Causative agents of keratomycosis in Ibadan: review of laboratory reports

Introduction: Fungi are responsible for less than 2.0 % of corneal infection around the globe. Trauma to the cornea is the leading cause of fungal keratitis especially with history of corneal trauma with vegetable or organic matter. Because of the dearth of data on the aetiological agents of Keratomycosis in this hospital, this study was aimed at finding the prevalence and fungal etiological agents responsible for this condition Ibadan, Nigeria. Methods: A retrospective review of the laboratory reports of corneal scrapings of patients that presented with signs and symptoms suggestive of Keratomycosis was carried out. The scrapings were subjected to wet preparation with 10.0 % KOH, Gram staining and Giemsa staining to rule out inclusion bodies. The diagnosis of Keratomycosis was made on the basis of the recognizable and characteristic appearance of fungal hyphae and fruiting bodies under microscopy. The media with no obvious growth after 3-4 weeks of incubation were regarded as negative. Results: A total of 48 specimens from patients with suspected diagnosis of Keratomycosis were included in the analysis. The patients consisted of 42 (87.3%) males and 6 (12.5%) females. The ages at diagnosis ranged from 3 to 73 years with a mean of 36.46 years and a median of 35.5 years. The prevalence of Keratomycosis among this group of patients in this hospital was 8.4 %. Candida albicans and Fusarium spp were the fungal isolates in these patients as it occurred in 4.2 % (2/48) of them respectively. Conclusions: Corneal scarring due to trauma or infections is a major cause of monocular blindness, especially in developing countries like Nigeria. Despite the low level of Keratomycosis in this study, high index of suspicion of possible diagnosis should be giving to patients with history of trauma, tissue devitalization with topical steroids and immunocompromised immunity.Keywords: Keratomycosis, Corneal, Fusarium and Candida

Physical activity and breast cancer survival

Physical activity improves quality of life after a breast cancer diagnosis, and a beneficial effect on survival would be particularly welcome. Four observational studies have now reported decreased total mortality among physically active women with breast cancer; the two largest have also reported decreased breast cancer specific mortality. The estrogen pathway and the insulin pathway are two potential mechanisms by which physical activity could affect breast cancer survival. Randomized trials are ongoing but trials of lifestyle factors are notoriously challenging to perform. Women with breast cancer have little to lose and may possibly gain from moderate exercise

Nasal polyps - clinical profile and management in Ibadan, Nigeria

Background: Nasal polyps are benign mucosal protrusions into the nasal cavity of multifactorial origin and are characterized by chronic mucosal inflammation. They result from the prolapsed lining of the ethmoid sinuses and block the nose to a variable degree depending on their sizes. This study aims to evaluate the clinical profile and management of nasal polyposis as seen in Ibadan, Nigeria. Method: A 5-year (1998-2002) prospective study of 63 nasal polyposis patients depicting the clinical profile and implications was done at the department of Otorhinolaryngology, University College Hospital, Ibadan, Nigeria. Results: There were 38(60%) males and 25(40%) females with M: F of 1.5:1 and with an average age of 34 years. The duration of symptoms ranged from 2months –14years with an average occurrence of 12 new cases a year. The main clinical presentations were nasal obstruction 95%, nasal discharge 81%, sneezing 59% and observed nasal polyps 78%. The polyps were found in the right nasal 16%, left nasal 25% while bilateral 37%. The rest were of antro-choanal polyps 22%. Polyps from ethmoidal region constituted 88% while from lateral nasal wall 12%. Treatment is a combination of surgery and medical therapy with topical corticosteroids. Eighty-Seven percent (87%) of the cases had surgical treatment; simple polypectomies 67%, Caldwell-Luc's operations 15%, and external ethmoidectomies 13% while internal ethmoidectomies 5%. The hospital stay ranged from 1- 6 weeks with recurrence rate of 13% and onset of recurrence ranged from 2 weeks – 4 years. Conclusion: Whatever therapeutic regimen is used nasal polyps are a chronic common condition in which their cause remain unknown, are prone to recurrence and in some cases with embarrassing frequencies. Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 164-16

Public awareness and the role of Islamic deposit insurance in promoting financial inclusion

Deposit Insurance Scheme is a safety-net instrument used by governments to ensure the stability of the banking systems and protect depositors in the event of bank failure. Islamic deposit insurance is a Shariah-compliant system that provides protection to depositors against this type of failure and reinforces consumer protection aspects inherent to Islam. The inculcation of Islamic deposit insurance will boost the potential and value proposition of Islamic finance, motivating non-users excluded due to lack of trust. This empirical research examines how a deposit insurance scheme for Islamic banks can enhance confidence and facilitate participation in the financial system. A sample of 412 depositors from both Islamic and conventional banks in Nigeria was used to determine the awareness level, knowledge and understanding of the potential of the Islamic deposit insurance scheme. The results suggest that the scheme offers a great opportunity and can lead to increase in access

A cohort study of the risk of cancer associated with type 2 diabetes

Background: There is evidence to suggest that diabetes may increase the risk of incidence and mortality from cancer. Methods: In a cohort study using record-linkage health-care datasets for Tayside, Scotland in 1993-2004, we followed up 9577 newly diagnosed patients with type 2 diabetes, and two matched non-diabetic comparators, in the national cancer register. Results and conclusions: The risk ratio for any cancer, adjusted for deprivation, was 0.99 (95%CI 0.90-1.09). Significantly increased risks were observed for pancreatic, liver and colon cancer

A comparison of radiographic techniques and electromagnetic transponders for localization of the prostate

<p>Abstract</p> <p>Background</p> <p>The aim of this study is to compare three methodologies of prostate localization and to determine if there are significant differences in the techniques.</p> <p>Methods</p> <p>Daily prostate localization using cone beam CT or orthogonal kV imaging has been performed at UT Southwestern Medical Center since 2006. Prostate patients are implanted with gold seeds, which are matched with the planning CT or DRR before treatment. More recently, a technology using electromagnetic transponders implanted within the prostate was introduced into our clinic (Calypso®). With each technology, patients are localized initially using skin marks and the room lasers. In this study, patients were localized with Calypso and either CBCT or kV orthogonal images in the same treatment session, allowing a direct comparison of the technologies. Localization difference distributions were determined from the difference in the offsets determined by CBCT/kV imaging and Calypso. CBCT-Calypso and kV imaging-Calypso localization data were summarized from over 900 and 250 fractions each, respectively. The Wilcoxon signed rank test is used to determine if the localization differences are statistically significant. We also calculated Pearson’s product–moment correlation coefficient (R²) to determine if there is a linear relationship between the shifts determined by Calypso and the radiographic techniques.</p> <p>Results</p> <p>The differences between CBCT-Calypso and kV imaging-Calypso localizations are −0.18 ± 2.90 mm, -0.79 ± 2.18 mm, -0.01 ± 1.20 mm and −0.09 ± 1.40 mm, 0.48 ± 1.50 mm, 0.08 ± 1.04 mm, respectively, in the AP, SI, and RL directions. The Pearson product–moment correlation coefficients for the CBCT-Calypso shifts were 0.71, 0.92 and 0.88 and for the OBI-Calypso comparison were 0.95, 0.89 and 0.85. The percentage of localization differences that were less than 3 mm were 86.1%, 84.5% and 96.0% for the CBCT-Calypso comparison and 95.8%, 94.3% and 97% for the kV OBI-Calypso comparison. No trends were observed in the Bland-Altman analysis.</p> <p>Conclusions</p> <p>Localization of the prostate using electromagnetic transponders agrees well with radiographic techniques and each technology is suitable for high precision radiotherapy. This study finds that there is more uncertainty in CBCT localization of the prostate than in 2D orthogonal imaging, but the difference is not clinically significant.</p

Outcome after surgical stabilization of rib fractures versus nonoperative treatment in patients with multiple rib fractures and moderate to severe traumatic brain injury (CWIS-TBI)

BACKGROUND: Outcomes after surgical stabilization of rib fractures (SSRF) have not been studied in patients with multiple rib fractures and traumatic brain injury (TBI). We hypothesized that SSRF, as compared with nonoperative management, is associated with favorable outcomes in patients with TBI. METHODS: A multicenter, retrospective cohort study was performed in patients with rib fractures and TBI between January 2012 and July 2019. Patients who underwent SSRF were compared to those managed nonoperatively. The primary outcome was mechanical ventilation-free days. Secondary outcomes were intensive care unit length of stay and hospital length of stay, tracheostomy, occurrence of complications, neurologic outcome, and mortality. Patients were further stratified into moderate (GCS score, 9-12) and severe (GCS score, ≤8) TBI. RESULTS: The study cohort consisted of 456 patients of which 111 (24.3%) underwent SSRF. The SSRF was performed at a median of 3 days, and SSRF-related complication rate was 3.6%. In multivariable analyses, there was no difference in mechanical ventilation-free days between the SSRF and nonoperative groups. The odds of developing pneumonia (odds ratio [OR], 0.59; 95% confidence interval [95% CI], 0.38-0.98; p = 0.043) and 30-day mortality (OR, 0.32; 95% CI, 0.11-0.91; p = 0.032) were significantly lower in the SSRF group. Patients with moderate TBI had similar outcome in both groups. In patients with severe TBI, the odds of 30-day mortality was significantly lower after SSRF (OR, 0.19; 95% CI, 0.04-0.88; p = 0.034). CONCLUSION: In patients with multiple rib fractures and TBI, the mechanical ventilation-free days did not differ between the two treatment groups. In addition, SSRF was associated with a significantly lower risk of pneumonia and 30-day mortality. In patients with moderate TBI, outcome was similar. In patients with severe TBI a lower 30-day mortality was observed. There was a low SSRF-related complication risk. These data suggest a potential role for SSRF in select patients with TBI. LEVEL OF EVIDENCE: Therapeutic, level IV