A Decade Of Hysterectomy In ATertiary Hospital In Urban Niger-delta Region Of Nigeria

Hysterectomy is a very common gynaecological procedure which has a significant place in optimizing the reproductive health outcomes ofwomen. To document the indications the type of hysterectomy commonly performed, the difficulties encountered and complications of the procedure at theCentralHospital,BeninCity. This was a retrospective review of the service delivery records of patients that had hysterectomy in the gynaecological unit between January, 1994 andDecember, 2003. There were 1216 major gynaecological operations during the study period. Of these, 131 (10.8%) hysterectomies were done. Total abdominal hysterectomy accounted for 80.4% of the procedures performed and most were done by consultants (94.4%). The mean age of the patients was 45.7 years with a median of 46years and theywere commonly grandmultiparous (71.0%).The commonest indication for the procedurewas symptomatic uterine fibroid (62.3%) followed by urogenital prolapse (13.1%). The crude morbidity rate was 30.3%and themortality ratewas 1.6%. Hysterectomy in this centre is a fairly safe procedure. There is paucity of skills for vaginal and radical procedures. Training is advocated with a view to reducing the presently high morbidity rate as well as achieving our aimof optimizing the reproductive health outcomes of ourwomen. Keywords: Decade,Hysterectomy,Tertiary Hospital,Urban Nigeria Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 359-36

A systematic review of resonant voice therapy

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Whole-body MRI for preventive health screening:A systematic review of the literature

Background The yield of whole-body MRI for preventive health screening is currently not completely clear. Purpose To systematically review the prevalence of whole-body MRI findings in asymptomatic subjects. Study Type Systematic review and meta-analysis. Subjects MEDLINE and Embase were searched for original studies reporting whole-body MRI findings in asymptomatic adults without known disease, syndrome, or genetic mutation. Twelve studies, comprising 5373 asymptomatic subjects, were included. Field Strength/Sequence 1.5T or 3.0T, whole-body MRI. Assessment The whole-body MRI literature findings were extracted and reviewed by two radiologists in consensus for designation as either critical or indeterminate incidental finding. Statistical Tests Data were pooled using a random effects model on the assumption that most subjects had 5-year) verification of negative findings. Only one study reported false-negative findings, with a proportion of 2.0%. Data Conclusion Prevalence of critical and indeterminate incidental whole-body MRI findings in asymptomatic subjects is overall substantial and with variability dependent to some degree on the protocol. Verification data are lacking. The proportion of false-positive findings appears to be substantial. Technical Efficacy: Stage 3 J. Magn. Reson. Imaging 2019;50:1489-1503

Incidence and Determinants of Stillbirth amongst Parturients in Two Hospitals in Southern Nigeria

Background: Fetal death is a major but often overlooked public health issue. Aim: Knowledge of the causes and risk factors will help in designing measures to reduce the burden of fetal death in Nigeria. Materials and Methods: A 5 year descriptive study of all fetal mortality of >28 weeks in Southern Nigeria. Relevant details were extracted from the case notes and the registers in the labor ward, maternity ward, the labor ward theater and the main theater. Statistical Analysis Used: The data was analyzed using Statistical Package for Social Scientist (SPSS PC+) and this consisted of univariate analysis and comparisons of identified relationships. Results: The total number of deliveries from 28 weeks was 25,780 and the number of parturients with fetal mortality after 28 weeks was 157 and therefore the incidence of stillbirth was 0.6% giving a mortality rate of 6.1/1000 total births. However, 148 (85%) case notes of the total fetal deaths were retrieved and formed the study sample. Socio-demographic variables such as extremes of age and parity, unbooked status, unemployment, unmarried, Isoko, Itsekiri and Ijaw ethnic groups and primary level or no formal education were determinants of stillbirth. Others were maternal diabetes mellitus, malaria, hypertension, labor duration >4 h, instrumental or assisted vaginal delivery, gestational age at booking >12 weeks, low birth weight and preterm births. Conclusion: The fetal mortality (stillbirth) rate was low and the determinants were identified. Public health education, female education and socio-economic empowerment are suggested preventive measures.Keywords: Amongst parturients, determinants, fetal mortality, incidence, Southern Nigeria, stillbirt

An unexpected twist to the activation of IKKβ:TAK1 primes IKKβ for activation by autophosphorylation

IKKβ {IκB [inhibitor of NF-κB (nuclear factor κB)] kinase β} is required to activate the transcription factor NF-κB, but how IKKβ itself is activated in vivo is still unclear. It was found to require phosphorylation by one or more ‘upstream’ protein kinases in some reports, but by autophosphorylation in others. In the present study, we resolve this contro-versy by demonstrating that the activation of IKKβ induced by IL-1 (interleukin-1) or TNF (tumour necrosis factor) in embryonic fibroblasts, or by ligands that activate Toll-like receptors in macrophages, requires two distinct phosphorylation events: first, the TAK1 [TGFβ (transforming growth factor β)-activated kinase-1]-catalysed phosphorylation of Ser(177) and, secondly, the IKKβ-catalysed autophosphorylation of Ser(181). The phosphorylation of Ser(177) by TAK1 is a priming event required for the subsequent autophosphorylation of Ser(181), which enables IKKβ to phosphorylate exogenous substrates. We also provide genetic evidence which indicates that the IL-1-stimulated, LUBAC (linear ubiquitin chain assembly complex)-catalysed formation of linear ubiquitin chains and their interaction with the NEMO (NF-κB essential modulator) component of the canonical IKK complex permits the TAK1-catalysed priming phosphorylation of IKKβ at Ser(177) and IKKα at Ser(176). These findings may be of general significance for the activation of other protein kinases

Study of Salmonella typhimurium mutagenicity assay of (E)-piplartine by the Ames test

Phytochemical studies carried out with Piperaceae species have shown great diversity of secondary metabolites among which are several displayed considerable biological activities. The species Piper tuberculatum has been intensively investigated and a series of amides have been described. For instance, (E)-piplartine showed significant cytotoxic activity against tumor cell lines, especially human leukemia cell lines; antifungal activity against Cladosporium species; trypanocidal activity and others. Considering the popular use of P. tuberculatum and the lack of pharmacological studies regarding this plant species, the mutagenic and antimutagenic effect of (E)-piplartine was evaluated by the Ames test, using the strains TA97a, TA98, TA100 and TA102 of Salmonella typhimurium. No mutagenic activity was observed for this compound.Key words: Piperaceae, Piper tuberculatum, (Z)-piplartine, mutagenic activated, Ames test

Spatial Interpolation of Air Pollutants in Bangalore: 2010-2013

Air pollutants and their ill effects on the environment and health of populations are well known. However for informed decisions on the protection of the health of populations from elevated levels of air pollution, an understanding of spatial-temporal variance of air pollutant patterns is necessary. Bangalore and other similar developing cities do not have an adequate number of fixed monitoring stations that could provide a complete coverage of the air pollution levels for the entire city. This can be overcome by using geospatial interpolation techniques that provide a complete coverage of the levels of pollutants. The aim of this study is to locate sample points, characterise distribution patterns, map air pollutant distributions using interpolation techniques, highlight areas exceeding standard levels and in doing so determine spatial and temporal patterns of the levels of air pollutants. An air pollution map indicating levels of the variability of the pollutants will aid in the analysis of effects on health in populations due to elevated levels of pollutants

Air Pollution in Bangalore, India: A Six-Year Trend and Health Implication Analysis

Air pollution is increasingly becoming a global concern and is believed to be amongst the leading causes of death in the world today. Developing countries, with rapidly growing economies, are struggling between the focus on economic development and curbing air pollution emissions. Bangalore is one of India’s fastest growing metropolises and, although benefiting economically due to its rapid development, has a rapidly deteriorating environment. This paper provides a critical analysis of the air pollution trend in the city over the period 2005-2011 at 6 specific locations where measurements have been consistently recorded. It also discusses the potential health implications pertaining to exceeding levels of pollutants where these are applicable

Spatio-Temporal Analysis of the Effects of Air Pollution Hazards on Cardiovascular Health Outcomes in Bangalore, India

Recent research has established a link between exposure to certain pollutants and exacerbation or onset of cardiac diseases. Diseases have a spatial context and the evolution of computer applications, such as Geographical Information Systems (GIS), has favoured the studies of environment and their effects on health and populations. To aid in understanding the extent of air pollution and cardiac diseases in the city of Bangalore (India), this research explores the data requirements and GIS analysis tools that could be used to undertake a spatio-temporal analysis by developing a web based GIS application. The ultimate goal is to identify hotspots of air pollution, explore the relationships between environmental pollution hazards and cardiovascular diseases, integrate the available data to enable sharing among decision makers and disseminate information

Mechanisms and Impacts of Earth System Tipping Elements

Tipping elements are components of the Earth system which may respond nonlinearly to anthropogenic climate change by transitioning toward substantially different long-term states upon passing key thresholds or “tipping points.” In some cases, such changes could produce additional greenhouse gas emissions or radiative forcing that could compound global warming. Improved understanding of tipping elements is important for predicting future climate risks and their impacts. Here we review mechanisms, predictions, impacts, and knowledge gaps associated with 10 notable Earth system components proposed to be tipping elements. We evaluate which tipping elements are approaching critical thresholds and whether shifts may manifest rapidly or over longer timescales. Some tipping elements have a higher risk of crossing tipping points under middle-of-the-road emissions pathways and will possibly affect major ecosystems, climate patterns, and/or carbon cycling within the 21st century. However, literature assessing different emissions scenarios indicates a strong potential to reduce impacts associated with many tipping elements through climate change mitigation. The studies synthesized in our review suggest most tipping elements do not possess the potential for abrupt future change within years, and some proposed tipping elements may not exhibit tipping behavior, rather responding more predictably and directly to the magnitude of forcing. Nevertheless, uncertainties remain associated with many tipping elements, highlighting an acute need for further research and modeling to better constrain risks