Diagnostic value of procalcitonin in neonatal sepsis

Introduction: Neonatal sepsis is a major cause of mortality in developing countries. Accurate and quick diagnosis are difficult because clinical presentation are non-specific, bacterial cultures are time-consuming and other laboratory tests lack sensitivity and specificity. Serum procalcitonin (PCT) has been proposed as an early marker of infections in neonates.Objectives: This study investigated the value of PCT in the diagnosis of Neonatal Sepsis.Methods: Neonates undergoing sepsis evaluation at the Special Baby Care Unit, Federal Medical Centre, Abeokuta, Nigeria between January and April 2013 were included. Blood samples were obtained for white cell count, blood cultures, serum CRP and PCT analysis. Neonates were categorised into Proven Sepsis, Suspected Sepsis and Clinical Sepsis groups on the basis of laboratory findings and risk factors. A control group with no clinical and biological data of infection was also included. Predictive values and area under the receiver operating characteristic curve (AUC) of PCT were evaluated.Result: Of the 85 neonates, 19 (22.4%) had positive blood culture. PCT level was significantly higher in neonates in all sepsis groups in comparison with those in the control group (P< 0.05). At a cut-off of 0.5 ng/ml, the negative predictive value (NPV) of PCT was 80% and the positive predictive value (PPV) 39%. There were no significant statistical difference between the AUC values of PCT in Early onset and Late onset sepsis, as well between AUC in Preterm and term cases. A higher percentage of neonates who died (96%) had elevated PCT levels compared to those who survived (46%).Conclusion: These findings support the usefulness of the PCT in diagnosis of Neonatal sepsis.Keywords: Neonatal Sepsis, Diagnosis, Procalcitonin, Receiver Operating Characteristic Curv

Haematology, Carcass and Relative Organ Weights of Growing Rabbits on Skip-A-Day Concentrate Feeding Regime

The potentials of two common weeds, Aspilia africana (Aa) and Tridax procumbens (Tp), as forages for rabbits were investigated in a study that lasted for 70 days. Thirty five (35) rabbit bucks of mixed breed of between 5 to 7 weeks of age, weighing 519 ±5g, were used for the study. The haematological, carcass and organ characteristics were examined. The rabbits were divided into 5 treatment groups of seven (7) rabbits each, with each rabbit serving as a replicate in a complete randomized design. Group 1 was placed on sole concentrate feeding while concentrate was skipped for 1, 2 and 3 days in groups 2, 3, and 4 respectively with ad-libitum forage (Aspilia africana {Aa} and Tridax procumbens {Tp}) feeding. Group 5 was fed on a sole forage diet of 250 g Aa: 250 g Tp for 56days, after which they were fed concentrate in addition to the forage for two weeks. The red blood cell count values for rabbits on sole concentrate feeding was significantly (P<0.05) higher than the values observed in rabbits on treatments 2, 3 4 and 5, that were similar (P>0.05). The final weights of the rabbits decreased linearly (P<0.05) as the number of days of concentrate feeding decreased. The dressing percentages in treatments 1, 2, 3 and 4 (64.21, 62.97, 64.73 and 62.51 % respectively) were similar (P>0.05) but significantly higher (P<0.05) than the value for rabbits in treatment 5 (56.88 %). Organ characteristics of the rabbits showed that, apart from the relative kidney weights, other organ weights were not significantly (P>0.05) affected by the dietary treatments. It can be concluded that although feeding rabbit with sole concentrate gave the highest weight gain, the use of these forages could reduce cost of production, especially feed cost, drastically, and where it is difficult to get concentrates, these forages can be fed to rabbits for maintenance. Their use would be expected to minimize cost of maintaining a clean environment and the use of non-competitive forages as rabbit feeds could encourage rural rabbit production.Keywords: Carcass, growing rabbit, forages, relative organs weights, skip-a day

Daycase urology at Ibadan, Nigeria: A ten year review

Introduction: The objective of the study was to report the extent of urological surgeries performed as day cases in a major tertiary hospital in Ibadan and document the outcome. Methods: We retrospectively reviewed the data of all urologic patients treated at the day- case theatre between January 2000 and December 2009. The parameters evaluated were: age, diagnosis, type of surgery/ procedure, anaesthesia administered and the rank of the surgeon. Day case endoscopic procedures as well as prostate biopsies were excluded from the study. Results: In total, 1292 patients were managed, 290 (22.4%) were children aged between 5 days and 15 years while 1002 (77.6%) adults aged between 17 years and 91 years. The majority of the procedures were carried out by the senior registrars (1169 cases, 90.5%) and consultants were involved in 123 cases (9.5%). General anaesthesia was primarily used in children (158 children vs. 4 adults), while local anaesthesia was used only in adults. 131 (45.2%) children had no anaesthesia for circumcision. The most common procedures performed in adults were varicocelectomy (426 cases, 42.5 %), orchidectomy (332 cases, 33.1%), testicular biopsy (120 cases, 12.0%). While in children male circumcision (231cases, 79.7%) was the main procedure performed. Conclusion: The day-case theatre is still suitable for day case urologic procedure in our setting. The common procedures are varicocelectomy, orchidectomy, and open testicular biopsy in the adults. While in children, male circumcision is commonly carried out

Diagnostic value of lipids, total antioxidants, and trace metals in benign prostate hyperplasia and prostate cancer

Background: Considerable overlap exists in the value of total prostate specific antigen (tPSA) in both prostate cancer (Pca) and benign prostate hyperplasia (BPH). Developing an effective biochemical screening test that will complement PSA assay could reduce the associated cost of care and give timely attention to prostate cancer patients even when they are still asymptomatic is therefore desirable. This work was therefore an attempt to evaluate the possible roles of lipids, antioxidants, and trace metals in breaking the diagnostic tie between Pca and BPH.Materials and Methods: Anthropometric characteristics, total prostate specific antigen (tPSA), serum lipids (total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides), Vit. E, total antioxidant status (TAS), and trace metals (Se, Cu, Fe, Zn, and Mn) were determined in 40 patients with histopathological diagnosis of BPH and Pca. Forty age matched control subjects were also recruited from the same community. Informed consent was obtained from all the participants in the study. A P-value < 0.05 was considered significant.Results: There were significant variations in the weight, hip circumference, and body mass index (BMI) across the group but the post hoc test did not show any difference between patients with prostate cancer and BPH. Among the biochemical parameters studied, only the total cholesterol and triglyceride differed significantly between patients with BPH and prostate cancer patients. Cut-offs from ROC for BPH and prostate cancer at 88.9 sensitivity and 66.7% specificity (95% CI) were 88.5 mg and 161 mg/dl for triglycerides and cholesterol respectively. Furthermore there were no significant variations in the mean levels of copper and tPSA, Vit E, and LDL cholesterol among the study subjects and the controls.Conclusion: Prior to prostate biopsy, serum lipid (especially, fasting triglycerides, total cholesterol) could help in early discrimination of patients with BPH from prostate cancer in adjunct to total PSA and other management protocol for diagnosis of prostate cancer. The use of trace metal or antioxidants may have limited advantages. Further studies in this regard will be very desirable to see if this pattern of triglyceride and total cholesterol values in BPH and Pca are sustainable

Impact of health system challenges on prostate cancer control: health care experiences in Nigeria

Prostate cancer is the second most frequently diagnosed cancer of men (913 000 new cases, 13.8% of the total) and the fifth most common cancer overall. Prostate cancer is the sixth leading cause of death from cancer in men (6.1% of the total)

Prevalence of complications of male circumcision in Anglophone Africa: a systematic review

BACKGROUND: There is growing evidence that male circumcision (MC) prevents heterosexual acquisition of HIV by males in sub-Saharan Africa, the region of the world heavily affected by the HIV pandemic. While there is growing support for wide-spread availability and accessibility of MC in Africa, there is limited discussion about the prevalence of physical complications of male circumcision on the continent. METHODS: A systematic literature search and review of articles in indexed journals and conference abstracts was conducted to collect and analyze prevalence of complications of MC in Anglophone sub-Saharan Africa. Information extracted included: indications for MC, complications reported, age of patients and category of circumcisers. RESULTS: There were 8 articles and 2 abstracts that were suitable for the analysis. The studies were not strictly comparable as some reported on a wide range of complications while others reported just a limited list of possible complications. Prevalence of reported complications of MC ranged from 0% to 50.1%. Excluding the study with 50.1%, which was on a series of haemophilia patients, the next highest prevalence of complications was 24.1%. Most of the complications were minor. There was no firm evidence to suggest that MCs performed by physician surgeons were associated with lower prevalence of complications when compared with non-physician health professionals. CONCLUSION: The available data are inadequate to obtain a reasonable assessment of the prevalence of complications of MC in sub-Saharan Africa. Some of the available studies however report potentially significant prevalence of complications, though of minor clinical significance. This should be considered as public health policy makers consider whether to scale-up MC as an HIV preventative measure. Decision for the scale-up will depend on a careful cost-benefit assessment of which physical complications are certainly an important aspect. There is need for standardized reporting of complications of male circumcision

Review of prostate cancer research in Nigeria

Prostate cancer (CaP) disparities in the black man calls for concerted research efforts. This review explores the trend and focus of CaP research activities in Nigeria, one of the ancestral nations for black men. It seeks to locate the place of the Nigerian research environment in the global progress on CaP disparities. Literature was reviewed mainly through a Pubmed search with the terms “prostate cancer”and “Nigeria”, as well as from internet and hard copies of journal pages

Urethroplasty for strictures in Nigerian children

Background/Objective: To review the outcome of urethroplasty performed for urethral strictures in children at the University College Hospital, Ibadan, Nigeria, highlighting the difficulties that may hamper successful outcome of reconstruction and suggesting factors that may enhance successful reconstruction. Method: A retrospective study of 16 children who had urethroplasty performed for urethral strictures over a 5-year period. Results: All the strictures were post- traumatic. There were no post-inflammatory strictures. Fourteen of the patients had patent anastomosis as demonstrated by the pericatheter urethrogram, and they were able to void satisfactorily thereafter. Two patients developed recurrent strictures that required surgical intervention. Conclusion: Urethroplasty should be performed for urethral strictures in children as soon as they present in order to prevent complications such as urinary tract infections, urinary calculi and epididymoorchitis, which may complicate prolonged catheterization. The outcome of urethroplasty in children can be satisfactory if appropriate fine instruments and fine sutures are used. Key words: Urethral strictures, Nigerian children Nig. J. of Surgical Research Vol.4(3-4) 2002: 80-8

Intrascrotal anomalies related to testicular torsion in nigerians: an anatomical studyLes anomalies intra scrotales associées à la torsion testiculaire chez les Nigériens - une étude anatomique

Objective: The abnormalities that predispose to torsion are often bilateral. They include horizontally lying testis, bell-clapper deformity (BCD), long mesorchium, well-developed spiral cremasteric muscle and ectopic testis. The pattern and incidence of intrascrotal anomalies that predispose to testicular anomalies in Nigerians have not been studied. Our objective was to define and document this. Material and Methods: The scrotal sacs of fifty cadaver scrotums and inguinal canals from patients aged between 35 and 57 years (mean age: 42 years) were examined. The parameters studied were the location (scrotal or canalicular), alignment (horizontal, vertical), mesorchium (height and width), cremasteric muscle development (well or poorly developed) and parietal tunica vaginalis investment of the testis (normal, intermediate or BCD). Results: Forty-nine testes had descended to the scrotal position; all were anchored by the ligamentum testis. The canalicular position was noted to be present in one cadaver. Forty-eight testes lay vertically. 16% of the testes had BCD, while intermediate tunica investment was noted in 12%. The most common type of epididymal and testicular relationship was Type I (84%). The mesorchium was normal in all specimens examined. Conclusion: The most common anomaly in our study was that of tunica investment, and this is usually bilateral. The need for bilateral orchiopexy in cases of testicular torsion is further strengthened since the anatomic anomalies are usually bilateral. Résumé Objectif: Les caractères anormaux qui prédisposent à la torsion testiculaire sont souvent bilatéraux. Ils incluent des testicules ascenseurs horizontalement, difformité du bell-clapper (BCD), un long mesorchium, un muscle cremasterien en spirale bien développé et testicules ectopiques. Le type et la fréquence d'anomalies intra scrotales qui prédisposent aux anomalies testiculaires chez les Nigériens n'ont pas été étudiés. Notre objectif était de définir et documenter ceci. Matière et méthodes: Les scrotums et les canaux inguinaux de cadavres de patients d'âge entre 35 et 57 années (âge moyen: 42 années) étaient examinés. Les paramètres étudiés étaient l'emplacement (scrotal ou canaliculaire), l'alignement (horizontal, vertical), le mesorchium (hauteur et largeur), le développement du muscle cremasterien (bien ou peu développé) et le développement de la tunica vaginalis pariétal des testicules (normal, intermédiaire ou BCD). Résultats: Quarante-neuf testicules étaient descendus en place dans le scrotum; tous ont été ancrés par les ligaments testiculaires. Le siège canalaire était présent chez un cadavre. Quarante-huit testicules sont disposés verticalement. 16% des testicules avaient un BCD, cependant le développement intermédiaire de la tunica vaginalis a été noté chez 12%. Le type le plus commun de rapport entre l'épididyme et le testicule était le Type I (84%). Le mesorchium était normal dans tous les spécimens examinés.Conclusion: L'anomalie la plus commune de notre étude était le développement intermédiaire de la tunica vaginalis, et c'est bilatéral habituellement. L'orchidopexie bilatérale dans les cas de torsion testiculaire est nécessaire parce que les anomalies anatomiques sont bilatérales habituellement. African Journal of Urology Vol. 12(1) 2006: 24-2