Outcome of primary posterior sagittal anorectoplasty of high anorectal malformation in well selected neonates

Background: Conventional posterior sagittal anorectoplasty (PSARP) for high anorectal malformation (ARM) involves initial colostomy creation with its attendant complications, but primary PSARP in neonates requires no initial colostomy.Objectives: To report on locally adapted inclusion criteria and outcomes of primary PSARP in neonates in Benin City.Materials and Methods: Babies who presented during the first week of life in clinically stable conditions, without cardiac anomaly, and had hemogram and blood chemistry within normal ranges, were included in this prospective study undertaken at the University of Benin Teaching Hospital in 2008‑2011.Results: Fifty children with ARM comprising 19 (38%) low/intermediate and 31 (62%) high anomalies were treated during the period. Five (10%) singletons delivered via spontaneous vaginal delivery at term. Aged at operation between two and seven (mean 4) days and comprised three males and two females (ratio 1.5:1), met the inclusion criteria for primary PSARP. The procedure was well tolerated by all the babies; oral intake was commenced on the second post‑operative day with nine days median hospitalization duration. No mortality was recorded on six months to four years follow‑up. Apart from minor superficial perianal surgical site infection in one baby which responded to antibiotics, no post‑operative sepsis or breakdown of repair was recorded. Continence and other anal functions were found excellent using the modified Wingspread scoring during follow‑up.Conclusion: These outcomes showed that with meticulous selection, primary PSARP in neonates was feasible and safe in a developing country. Multicenter studies and long‑term follow‑up are advocated World‑wide.Key words: Anorectoplasty, anorectal malformation, neonates, primary, posterior, sagitta

Antioxidant and antimicrobial activities of polyphenols from ethnomedicinal plants of Nigeria

The antioxidant properties and antimicrobial potential of three ethnomedicinal plants, (Momordica charanta, Senna alata and Nauclea lafifolia) extracted with acetone were investigated. Polyphenols fromthe medicinal plants were screened for their antioxidant and antimicrobial activities against pathogenic micro organisms (Staphylococcus aureus, Streptococcus pyogenes, Esherichia coli and Candida albicans). The medicinal plants displayed different polyphenols contents and antioxidant activities. In addition, varying antimicrobial susceptibility patterns were exhibited. The highest amount of total phenolic compounds was shown by S. alata and the lowest one was M. charanta. The extract of S. alatashowed the highest antioxidant activity. Some micro organisms (S. aureus and C. albicans) were susceptible to the polyphenol extracts with minimum inhibitory concentration values between 1.25 to 5.00 mg/ml while other microorganisms (S. pyogenes and E. coli) appeared to be resistant to theextracts. The results suggested that these plants are not only potential sources of phenolic antioxidants but also potentially, good source of antimicrobial agents

Determinants and effect of girl child marriage: a cross sectional study of school girls in Plateau State, Nigeria

Background: Child marriage is a major problem contributing to maternal morbidity and mortality in Nigeria. It has effect on both social and health of not only the girl child but the children born to these young mothers. Aim: This study aimed at assessing the determinants of early marriage among secondary school girls in Plateau State and its effect especially on their health and education. Methods: The study was a cross sectional study of young girls in 21 secondary schools across the three geopolitical zones in Plateau state, selected through a simple random sampling technique after obtaining consent from the JUTH ethical committee and permission from the State ministry of education and the principals of the various schools.Results: The study found that while must marriages among girls are forceful marriages, the factors that influenced early marriage was poor educational level of parents, poverty and place of residence. The girls who married among them reported having had some health challenges and educational backwardness as a result of early marriage. Conclusion: This study found that poverty and poor education are the underlying cause of child marriage and child marriage is usually against the will of the girls who desire to be educated.Key words: Early marriage, maternal and childhood morbidity and mortality, Child Right Act, girl child education, puberty, teenage pregnanc

Analysis of cases of rape as seen at the Jos University Teaching Hospital, Jos, north central Nigeria

No Abstract

The Oxford Classic links epithelial-to-mesenchymal transition to immunosuppression in poor prognosis ovarian cancers

Purpose: Using RNA sequencing, we recently developed the 52-gene–based Oxford classifier of carcinoma of the ovary (Oxford Classic, OxC) for molecular stratification of serous ovarian cancers (SOCs) based on the molecular profiles of their cell of origin in the fallopian tube epithelium. Here, we developed a 52-gene NanoString panel for the OxC to test the robustness of the classifier. Experimental Design: We measured the expression of the 52 genes in an independent cohort of prospectively collected SOC samples (n = 150) from a homogenous cohort who were treated with maximal debulking surgery and chemotherapy. We performed data mining of published expression profiles of SOCs and validated the classifier results on tissue arrays comprising 137 SOCs. Results: We found evidence of profound nongenetic heterogeneity in SOCs. Approximately 20% of SOCs were classified as epithelial-to-mesenchymal transition–high (EMT-high) tumors, which were associated with poor survival. This was independent of established prognostic factors, such as tumor stage, tumor grade, and residual disease after surgery (HR, 3.3; P = 0.02). Mining expression data of 593 patients revealed a significant association between the EMT scores of tumors and the estimated fraction of alternatively activated macrophages (M2; P < 0.0001), suggesting a mechanistic link between immunosuppression and poor prognosis in EMT-high tumors. Conclusions: The OxC-defined EMT-high SOCs carry particularly poor prognosis independent of established clinical parameters. These tumors are associated with high frequency of immunosuppressive macrophages, suggesting a potential therapeutic target to improve clinical outcome

The Oxford Classic links epithelial-mesenchymal transition to immunosuppression in poor prognosis ovarian cancers

Purpose: Using RNA sequencing, we recently developed the 52-gene–based Oxford classifier of carcinoma of the ovary (Oxford Classic, OxC) for molecular stratification of serous ovarian cancers (SOCs) based on the molecular profiles of their cell of origin in the fallopian tube epithelium. Here, we developed a 52-gene NanoString panel for the OxC to test the robustness of the classifier. Experimental Design: We measured the expression of the 52 genes in an independent cohort of prospectively collected SOC samples (n = 150) from a homogenous cohort who were treated with maximal debulking surgery and chemotherapy. We performed data mining of published expression profiles of SOCs and validated the classifier results on tissue arrays comprising 137 SOCs. Results: We found evidence of profound nongenetic heterogeneity in SOCs. Approximately 20% of SOCs were classified as epithelial-to-mesenchymal transition–high (EMT-high) tumors, which were associated with poor survival. This was independent of established prognostic factors, such as tumor stage, tumor grade, and residual disease after surgery (HR, 3.3; P = 0.02). Mining expression data of 593 patients revealed a significant association between the EMT scores of tumors and the estimated fraction of alternatively activated macrophages (M2; P < 0.0001), suggesting a mechanistic link between immunosuppression and poor prognosis in EMT-high tumors. Conclusions: The OxC-defined EMT-high SOCs carry particularly poor prognosis independent of established clinical parameters. These tumors are associated with high frequency of immunosuppressive macrophages, suggesting a potential therapeutic target to improve clinical outcome