Cyclooxygenase-2 is Upregulated in Copper-Deficient Rats

Copper deficiency inactivates Cu/Zn-SOD and promotes accumulation of reactive oxygen species. This process likely impairs nitric oxide (NO)-mediated relaxation as well as triggers vascular inflammation. The current study was designed to determine whether COX-2, a proinflammatory protein, expression and activity are upregulated in the oxidative environment associated with inadequate Cu. Weanling male Sprague Dawley rats were fed purified diets which were either Cu-adequate (Cu-A); Cu-marginal (Cu-M), Cu-deficient (Cu-D), or the Cu-D diet combined with the SOD mimetic Tempol (Cu-D/T; 1 mM in drinking water) for 4 weeks. COX-2 protein, PGE₂ (COX-2 metabolite) and isoprostanes (index of oxidative stress) were all higher in the Cu-D group vs Cu-A group, but no significant differences occurred between the Cu-M and Cu-A groups. Tempol protected against an attenuation of NO-mediated vasodilation in the Cu-D rats but did not prevent the elevation of PGE₂ or isoprostanes. Our data suggest a role for copper as a modulator of oxidative stress and inflammation independent of SOD activity or NO-derived oxidants.     

A randomised control trial of surgical task performance in rigid bronchoscopy: foreign body extraction with optical versus non-optical forceps

There are currently two types of forceps used for foreign body removal at rigid bronchoscopy, these can be classified as standard bronchoscopy forceps and optically guided grasping forceps. In order to evaluate them in the removal of foreign bodies from the tracheo-bronchial tree a randomised subject controlled trial was conducted. All 80 bronchoscopies were recorded and analysed by a single observer according to predetermined criteria for surgical error. The data was analysed using a t-test for paired groups. The results showed no significant differences between the two groups. We conclude that no clear advantages were found comparing the optically guided forceps with the standard bronchoscopy forceps and that further clinical evaluation will be difficult to initiate.     

Convergence of behaviour change models for AIDS risk reduction in sub-Saharan Africa

There is increasing programme focus on the impact of HIV and AIDS and the advances in biomedical research that are taking central stage even in sub-Saharan Africa. Perhaps out of frustration, communication and behaviour change efforts are receiving lesser attention. But as long as heterosexual intercourse remains the predominant means of transmission of HIV in sub-Saharan Africa, there is the inherent danger of more people getting infected thus mopping up the gains from other approaches. This paper therefore argues for evidence based behaviour change interventions in sub-Saharan Africa, revisits the behaviour change theories and their relevance to the African situation. It proposes an integration of models based on the convergence of three existing theories of social learning, diffusion of innovation and social networks and the author's understanding of some African culture. The beauty of the model is based on the fact that 'social norms are best understood and influenced at the level of social networks'; existing chains of communication and the naturalness of exchange of information. A case is made for application of the 'model' to precipitate sexual behaviour change and HIV reduction in sub-Saharan Africa.     

Vernal keratoconjunctivitis and intestinal parasitic infestations in black children

The study aimed at finding out any association between vernal keratoconjunctivitis (VKC) and intestinal worm infestations in black children in Nigeria. This is a report of a case-control study of a total of 117 cases of VKC and 198 controls, who were newly presenting to two hospitals in Ibadan. The controls were comparable to the cases in many respects. While 67 (57%) of cases admitted to previous passage of worms, 59 (50.5%) children actually had parasitic infestations. Of these 59 children, 30 (51%) were due to roundworm, 12 (20%) to hookworm, 14 (24%) to protozoal infestation and others, e.g., tapeworms, 13 (5%). Among controls, 36.8% had parasitic infestation, out of which roundworms were responsible for 11.6%, hookworms 7.6%, protozoa 14.1% and others 3.5%. Children with VKC have almost twice (odds ratio = 1.68) the risk of having been infested by worms. Both older age in children and roundworm infestation were not independent risk factors for VKC. There was no significant association among all ages, sex, hookworm and other worms with VKC. Deworming may prove beneficial for children with VKC; however, more studies with appropriate design are required to prove this.     

Retinoblastoma presenting with a cheek mass

This is a report of a case of retinoblastoma that mimicked Burkitt's lymphoma by presenting with a left proptosis and a right cheek mass. With the aid of fine-needle aspiration cytology, the diagnosis was established as retinoblasstoma and a left modified exenteration was performed. The patient had adjuvant chemotherapy and radiotherapy to the left orbit and the right maxilla with regression. At 12 months postoperatively, there was no evidence of recurrence, and the patient was still hale and hearty. In conclusion, this patient had left retinoblastoma with metastasis to the contralateral jaw. It is important to note that orbital Burkitt's lymphoma can be a differential diagnosis of retinoblastoma.     

Ophthalmic assessment in black patients with vitiligo

The objective of this study was to describe and estimate the prevalence of pigmentary disturbances occurring in the eyes of patients presenting with vitiligo in a teaching hospital in Ibadan, Nigeria. Patients presenting with vitiligo to the dermatology clinic of the University College Hospital between March and December 2001 were referred to the eye clinic of the same hospital for ophthalmic evaluation. Patients were assessed by visual acuity, intraocular pressure, refraction, slit-lamp biomicroscopic evaluation of the anterior segments and funduscopic examination of the two eyes. Visual fields estimation was done using the Goldman's perimeter. A total of 26 patients were referred to the eye clinic. Of these, only 17 patients were considered evaluable for the study. There were seven males and eight females. The age range was 5-30 years. The largest extent of vitiligo recorded in the study population was 25% of the body surface area. The duration of the vitiligo was two months to 3 1/4 years. None of the patients complained of any visual disturbance. All ophthalmologic assessment profiles were normal for all patients. One of the patients had poliosis. No pigmentary disturbance of the eyes was noticed in any of our patients. Pigmentary changes were not seen in these groups of blacks with vitiligo.     

Risk factors for ectopic pregnancy in Lagos, Nigeria

BACKGROUND: Ectopic pregnancy is an important cause of maternal deaths in Nigeria and in other developing countries. In Lagos, Nigeria, it is responsible for 8.6% of maternal deaths, and has a case fatality rate of 3.7%. The purpose of this study was to determine the risk factors for ectopic pregnancy in Lagos. METHODS: A case-control study of 100 patients and 280 controls was performed in the three hospitals--Lagos University Teaching Hospital, Ayinke House Maternity Hospital, and Lagos Island Maternity Hospital--in Lagos from June 1999 to December 1999. Data were analyzed by using logistic regression. RESULTS: The incidence was 23.1/1000 (1 : 43) deliveries and was responsible for 48.5% of gynecologic emergencies. Age, marital status, socioeconomic status, and parity were not the significant risk factors for ectopic pregnancy. An early age of sexual debut increased the risk of ectopic pregnancy almost two-fold (adjusted OR = 1.93; 95% CI = 1.71-2.93), whereas a late age of sexual debut was protective (adjusted OR = 0.37; 95% CI = 0.19-0.59). History of multiple lifetime sexual partners, induced abortions, pelvic inflammatory disease, sexually transmitted disease (STD), miscarriage, and pelvic surgery independently and significantly increased the risk of ectopic pregnancy. Induced abortion and STD increased the risk 14-fold and nine-fold, respectively. Previous use of intrauterine contraceptive device increased the risk almost four-fold (adjusted OR = 3.76; 95% CI = 2.12-6.69), whereas the use of condoms was protective (adjusted OR = 0.35; 95% CI = 0.17-0.71). CONCLUSIONS: Proper sex education, prevention of unwanted pregnancy, and prevention and proper treatment of sexually transmitted infections will reduce the incidence of ectopic pregnancy.