Proximate composition and nutritional values of some commonly consumed fishes from the Cross River estuary

Protein, fat, moisture, carbohydrate, ash and fibre content in the bodies of 6 fish species, Cynoglossus senegalensis, Chrysichthys nigrodigitatus, Carasssius carassius, Hydrocynus lineatus, Citharinus macrolepis and Synodontis nigrita, were investigated. Statistical analysis using ANOVA showed significant differences in the values of the six parameters in the six fishes studied (P<0.01). In terms of percentages, Protein content was highest in C. senegalensis (75.43 ± 0.20 %) and lowest in C. macrolepsis (64.25 ± 0.01 %). Fat content was found to be highest in S. nigrita (25.10 ± 0.30 %) and lowest in C. senegalensis (19.53 ± 0.20 %), moisture content was highest in S. nigrita (23.52 ± 0.02 %) and lowest in C. senegalensis (21.08 ± 0.01 %). Carbohydrate content was found to be highest in C. macrolepis (4.38 ± 0.02) and lowest in H. lineatus (1.52 ± 0.02 %). Ash content was highest in C. macrolepis (3.75 ± 0.02 %) and lowest in C. carassius (1.20 ± 0.20 %) while fibre content was highest in H. lineatus (2.30 ± 0.10 %) and lowest in C. senegalensis (1.09 ± 0.20 %).Key words: Proximate composition, Fishes, Calabar, Cross river estuary, Nigeria

Les tumeurs cérébrales : Quel algorithme pour une prise en charge utile et efficiente à l’Hôpital Central de Yaoundé?

Les tumeurs cérébrales désignent l’ensemble des processus expansifs intracrâniens bénins ou malins, primaires ou secondaires se développant au dépend des tissus intracrâniens. Leur grande diversité histologique, la multiplicité des protocoles de prise en charge, les ressources limitées des patients dans notre environnement rendent le traitement, l’évaluation et le suivi difficiles. C’est la raison pour laquelle nous avons décidé de mener cette étude portant sur la détermination d’un algorithme pour la prise en charge des tumeurs intracrâniennes à l’Hôpital Central de Yaoundé. Ils’agissait d’une étude transversale descriptive menée dans le service de neurochirurgie de l’Hôpital Central de Yaoundé pendant la période allant du 1er Décembre 2011 au 31 Mai 2017 où tous les patients pris en charge pour processus expansif intracrânien ont été rétrospectivement inclus. Les données étaient collectées à l’aide d’une fiche technique préétablie sous forme de questionnaire visant à recueillir les informations sur les données sociodémographiques, les données cliniques, les données para-cliniques, l’histologie, le protocole utilisé et le traitement administré. Les analyses statistiques étaient effectuées à l’aide des logiciels Excel version 2013 de Microsoft® et Epi-info dans sa version 3.5.4. 121 tumeurs cérébrales ont été inclues. La confirmation histopathologique était obtenue dans 98 cas. 46 patients (46,9%) étaient de sexe masculin et 52 patients(53,1%) de sexe féminin. L’âge moyen était de 40,3± 16,2 ans avec des extrêmes de 05 et 78 ans. Les types histologiques étaient largement dominés par les méningiomes (49%), suivis des adénomes hypophysaires (18,4%), les astrocytomes de bas grade (11,2%), les glioblastomes 5,1%), les craniopharyngiomes (5,1%) et les métastases (3,1%). Les autres tumeurs étaient peu représentées. Plusieurs protocoles étaient utilisés dans le service selon les chirurgiens,selon le type d’imagerie fonctionnelle disponible dansl’hôpital au moment du diagnostic,selon lesressourcesfinancières du patient et des facteurs culturels. Compte tenu de la prédominance des tumeurs primaires bénignes ou malignes dans notre série (3,3%) des métastases, nous avons conçu un arbre décisionnel où après l’imagerie cérébrale, l’acte chirurgical passe en priorité (diagnostic histologique et traitement) ; le bilan d’extension ou la recherche de la lésion primaire s’effectue dans un 2ème temps et sera orienté par l’histologie. Ce travail a permis de montrer que le bilan d’extension et de la recherche du foyer primaire ne doit pas être systématique devant tout PEIC tumoral dans notre environnement, sauf dans le cas des lésions multiples ou d’antécédent de tumeur primaire connu. Cependant, un audit annuel est nécessaire pour monitorer le ratio coût-bénéfice en permanence.Mots clés : tumeurs cérébrales, arbre décisionnel, Yaoundé.Brain tumors refer to all benign or malignant intracranial expansive processes, primary or secondary, developing at the expense of intracranial tissues. Their great histological diversity, the multiplicity of treatment protocols and the limited resources of patientsin our environment make treatment, evaluation and monitoring difficult. This is why we decided to conduct this study on the determination of an algorithm for the management of intracranial tumors at Yaoundé Central Hospital. This was a descriptive cross-sectional study conducted in the Neurosurgery Department of Central Hospital of Yaounde from December 1, 2011 to May 31, 2017 where all patients supported for intracranial expansive process were retrospectively included. The data were collected using a preestablished technical form in the form of a questionnaire aimed at collecting socio-demographic information, clinical data, para-clinical data, histology, the protocol used and the treatment administered. The statistical analyzes were carried out by Excel version 2013 of Microsoft® software and Epi-info version 3.5.4. 121 brain tumors were included. Histopathological confirmation was obtained in 98 cases. The male sex was found in 46 cases (46.9%) and the female sex in 52 (53.1%). The average age of the series was 40.3 ± 16.2 with extremes of 05 and 78 years. The histological types were largely dominated by meningiomas (49%), followed by pituitary adenomas (18.4%), low grade astrocytomas (11.2%), glioblastomas 5.1%), craniopharyngiomas(5, 1%) and metastases (3.1%). Other tumors were poorly represented. Several protocols were used in the service according to the surgeons, depending on the type of functional imaging in the hospital at the time of diagnosis depending on the patient's financial resources and cultural factorsrelated to the patient. Given the predominance of primary benign or malignant tumors in our series (3.3%) of metastases, we designed a decision tree where after brain imaging , the surgical procedure is given priority (histological diagnosis and treatment); the extension assessment or the search forthe primary lesion is carried out in a second time and guided by histology. This work made it possible to show that the assessment of extension and research of the primary focus should not be systematic before any intracranial expansive process tumor in our environment, except in the case of multiple lesions or history of known primary tumor. However, an annual audit is necessary to monitor the cost-benefit ratio permanently.Key words: Brain tumors, decision tree, Yaound

Giant cell cyst of the skull : à case report

Les tumeurs à cellules géantes de l'os sont des lésions rares qui touchent principalement les épiphyses des os longs. Ils représentent 3 à 7% des tumeurs osseuses primitives. Ces tumeurs sont exceptionnelles dans le crâne et touchent principalement le sphénoïde et les os temporaux. Ces lésions sont généralement bénignes, localement agressives et nécessitent une ablation complète. Nous rapportons un cas de kyste à cellules géantes du crâne impliquant la voûte crânienne dans notre environnement. Une femme de 20 ans s'est présentée avec une masse occipito-cervicale droite, localisée, non sensible et fixée. Elle s'est présentée avec un syndrome cérébelleux. Une tomodensitométrie (TDM) a montré une lésion extraaxiale lytique impliquant l'os occipital droit et s'étendant dans la fosse postérieure. La patiente a subi une craniectomie occipitale droite avec résection de l'os et de la masse épidurale suivie d'une reconstruction osseuse artificielle (ciment de méthacrylate de méthyle). L'analyse histopathologique a révélé une tumeur à cellules géantes. L'évolution postopératoire s'est déroulée sans incident.Aucune récidive locale n'a été observée après un suivi de 3 ans. Les tumeurs à cellules géantes sont généralement des lésions bénignes localement agressives avec un taux élevé de récidive locale. L'excision chirurgicale totale est le traitement de choix. Ce rapport contribue à la littérature sur la tumeur à cellules géantes du crâne, en particulier la fosse postérieure et la méthode d'intervention chirurgicale utilisée pour le traitement. La place de la thérapie adjudante reste controversée.Mots clés : tumeur à cellule géante, crâne, os occipitale, chirurgie.Giant cell tumors of the bone are rare lesions that primarily affect the epiphyses of long bones. They represent 3 to 7% of primitive bone tumors. These tumors are exceptional in the skull and affect mainly the sphenoid and the temporal bones. These lesions are usually benign as well aslocally agressive and require complete removal. We report a case of giant cell cyst of the skull involving the cranial vault in a 20-year-old woman presented with localized, non tender, fixed right occipito-cervical mass. Her physical exam revealed a cerebellar syndrom. A computed tomography (CT) scan showed a lytic extensive extraaxial lesion involving the right occipital bone and expanding into the posterior fossa. The patient underwent a right occipital craniectomy with resection of the bone and the epidural mass followed by an artificial bone reconstruction (methyl methacrylate cement). Histopathologic analysis revealed a giant cell tumor. Post-operative course was uneventful. No local recurrence was observed after 3 years follow-up. Giant cell tumors are generally benign, locally aggressive lesions with a high rate of local recurrence. Total surgical excision is the treatment of choice. This report contributes to the litterature of giant cell tumor of the skull, especially the posterior fossa and the method of surgical intervention used fortreatment. The place of the adjuvent therapy remains controversial.Keywords : Giant cell tumor, skull, occipital bone, surger

Capillariasis in Chrysicthys Nigrodigitatus (Catfish), Cynoglossus Senegalensis (Sole) and Pseudotolthus Elongatus (Bobo Croaker) from Cross River Estuary and Adjacent Coastal Waters

A total of 400 sample each of Chrysichthys nigrodigitatus, Cynoglossus senegalensis and Pseudotolitus elongatus from Cross river estuary and adjacent coastal waters were examined for Capillaria species using parasitological techniques. 237 (59.3%) 85 (21.3%) and 68 (17.0%) respectively of the 3 fish examined were infected by Capillaria. Monthly prevalence of Capillaria ranged between 15.6% to 100%, 0.0 to 34.1% and 9.0 to 43.2% respectively. Intensity range from 2 to 4, 0 – 3 and 2 to 3 were observed. Hyperytrophy of the ovarian, tissue of C. senegalensis was observed. Histological examination of the intestine of C. nigrodigitatus revealed alteration in the columinar nature of the epithelium which assumed squamous shape. Brunner’s gland was dilated and laminar propria grossly distorted. Generally, infected fish appeared weak and emaciated

Understanding the neuroprotective effect of tranexamic acid: an exploratory analysis of the CRASH-3 randomised trial

Background: The CRASH-3 trial hypothesised that timely tranexamic acid (TXA) treatment might reduce deaths from intracranial bleeding after traumatic brain injury (TBI). To explore the mechanism of action of TXA in TBI, we examined the timing of its effect on death. Methods: The CRASH-3 trial randomised 9202 patients within 3 h of injury with a GCS score ≤ 12 or intracranial bleeding on CT scan and no significant extracranial bleeding to receive TXA or placebo. We conducted an exploratory analysis of the effects of TXA on all-cause mortality within 24 h of injury and within 28 days, excluding patients with a GCS score of 3 or bilateral unreactive pupils, stratified by severity and country income. We pool data from the CRASH-2 and CRASH-3 trials in a one-step fixed effects individual patient data meta-analysis. Results: There were 7637 patients for analysis after excluding patients with a GCS score of 3 or bilateral unreactive pupils. Of 1112 deaths, 23.3% were within 24 h of injury (early deaths). The risk of early death was reduced with TXA (112 (2.9%) TXA group vs 147 (3.9%) placebo group; risk ratio [RR] RR 0.74, 95% CI 0.58–0.94). There was no evidence of heterogeneity by severity (p = 0.64) or country income (p = 0.68). The risk of death beyond 24 h of injury was similar in the TXA and placebo groups (432 (11.5%) TXA group vs 421 (11.7%) placebo group; RR 0.98, 95% CI 0.69–1.12). The risk of death at 28 days was 14.0% in the TXA group versus 15.1% in the placebo group (544 vs 568 events; RR 0.93, 95% CI 0.83–1.03). When the CRASH-2 and CRASH-3 trial data were pooled, TXA reduced early death (RR 0.78, 95% CI 0.70–0.87) and death within 28 days (RR 0.88, 95% CI 0.82–0.94). Conclusions: Tranexamic acid reduces early deaths in non-moribund TBI patients regardless of TBI severity or country income. The effect of tranexamic acid in patients with isolated TBI is similar to that in polytrauma. Treatment is safe and even severely injured patients appear to benefit when treated soon after injury. Trial registration: ISRCTN15088122, registered on 19 July 2011; NCT01402882, registered on 26 July 2011