Patterns of practice of palliative radiotherapy in Africa, Part 1: Bone and brain metastases

PURPOSE: To provide data on the pattern of practice of palliative radiotherapy (RT) on the African continent. METHODS AND MATERIALS: A questionnaire was distributed to participants in a regional training course of the International Atomic Energy Agency in palliative cancer care and sent by e-mail to other institutions in Africa. Requested information included both infrastructure and human resources available and the pattern of RT practice for metastatic and locally advanced cancers. RESULTS: Of 35 centers contacted, 24 (68%) completed the questionnaire. Although RT is used by most centers for most metastatic cancers, liver and lung metastases are treated with chemotherapy. Of 23 centers, 14 (61%) had a single RT regimen as an institutional policy for treating painful bone metastases, but only 5 centers (23%) of 23 used 8 Gy in 1 fraction. Brain metastases were being treated by RT to the whole brain to 30 Gy in 10 fractions, either exclusively (n=13, 56%) or in addition to the use of 20 Gy in 5 fractions (n=3, 14%). CONCLUSION: Radiotherapy is a major component of treatment of cancer patients in African countries. There is consensus among few centers for treatment schedules for almost all sites regarding time and dose-fractionation characteristics of RT regimens used and/or indications for the use of RT in this setting.     

<Emphasis Type="Italic">Acanthus montanus</Emphasis>: An experimental evaluation of the antimicrobial,anti-inflammatory and immunological properties of a traditional remedy for furuncles

Background  

Acanthus montanus (Nees) T. Anderson (Acanthaceae) is a shrub widespread in Africa, the Balkans, Romania, Greece and Eastern Mediterranean. It is used in African traditional medicine for the treatment of urogenital infections, urethral pain, endometritis, urinary disease, cystitis, leucorrhoea, aches and pains. In southeastern Nigeria, the root is popular and acclaimed highly effective in the treatment of furuncles. This study was undertaken to experimentally evaluate the antimicrobial and anti-inflammatory properties of the root extract as well as its effect on phagocytosis and specific cell-mediated immune response which may underlie the usefulness of the roots in treatment of furuncles.     

Diabetes foot ulceration in a Nigerian hospital: in‐hospital mortality in relation to the presenting demographic,clinical and laboratory features

This prospective study assessed in‐hospital mortality from diabetic foot ulcer in relation to the demographic, clinical and laboratory features at presentation. Forty‐two patients admitted with diabetic foot ulcer were followed up from admission till discharge from hospital. Those who survived or died were compared for any differences in demographic, clinical and laboratory parameters at presentation. The mean age and duration of diabetes for the 42 patients were 56.1 ± 1.9 years and 8.3 ± 1.1 years, respectively. The in‐hospital mortality rate amongst the 42 subjects was 40.5%. Ulcer grade 4, leucocytosis and anaemia were more prevalent in those who demised in comparison with survivors.     

Emotional distress is associated with poor self care in type 2 diabetes mellitus

Background: The aim of the present study was to evaluate possible clinical and psychosocial variables that influence diabetes self‐care management in patients with type 2 diabetes mellitus (T2DM). Methods: A total of 150 individuals with T2DM who had had diabetes for at least 6 months were recruited to this cross‐sectional study. Levels of self‐care and psychosocial status were determined using the Self‐Care Inventory (SCI) and Problem Areas in Diabetes (PAID) scale. The PAID scores were calculated using a five‐point Likert scale with options ranging from 0 (not a problem) to 4 (serious problem). Data were evaluated using non‐parametric and parametric tests as appropriate. Results: The mean age of the study participants was 69.97 ± 8.68 years. Cronbach’s α for SCI and PAID scores was 0.85 and 0.98, respectively. People with poor glycemic control had significantly higher mean (±SD) total PAID scores than individuals with good glycemic control (29.5 ± 30.9 vs 16.7 ± 26.9, respectively; P = 0.012). There was a significant relationship between PAID scores and glycemic control (r = 0.2; P = 0.012). Conclusions: The present study demonstrates that psychosocial factors directly influence glycemic control and diabetes self‐care habits. In addition, diabetes‐specific distress in study population was unrelated to the duration of diabetes, the age of the patients and anthropometric indices.     

Case Report: Saw-Scaled Viper Bites in Sri Lanka: Is It a Different Subspecies? Clinical Evidence from an Authenticated Case Series

The saw-scaled viper (SSV) (Echis carinatus) is considered to be a highly venomous snake in Sri Lanka despite any published clinical justification. Being a rarity, the clinical profile of SSV bites is not well established in Sri Lanka. We report a series of 48 (n-48) SSV bites from the Northern Province of Sri Lanka. The majority (65%) of victims had evidence of local envenoming at the site of the bite; however, 29% showed spontaneous bleeding and 71% had coagulopathy. There were no deaths in the series. The envenoming was mild in contrast to the mortality and significant morbidity associated with SSV bites in West Africa and some parts of India. These observations need to be further explored with laboratory studies to identify the venom components, study of morphological characteristics, and genetic profiling of the Sri Lankan SSV to see if it is different from the subspecies found elsewhere.     

Improving quality of family life among Christian parents of children with low vision in Nsukka catholic diocese using rational emotive family health therapy

Background:Most Christian parents living with children with low vision have reported to be experiencing psychological disturbances that are affecting the family health. As a result, the quality of family life is being impaired. The experience of parents catering for children with low vision is mainly influenced by psychosocial factors that could determine the quality of family life of such parents. This present study is to investigate the efficacy of rational emotive family health therapy in reducing poor quality of family life among Christian parents of children with low vision in Nsukka Catholic Dioceses.Method:This is a randomized pretest and posttest control trial. Participants were 88 parents of children living with low vision in Nsukka Catholic Dioceses, Nigeria. The power of the sample size was determined using Gpower statistical software. The participants in rational emotive family health therapy programme-group were exposed to a 12-session treatment programme whereas their counterparts in waitlisted control group did not receive anything. A family quality of life scale was utilized in assessing the participants. Data analyses were performed using repeated measures ANOVA.Results:It was found that rational emotive family health therapy had a significant positive effect on increasing quality of family life among the study participants compared to those in the waitlisted control group.Conclusion:This study contributed and validated the efficacy of rational emotive family health therapy in improving quality of family life among parents of children with low vision.     

Antiplasmodial and antimicrobial activities of South African marine algal extracts

Seventy-eight crude organic fractions from nineteen species of marine algae collected from the coast of South Africa were screened for activity against a chloroquine sensitive strain of Plasmodium falciparum (D10), Staphylococcus aureus, Klebsiella pneumoniae, Mycobacterium aurum and Candida albicans. Fifteen crude fractions showed good antiplasmodical activity (IC₅₀?<10 μg/mL). The dichloromethane fraction from Sargassum heterophyllum (Turner) C. Agardh (Sargassaceae) was the most active with an IC₅₀ value of 2.8 μg/mL. Eleven extracts showed MIC values ≤?1?mg/mL against at least one of S. aureus, K. pneumoniae, M. aurum and C. albicans. The broadest spectrum of antimicrobial activity was exhibited by the aqueous-HP20 fraction of Polysiphonia incompta Harvey (Rhodomelaceae). This study shows that marine algae not only produce antimicrobial compounds but also may be a source of antimalarial lead compounds.     

Diabetes mellitus in Nigeria: The past,present and future

Diabetes mellitus (DM) is a diverse group of metabolic disorders that is often associated with a high disease burden in developing countries such as Nigeria. In the early nineties, not much was known about DM in Nigeria and traditionally, people related DM to “curses” or “hexes” and diagnosis was made based on blood or urinary tests for glucose. Currently, oral hypoglycaemic agents but not insulin are readily accessible and acceptable to persons with DM. The cost of diabetes care is borne in most instances by individuals and often payment is “out of pocket”-this being a sequel of a poorly functional national health insurance scheme. An insulin requiring individual on a minimum wage would spend 29% of his monthly income on insulin. Complementary and alternative medicines are widely used by persons with DM and form an integral component of DM care. Towards reducing the burden of DM in Nigeria, we suggest that there be concerted efforts by healthcare professionals and stakeholders in the health industry to put in place preventative measures, a better functioning health insurance scheme and a structured DM program.