“Their place is beyond the town's border”: A qualitative exploration of stigma associated with tuberculosis in rural and urban areas of Lagos,Nigeria

Tuberculosis (TB) remains a major public health challenge in Nigeria with a minimum yield of various TB control efforts due to sociocultural determinants of health including TB-associated stigma. Therefore, to achieve the Sustainable Development Goal targets for TB control, an understanding and reduction in TB-associated stigma is necessary. The study aims to explore the perspective of community members and investigate the possible ways of mitigating TB-associated stigma in rural and urban areas in Lagos State, Nigeria. Eight focus group discussions (FGD) were conducted among eight homogenous groups of participants living in the community in rural and urban areas of Lagos state who were stratified by gender, between July and November 2017. Analysis of data was done using the modified grounded theory. A total of 86 participants took part in the FGDs. There were various stigmatising behaviours towards people infected with TB in rural and urban communities studied. This includes: Not willing to eat with people suffering from TB, withdrawal from TB patients in social gatherings, verbal abuse of TB patients and refusing to visit their houses because of their illness. There were also misconceptions about the cause of TB in our study which includes spiritual attack, ingestion of cat hair and inhalation of dust. However, participants in the study believed that mitigating the effect of TB-associated stigma will require adequate community education on TB, provision of financial and emotional support to the patients, as well as the involvement of community leaders in TB control activities and stigma reduction interventions. TB-associated stigma exists in rural and urban communities, with a lack of appropriate knowledge of TB and fear of infection as a major determinant in rural and urban areas respectively. Health education and sensitisation about TB, with community leaders as champions could help to mitigate the effect of TB-associated stigma.     

示指双血管蒂岛状皮瓣急诊拇指再造1例

０　引言　拇指外伤后的急诊修复十分重要,以往各种方法各有其优缺点,我们介绍一种新的尝试．１　病例报告　患者男性,４２岁,左拇指机器绞伤２ｈ就诊．查体：全身情况好,左拇指近节中段以远皮肤软组织大部分撕脱,只有背部约１ｃｍ皮肤相连,但已受挤压,远端无充血...     

Severe gastrointestinal haemorrhage due to primary intestinal kaposi’s sarcoma — a case report

Kaposi’s Sarcoma (KS) was previously a relatively rare disease. With the advent of HIV/AIDS pandemic however, AIDS-related KS has been on the increase and so has interest in the disease. Ninety percent of patients with KS present with skin lesions. While the gastrointestinal tract is a fairly common site of metastatic KS, primary gastrointestinal KS is uncommon. The presentation of gastrointestinal KS with severe gastrointestinal bleeding is rarer still. In this report, we present a 56-year-old HIV-negative patient who presented with severe gastrointestinal bleeding without any skin lesions. Multiple hemorrhagic polypoidal lesions were found on the walls of the jejunum and ileum as well as the liver at exploratory laparotomy and these were found to be KS on histopathologic examination. We also discuss the diagnostic and therapeutic challenges we had with this rare cause of severe GI bleeding.     

hVEGF165基因转染后骨髓间充质干细胞蛋白分泌功能及成骨活性的检测

目的：血管内皮细胞生长因子（vascular endothelial growth factor，VEGF）在血管再生和骨组织再生过程中起着重要的调节作用。观察hVEGF165基因转染的骨髓间充质干细胞分泌VEGF的功能及转染后细胞的成骨活性。 方法：实验于2004—07／2005—12在江苏省血液研究所国家重点实验室完成。①体外分离、培养大鼠骨髓间充质干细胞，传代培养后以1μg PcDNA3．1-hVEGF165：3μL阳离子脂质体Lipofectamine的比例转染，通过免疫组织化学SP方法检测转染后细胞中外源性VEGF的表达。②体外分离、培养大鼠肾微血管内皮细胞，分别加入hVEGF165基因转染48h及1周后细胞上清、空载体转染及未转染组细胞上清，MTT法观察细胞增殖情况，以了解转染后细胞培养上清中VEGF的生物学活性。③测定在正常条件培养和成骨条件培养下，转染后细胞上清中碱性磷酸酶、骨钙素的水平。 结果：①hVEGF165基因转染的骨髓间充质干细胞能成功分泌VEGF蛋白。②hVEGF165基因转染48h组大鼠肾微血管内皮细胞A值高于空载体转染及未转染组（P〈0．05），但低于hVEGF165基因转染1周组。③成骨条件培养下，基因转染组细胞碱性磷酸酶和骨钙素的分泌量明显高于未转染组（P〈0．05）；而在正常条件培养下，基因转染组细胞碱性磷酸酶和骨钙素的表达分泌量较低。 结论：①采用基因转染技术可将hVEGF165基因转染到骨髓间充质干细胞中并可有效表达具有生物活性的VEGF，且这种生物学活性呈剂量依赖性。②在成骨条件培养下，转染hVEGF165基因后骨髓间充质干细胞的成骨能力增强。