Metastatic choriocarcinoma presenting as advanced renal cell carcinoma: A case report

Choriocarcinoma is an aggressive tumour arising as a malignant transformation of the gestational trophoblastic disease or rarely from the germ cells in the ovary and from testicular mixed germ cell tumour. Renal involvement due to Choriocarcinoma is rare we report here one of such rare cases. A 26yr old woman presented with painful right sided loin swelling with painless total haematuria of 3weeks duration .Abdominal Ultrasound and CT scan showed a solid Right kidney mass with a cystic component. She had right radical nephrectomy.Histopathological examination revealed metastatic choriocarcinoma. The challenges we faced in her management is highlightedand a brief review of literature on the subject is presented

THE DEARTH OF STANDARD ANATOMICAL TERMINOLOGIES IN YORÙBÁ LANGUAGE: Butchers’ terminologies to the rescue?

The need to replace foreign-language medical terms with indigenous terms has prompted researchers to search for indigenous equivalents of the foreign medical terms. This study which focused on the dearth of standard anatomical terminologies in Yorùbá language was an attempt to examine the adoptability of butchers’ terminologies as descriptive anatomical terms for human abdomino-thoracic organs. Practising butchers in the South West Nigeria were interviewed on their terminologies for cow’s abdomino-thoracic organs and the basis for each terminology. The butchers’ terminologies, in Yorùbá language were critically appraised for adoptability as anatomical terms for human abdomino-thoracic organs. The study observed that cow’s abdomino-thoracic organs were grossly similar to those of humans. Majority (65%) of the cow’s abdomino-thoracic organs are named by the butchers’ in traditional Yorùbá terminologies. The butchers’ terminologies were etymologically derived based on pre-existing concepts similar to the modern terminologies derived from the ancient Greek and Latin words. About 25% of the butchers’ terminologies were the same with some human anatomical terminologies which were in use by the health care professionals. The terminologies concur with the cultural attitudes of the Yorùbá with reference to the private parts of the human body and majority (80%) of the butchers’ terminologies is simple and familiar to the people. Given these characteristic features, we concluded that the butchers’ terminologies are strongly adoptable as descriptive anatomical terms for human abdomino-thoracic organs and may resolve the dearth of standard anatomical terminologies in Yorùbá language. The findings may form a baseline for future studies on the translation of anatomical terminologies to Yorùbá language

Neuroprotection by Skimmianine in Lipopolysaccharide-Activated BV-2 Microglia

Skimmianine is a furoquinoline alkaloid which is found in the Zanthoxylum genus and also in other plants of the Rutaceae family. This study evaluated the effects of skimmianine on the production of pro-inflammatory mediators in LPS-activated BV-2 microglia. Cultured BV-2 cells were treated with skimmianine (10, 20 and 30 μM), followed by stimulation with LPS (100 ng/mL). Levels of TNFα and IL-6 in cell supernatants were measured using ELISA, while NO and PGE2 levels were evaluated with Griess assay and EIA, respectively. Western blotting was used to determine the protein expression of iNOS, COX-2, phospho-p65 and phospho-IκBα. Results showed that Skimmianine reduced LPS-induced elevated the secretion of TNFα, IL-6, NO, and PGE2, as well as the increased protein expression of iNOS and COX-2. Experiments to elucidate the mechanisms of the anti-neuroinflammatory activity of skimmianine revealed the significant inhibition of LPS-induced increased NF-κB-mediated luciferase activity. Pre-treatment with skimmianine also reduced LPS-induced the increased phosphorylation of NF-κB/p65 and IκBα proteins. Furthermore, skimmianine interfered with the binding capacity of NF-κB to consensus sites. Skimmianine pre-treatment protected HT-22 cells from toxicity induced by microglia-conditioned media, as well as increasing MAP-2 expression. The results of this study suggest that skimmianine inhibits neuroinflammation in LPS-activated microglia by targeting the NF-κB activation pathway. Skimmianine also produced neuroprotection against neurotoxicity induced by microglia-conditioned media

Pattern of Tympanic Membrane Perforation in a Tertiary Hospital in Nigeria

Background/Objectives: Tympanic membrane perforation is a common otological disorder with associated hearing impairment. This study aimed at determining the clinicoepidemiological pattern, etiological factors, clinical presentation, and management of tympanic membrane perforation in a tertiary hospital in Nigeria. Materials and Methods: This was a prospective, hospital‑based study of patients with the clinical finding of perforated tympanic membrane. The study was carried out over a period of 5 years (September 2012 to August 2017). Interviewer‑assisted questionnaire was administered to obtain the detailed history and clinical findings from consenting patients. Data collected were collated and analyzed using SPSS version 16.0. Results: A total of 529 patients had tympanic membrane perforation, of which 368 (69.6%) were males and 161 (30.4%) were females with a male‑to‑female ratio of 2:1. The prevalence of tympanic membrane perforation in this study was 7.8%. The most common presenting symptom among the patients was otorrhea in 81.5%, otalgia in 72.8%, and tinnitus in 55.7%. Acute suppurative otitis media was a cause of tympanic membrane perforation in 28.4% of the patients while 55.7% of the patients proceed to chronic suppurative otitis media. Unilateral tympanic membrane perforation was 79.0%. The left ear tympanic membrane perforation was 43.9%. Grade 1 tympanic membrane perforation accounted for 39.3% while grade 2 accounted for 32.3%. The most common types of tympanic membrane perforation were central in 38.2%, anterior central in 32.3%, and posterior central in 19.3%. Conductive hearing impairment accounted for 61.6% while sensorineural hearing impairment 25.3%. The most common degrees of hearing impairment were mild and moderate and accounted for 47.1% and 25.1%, respectively. The most common complications of tympanic membrane perforation were hearing impairment in 52.6%. Majority of the patients (425) were treated conservatively, six had fat patches, while 98 were treated surgically. Tympanic membrane perforation healed at the end of 3 months in 81.5%, while 18.5% did not heal after 3 months. Conclusion: Tympanic membrane perforation arises mainly from middle ear infections and traumatic causes. At presentation, size and location of perforation vary which depend on duration of infection or the traumatic causes

Knowledge and Practice of Sneeze and Cough Etiquettes among Participants in A Randomized Study in Ekiti-State, South-Western Nigeria

Background: Indiscriminate sneezing and coughing with infectious runny nose pose threats to public health. In this study, we investigate knowledge and practice of sneeze and cough etiquettes among residents in Ekiti-State, South- Western Nigeria. Objective: To sensitize the public on the roles of sneeze and cough etiquettes in the prevention the spread of infectious respiratory diseases. Methodology: A prospective, cross-sectional, randomized study of respondents in Ekiti State was conducted. Results: In all, 395 participants were studied. Of this number, 228 (57.7%) sneeze or cough into air without a cover on their nose or mouth, 82 (20.7%) into handkerchiefs, 20 (5.1%) into tissue, 22 (5.6%) into bare hand, 5 (1.3%) into sleeve or crook of elbow and 38 (9.6%) use a combination of methods. The proportion of respondents that wash hands or handkerchief soon after clean-up of the runny nose was only 38%. There was an inverse relationship between education attainment and hospital care of runny nose. Conclusion: This study shows that the majority (57.7%) of the respondents sneeze or cough into air without a cover on the nose or mouth. Only 1.3% of the respondents sneezes or coughs into sleeve or crook of the elbow which is the most acceptable form of hygiene etiquette. The proportion of respondents that wash hands or handkerchief soon after a clean-up of runny nose was quite small. Education has no comparative advantage over illiteracy in the uptake of treatment of runny nose. We, therefore, recommend that the public must be educated on the best sneeze, cough and respiratory hygiene etiquettes irrespective of their educational attainment

Patterns of Otolaryngologic Sequelae of Suicide Attempts Seen in Nigerian Tertiary Hospitals

Background: Otolaryngologic sequelae of suicide attempts are rarely reported as an entity. In this report, we describe the patterns otolaryngologic sequelae of suicide attempts seen in Nigerian tertiary hospitals. Objective: To improve among clinicians, knowledge of the patterns of otolaryngologic sequelae of suicide attempts with a view to promote their management at the three tiers of health care delivery. Methodology: A retrospective analysis of clinical records of survivors of suicide attempts seen in Nigerian tertiary hospitals. Results: In all, 52 patients were seen. Of this, 34 were cases of otolaryngologic sequelae. Majority, (56.0%) of the sequelae were corrosive oesophagitis. Other sequelae were: corrosive oropharyngoesophagitis (14.7%), corrosive oropharyngitis (8.8%), and corrosive laryngitis (5.9%), hypertrophy scar on the neck (5.9%), laryngeal stenosis (2.9%), pharyngocutaneous fistula (2.9%) and sudden hearing loss (2.9%). The sudden hearing loss was caused by overdose of diazepam. There was discordance in the prevalence of isolated corrosive oesophagitis and oropharyngitis as noted by the 56.0% vs. 8.8% respectively in a pathologic continuum. Conclusion: Corrosive oesophagitis is the most common otolaryngologic sequelae of suicide attempts accounting for 56.0% of cases in this study. There was discordance in the patterns of corrosive injuries of the oesophagus and oropharynx as noted by the 56.0% and 8.8% prevalence respectively, in a pathologic continuum. This stresses the need to avoid using the clinical state of the oropharynx to gauge the condition of the oesophagus. It also emphasizes the importance of diagnostic endoscopy in all symptomatic cases of corrosive ingestion. The occurrence of sudden hearing loss post-ingestion of diazepam remains enigmatic. We therefore suggest empirical studies on this unique finding using laboratory animals

Pomegranate inhibits neuroinflammation and amyloidogenesis in IL-1β stimulated SK-N-SH cells

Purpose: Pomegranate fruit, Punica granatum L. (Punicaceae) and its constituents have been shown to inhibit inflammation. In this study we aimed to assess the effects of freeze-dried pomegranate (PWE) on PGE2 production in IL-1β stimulated SK-N-SH cells. Methods: An enzyme immuno assay (EIA) was used to measure prostaglandin E2 (PGE2) production from supernatants of IL-1β stimulated SK-N-SH cells. Expression of COX-2, phospho-IκB and phospho-IKK proteins were evaluated, while NF-κB reporter gene assay was carried out in TNFα-stimulated HEK293 cells to determine the effect of PWE on NF-κB transactivation. Levels of BACE-1 and Aβ in SK-N-SH cells stimulated with IL-1β were measured with an in cell ELISA. Results: PWE (25-200 µg/ml) dose dependently reduced COX-2 dependent PGE2 production in SK-N-SH cells stimulated with IL-1β. Phosphorylation of IκB and IKK were significantly (p<0.001) inhibited by PWE (50- 200 µg/ml). Our studies also show that PWE (50-200 µg/ml) significantly (p<0.01) inhibited NF-κB transactivation in TNFα-stimulated HEK293 cells. Furthermore PWE inhibited BACE-1 and Aβ expression in SK-N-SH cells treated with IL-1β. Conclusions: Taken together, our study demonstrates that pomegranate inhibits inflammation, as well as amyloidogenesis in IL-1β-stimulated SK-N-SH cells. We propose that pomegranate is a potential nutritional strategy in slowing the progression of neurodegenerative disorders like Alzheimer’s disease