Neurological disorders in Nigerian Africans: a community-based study

In a Nigerian town with a stable population of 20,000, a door-to-door survey was conducted, using a questionnaire involving a complete census and a simple neurological evaluation which had previously showed a 95% sensitivity and an 80% specificity for detecting neurological disease. Positive responders were evaluated and categorised, using agreed criteria for diagnoses. Nearly 100% cooperation was obtained. Life prevalence ratio for at least one episode of headache was 51/1000. Crude point prevalence ratio for migrainous headache was 5.3/100, and peak age-specific ratio was in the first decade. Prevalence ratio for epilepsy was 533/100,000 and peak age-specific prevalence ratio occurred in the 5-14 years age groups. The prevalence ratio for peripheral nerve disorders was 268/100,000, and age-specific prevalence ratio for tropical neuropathy increased with age. Prevalence ratio for stroke was rather low at 58/100,000, but was probably due to the people's attitude to the disabled elderly and high mortality of stroke which showed annual mortality rate of 70/100,000 which increased with age to 1519/100,000 per year in the eighth decade. Crude prevalence ratios (cases per 100,000) for others are 112 for neurological complications (including sciatica) of spondylosis, 15 each for poliomyelitis, motor neurone disease, development speech disorders, 10 each for syncope, hereditary neuropathies. Parkinson's disease, benign essential tremor, primary cerebellar degeneration, cerebral palsy, mental retardation, organic psychosis (probable intracranial tumor) and 5 each for muscular dystrophy, pyomyositis, spina bifida occulta, alcohol dependence and cerebral malaria. The implications of the findings are important for development of community neurological services in the developing countries.     

Measurement of vasoactivity in the guinea-pig choroid

Purpose: A perfusion system for studying the vasoactive properties of the guinea-pig choroid is described. Methods :The principle of operation is that the vascular resistance of the entire vascular network of an isolated, perfused eye can be monitored by recording the pressure required to deliver a constant flow of perfusate through the network. Delivery of the pharmacological agent of interest into the perfusate stream and the subsequent determination of the magnitude of any induced pressure changes allows the vasoactive potency of various agonists to be assessed. Results: The baseline vascular resistance was 1.35 ± 0.16 mmHg. min/μL (mean ± SEM; n=10) and the mean response to intraluminal delivery of 124 mmol/L K⁺ Krebs was an increase in resistance of 297±67%. Vasoactive responses were sustainable for more than 8 h. Conclusions: This system will now be used to study the vasoactive properties of the guinea-pig choroid in greater detail.     

Oral Cancer Screening at Workplace in India��One-year Follow-up

Background:

Oral cancer remains the commonest form of cancer and cancer-related deaths among Indian males due to popularity of avoidable risk factors such as tobacco and alcohol use. A workplace oral cancer screening and tobacco cessation study was commenced on World No Tobacco Day 2007 at a chemical industry in rural Maharashtra.

Aims:

The objectives were to screen the employees for oral neoplasia and to correlate it with their tobacco consumption pattern. In addition, the objective was to provide tobacco cessation services at the workplace.

Materials and Methods:

This is an interventional cohort study among 104 employees of a chemical industrial unit in rural Maharashtra. Naked eye examination of the oral cavity was performed for all employees by a doctor irrespective of the tobacco habits at the beginning and at the end of 1 year. In between, the tobacco users were regularly examined during each follow-up.

Statistical analysis used:

Through personal interviews of the participants, data were manually recorded and were transferred to electronic data base. Data analysis was conducted in STATA™ 8.2 on intention to treat basis.

Results and Conclusions:

Among the 104 employees, 50 (48.08%) were current tobacco users at the beginning of the program. Oral precancers were seen exclusively among 20 (40%) tobacco users. After 1 year of workplace tobacco cessation intervention, 80% of oral precancers regressed. This shows that screening of the oral cavity at the workplace is effective when combined with tobacco cessation.     

Trapezoid fracture caused by assault

In this report we describe an open fracture of trapezoid and break in anterior cortex of capitate due to assault in a young adult male. Direct impact force of a sharp object to the first web space caused the above fractures. Open reduction and internal fixation of the trapezoid was carried out using Kirschner wires. Cut extensor tendons, extensor retaniculum, capsule, adductor pollicis muscle, first dorsal interosseous muscle, soft tissue and overlying skin were sutured primarily. Three months after the operation the patient has made a complete recovery. There is no similar case reported in the literature.