The effects of nomegestrol acetate subdermal implant (Uniplant) on serum cholesterol, triglycerides, and lipoproteins in Nigerian users

The study was conducted to assess the effects of a nomegestrol acetate subdermal contraceptive implant (Uniplant(R)) on the lipid profiles of indigenous Nigerian women. Cholesterol content of the major lipoproteins, along with total cholesterol and triglycerides, were measured in fasting blood samples collected before implant insertion and then at months 1, 3, 6, and 12 of use. All volunteers were of the reproductive age, healthy, and had no contraindications to hormonal contraception.The mean levels of cholesterol and low density lipoprotein-cholesterol (LDL-C) increased gradually, albeit insignificantly, from insertion to month 12 of implant use. An initial decline in the mean levels of high density lipoprotein-cholesterol (HDL-C), reaching a minimal level (37.31 +/- 4.95 mg/dl) at month 3 of implant use, was observed. This was followed by a gradual rise that peaked (39.73 +/- 5.53 mg/dL) at month 12. These values were, however, not significantly different from the preinsertion value. The only significant difference (p <0. 005 ) was in the mean level of triglycerides at month 12 (90.90 +/- 17.75 mg/dL) when compared with the preinsertion mean level of 81.77 +/- 24.14 mg/dL. Both values were, however, within normal limits. These results indicate that Uniplant does not have a deleterious effect on the lipid profiles of Nigerian acceptors and can be safely prescribed to women seeking contraception.     

Association of malarial parasitaemia with dehydrating diarrhoea in Nigerian children

Records of 402 children--216 (53.7%) males and 186 (46.3%) females--aged 1-36 month(s), admitted to the Diarrhoea Treatment and Training Unit of the University of Benin Teaching Hospital, Benin city, Nigeria, during July 1993-June 1996, were reviewed to document the relationship between dehydration and malaria parasitaemia. There was a significant association between severity of dehydration and malaria parasitaemia (p < 0.0001). Association of parasitaemia (p < 0.006) with dehydration (p < 0.0001) was significantly more marked in patients with acute watery diarrhoea than in those with persistent and bloody diarrhoea. Parasitaemia was demonstrated in 50.5% of those not initially suspected to have malaria. Parasitaemia was also significantly associated with fever (p < 0.001) and fever coexisting with vomiting (p < 0.01). The prevalence of malaria-associated diarrhoea was 61.7%. More infants (75.6%) than older children had diarrhoea. It was concluded that the prevalence of malaria-associated diarrhoea was high and that children with dehydration are more likely to manifest malaria parasitaemia.     

Report of two cases: Rattlesnake venom-induced thrombocytopenia

We report 2 patients who presented with vasomotor symptoms and severe thrombocytopenia following rattlesnake bites. These symptoms persisted in spite of treatment with antivenin and transfusion of multiple doses of platelets. Thrombocytopenia is a common occurrence in moderate to severe crotaline envenomation. Algorithms suggested for the treatment of rattlesnake envenomation with crotaline-specific antivenin may not reverse the associated thrombocytopenia. The precise mechanism of venom-induced thrombocytopenia (VIT), even in the absence of significant coagulopathy, is unknown. Our experience suggests that, unless spontaneous bleeding occurs, repeated transfusion of fresh frozen plasma and/or platelets may not be indicated.     

In vitro synergistic activity of NCL195 in combination with colistin against Gram-negative bacterial pathogens

In this study, the potential of using the novel antibiotic NCL195 combined with subinhibitory concentrations of colistin against infections caused by Gram-negative bacteria (GNB) was investigated. We showed synergistic activity of the combination NCL195 + colistin against clinical multidrug-resistant GNB pathogens with minimum inhibitory concentrations (MICs) for NCL195 ranging from 0.5–4 μg/mL for Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa, whereas NCL195 alone had no activity. Transmission electron microscopy of the membrane morphology of E. coli and P. aeruginosa after single colistin or combination drug treatment showed marked ultrastructural changes most frequently in the cell envelope. Exposure to NCL195 alone did not show any change compared with untreated control cells, whereas treatment with the NCL195 + colistin combination caused more damage than colistin alone. Direct evidence for this interaction was demonstrated by fluorescence-based membrane potential measurements. We conclude that the synergistic antimicrobial activity of the combination NCL195 + colistin against GNB pathogens warrants further exploration for specific treatment of acute GNB infections.     

Indian childhood-like cirrhosis in three Saudi Arabian siblings

Three Saudi siblings, two girls and one boy, presented at the ages of 7, 6 and 2.5 years, respectively, and were diagnosed as having features of Indian childhood cirrhosis (ICC). The two girls presented at a late stage of the disease and the boy was diagnosed during routine examination of the family. The initial presenting complaint was abdominal distention and pruritus. All three had a rapid and fatal course. There was no evidence of increased copper ingestion by the families, supporting the suggestion of a hereditary metabolic role in the aetiology of ICC. As far as we are aware, this is the first report of ICC in Saudi Arabian children.     

Pediatric obesity at renal transplantation: a single center experience

Obesity is a major issue affecting health care delivery. While studies have been done in adults with end-stage renal disease, similar studies are lacking in pediatric patients with this disease. We retrospectively analyzed our renal transplant database from 1978 to 2002, to identify prevalence and predisposing factors to obesity in a pediatric end-stage renal disease population. Obesity, particularly in younger individuals, was found to be prevalent at transplantation.     

Psychiatric morbidity in a gynaecology clinic in Nigeria.

Psychological disorders among 233 women attending a gynaecology out-patient clinic was assessed by a two-stage screening procedure, using the GHQ-30 and the PSE. The prevalence of psychiatric disorders was found to be 35.2%. Psychiatric morbidity was significantly associated with a history of induced abortion, previous marriages, having no children, complaints of menstrual abnormalities, chronic pelvic pain and having unsupportive husbands. It is suggested that more attention needs to be paid to the psychological health of patients with gynaecological disorders (in line with the biopsychosocial model of health care). This will ensure an overall improvement in the quality of care.     

Accounting for youth audiences’ resistances to HIV and AIDS messages in the television drama Tsha Tsha in South Africa

Theoretical debates and literature on E-E efforts in Africa have largely focussed on understanding how and why interventions on HIV and AIDS are effective in influencing behaviour change among target communities. Very few studies have sought to investigate and understand why a substantial number of targeted audiences resist the preferred readings that are encoded into E-E interventions on HIV and AIDS. Using cultural studies as its conceptual framework and reception analysis as its methodology, this study investigated and accounted for the oppositional readings that subaltern black South African youths negotiate from Tsha Tsha, an E-E television drama on HIV and AIDS in South Africa. Results from the study show that HIV and AIDS messages in Tsha Tsha face substantial resistances from situated youth viewers whose social contexts of consumption, shared identities, quotidian experiences and subjectivities, provide critical lines along which the E-E text is often resisted and inflected. These findings do not only hold several implications for E-E practice and research, they further reflect the utility of articulating cultural studies and reception analysis into a more nuanced theoretical and methodological framework for evaluating the ‘impact’ of E-E interventions on HIV and AIDS.