8 research outputs found

    Kimura’s disease in a Nigerian: Case report

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    Kimura’s disease (KD) is a chronic inflammatory disease presenting as multiple  subcutaneous swellings within the head and neck region. Aetiology has been suggested to be due to allergy or an immune response and it’s predominantly seen in young and middle-aged males. Histopathologically, hyperplasia of lymphoid tissue, with well-developed lymphoid follicles and marked infiltration of eosinophils are seen. KD is a relatively rare disease previously reported to be endemic in Asians of Chinese decent. However, they can constitute a diagnostic challenge where there is low index of suspicion. Therefore, we report a case of KD in an adult male Nigerian

    Fish sorting assessments of Clarias gariepinus fingerlings raised in fish tanks

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    Fish sorting assessments of Clarias gariepinus fingerlings stocked and raised in fish tanks were undertaken for a 6-month culture period: Sorting was undertaken from the first, second, and third months of stocking the fish fingerlings while the control was not sorted at all. The sorting assessments revealed that the twice sorting of fish fingerlings stocked with a Marginal Rate of Return (MRR) of 3.44 was significantly different (p>0.05) from those sorted once with MRR of 0.912, and three times with MRR of 2.65 respectively, thus making twice sorting most advisable for fish farmers utilizing Clarias gariepinus fingerlings for tank aquacultur

    Primary stroke prevention worldwide : translating evidence into action

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    Funding Information: The stroke services survey reported in this publication was partly supported by World Stroke Organization and Auckland University of Technology. VLF was partly supported by the grants received from the Health Research Council of New Zealand. MOO was supported by the US National Institutes of Health (SIREN U54 HG007479) under the H3Africa initiative and SIBS Genomics (R01NS107900, R01NS107900-02S1, R01NS115944-01, 3U24HG009780-03S5, and 1R01NS114045-01), Sub-Saharan Africa Conference on Stroke Conference (1R13NS115395-01A1), and Training Africans to Lead and Execute Neurological Trials & Studies (D43TW012030). AGT was supported by the Australian National Health and Medical Research Council. SLG was supported by a National Heart Foundation of Australia Future Leader Fellowship and an Australian National Health and Medical Research Council synergy grant. We thank Anita Arsovska (University Clinic of Neurology, Skopje, North Macedonia), Manoj Bohara (HAMS Hospital, Kathmandu, Nepal), Denis ?erimagi? (Poliklinika Glavi?, Dubrovnik, Croatia), Manuel Correia (Hospital de Santo Ant?nio, Porto, Portugal), Daissy Liliana Mora Cuervo (Hospital Moinhos de Vento, Porto Alegre, Brazil), Anna Cz?onkowska (Institute of Psychiatry and Neurology, Warsaw, Poland), Gloria Ekeng (Stroke Care International, Dartford, UK), Jo?o Sargento-Freitas (Centro Hospitalar e Universit?rio de Coimbra, Coimbra, Portugal), Yuriy Flomin (MC Universal Clinic Oberig, Kyiv, Ukraine), Mehari Gebreyohanns (UT Southwestern Medical Centre, Dallas, TX, USA), Ivete Pillo Gon?alves (Hospital S?o Jos? do Avai, Itaperuna, Brazil), Claiborne Johnston (Dell Medical School, University of Texas, Austin, TX, USA), Kristaps Jurj?ns (P Stradins Clinical University Hospital, Riga, Latvia), Rizwan Kalani (University of Washington, Seattle, WA, USA), Grzegorz Kozera (Medical University of Gda?sk, Gda?sk, Poland), Kursad Kutluk (Dokuz Eylul University, ?zmir, Turkey), Branko Malojcic (University Hospital Centre Zagreb, Zagreb, Croatia), Micha? Maluchnik (Ministry of Health, Warsaw, Poland), Evija Migl?ne (P Stradins Clinical University Hospital, Riga, Latvia), Cassandra Ocampo (University of Botswana, Princess Marina Hospital, Botswana), Louise Shaw (Royal United Hospitals Bath NHS Foundation Trust, Bath, UK), Lekhjung Thapa (Upendra Devkota Memorial-National Institute of Neurological and Allied Sciences, Kathmandu, Nepal), Bogdan Wojtyniak (National Institute of Public Health, Warsaw, Poland), Jie Yang (First Affiliated Hospital of Chengdu Medical College, Chengdu, China), and Tomasz Zdrojewski (Medical University of Gda?sk, Gda?sk, Poland) for their comments on early draft of the manuscript. The views expressed in this article are solely the responsibility of the authors and they do not necessarily reflect the views, decisions, or policies of the institution with which they are affiliated. We thank WSO for funding. The funder had no role in the design, data collection, analysis and interpretation of the study results, writing of the report, or the decision to submit the study results for publication. Funding Information: The stroke services survey reported in this publication was partly supported by World Stroke Organization and Auckland University of Technology. VLF was partly supported by the grants received from the Health Research Council of New Zealand. MOO was supported by the US National Institutes of Health (SIREN U54 HG007479) under the H3Africa initiative and SIBS Genomics (R01NS107900, R01NS107900-02S1, R01NS115944-01, 3U24HG009780-03S5, and 1R01NS114045-01), Sub-Saharan Africa Conference on Stroke Conference (1R13NS115395-01A1), and Training Africans to Lead and Execute Neurological Trials & Studies (D43TW012030). AGT was supported by the Australian National Health and Medical Research Council. SLG was supported by a National Heart Foundation of Australia Future Leader Fellowship and an Australian National Health and Medical Research Council synergy grant. We thank Anita Arsovska (University Clinic of Neurology, Skopje, North Macedonia), Manoj Bohara (HAMS Hospital, Kathmandu, Nepal), Denis Čerimagić (Poliklinika Glavić, Dubrovnik, Croatia), Manuel Correia (Hospital de Santo António, Porto, Portugal), Daissy Liliana Mora Cuervo (Hospital Moinhos de Vento, Porto Alegre, Brazil), Anna Członkowska (Institute of Psychiatry and Neurology, Warsaw, Poland), Gloria Ekeng (Stroke Care International, Dartford, UK), João Sargento-Freitas (Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal), Yuriy Flomin (MC Universal Clinic Oberig, Kyiv, Ukraine), Mehari Gebreyohanns (UT Southwestern Medical Centre, Dallas, TX, USA), Ivete Pillo Gonçalves (Hospital São José do Avai, Itaperuna, Brazil), Claiborne Johnston (Dell Medical School, University of Texas, Austin, TX, USA), Kristaps Jurjāns (P Stradins Clinical University Hospital, Riga, Latvia), Rizwan Kalani (University of Washington, Seattle, WA, USA), Grzegorz Kozera (Medical University of Gdańsk, Gdańsk, Poland), Kursad Kutluk (Dokuz Eylul University, İzmir, Turkey), Branko Malojcic (University Hospital Centre Zagreb, Zagreb, Croatia), Michał Maluchnik (Ministry of Health, Warsaw, Poland), Evija Miglāne (P Stradins Clinical University Hospital, Riga, Latvia), Cassandra Ocampo (University of Botswana, Princess Marina Hospital, Botswana), Louise Shaw (Royal United Hospitals Bath NHS Foundation Trust, Bath, UK), Lekhjung Thapa (Upendra Devkota Memorial-National Institute of Neurological and Allied Sciences, Kathmandu, Nepal), Bogdan Wojtyniak (National Institute of Public Health, Warsaw, Poland), Jie Yang (First Affiliated Hospital of Chengdu Medical College, Chengdu, China), and Tomasz Zdrojewski (Medical University of Gdańsk, Gdańsk, Poland) for their comments on early draft of the manuscript. The views expressed in this article are solely the responsibility of the authors and they do not necessarily reflect the views, decisions, or policies of the institution with which they are affiliated. We thank WSO for funding. The funder had no role in the design, data collection, analysis and interpretation of the study results, writing of the report, or the decision to submit the study results for publication. Funding Information: VLF declares that the PreventS web app and Stroke Riskometer app are owned and copyrighted by Auckland University of Technology; has received grants from the Brain Research New Zealand Centre of Research Excellence (16/STH/36), Australian National Health and Medical Research Council (NHMRC; APP1182071), and World Stroke Organization (WSO); is an executive committee member of WSO, honorary medical director of Stroke Central New Zealand, and CEO of New Zealand Stroke Education charitable Trust. AGT declares funding from NHMRC (GNT1042600, GNT1122455, GNT1171966, GNT1143155, and GNT1182017), Stroke Foundation Australia (SG1807), and Heart Foundation Australia (VG102282); and board membership of the Stroke Foundation (Australia). SLG is funded by the National Health Foundation of Australia (Future Leader Fellowship 102061) and NHMRC (GNT1182071, GNT1143155, and GNT1128373). RM is supported by the Implementation Research Network in Stroke Care Quality of the European Cooperation in Science and Technology (project CA18118) and by the IRIS-TEPUS project from the inter-excellence inter-cost programme of the Ministry of Education, Youth and Sports of the Czech Republic (project LTC20051). BN declares receiving fees for data management committee work for SOCRATES and THALES trials for AstraZeneca and fees for data management committee work for NAVIGATE-ESUS trial from Bayer. All other authors declare no competing interests. Publisher Copyright: © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 licenseStroke is the second leading cause of death and the third leading cause of disability worldwide and its burden is increasing rapidly in low-income and middle-income countries, many of which are unable to face the challenges it imposes. In this Health Policy paper on primary stroke prevention, we provide an overview of the current situation regarding primary prevention services, estimate the cost of stroke and stroke prevention, and identify deficiencies in existing guidelines and gaps in primary prevention. We also offer a set of pragmatic solutions for implementation of primary stroke prevention, with an emphasis on the role of governments and population-wide strategies, including task-shifting and sharing and health system re-engineering. Implementation of primary stroke prevention involves patients, health professionals, funders, policy makers, implementation partners, and the entire population along the life course.publishersversionPeer reviewe

    “Myasthenia Gravis and Anesthesia – A Review of the Literature” (English)

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    Myasthenia gravis (MG) is an immunological disorder characterized by damaged acetylcholine receptors (AchR) due to antibody, which not only blocks the receptor site but also causes degenerations of the receptors.. It is closely associated with disorders of similar pathogenesis, such as pernicious anaemia, thyrotoxicosis, SLE, hypothyroidism, rheumatoid like arthritis, red cell aplasia and polymyositis. The disease is characterized by skeletal muscle weakness and fatigability upon sustained effort and commonly affects the ocular, bulbar and limb muscles. Anticholinesterases, immunosuppressive drugs, plasmaphresis, and thymectomy are the four strategies in the treatment of myasthenia. The thymus plays a critical role in immuno surveillance and has been incriminated in its pathogenesis. There is therefore a general consensus that adults with myasthenia gravis should have thymectomy. The anaesthetic management of the myaesthenic patient must be individualized to the severity of the disease and the type of surgery. Such patients may have an abnormal response to muscle relaxants, a restricted respiratory capacity with inability to cough and clear the increased secretions resulting from anticholinesterase therapy or have a co-existing cardiomyopathy. It may be safe and advantageous to discontinue anticholinesterase therapy just before surgery in order to minimize their vagotonic side effects. It is also safe to decrease the dose of depolarizing and non-depolarising blockers required to maintain muscle relaxation during surgery. Furthermore, MG patients are at increased risk of developing post-operative respiratory failure and it is likely that they would require ventilatory support after surgery. Post-operative care should be done in the intensive care unit with tracheal suction and monitoring of respiratory function as well as chest physiotherapy. Despite the anaesthetic, intra- and post-operative problems envisaged in patients with myasthenia gravis, cases with mild generalized MG could have uneventful operations if necessary precautions are taken. The course of MG is extremely variable, although, spontaneous remission is common, relapse is the rule. Résumé La myasthénie gravis (MG) est liée à un dysfonctionnement du système immunitaire. (Il) Elle se caractérise par une anomalie des récepteurs de l´acétylcholine (AchR) causée par des anticorps avec pour conséquence non seulement un blocage du site des récepteurs mais également leur dégénerescence. Elle peut être associée à des affections de pathogénie identique telles que l´anémie pernicieuse, la thyréotoxicose, l´hypothyroïde ou encore la polyarthrite rhumatoïde, l´aplasie médullaire et la polymyosite. La maladie se caractérise par une faiblesse des muscles squelettiques et une fatigabilité après un effort soutenu. Elle atteint généralement les muscles oculaires extrinsèques, les muscles pharyngo-laryngés et de la face ainsi que les muscles des membres. Il existe quatre types de traitement contre la myasthénie : les anticholinesthérasiques, les immunodépresseurs, les échanges plasmatiques et la thymectomie. Le thymus qui joue un rôle décisif dans l´immuno-régulation et est impliquée dans la pathogénie . Ainsi, l´on s´accorde à penser que les adultes atteints de myasthénie gravis devraient avoir recours à une thymectomie. La prise en charge anesthésique du malade myasthénique doit être individualisée selon la gravité de la maladie et le procédé chirurgical. En effet, ces patients peuvent avoir une réaction négative aux relaxants musculaires, souffrir d´une insuffisance respiratoire ou être dans l´impossibilité de tousser et d\'expectorer les sécrétions importantes apparues après un traitement anticholinestérasique ou en rapport avec une myocardiopathie coexistante. Il est prudent d´interrompre le traitement anticholinesthérasique juste avant l´intervention afin de réduire les effets vagotoniques secondaires. Il est également conseillé de réduire la dose de curarisants polarisants et non - polarisants nécessaires au maintien du relâchement musculaire au cours de l´intervention. En outre, les malades myasthéniques sont exposés à des risques respiratoires importants et peuvent développer des défaillances en post-opératoire nécessitant ainsi assistance respiratoire. Des soins post-opératoires devront être apportés dans le service de soins intensifs : aspiration trachéale, monitoring des fonctions respiratoires et kinésithérapie respiratoire. En dépit des problèmes anesthésiques per-opératoires et post-opératoires pouvant survenir chez les patients atteints de myasthénie gravis, la forme légère généralisée peut être opérée sans complication à condition de prendre les précautions nécessaires. L´évolution de la maladie est extrêmement variée marquée par des poussées et bien qu´une rémission soit courante, il faut néanmoins s´attendre à des rechutes. (Af. J. of Neurological Sciences: 2003 22(2)

    Immunohistochemical Expression of Vitamin-D Receptor in Oral and Skin Squamous Cell Carcinoma of a Black African Subpopulation

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    Objective: The nuclear vitamin D receptor (VDR) is involved in multiple pathways that have a role to play in the biology of cancer. Recent evidence indicates that the active form of vitamin D (1alpha, 25-dihydroxycholecalciferol) (VD) exhibits several anti-growth effects. Thus it is useful as an antineoplastic agent in several human malignancies. We aim to analyze the expression of VDR in skin and oral squamous cell carcinomas (skin SCC and OSCC) from a black African sub-population to determine potential for active VD therapy in such patients.Design: Nineteen formalin fixed paraffin embedded (FFPE) blocks of OSCC and 15 Skin SCC FFPE were prepared for Abcam Rabbit polyclonal Anti- Vitamin D Receptor antibody ChIP Grade (ab3508). Nuclear brown staining was considered as positive for VDR. The Sinicrope scoring method was used to evaluate the stained epithelial cells. All slides were viewed with a Nikon ECLIPSE 80i microscope and microphotographs recorded.Results: Among 15 moderately differentiated OSCC 7 (46.7%) showed moderate to strong positivity for VDR, while 8 were weak or negative for VDR. Among 10 well-differentiated SCC of the skin, 8 (80%) cases showed moderate to strong VDR positivity, while 2 cases showed weak expression. Overall, approximately the same number of OSCC (9 cases) and Skin SCC (10 cases) expressed moderate to strong positivity for VDR.Conclusion: In our study, we noted that the OSCC and skin SCC have similar number of cases expressing moderate to strong positive staining for VDR. Thus we suggest that the chemotherapeutic role already established for VD is of relevance in OSCC and skin SCC in black Africans
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