Outcome of Adenotonsillectomy for Sleep and Breathing Difficulties in Nigerian Children with Obstructive Adenotonsillar Enlargement

The aim of this study was to examine improvements or otherwise, in sleep disturbance and breathing difficulties after adenotonsillectomy (AT) for chronic upper airway obstruction in children. In a prospective clinical study and tertiary referral center setting, the study population included consecutive children aged 1.5 through 12 years who underwent AT for chronic upper airway obstruction due to adenotonsillar enlargement, without any history of previous AT. The validated “Symptomatology score” (SS) parameters were used to grade the symptoms before and after AT. The extent of improvement of the symptoms after surgery were estimated by a standardized response mean (SRM). The study included 59 children, 40 of whom were males (68%). Their ages ranged from 1.5 to 12 years with a mean of 3.3 years and 63% were <4 years. The results showed that tonsillar size was correlated significantly with a high preoperative SS (P ≤ 0.001). The mean preoperative SS for the study population was 7.2, whereas the mean postoperative SS was 1.7. This change was highly significant (P < 0.001). The symptom domain with the greatest change in mean score was snoring, which improved by 2 points with SRM of 2.2. The changes in total score and in the scores for each symptom domain were highly significant (P < 0.002). We concluded that adenotonsillectomy is associated with remarkable improvement in breathing difficulties and sleep disturbances in children with obstructive adenotonsillar hypertrophy regardless of the condition whether it is mild or severe.     

Sexual dysfunction among female patients of reproductive age in a hospital setting in Nigeria

Although sexual dysfunction is an important public-health problem in Nigeria, little research has been conducted on this topic in Nigeria. This cross-sectional study was conducted to determine the prevalence of sexual dysfunction and their correlates among female patients of reproductive age using a questionnaire. Respondents were recruited from the out-patients clinics of a teaching hospital setting in Ile-Ife/ Ijesa administrative health zone, Osun State, Nigeria. Of 384 female patients interviewed, 242 (63%) were sexually dysfunctional. Types of sexual dysfunction included disorder of desire (n=20; 8.3%), disorder of arousal (n=l 3; 5.4%), disorder of orgasm (n=154; 63.6%), and painful coitus (dyspareunia) (n=55; 22.7%). The peak age of sexual dysfunction was observed among the age-group of 26-30 years. Women with higher educational status were mostly affected. The reasons for unsatisfactory sexual life mainly included psychosexual factors and medical illnesses, among which included uncaring partners, present illness, excessive domestic duties, lack of adequate foreplay, present medication, competition among wives in a polygamous family setting, previous sexual abuse, and guilt-feeling of previous pregnancy termination among infertile women. The culture of male dominance in the local environment which makes women afraid of rejection and threats of divorce if they ever complain about sexually-related matters might perpetrate sexual dysfunction among the affected individuals. Sexual dysfunction is a real social and psychological problem in the local environment demanding urgent attention. It is imperative to carry out further research in society at large so that the health and lifestyles of affected women and their partners could be improved.     

Clinical versus sonographic estimation of foetal weight in southwest Nigeria

A prospective study was conducted at Obafemi Awolowo University Teaching Hospital Complex, Ile-Ife, Nigeria, between 3 January and 31May 2004, to compare the accuracy of clinical and ultrasonographic estimation of foetal weight at term. One hundred pregnant women who fulfilled the inclusion criteria had their foetal weight estimated independently using clinical and ultrasonographic methods. Accuracy was determined by percentage error, absolute percentage error, and proportion of estimates within 10% of actual birth-weight (birth-weight of +10%). Statistical analysis was done using the paired t-test, the Wilcoxon signed-rank test, and the chi-square test. The study sample had an actual average birth-weight of 3,255+622 (range 2,150-4,950) g. Overall, the clinical method overestimated birth-weight, while ultrasound underestimated it. The mean absolute percentage error of the clinical method was smaller than that of the sonographic method, and the number of estimates within 10% of actual birth-weight for the clinical method (70%) was greater than for the sonographic method (68%); the difference was not statistically significant. In the low birth-weight (<2,500 g) group, the mean errors of sonographic estimates were significantly smaller, and significantly more sonographic estimates (66.7%) were within 10% of actual birth-weight than those of the clinical method (41.7%). No statistically significant difference was observed in all the measures of accuracy for the normal birth-weight range of 2,500-<4,000 g and in the macrosonic group (> or =4,000 g), except that, while the ultrasonographic method underestimated birth-weight, the clinical method overestimated it. Clinical estimation of birth-weight is as accurate as routine ultrasonographic estimation, except in low-birth-weight babies. Therefore, when the clinical method suggests weight smaller than 2,500 g, subsequent sonographic estimation is recommended to yield a better prediction and to further evaluate foetal well-being.     

生物标志物与非小细胞肺癌治疗结局相关

血管内皮生长因子（VEGF）和可溶性VEGF受体2（sVEGFR-2）由VEGF通路抑制因子所调控,化疗、VEGFR抑制剂或两者联合治疗是否可引起细胞因子和血管生成因子（CAFs）的改变,而这些改变是否又能预示临床获益？     

Protective Effect of Garcinia Kola (Kolaviron) Extract on Predisposition of Rats to Cardiovascular Diseases Following Separate Administration of Amodiaquine and Artesunate

This study was carried out to investigate the cardiovascular effect of administration of antimalarial drugs amodiaquine and artesunate and the efficacy of Garcinia kola extract (kolaviron) in protecting against such possible effect. Thirty (30) adult male albino rats divided into six (6) groups were used in this study. Groups D, E and F were treated with 100 mg/Kg b. w of the extract twice daily for the first one week and 200 mg/Kg b. w. /day for the subsequent three (3) weeks. Amodiaquine (10mg/Kg. b. w. /day) was administered orally for four (4) days into rats in groups A and E while rats in groups B and F were treated with artesunate (5mg/Kg b. w. /day) for four (4) days. Group C rats (normal control) were treated with normal saline. All the rats were sacrificed after four (4) weeks treatment period. Blood was withdrawn by cardiac puncture while the liver, kidney, stomach and heart were removed, cleansed and weigh. Total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides were measured in the serum, while total fibrinogen, platelet count, red blood cell and white blood cell count were measured in the whole blood. The artherogenic and coronary risk index were also determined. Results indicate that both amodiaquine and artesunate predispose to cardiovascular disease, however the effect was more pronounced with artesunate than amodiaquine. The result also suggests that both drugs could increase the risk of coronary and artherogenic diseases and that Garcinia kola do not prevent the cardiotoxicity and coronary risk effect.     

Dermoscopy is a suitable method for the observation of the pregnancy-related changes in melanocytic nevi

BACKGROUND: It is a common opinion that expansion and darkening in melanocytic nevi may occur during pregnancy. The main problem is that whether it is a usual finding, or it is a condition that requires suspicion about melanoma. OBJECTIVES: It was aimed to find the changes that might occur in the sizes and structures of melanocytic nevi during pregnancy. METHODS: Ninety-seven nevi of the 56 pregnant women in the first trimester were evaluated in the study. The localization and size of the nevi were recorded on a standard body diagram. After clinical examination, dermoscopic analyses were applied. Pattern analyses were done, and total dermoscopy scores (TDS) were calculated by applying ABCD scoring system. All subjects were seen again during the third trimester. RESULTS: There was a statistically significant difference between the mean diameters of nevi in the first and third trimester (P = 0.001). Of nevi whose diameters increased, 10 (50.00%) were localized on the front of body, 6 (30.00%) on the face and neck, 3 (15.00%) on the legs, and 1 (5.00%) on the back. The enlargement in diameters was more significant on the front of the body, but there was no statistically significant difference. Compared according to the pattern analysis, new dot formation was observed only on the structure of six nevi during the last trimester. Four of them were localized on the front of the body. There was statistically significant increase in mean TDS in comparison between the first and third trimesters (P = 0008). CONCLUSIONS: During the pregnancy, widening in diameters and structure changes of nevi may be seen especially on the front of the body. We also think that these findings might be connected with expansion of the skin during pregnancy. Dermoscopic controls are the first choice of method to analyse the nevi since the patient may not recognize these changes.