Effect of hyperbaric oxygen on guinea pig lens optical quality and on the refractive state of the eye

The main objective of this study was to investigate the effect of in vivo hyperbaric oxygen (HBO) treatment of albino guinea pigs on ocular refractive state and optical properties of the lens in vitro, as well as on the integrity of the mitochondria of the lens. The animals were treated 30-35 times (2.5-3 months) or 70 times (6 months) with HBO. An increased level of lens nuclear light scattering was evident by slit-lamp at 30 treatments, and this increased at 70 treatments. After 30-35 HBO treatments a myopic shift in refractive state of the eye was seen in two separate studies with two different refractionists. Also, the average back vertex distance of the lens was significantly shorter after 35 HBO treatments while spherical aberration (focal variability) increased after 70 treatments. No difference in refractive state was noted after 70 HBO treatments (a reversal of the initial myopic effect). The mitochondrial distribution and morphology of the lens epithelium and the superficial cortical fibre cells were normal after both 35 and 70 HBO treatments, highlighting that HBO treatment does not affect the superficial cortex of the lens. The results of the in vitro lens optical analysis carried out in this study correlate with the myopia observed after 30-35 HBO in vivo treatments. A similar reversible myopia and increase in lens nuclear light scattering is known to occur in humans treated with HBO for extended periods and the results suggest that the myopia was caused by a change in the refractive index of the lens. The significant loss of sharp focus after 70 HBO treatments can be correlated with previous reports of biochemical and morphological changes associated with HBO-induced loss of lens nuclear transparency in mature guinea pigs. The guinea pig HBO model may be a useful approach for the study of lens development and refractive error.     

Denture care practice among patients attending the prosthetic clinic in a Nigerian teaching hospital

Background:

Good denture care practice by individuals using Removable Partial Denture (RPD) is an important component of oral health measures. An assessment of denture care practice of such individuals by dental care practitioners is necessary.

Objective:

To evaluate the denture care practice among prosthetics patients attending a tertiary Hospital Dental Centre in Nigeria.

Materials and Methods:

An interviewer administered questionnaire was used to obtain information from RPD wearers that were willing to participate. The questionnaire assessed among other things, patients’ bio-data, frequency, techniques and device used for cleaning their dentures. Data was analyzed using Chi-square test (P < 0.05).

Results:

One hundred and ninety eight denture wearers consisting of 100 (50.5%) males and 98 (49.5%) females participated in the study. Majority 110 (55.6%) cleaned their dentures once daily and toothbrush and pastes were used by 105 (53%) of the participants. More than 70% of the respondents removed their dentures at night. One hundred and sixty-six (83.8%) visited the dentist only when they needed treatment. There was a statistical significant relationship between frequency and technique of cleaning denture, and denture cleanliness (P < 0.05).

Conclusion:

This study shows that once daily cleaning of dentures and cleaning the denture with rest of the teeth are ineffective in prevention of plaque accumulation.     

Chronic renal failure in a patient with bilateral ureterocele

Ureterocele is a congenital anomaly, in which there is mal-development of the caudal segments of the ureter. There is a female preponderance with most cases seen in Caucasians. Among the reported complications of this condition, chronic renal failure occurring in the setting of ureterocele has not been well documented. We report a case of a young girl with bilateral ureterocele presenting with chronic renal failure, whose management presented a diagnostic failure and inadequate treatment.Ureterocele is a rare congenital cystic dilatation of the terminal segments of the ureter at its opening into the urinary bladder.1 The condition occurs almost exclusively in Caucasians.2 Ureterocele have been variously classified based on the anatomical and functional criteria. A simple and frequently used classification was developed by the American Academy of Paediatrics (AAP).3 There are controversies surrounding the etiology of ureterocele. However, the most commonly accepted theory in the pathogenesis of ureterocele is the incomplete dissolution of the Chwalla’s membrane during developmental stages. Other theories include incomplete masculinization and excessive dilation of the intramural ureter during the development of the bladder and trigone, and obstruction of the ureteral orifice. Commonly, ureteroceles are predisposed to urinary stasis and subsequent infection in neonatal periods. Ureterocele may manifest as failure to thrive in children, and abdominal or pelvic pain in adults. Other modes of presentation include; hematuria, purulent urine, and pyelonephritis. Urinary incontinence or retention may also be seen in the presence of obstruction at the level of the bladder. Ultrasonography is a useful diagnostic imaging tool in the prenatal and early childhood period.4 However, a voiding cystourethrography (VCU) and intravenous pyelography (IVP) for evaluation of the urinary tract and the voiding status are essential in the assessment of the excretory function. The degree of obstruction and the differential functions of the kidneys can be demonstrated with diuretic renograms. Cystoscopy, an endoscopic procedure that allows direct inspection and examination of the urinary tract is a helpful diagnostic procedure in the management of ureterocele. Management of ureterocele may not be generalized due to varied complications that may ensue. Endoscopically or surgically, unroofing of the ureterocele can be performed. The surgical procedures include excision of ureteroceles and reimplantation of ureters into the bladder for bladder level surgery, and partial heminephrectomy and ureterectomy for upper-level surgery. Endoscopic treatment includes transurethral puncture and transurethral incision, which are applicable mainly to the intravesical types. Despite the rarity of this condition among the Black race, there is a need for a high index of suspicion in order to prevent a possible irreversible renal failure among other associated complications. We report a rare case of chronic renal failure in an 18-year-old girl with bilateral ureterocele. Our objective in presenting this particular case is to highlight chronic renal failure requiring renal replacement therapy as a unique complication of ureterocele in a poor resource constrained developing country.     

A Semiquantitative Scoring System for Histopathological and Immunohistochemical Assessment of Lesions and Tissue Tropism in Avian Influenza

The main findings of the post-mortem examination of poultry infected with highly pathogenic avian influenza viruses (HPAIV) include necrotizing inflammation and viral antigen in multiple organs. The lesion profile displays marked variability, depending on viral subtype, strain, and host species. Therefore, in this study, a semiquantitative scoring system was developed to compare histopathological findings across a wide range of study conditions. Briefly, the severity of necrotizing lesions in brain, heart, lung, liver, kidney, pancreas, and/or lymphocytic depletion in the spleen is scored on an ordinal four-step scale (0 = unchanged, 1 = mild, 2 = moderate, 3 = severe), and the distribution of the viral antigen in parenchymal and endothelial cells is evaluated on a four-step scale (0 = none, 1 = focal, 2 = multifocal, 3 = diffuse). These scores are used for a meta-analysis of experimental infections with H7N7 and H5N8 (clade 2.3.4.4b) HPAIV in chickens, turkeys, and ducks. The meta-analysis highlights the rather unique endotheliotropism of these HPAIV in chickens and a more severe necrotizing encephalitis in H7N7-HPAIV-infected turkeys. In conclusion, the proposed scoring system can be used to condensate HPAIV-typical pathohistological findings into semiquantitative data, thus enabling systematic phenotyping of virus strains and their tissue tropism.     

Health‐care‐seeking behaviour for childhood illnesses in a resource‐poor setting

Aim: To determine health‐care‐seeking behaviour for childhood illnesses in a resource‐poor setting. Method: Cross‐sectional survey was conducted in the children emergency room in a Nigerian tertiary hospital. Socio‐demographic data and details of the place and type of care given to ill children before presentation in the tertiary hospital were obtained. Results: A total of 168 mother–child pairs were studied. The leading illnesses were characterised by fever (35.1%), cough (26.2%) and stooling (19.1%). Initial care was sought within homes (57.1%) and after 24 h of onset (61.9%). A significantly higher proportion of the mothers who sought care within 24 h did so within the homes (P < 0.001). Only 38.1% of the mothers felt that the illnesses were severe. Although 66.7% lived close to orthodox health facilities, only 50.6% utilized such orthodox health facilities. Care was mostly sought outside the homes from drug vendors (55.5%) and private clinics (25.0%). Overall, 72.2% of the mothers administered various drugs to their children before presentation. Home care mainly involved the use of drugs (52.1%) and herbal preparations (15.6%). Care was sought within 24 h of onset for children with fever compared with those with cough (P < 0.001) and stooling (P < 0.001). The leading reasons for not utilising orthodox health services at the onset of illnesses included non‐recognition of the severe nature of the illness and poor finances. Conclusion: Care‐seeking for childhood illnesses was often delayed beyond 24 h, and most mothers sought care within homes. Health education is required to improve timely seeking of appropriate health care for childhood illnesses.     

The role of men in family planning decision-making in rural and urban Nigeria

Objectives To determine the role of men in family planning decision-making in both rural and urban areas of Nigeria.

Methods A total number of 370 married men (244 rural and 126 urban) were interviewed using a pre-tested, semi-structured interviewer based questionnaire. The study was conducted in the Iwaro community in Atakumosa West Local Government area (rural men) and the Oranfe Community in Ife East Local government area (urban men), both in Osun State, South West Nigeria.

Results The results showed a high level of awareness of family planning among both study groups (98.3% rural and 98.4% urban). Most men in both groups believe that a decision about family planning should be made jointly by the spouses instead of being the prerogative of either. This contrasts with the generally held belief that men are opposed to family planning and a take predominant role in contraceptive decision-making. The condom was the most commonly known and used method with a preponderance among urban (81.1%) over rural men (69.4%). Many men would use family planning if their wives demanded it. However, most respondents in both study groups believed that men should not accompany their wives to the family planning centre to obtain contraceptive supplies and advice.

Conclusion Deciding about contraception should be done jointly by men and women in South West Nigeria.     

Population Pharmacokinetics of Fusidic Acid: Rationale for Front-Loaded Dosing Regimens Due to Autoinhibition of Clearance

The objectives of this analysis were to develop a population pharmacokinetic (PK) model to describe the absorption and disposition of fusidic acid after single and multiple doses and to determine the effect of food on the rate and extent of bioavailability. Plasma PK data from three phase 1 studies (n = 75; n = 14 with and without food) in which healthy subjects received sodium fusidate (500 to 2,200 mg) as single or multiple oral doses every 8 h (q8h) or q12h for up to 7 days were modeled using S-ADAPT (MCPEM algorithm). Accumulation of fusidic acid after multiple doses was more than that predicted based on single-dose data. The PK of fusidic acid was best described using a time-dependent mixed-order absorption process, two disposition compartments, and a turnover process to describe the autoinhibition of clearance. The mean total clearance (% coefficient of variation) was 1.28 liters/h (33%) and the maximum extent of autoinhibition was 71.0%, with a 50% inhibitory concentration (IC₅₀) of 46.3 mg/liter (36%). Food decreased the extent of bioavailability by 18%. As a result of the autoinhibition of clearance, steady state can be achieved earlier with dosing regimens that contain higher doses (after 8 days for 750 mg q12h and 1 day for 1,500 mg q12h on day 1 followed by 600 mg q12h versus 3 weeks for 500 mg q12h). Given that large initial doses autoinhibit the clearance of fusidic acid, this characteristic provides a basis for the administration of front-loaded dosing regimens of sodium fusidate which would allow for effective concentrations to be achieved early in therapy.