%). The majority (56.0%) of the perpetrators were known to the victims. Conclusion: Important information about the victims and circumstances in which rape occurs as reported herein can be used to inform the design of effective intervention programmes for sexual crime prevention and management in Kimberly, South Africa. Contribution: This study helped to advance knowledge and understanding of the epidemiological pattern associated with rape in Kimberley, Northern Cape Province of South Africa