29 research outputs found
Evaluation of In-vivo Antimalarial Activity of Methanol Leaf Extract of Glyphaea brevis in Plasmodium berghei-Infected Mice
Purpose: To evaluate the in-vivo antimalarial activity of the methanol extract of the leaves of Glyphaea brevis in Plasmodium berghei infected mice.Methods: The phytochemical profile of ethylacetate, n-butanol, and residual aqueous fractions of the methanol extract of G. brevis were determined using standard procedures. Mice, weighing between 15 - 30 g, were used for this study. Plasmodium berghei infected blood (0.2 ml) was used to infect each of 55 mice (5 in 11 groups) intraperitoneally. Animals in the infected groups were treated orally with varying doses (200, 300 and 400 mg/kg body weight) of the ethylacetate, n-butanol and residual aqueous fractions daily, using artemisinin (5 mg/kg body weight per day) as standard drug, over a period of four days. The non-infected (normal control, n = 5) received distilled water (0.2 ml) while the infected control group (n = 5) was administered 0.2 ml normal saline. The suppressive antiplasmodial properties of the fractions as well as the serum concentrations of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were determined.Results: Alkaloids, carbohydrates, cardiac glycosides, flavonoids, saponins, tannins, steroids and triterpenes were present in the extract fractions. The suppressive antiplasmodial activity of n-butanol, residual aqueous portion and ethylacetate fractions was 76.64, 73.25 and 72.99 %, respectively, while that of artemisinin was 86.13 %. The serum concentrations of AST, ALT, and ALP in the infected control group were significantly higher (p < 0.05) than those of the treated malaria-infected groups treated with the three fractions.Conclusion: Glyphaea brevis possesses significant antiplasmodial properties and could be a source of lead molecules for the development of new antimalarial agents.Keywords: Antimalarial, Glyphaea brevis, Plasmodium berghei, Artemisini
Morphology and Clinical Presentation of Duplicate External Auditory Canal-Literature Review
First branchial cleft anomalies (FBCA) such as duplication of the external auditory canal are due to failure to obliterate the ventral portion of the 1st cleft while external auditory canal stenosis and atresia are abnormalities of the dorsal portion.The annual incidence is 1:1000,000 and itâs been found to be commoner among females 69% than males 31% with the left ear most affected.FBCA can present as fistula, sinus or cysts located around/along the EAC, periauricular region and the neck above the hyoid bone. Keywords: Duplicate External auditory canal,First branchial anomaly,auditory canal stenosis DOI: 10.7176/JHMN/64-04 Publication date:July 31st 201
Posterior Cerebral Artery Ischemic Stroke in a Patient with Hypoplastic P1 Segment of the Posterior Cerebral Artery
Posterior circulation stroke usually presents with clinical challenges, and symptoms may include blindness. Hypoplastic or atretic cerebral artery may be a risk factor for future ischemic stroke. We present a 75âyearâold male patient with posterior cerebral artery ischemic stroke who presented with sudden visual deterioration, and brain magnetic resonance angiography showed hypoplastic right P1.
Keywords: Hypoplastic artery, ischemic stroke, posterior circulation, visual impairmen
The burden of coexistent allergic rhinitis and allergic conjunctivitis on healthârelated quality of life
Background: Allergic rhinitis (AR) is a symptom complex of consisting of nasal congestion, rhinorrhoea,
sneezing and nasal itching arising from an IgEâmediated allergic reaction and inflammation of the mucosal
lining of the nose and contiguous mucosal membranes usually due to airborne allergen. AR may occur in
isolation or may coexist with allergic conjunctivitis (AC).
Aim: The aim of this study is to assess and evaluate the importance of healthârelated quality of life (HRâQoL)
in patients suffering from concomitant AC with AR with different types of qualityâofâlife instruments.
Methods: A sum of 220 patients who attended the outpatient department of ENT clinic were involved in
this study. All patients undertook an ophthalmologic examination for coexistent AC. The rhino conjunctivitis
quality of life questionnaire (RQLQ) was used to evaluate the quality of life in all patients.
Results: The mean age of the 220 patients (116 females and 104 males) involved in the study was 26.8 years.
The maleâtoâfemale ratio was 1:1.1. Of the 220 patients, 55% studied up to secondary school graduation
and 18% dwelt in the rural area. In the assessment of the statistics obtained from the AR and conjunctivitis
symptom scoring, the mean total complaint score was found to be 13.2 ± 4.0.
Conclusion: AR can vary based on a regionâs flora, weather and socioeconomic status. AR could lead to
severe impairment in HRâQoL
Correlation of Features of Allergic Rhinitis and Allergic Conjunctivitis with Treatment Modalities
Introduction: Allergic Rhinitis (AR) is a chronic, symptomatic allergic disorder of the nose that is
usually caused by IgE-mediated inflammatory response following exposure to an allergen. The
allergen could be in the form of dust, pollen, flower, animal dander, mold, cold, food allergens or
insect. Clinically, AR occurs when there are recurrent nasal symptoms which are reversible either
spontaneously or with medication in the preceding one year. Such symptoms include at least two of the following; excessive sneezing, running nose, nasal itching, nasal discharge, nasal
congestion or obstruction.
Previous studies have linked AR to be co-existed with another form of allergic disorders including
AC, Atopic dermatitis and Allergic Asthma.
This study is aimed at assessing the feature of AR patients with coexistent AC as well as
evaluating the effectiveness of the treatments offered to them.
Objectives: The study was aimed at finding the correlation between the nasal and eye features in
a patient who has co-existing allergic rhinitis and allergic conjunctivitis.
Methodology: This was a cross-sectional descriptive study conducted between August 2018 and
November 2019 among 38 patients who presented to ENT and Ophthalmology departments of
Federal Teaching Hospital Ido-Ekiti, Ekiti State, Southwestern Nigeria and was diagnosed with
both allergic rhinitis and allergic conjunctivitis. Relevant data obtained were analyzed using SPSS
version 20. P †0.05 was taken as significant.
Results: The patientsâ age range between 8 and 81 years with a median age of 33 years. The
majority were less than 45 years (63.2%) with the male to female ratio of almost. Eye pain, itching,
and redness account for 97.4% of all the eye features, while the presence of Cobblestone-like
papillae is the least and accounted for 5%. Nasal itching (92.1%) was the commonest nasal
symptom. Sleep disturbance was found to be the most common among those with eye itching
(29.7%).
Conclusion: This research was conducted to correlate the features of allergic rhinitis with those of
conjunctivitis and common management and preventive measures offered to the patients seen in
our clinics. The majority of the patients were less than 45 years with almost equal sex ratio. Eye
pain, itching, and redness account for the majority of all the eye features, while the presence of
Cobblestone-like papillae is the least eye feature. Nasal itching was the commonest nasal
symptom and this was seen in the majority of the patients with eye symptoms
A Prospective Analysis of Otomycosis in a Tertiary Care Hospital
Background: Otomycosis is a fungal infection of the external
auditory canal, commonly encountered in the general
otolaryngology department. Otomycosis is more frequently
observed in hot and humid climates and various individual,
as well as environmental factors, predispose to this infection.
This study aims to explore the prevalence of otomycosis
in a tertiary care hospital in Ekiti state, Nigeria, along
with a focus on patient demographics, predisposing risk factors,
and pathogenic causes.
Materials and methods: The study was conducted in the
Ear, Nose, and Throat (ENT) department of Federal Teaching
Hospital Ido-Ekiti, which is a tertiary care hospital in Ekiti
state, Nigeria. The study involved 275 patients above the
age of 10, who presented in the ENT department over 5
years period and were clinically diagnosed cases of otomycosis.
Certain patient demographics such as age, gender,
and clinical presentations were recorded along with possible
risk factors and clinically observed findings. Microbiological
causes were evaluated via the culture of samples collected
from each individual. Results were statistically analysed and
the results are presented in a tabulated manner.
Results: The results obtained in our study revealed that
the majority of the subjects were between the ages of 20
and 30 years, making a total of 38.2% of the study population.
Males were observed more commonly then females
accounting for 56% of the total study population. 267 patients
reported unilateral ear involvement among which the
right ear was involved in 82% of the cases. The most frequently
observed risk factor was self-cleaning of ears with
objects such as q-tips, wooden sticks, metal pickers, etc.
seen in 71% of the study population, followed by the use of
antibiotic ear drops observed in 57% and instillation of mustard
oil in 52% of the study group. The most common presenting
symptom in the study population was reported to
be pruritus of the ear in 73% followed by otalgia in 66.5%,
and sensation of blocked ear observed in 57%. Fungi were
established to be the causative organism in 270 out of the
total 275 samples and the most commonly isolated fungi
were Aspergillus seen in 91% of the total population. The
most common species of Aspergillus that was isolated from
samples was Aspergillus Niger seen in 56%. The second
most commonly isolated fungus was Candida in 13.8% of
the group. Bacteria were isolated from 56.4% of the total
samples as a concomitant organism, Staphylococcus aureus
is the most commonly seen in 58% of the samples. The
present study, apart from highlighting the patient population
and causative agents of otomycosis, also places stringent
focus on the need for education to eradicate the aforementioned
predisposing risk factors to hinder the incidence of
otomycosis
Immunotherapy for head and neck cancers
Head and neck squamous cell carcinoma (HNSCC) is a frequent tumour which arises from various anatomical areas in the head and neck region. HNSCC has multiple resistance mechanisms through which it evades the immune responses. It is particularly characterized by an immunosuppressive environment which includes the release of immunosuppressive factors, expansion, and expansion of immune cells which have inhibitory activity reduction of tumour immunogenicity. Human papillomavirus positive (HPV+) HNSCC tumours have one of the higher levels of T cells infiltration. Studies which explore this relationship to the prognosis of patients vary, with some showing benefit only with high CD8/Treg ratio as seen with HPV+ disease and others showing improved prognosis with a higher number of TIL Treg. High CD8+ TIL seen in HPV + disease has been shown in several studies to confer improved disease-free survival. The most successful vaccination strategy is preventive vaccination for HPV. Investigations using different approaches have been carried out on therapeutic vaccines for HPV-associated HNSCC. Despite immune responses being seen in a number of studies, these vaccines are still not effective for clinical use as of ye
Diagnosis and Management of Benign Paroxysmal Positional Vertigo in a West African Country
Objectives: Management of benign paroxysmal positional vertigo is inadequate in many developing countries. Also,
there is a paucity of literature on benign paroxysmal positional vertigo in developing countries including West
African countries.
This study aimed at determining the pathological distribution, clinical presentation, comorbid illnesses, patients
limitations, prehospital and Specialist treatment of benign paroxysmal positional vertigo in our center. It will also
form the basis for further study on benign paroxysmal positional vertigo.
Methods: This was a prospective hospital-based study of all patients with the diagnosis of benign paroxysmal
positional vertigo. Pretested interviewer assisted questionnaire was administered to obtain data. Otoscopic
examination, otoneurologic review, followed by mandatory Dix Hallpike manoeuvre and supine roll test was
performed on all patients. All the patients were treated appropriately by Epley manoeuvre and Semont liberation
manoeuvre. All the data obtained were collated and analysed by using SPSS version 18.0.
Results: The mean age of the patients studied was 48.7. Males accounted for 46.1% with male to female ratio of
1:1.2. There was unilateral benign paroxysmal positional vertigo in 99.4% and right benign paroxysmal positional
vertigo in 64.3%. 66.2% was posterior semicircular canal followed by 24.7% lateral semicircular canal. Majority
83.8% had more than 4 episodes before the presentation. Commonest clinical experience among our patients was
vertigo, nystagmus, and loss of balance in 85.1%, 81.8%, and 80.5% respectively. Chronic cases (greater than 3
months) of benign paroxysmal positional vertigo occurred in 92.9%. 97.2% of the patients were reviewed ear, nose,
and throat outpatient clinic.
Associated comorbid illnesses were a visual disorder, hypertension, arthritis and diabetes mellitus in 27.9%, 23.4%,
22.1%, and 2.6% respectively.
Patients major sources of referral was a general practitioner in 57.8%. The Commonest affected quality of life
among patients was anxiety in 31.8%. It limits the daily activities of patients in 31.8% movement restrictions, 29.9%
avoid turning on the bed, 24.7% indoor and 1.9% avoid driving a car.
Majority 72.7% of the patients had one or more form of prehospital treatment. These were 46.1% pharmacy
consultation, 30.5% over the counter drugs, 44.2% spiritual intervention, 23.4% herbal medication and 5.2% dietary
approach. Majority 65.6% of the patients were on one or more form of medication(s) of which labyrinthine sedative
was 63.0%.
Conservative treatment was offered in 79.2%. Only 59.1% had canalith repositioning manoeuvres at presentation
with two or more sessions in 50.6%. Comorbid illnesses were responsible for referral in 9.1% for experts review and
management.
Conclusion: Benign paroxysmal positional vertigo is a common otologic disorder with significant comorbid
illnesses which limits patients daily activities and affect their quality of life. The illness was associated with late presentation and poorly treated by an unskilled hand, thus there is a need for public enlargement on vertigo and
treatment
Surgical Outreach as a Tertiary Hospitalâs Corporate Social Responsibility: Shall we do more?
Introduction: The underserved populations of the rural and suburban communities of developing countries are challenged by the twin hurdles of low-income earning and out-of-pocket payment for surgical care services. This study aims at appraising the process, outcome, and impact of a free surgical outreach programme carried out by a Federal Teaching Hospital in South-western Nigeria.
Methods: A free day-case surgical outreach programme was announced through a popular radio jingle for a period of 1 week to attract wouldâbe beneficiaries of the programme. A 2-day screening exercise was conducted by the concerted efforts of various specialists in the department of surgery and ophthalmology to select those who are suitable for day-case surgery. Across-sectional survey of patients who participated in the 5-day surgical outreach programme was carried out. A structured questionnaire was used to obtain information on biodata, diagnosis, surgical operations, complications, and level of satisfaction. A 3âpoint bipolar satisfaction outcome scale was used to assess the level of satisfaction. The data obtained were analyzed using the SPSS software version 20.0.
Results: One hundred and fiftyâeight patients were screened, but only 124 participated. Ophthalmic cases constituted 60.5%, whereas the rest (39.5%) were non-ophthalmic cases. Patients with cataract were 73 (58.9%) of all the surgical lesions operated during the outreach programme. Two (1.6%) patients with pterygium were the other ophthalmic cases, whereas the non-ophthalmic cases were mainly hernias. A total of 129 surgical operations were performed in the 124 patients, with 5 (0.4%) of them having bilateral cases. One hundred and seventeen patients (94.4%) expressed satisfaction with their experience of the programme.
Conclusions: Optimal corporate social responsibility of tertiary hospitals can be performed effectively and satisfactorily through a properly organized surgical outreach
The Practicality of the Use of Liquid Biopsy in Early Diagnosis and Treatment Monitoring of Oral Cancer in Resource-Limited Settings
An important driving force for precision and individualized medicine is the provision of tailor-made care for patients on an individual basis, in accordance with best evidence practice. Liquid biopsy(LB) has emerged as a critical tool for the early diagnosis of cancer and for treatment monitoring, but its clinical utility for oral squamous cell carcinoma (OSCC) requires more research and validation. Hence, in this review, we have discussed the current applications of LB and the practicality of its routine use in Africa; the potential advantages of LB over the conventional “gold-standard” of tissue biopsy; and finally, practical considerations were discussed in three parts: pre-analytic, analytic processing, and the statistical quality and postprocessing phases. Although it is imperative to establish clinically validated and standardized working guidelines for various aspects of LB sample collection, processing, and analysis for optimal and reliable use, manpower and technological infrastructures may also be an important factor to consider for the routine clinical application of LB for OSCC. LB is poised as a non-invasive precision tool for personalized oral cancer medicine, particularly for OSCC in Africa, when fully embraced. The promising application of different LB approaches using various downstream analyses such as released circulating tumor cells (CTCs), cell free DNA (cfDNA), microRNA (miRNA), messenger RNA (mRNA), and salivary exosomes were discussed. A better understanding of the diagnostic and therapeutic biomarkers of OSCC, using LB applications, would significantly reduce the cost, provide an opportunity for prompt detection and early treatment, and a method to adequately monitor the effectiveness of the therapy for OSCC, which typically presents with ominous prognosis