Predictors of Late Presentation for HIV Diagnosis: A Literature Review and Suggested Way Forward

Early commencement of antiretroviral treatment can be beneficial and economical in the long run. Despite global advances in access to care, a significant proportion of adults presenting at HIV/AIDS care facilities present with advanced HIV disease. Understanding factors associated with late presentation for HIV/AIDS services is critical to the development of effective programs and treatment strategies. Literature on factors associated with late presentation for an HIV diagnosis is reviewed. Highlighted is the current emphasis on socio-demographic factors, the limited exploration of psychosocial correlates, and inconsistencies in the definition of late presentation that make it difficult to compare findings across different studies. Perspectives based on experiences from resource limited settings are underreported. Greater exploration of psychosocial predictors of late HIV diagnosis is advocated for, to guide future intervention research and to inform public policy and practice targeted at ‘difficult to reach’ populations.     

The burden of hearing loss in Kaduna, Nigeria: a 4-year study at the National Ear Care Centre

Hearing loss among people in developing countries has been recognized as a major source of disability. Many of its causes are preventable, and others are curable. We reviewed the records of 5,485 patients who had presented during a 4-year period to the National Ear Care Centre in Kaduna, Nigeria. Of these, we identified 1,435 patients-812 males and 623 females, aged 9 months to 90 years (mean: 29.2 yr)-who had been diagnosed with hearing loss (26.2%). In addition to demographic data, we compiled information on each patient's type and degree of hearing loss, the affected side, and the predisposing factors. Sex and age cross-tabulations revealed that the greatest proportion of hearing loss according to sex occurred between the ages of 11 and 20 years for males and 21 and 30 years for females. The most common type of hearing loss was sensorineural, which was seen in 78.9% of patients; conductive hearing loss was seen in 17.7% and mixed in 3.4%. More than three-quarters of hearing losses were either moderate, moderately severe, or severe. Bilateral losses were far more common than unilateral losses; among the latter, the left side was affected slightly more often than the right. Predisposing factors were not documented in the vast majority of cases (87.6%), but when they were, the most common were chronic suppurative otitis media, meningitis, febrile convulsion, measles, and trauma. We present these findings to highlight the burden of hearing loss in our part of the world.     

Heterotropic pregnancy: a report of two cases

Heterotropic pregnancy is reported infrequently in Nigeria. Two cases were managed within the span of five years with the successful delivery of a live term baby in one of the patients. A high clinical index of suspicion is required because an intra uterine gestation does not rule out a co-existing ectopic gestation especially in this region with high twinning rate and tubal disease     

A case of Mycoplasma hominis septic arthritis postpartum

A 17-year-old woman presented 1-week post caesarean section with septic arthritis which was unresponsive to first-line empirical antimicrobial therapy. Cultures of the hip aspirate revealed Mycoplasma hominis as the causative organism. M. hominis-associated septic arthritis is extremely rare in the absence of underlying joint abnormalities or immunosuppression. Strikingly four of the 26 cases reported have been pregnancy-associated.     

Project among African-Americans to explore risks for schizophrenia (PAARTNERS): recruitment and assessment methods

The Project among African-Americans to Explore Risks for Schizophrenia (PAARTNERS) is a multi-site, NIMH-funded study that seeks to identify genetic polymorphisms that confer susceptibility to schizophrenia among African-Americans by linkage mapping and targeted association analyses. Because deficits in certain dimensions of cognitive ability are thought to underlie liability to schizophrenia, the project also examines cognitive abilities in individuals affected by schizophrenia and their extended family members. This article describes PAARTNERS study design, ascertainment methods and preliminary sample characteristics. We aim to recruit a sample of 1260 African-American families, all of whom have at least one proband with schizophrenia or schizoaffective disorder. The data collection protocol includes a structured Diagnostic Interview for Genetic Studies, Family Interview for Genetic Studies, focused neurocognitive assessment, medical records review, and the collection of blood or buccal cells for genetic analyses. We have currently completed study procedures for 106 affected sib-pair, 457 case-parent trio and 23 multiplex families. A total of 289 probands have completed the best estimate final diagnosis process and 1153 probands and family members have been administered the computerized neuropsychological battery. This project lays the foundation for future analysis of cognitive and behavioral endophenotypes. This novel integration of diagnostic, neurocognitive and genetic data will also generate valuable information for future phenotypic and genetic studies of schizophrenia.     

Oxidative Stress and Carcinogenesis: Potential of Phytochemicals in Breast Cancer Therapy

Breast cancer remains a burden in both developed and developing countries, with higher mortality in developing countries. Attempts to eradicate cancer have not been successful despite the progress made in the development of more novel chemotherapeutic drugs. Reactive-oxygen-species-mediated oxidative stress is known to play a role in breast cancer pathogenesis via genetic and epigenetic modifications, resulting in uncontrolled cell proliferation. Phytochemicals could provide leads for the development of alternative therapeutic agents due to their antioxidant activity, as well as their ability to induce apoptosis in cancer cells. However, most of the studies carried out using in vitro models do not continue with further studies in estrogen-receptor-positive in vivo breast cancer models, or fail to examine the possible biochemical mechanisms of phytochemical-based amelioration. This review examines oxidative-stress-mediated carcinogenesis and the potential of phytochemicals as anticancer agents.     

Correlates of serum lipoprotein (A) in children and adolescents in the United States. The third National Health Nutrition and Examination Survey (NHANES-III)

Objective  

To determine the correlates of serum lipoprotein (a) (Lp(a)) in children and adolescents in the United States.     

Foot and mouth disease in Zambia: a review of the aetiology and epidemiology and recommendations for possible control

In Zambia, foot and mouth disease (FMD) has been caused by all three of the South African Territories serotypes (SAT 1, 2 and 3) and by European types O and A. Three areas of the country which have experienced repeated occurrences of the disease are considered high-risk areas. The three areas are as follows: the southern border area between Zambia and Zimbabwe, Botswana and Namibia, the Kafue Flats and the northern border with Tanzania in the Nakonde and Mbala districts. The transfer mechanism of the virus is poorly understood but the African buffalo (Syncerus caffer) is considered to be the natural host, acting as a reservoir of infection for the SAT types of the virus. Cattle are known to be carriers of the virus for up to two and a half years and individual semi-domesticated buffalo have been reported to act as carriers for up to five years. In wild herds of buffalo, the virus has been recorded for periods of up to twenty-five years. Current control measures include mass vaccination of cattle in high-risk areas and restrictions on the movement of cattle from areas in which contact exists with buffalo. New protocols should be developed for the prevention and control of FMD, including the enforcement of livestock movement control, improved disease surveillance and reporting, and the monitoring of FMD virus in carrier cattle and buffalo. These measures will contribute towards building the confidence of the regulatory bodies of importing countries in the region.     

Phytochemical, Analgesic and Anti-Inflammatory Effects of the Ethylacetate Extract of the Leaves of Pseudocedrella Kotschyii

Phytochemical screening was carried out on the ethylacetate portion of the ethanolic extract of the leaves of Pseudocedrella kotschyii and then evaluated for its analgesic (acetic acid-induced writhing) and anti-inflammatory (raw egg albumin-induced oedema) activities in mice and rats respectively. Phytochemical screening of the ethylacetate partition portion of ethanolic extract revealed the presence of flavonoids, glycosides and tannins as major chemical constituents. Alkaloids saponins, cardiac glycosides, steroids were not dictated in the extract. The ethylacetate extract (50 and 100 mg/kg i.p) exhibited significant activity (p<0.05) against acetic acid-induced writhing in a dose dependent manner. In the anti-inflammatory activity the ethylacetate extract (50 and 100 mg/kg i.p.) caused a slight effect against the raw egg albumin-induced oedema. The effect was however observed not to be dose dependent. All these effects were compared with standard drug piroxicam (20 mg/kg i.p.).