Congenital infantile digital fibromatosis: a case report and review of the literature

Infantile digital fibromatosis (IDF), also called inclusion body fibromatosis is an uncommon benign tumour occurring in the digits of young children. In about a third of cases, it is congenital and the diagnosis is based on the presence of peculiar intracytoplasmic inclusions on histology. Recurrence rate post-surgery is high. However, spontaneous regression has been reported. We present a case of a 5-month-old infant who had excision of a right second toe mass, which has been present from birth. Histological examination revealed this to be infantile digital fibromatosis. To the best of our knowledge, no report of this has been made in Nigeria. It is important that this diagnosis be entertained in young children with masses on the digits as this will influence the management instituted.     

Association of high-sensitivity C-reactive protein and odds of breast cancer by molecular subtype: analysis of the MEND study

Breast cancer (BC) in Nigeria is characterized by disproportionately aggressive molecular subtypes. C-reactive protein (CRP) is associated with risk and aggressiveness for several types of cancer. We examined the association of high-sensitivity CRP (hsCRP) with odds of BC by molecular subtype among Nigerian women. Among 296 newly diagnosed BC cases and 259 healthy controls, multivariable logistic regression models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for the association between hsCRP and odds of BC overall and by molecular subtype (luminal A, luminal B, HER2-enriched and triple-negative or TNBC). High hsCRP (> 3 mg/L) was observed in 57% of cases and 31% of controls and was associated with 4 times the odds of BC (aOR: 4.43; 95% CI: 2.56, 7.66) after adjusting for socio-demographic, reproductive, and clinical variables. This association persisted regardless of menopausal status and body mass index (BMI) category. High hsCRP was associated with increased odds of TNBC (aOR: 3.32; 95% CI: 1.07, 10.35), luminal A BC (aOR: 4.03; 95% CI: 1.29, 12.64), and HER2-enriched BC (aOR: 6.27; 95% CI: 1.69, 23.25). Future studies are necessary in this population to further evaluate a potential role for CRP as a predictive biomarker for BC.     

Pasting Characteristics,Baking and Sensory Qualities of Cakes from Blends of Cassava and Wheat Flours

Wheat flour was replaced with cassava flour (30 to 100%) to produce cake. Composition and pasting properties of the flours and their composite flour blends were determined. Baking and sensory qualities of the resulting cake samples were evaluated. Protein starch and fiber contents of the cassava and wheat flours were 1.5; 71.50; 1.94% and 10.9; 69.89; 2.81% respectively, which significantly influenced their pasting and baking characteristics and also reflected in their composite blends. Peak, holding, breakdown and final viscosities of the blends ranges from 90.1 to 121.1; 51.6 to 82.7; 38.21 to 42.62; and 93.4 to 125.8 Rapid Visco Unit (RVU) respectively. Specific volume decreased from 1.49 to 1.18 ml/g. Cake of comparable qualities with that obtained from wheat were obtained within 40% substitution level.     

Pneumonia in Nigeria: The way forward

Pneumonia is the leading cause of child deaths in Nigeria. Interventions to combat pneumonia are known and globally available, but not yet deployed effectively in Nigeria. While the under‐five pneumonia deaths dropped globally by 51% during the Millennium Development Goals (MDG) years (2000 to 2015), the rate declined by a mere 8% in Nigeria. In this commentary, we focus on three factors that may have stalled Nigeria's progress on pneumonia control. First, a chronically weak health system failed to deliver the needed services at scale. Second, strong coordination of a multipronged and well‐funded push against pneumonia was absent. Third, sound and timely data on pneumonia intervention coverage were lacking, thus blunting the accountability mechanisms that could have driven quick, targeted action. In response, the Federal Ministry of Health recently developed a National Pneumonia Control Strategy with the support of the “Every Breath Counts Coalition” (EBCC). This strategy, a first of its kind, articulates a common vision for reducing pneumonia‐led morbidity and mortality and provides a unified approach to respond comprehensively to pneumonia within and outside the health sector. Strong political will and sustainable financing are now needed to effectively implement this strategy and accelerate progress on pneumonia control. This will contribute hugely to achieving the government's health goals, the Sustainable Development Goal (SDG) 3.2 and the Global Action Plan on Pneumonia and Diarrhoea (GAPPD) targets.     

Pharmacological inhibition of TLR4/NF‐κB with TLR4‐IN‐C34 attenuated microcystin‐leucine arginine toxicity in bovine Sertoli cells

This study investigated the pharmacological inhibition of the toll‐like receptor 4 (TLR4) genes as a measure to attenuate microcystin‐LR (MC‐LR) reproductive toxicity. Bovine Sertoli cells were pretreated with TLR4‐IN‐C34 (C34) for 1 hour. Thereafter the pretreated and non‐pretreated Sertoli cells were cultured in medium containing 10% heat‐activated fetal bovine serum + 80 μg/L MC‐LR for 24 hours to assess the ability of TLR4‐IN‐C34 to attenuate the toxic effects of MC‐LR. The results showed that TLR4‐IN‐C34 inhibited MC‐LR‐induced mitochondria membrane damage, mitophagy and downregulation of blood‐testis barrier constituent proteins via TLR4/nuclear factor‐kappaB and mitochondria‐mediated apoptosis signaling pathway blockage. The downregulation of the mitochondria electron transport chain, energy production and DNA replication related genes (mt‐ND2, COX‐1, COX‐2, ACAT, mtTFA) and upregulation of inflammatory cytokines (interleukin [IL]‐6, tumor necrosis factor‐α, IL‐1β, interferon‐γ, IL‐4, IL‐10, IL‐13 and transforming growth factor β1) were modulated by TLR4‐IN‐C34. Taken together, we conclude that TLR4‐IN‐C34 inhibits MC‐LR‐related disruption of mitochondria membrane, mitophagy and downregulation of blood‐testis barrier proteins of the bovine Sertoli cell via cytochrome c release and TLR4 signaling blockage.     

Effects of supplemental measles immunization on cases of measles admitted at the Wesley guild hospital,Ilesa, Nigeria

Background

Measles is a highly contagious vaccine-preventable infection which continues to be a significant cause of childhood morbidity and mortality in developing countries particularly those with poor routine immunisation coverage. Supplemental immunisation activities (SIAs) were thus introduced to improve vaccine coverage.

Objective

This study was carried out to assess the impact of the supplemental measles vaccinations on the cases of measles admitted at a tertiary health facility in South west Nigeria.

Methods

Weretrospectivelylooked at therecords of cases of measles in children admitted to the Wesley Guild Hospital, Ilesa over a ten year period (2001 – 2010); five years before and five years after the nationwide commencement of supplemental measles immunisation activities (SIAs) in the region in 2006. Measles cases were defined using the WHO case definition.

Results

Over the ten year study period, a total of 12,139 children were admitted andmanaged; out of which 302 (2.5%) were cases of complicated measles. There was no difference in the mean (SD) of children admitted in the years before and after the introduction of the SIAs {6040 (122.7) vs.6099 (120.2); t-test 0.02, p =0.988.} There was however a remarkable reduction in the proportion of the cases of measles admitted after the introduction of SIAs compared to the period before SIAs (4.3% vs. 0.6% x2=169.580; p < 0.001)

Conclusion

SIAs have remarkably reduced morbidity and mortality associated with measles in the region. We advocate for sustenance of these efforts as well as improvement in routine immunisation coverage to avoid a backlash which can lead to devastating measles outbreak.     

Antireproductive effect of calcium channel blockers on male rats

Introduction  Drugs have been shown to adversely affect male fertility and recently anti-hypertensive drugs were added to the list. The anti-fertility effects of nifedipine and similar calcium channel blockers are well-illustrated in in vitro experiments but not in vivo. Purpose  The present study was designed to experimentally elucidate the sub-chronic effect of nifedipine, verapamil and diltiazem on sperm functions and reproductive hormone levels in vivo. Methods  Male rats (150–200 g) were divided into four groups of ten rats each. Group 1 (control) received distilled water; Group 2 received nifedipine 0.57 mg/kg BW; Group 3 were given verapamil 3.40 mg/kg BW and Group 4 were given diltiazem 2.57 mg/kg BW. Each drug-treated group had its own recovery group from which treatment was discontinued for 30 days before the animals were sacrificed. Blood samples were collected for hormonal assay of FSH, LH and testosterone. Semen evaluation was done and the testes, seminal vesicle, epididymis and prostate were removed, and weighed immediately. Results  Nifedipine, verapamil and diltiazem significantly decreased (P < 0.05) sperm count and motility in drug treated groups. The weight of the epididymis was significantly reduced (P < 0.05) in the drug treated rats. Semen parameters and other associated changes were restored after 30 days of drug withdrawal. Conclusion  Calcium channel blockers appear to have a reversible anti-fertility effect on male rats which does not occur through inhibition of the pituitary-gonadal axis.