Cutaneous hydrophilic polymer embolism in a patient with acute kidney injury post endovascular procedure

Background: Hydrophilic polymer gel coatings are used on different intravascular devices to prevent vasospasm and thrombosis. However, it may become dislodged from these devices, leading to ischaemic complications in various organs including the skin, kidneys, brain, heart or lungs. Hydrophilic polymer embolisation (HPE) is a rare complication following endovascular procedures that is currently not fully recognised. The current knowledge of this phenomenon is based on reports consisting of histologic evidence of foreign polymers in the affected organ. Case description: A 76-year-old male with a history of hypertension, type 2 diabetes, renal cell carcinoma and chronic kidney disease underwent endovascular stenting of the superficial femoral artery due to critical limb ischaemia of the right foot. The patient had an acute kidney injury following the procedure. Upon examining the legs, there were tender non-blanching macular lesions on the right lower limb. A skin biopsy of the lesion was performed and showed hydrophilic polymer embolisation. Unfortunately, a few weeks later the patient was readmitted due to a worsening of the right foot wound situation, which required below-knee amputation. Conclusion: HPE is a rarely reported complication after endovascular interventions, with the potential to embolise to multiple organs. By observing skin manifestations, it is possible to aid the early detection of ischaemic events in other organs and identify their underlying causes. Generally speaking, the course is benign and self-limiting when the skin is involved, but may be more sinister especially when other organs (e.g. brain) are involved

Trend Analysis of Hydro-meteorological Variables using the Mann-Kendall Trend Test: Application to the Niger River and the Benue Sub-Basins in Nigeria

This paper presents the outcome of the trend analysis of hydro-meteorological variables in the Niger River and the Benue sub-basins in Nigeria. A non-parametric Mann-Kendall trend test was used to analyse the trends exhibited by the variables. The results revealed that precipitation exhibits insignificant positive trends in five locations, while insignificant negative trends were exhibited in the remaining six locations. This implies that the increase or decrease in precipitation would not be noticeable in all the locations, since the changes are statistically insignificant. The evaporation exhibits a significant positive trend in three locations, while in another three locations it exhibits an insignificant positive trend and also exhibits an insignificant negative trend in the remaining five locations. This is an indication that the incremental change in evaporation would be noticeable in three locations, while the increase or decrease would not be noticed in the remaining eight locations. In the case of minimum and maximum temperature, the trends in almost all the locations, except Ibi, are statistically significant positive. However, the runoff and water level in five locations out of six locations exhibit a significant negative trend. The downward trends exhibited by the runoff and water level in the two sub-basins may be due to the effect of climate variability on the hydro-meteorological variables. The reduction of runoff is an indication of the decrease in water resources in the sub-basins and this can result in low reservoir inflow to the Kainji and Jebba hydropower dams located in the basin

Biology Education and Bio Entrepreneur Opportunities in Nigeria

Nigeria has been experiencing various socioeconomic and environmental challenges such as unemployment, poverty, insecurity and climate change within the past few decades. These challenges are traceable to a lack of synergy between capital and nature.  Knowledge and skills in various fields of biology such as Bioeconomics and Bio-entrepreneur are potent tools for building a strong synergy between capital and nature to enhance sustainable socio-economic development in the nation. This paper focuses on how biology education can be utilised to develop and promote Bio-entrepreneur opportunities among Nigerian youths for sustainable national development. The paper provided overviews of concepts such as biology education, bio-entrepreneur, bio-economics and so forth. The millennium development goals and the 21st-century skills within the context of sustainable development in Nigeria. Finally, the paper advocated for urgent realignment of biology and science education for sustainable national developmen

EVAR of AAA: Long term outcomes, disease progression and risk stratification

BackgroundEndovasvular aortic repair (EVAR) is the most commonly utilised technique for the treatment of abdominal aorticaneurysms (AAA) in tertiary referral centers. Detailed long-term outcomes of this technique are relatively scarce,especially for patients presenting symptomatically with AAA. Intra-operatively, proximal type Ia endoleak, involvingblood circulating into the AAA – due to poor proximal seal of the endograft to the aortic neck region – is a fearedcomplication which is usually promptly treated, given its association with post-operative AAA expansion andrupture. Aneurysmatic disease is usually considered a progressive pathology with potential for progression toareas of the aorta beyond the known aneurysmatic segment. Arterial calcifications are established as a marker foratherosclerosis, yet the association of ilio-femoral calcification with post-operative mortality after EVAR is notknown.Aims1. Evaluate the long-term results of EVAR of AAA using a single endograft2. Compare the early and late results of EVAR of symptomatically presenting patients to those treated asymptomatically3. Study the long-term results of intra-operative treatment of type Ia endoleak using large, balloon expandable stents4. Study the progression of aortic disease for patients treated with endovascular means in the postoperative period5. Assess the novel ilio-femoral calcium score as a potential predictor for overall and cardiac-specific mortality after EVARResultsEVAR of AAA yields sustainable results in the long-term, for both symptomatic and asymptomatic patients. Thereis ≈ x4 elevated early mortality in symptomatic patients as compared to asymptomatic ones. Intra-operativetreatment of type Ia endoleaks using large, balloon-expandable stents should be reserved to patients treatedacutely with EVAR. Aortic expansion beyond the sealing zone is relatively uncommon, and seems related to theforce exerted on the aortic wall by the endograft. Ilio-femoral calcium score may predict long-term overall andcardiac mortality after EVAR, albeit the relation is weak. Therefore, further studies are needed to establish thisassociation

Physicochemical Properties of Oil Extracted from Pumpkin (Cucurbita pepo) Seeds

Pumpkin (Cucurbita pepo) is a member of the family Cucurbitaceae and its fruit parts are edible. This study evaluated the physicochemical properties of extracted oil from the seed of pumpkin. The results revealed a percentage yield of 41.08 ± 2.33, refractive index of 1.47 ± 0.18, relative density of 0.09 ± 0.02 g/cm3; saponification value of 184.60 ±1.67 mg/KOH/g, Acid value of 2.64 ±1.31 mgKOH/g, iodine value of 80.27±2.09 g of I2/100 g, and peroxide value of 11.0 ±1.0 mEq/Kg. The result shows that pumpkin seed oil may find application either in food industry as food addictive as it may pose a good quality shelf life or energy generation as biofuels

Simple diameter measurements with ultrasound can be safely used to follow the majority of patients after infrarenal endovascular aneurysm repair

Background: The optimal imaging follow-up after infrarenal EVAR is still undefined. The aim of this study was to analyze the outcome of a personalized follow-up program after infrarenal EVAR based on ultrasound AAA diameter measurements for low-risk patients. Methods: All consecutive patients followed-up locally after elective and acute infrarenal EVAR between 2010 and 2015 were retrospectively reviewed. Patients underwent CTA at 1-month post-EVAR whereby the attending surgeon defined the subsequent follow-up. Patients considered at low risk were followed with ultrasound only assessing AAA diameter at 1, 2, 3 and every 5 years postoperatively (group A). Low risk required a favorable pre-operative anatomy especially regarding the aneurysm neck, satisfactory intraoperative result and uneventful 1 month CTA (type 2 endoleaks acceptable). Patients not fulfilling the criteria for group A were followed with yearly 3-phase-CTAs (group B). Results: Two hundred twenty-two patients with a AAA median diameter of 58 (54-68) mm were included. One hundred ninety-one were allocated into group A and 31 in group B. Median follow-up time was 36 (24-59) months. Five-year primary and primary-assisted success was 82±5% and 93±3% for group A and 70±13% and 93±5% for group B, respectively (P=0.042 and P=0.504, respectively). Sixteen late aneurysm-related reinterventions were performed in 12 patients (7 in group A and 9 in group B). In group A, 5 reinterventions were rupture-preventing and 2 were symptomatic. All late reinterventions in group B were performed following findings on follow-up imaging. Five-year late reintervention-free survival was 95±2% and 84±7% for groups A and B, respectively (P=0.046). Five-year survival was 80±3% and 63±10% for group A and B, respectively (P=0.024). Conclusions: A customized follow-up program after infrarenal EVAR based on ultrasound AAA diameter measurements in low-risk patients seems to be effective in maintaining a very high mid-term clinical success rate

Low Iliofemoral Calcium Score May Predict Higher Survival after EVAR and FEVAR

Background: Abdominal aortic aneurysm is associated with an increased mortality, mostly cardiovascular events. Moreover, aortoiliac calcification is associated with increased mortality in patients with peripheral occlusive disease. The aim of this study is to assess the potential association between iliofemoral calcification, assessed by calcium score, in patients undergoing infrarenal (endovascular aneurysm repair [EVAR]) or fenestrated endovascular aortic repair (FEVAR) and long-term mortality, particularly caused by cardiac events. Methods: All patients with preoperative noncontrast-enhanced computed tomographic scans who underwent infrarenal EVAR and FEVAR of nonruptured abdominal aortic aneurysm between 2004 and 2012 at a single tertiary center were screened for inclusion. Agatston calcium score was measured from the aortic bifurcation to common femoral arteries using a dedicated postprocessing software. The values are presented as median and interquartile range. Results: About 404 (62.05%) of 651 patients who underwent EVAR and FEVAR had sufficient imaging quality to be included. There was no difference in survival between included and excluded patients (P = 0.33). Nine patients (2.2%) died within 30 days of the operation, whereas the remaining were followed up for 6.3 (4.7–8.4) years. The iliofemoral calcium score was 8348 (3830–14,179). Estimated overall survival at 5 years was 73 ± 2%. Patients within the lowest quartile of iliofemoral calcium score had significantly higher overall survival (5 years: 79 ± 4% vs. 71 ± 3%; P = 0.01) and cardiac event–free survival (5 years: 95 ± 2% vs. 91 ± 2%; P = 0.033) when compared with the remaining ones. Calcium score was associated with neither univariate regression analysis with survival (odds ratio, 1.016 [0.988–1.045]; P = 0.268) nor cardiac event–free survival (odds ratio, 1.024 [0.986–1.063]; P = 0.222). Conclusions: Low iliofemoral calcium score may be associated with lower incidence of fatal cardiac events and all-cause long-term mortality after EVAR and FEVAR. This may be partially a reflection of aging and cardiovascular comorbidity but needs to be studied further