Sonographic diagnosis of diastematomyelia in utero: a case report and literature review

Fetal diastematomyelia is a rare form of spinal dysraphism that is characterized by a complete or incomplete division of the spinal cord by an osseous or fibrocartilaginous septum. A case of diastematomyelia, which was detected on the routine third trimester detailed ultrasound scan, is presented. The diagnosis was based on the detection of an echogenic focus in the posterior aspect of the spine in association with widening of the interpedicular vertebral space. The case illustrates that diastematomyelia can occur in the absence of overt spina bifida and that prenatal detection will allow timely postnatal investigation and treatment. Prenatal literature is further reviewed to assess the clinical significance of this finding.     

Sonographic diagnosis of diastematomyelia in utero: A case report and literature review

Fetal diastematomyelia is a rare form of spinal dysraphism that is characterized by a complete or incomplete division of the spinal cord by an osseous or fibrocartilaginous septum. A case of diastematomyelia, which was detected on the routine third trimester detailed ultrasound scan, is presented. The diagnosis was based on the detection of an echogenic focus in the posterior aspect of the spine in association with widening of the interpedicular vertebral space. The case illustrates that diastematomyelia can occur in the absence of overt spina bifida and that prenatal detection will allow timely postnatal investigation and treatment. Prenatal literature is further reviewed to assess the clinical significance of this finding.     

Suppression of humoral immunity following exposure to the perfluorinated insecticide sulfluramid

Perfluorinated hydrocarbons have been manufactured for over 40 yr and have numerous applications in industry. This group of compounds has recently generated much interest, as some of these compounds such as perfluorooctane sulfonate (PFOS) and perfluoroctanic acid (PFOA) are persistent in the environment and detectable in blood samples of both wildlife and humans. Studies show that these perfluorinated compounds induce peroxisomal proliferation, induce hepatomegaly, alter steroidogenesis, and decrease body weight, accompanied by a wasting syndrome; however, effects on immune function have not been addressed at length. This study examined sulfluramid, a perfluorinated pesticide that is currently available in the marketplace and is a representative member of this class of chemicals. Adult female B6C3F1 mice were exposed via gavage to either an oil carrier control or sulfluramid for 14 d (1, 3, 10, or 30 mg/kg/d) or 28 d (0.3, 1, 3, or 10 mg/kg/d). Although responses were normal in natural killer cell activity and lymphocyte proliferation, dose-responsive suppression was noted in the plaque forming cell (PFC) response at exposure levels as low as 3 mg/kg/d in the 14-d exposure and 0.3 mg/kg/d for 28 d. Dose-responsive increases in liver mass were observed following treatment with 1, 3, 10, or 30 mg/kg/d for 14 d and 0.3, 1, 3, or 10 mg/kg/d for 28 d. A significant reduction in body weight was observed at the highest dose level in each study. Novel findings in this study indicate that sulfluramid suppresses immunoglobulin (Ig) M production. Additional immunotoxicity studies are required to understand potential mechanisms of suppression and determine potential health risks associated with exposure to perfluorinated hydrocarbons.     

Assesssing Herbal Medical Practitioners in Professional Qualifying Examination in Ghana, a Model

About 70% of Ghanaians depend on Alternative health practice for their primary health care needs. Hence, there is the need to streamline and regulate these practices. Graduates from the Faculty of Pharmacy and Pharmaceutical Sciences, Kwame Nkrumah University of Science and Technology (K.N.U.S.T), Kumasi-Ghana were assessed by the Professional Qualifying Examination Board of the Traditional Medicine Practice Council (TMPC), Ghana, after two years of internship training. A model of assessment took into consideration, the scope of the university training, internship and the primary health care needs of the society.     

Constituents of West African Medicinal Plants. IX. Dihydrocubebin, a new lignan from Piper guineense.

An extract of the leaves of Piper guineense Schum. and Thonn. afforded a new lignan, dihydrocubebin, which was characterized by its spectral properties and identified by direct comparison with a reference sample obtained by catalytic hydrogenation of sesamin.     

Constituents of West African medicinal plants. VII: Alkaloids of Tiliacora dinklagei.

Tiliacore dinklagei (Menispermaceae), a woody climber of the rain forests of West Africa, has been used as a native medicinal and an article of commerce. Chromatography of an ethanolic extract of the powdered roots afforded the three alkaloids tiliacorinine, funiferine and nortiliacorinine A; the new alkaloid, tiliageine and the incompletely characterized alkaloid, TD-2.     

Constituents of West African medicinal plants. XIV. Constituents of Piper guineense Schum, and Thonn.

Piper guineense Schum, and Thonn. (Piperaceae), a woodsy climber of Ghana and other parts of West Africa, has been used as a condiment and a native medicinal. Chromatography of an extract of the fruits afforded the amides piperine, N-isobutyloctadeca-trans-2-trans-4-dienamide, sylvatine, delta alpha beta-dihydropiperine, trichostachine and delta alpha beta-dihydropiperlonguminine, the last of which is a new naturally occurring amide. In a similar manner, chromatography of an acetone extract of the roots afforded piperine, trichostachine and delta alpha beta-dihydropiperine while an acetone extract of the leaves yielded dihydrocubebin, a new naturally occurring lignan.     

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome: ultrasonography as a diagnostic tool

Remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome is characterized by symmetrical synovitis and swelling of both the upper and lower extremities. The anatomical determinant of RS3PE is predominantly extensor tenosynovitis as revealed by magnetic resonance imaging (MRI). Given the cost constraints, time, and expertise required in carrying out MRI and ease in diagnosing tenosynovitis by ultrasound, we utilized high-frequency ultrasonography (USG) for evidence of tenosynovitis of the distal tendons in patients with RS3PE. Diagnosis of tenosynovitis was made on the basis of anechoic or hypoechoic signals around the tendon sheaths in both transverse and longitudinal planes. Flexor and extensor tendons at the wrist and metacarpal heads and extensor digitorum longus (EDL) tendons at the ankle were evaluated with a 7.5–10-MHz linear probe. There were ten patients (seven males) with a mean age of 59.5 years (range: 52–78 years) and mean disease duration of 6.1 months (range: 1.5–12 months). Disease onset was acute in all of the cases. Pitting edema of the hands was present in all except two patients whereas four patients, in addition, had edema of the feet. Edema was symmetrical in seven patients. Inability to make a complete fist was noted in all. Tenosynovitis of extensor and flexor tendons at the wrist and the metacarpal heads was documented in all patients with edema of the hands. In seven cases extensor tendon tenosynovitis was more prominent compared to the flexor tendons. Tenosynovitis of EDL tendons was detected in six cases. Dramatic relief with low-dose prednisolone was noted in all patients within 6 weeks of therapy. At a mean follow-up of 10.1 months all patients had marked relief in edema of extremities and improvement in the grip strength. Our study confirms that tenosynovitis of both flexor and extensor tendons at the wrist and extensor tendons of the feet is the hallmark of RS3PE syndrome. USG is a reliable and cost-effective modality for evaluation of patients with suspected RS3PE.