Morphometric study of post menarcheal nulliparous breasts, their clinical relevance and relationship with body size indicators in a Nigerian population

Background

The female breast is a symbol of femininity and aesthetics having a great psychosocial impact on the woman's sense of wellbeing and self-esteem. To optimize satisfaction of patients in cosmetic and reconstructive breast surgeries, there is a need to define the dominant breast size and shape that connotes feminine attractiveness. This necessitates the knowledge of ideal data for normal nulliparous female breast parameters and volume for various body sizes in the particular population, nationality, and race.

Aim

To establish reference data for normal breast parameters and volumes for the various body sizes amongst the Nigerian population and to determine their relationships with other body parameters.

Patients and Methods

A total of 528 breasts from 264 Nigerian undergraduate post-menarcheal nulliparous students of the University of Nigeria Enugu Campus aged between 17 and 29 years were measured. Thirty-one (31) anthropomorphic parameters and five body size anthropometric indicators were measured. Data obtained were analyzed using Statistical Package for Social Sciences (SPSS) version 21(IBM) and were summarized using various descriptive statistics tools.

Results

The mean nipple-nipple distance is 23.37 ± 3.10. The mean left Midclavicle-nipple Length (22.17 ± 3.5 cm) is significantly (P = 0.04) higher than the right (21.79 ± 3.3 cm) just as the mean left (12.60 ± 2.5) medial radius is significantly (P = 0.0001) longer than the right (12.45 ± 2.4 cm). The mean left nipple projection (0.37 ±0.2 cm) and left vertical surface dimension (32.27 ± 5.7 cm) are significantly (P > 0.05) longer than the right (0.33 ±0.2) and (31.76 ± 5.2 cm). Also the mean volume for the left breast (605.26 ± 280.52 cm) is significantly (0.0001) higher than that of the right breast (592.53 ± 278.69). Breast volume correlated well with most of the breast parameters, BMI, and other anthropometric variables. Most breasts were ptotic (51%, 55%), especially the left breasts. Breast dimensions were asymmetrical in >50% of subjects, where the left breasts were seen to have slightly greater breast dimensions than right.

Conclusion

Breast values and related body size parameters were noted to be comparatively higher than earlier reported values mostly for the Asian population.

The Effects of Alkaloids Fraction of Cyperus esculentus on Some Biochemical Parameters and Histopathology of the Testis of Lead-Induced Toxicity

Aim: This study evaluated the protective effect of alkaloids fraction of Cyperus esculentus on lead-induced testicular toxicity in Wistar rat. Methodology: Twenty-five adult male Wistar rats were randomly divided into five (5) groups, (n=5). Group 1 was administered with 1ml normal saline only, group 2 was administered with 30 mg/kg of lead, group 3 was administered with 50mg/kg of alkaloids and 30 mg/kg of lead, group 4 was administered with 100 mg/kg of alkaloids and 30 mg/kg of lead, group 5 was administered 150mg/kg of alkaloids and 30 mg/kg of lead orally for 28 days. The testes of the rats were harvested on day 29 of the experiment and histological studies done using the H&E and Verhoeff-Van Gieson (VVG) stains. Sperm parameters, sex hormones and antioxidant of testicular homogenates were analysed. Results: Histological examination of the testes revealed increased spermatogenic cells and Leydig cell proliferation in the rats in groups 3, 4, and 5 administered with 50 mg/kg, 100 mg/kg, and 150 mg/kg of Alkaloids, and 30 mg/kg of lead, respectively, when compared with group 2 administered with 30 mg/kg of lead alone. Also there was significant increase in levels of serum testosterone (p < .05) in groups 3, 4, and 5 when compared with group 2. There was increase in levels of follicle stimulating hormone in groups 4, and 5 when compared with group 2. However, significant decreased in luteinizing hormone was observed in groups 3, 4 and 5. Group 2, treated with 30 mg/kg of lead only showed increased malondialdehyde levels when compared with group 1 that received 1ml normal saline. Group 3, 4, and 5, treated with 50 mg/kg, 100 mg/kg, and 150 mg/kg of alkaloid plus 30 mg/kg lead, respectively, showed significant growth of seminiferous epithelium, improved sperm quality, and decreased levels of malondialdehyde (p < .05). Conclusion: This study shows that alkaloids fraction of Cyperus esculentus may have a protective effect on the testis of Wistar rat when it is exposed to toxicity from lead.

Haemopoietic Potential of Tannin Fractionates of Vitex doniana Leaf on Nitrosobis (2-Oxopropyl) Amine Comobidity in Docetaxel-Induced Myelosuppression in Wistar Rat

Aim: This study investigated the haemopoietic potential of tannin fractionate of Vitex doniana leaf against nitosobis (2-oxopropyl) amine comorbidity in docetaxel-induced bone marrow suppression. Study Design: This is an experimental research. Place of Research: University of Nigeria, Enugu campus. Methodology: The male Wistar rats used in this experiment were twenty-eight in number, and they were grouped into 7, with each group having four rats. Group 1 served as control, and received 1ml of normal saline, while groups 2-7 were treated with Nitrosobis (2-oxopropyl) amine 5 mg/kg daily for 2 weeks. Then groups 3-7 were treated with 8 mg/Kg of docetaxel weekly for 2 weeks. And groups 4, 5 and 6 also received 250 mg/Kg and 500 mg/Kg and 1000 mg/kg of tannin, respectively, daily for 2 weeks. Group 7 received 40 mg/Kg of fesolate daily for 2 weeks. Results: The haemoglobin concentration and white blood cell count of rats in the groups treated with Nitrosobis (2-oxopropyl) amine alone (group 2) and Nitrosobis (2-oxopropyl) amine plus Docetaxel (group 3) showed statistically significant reduction (p=.05) in number when compared with the group treated with normal saline (group 1). The haemoglobin concentration and white blood cell count of the rats in the groups treated with 250 mg/kg, 500 mg/kg, and 1000 mg/kg of the tannin fractionate, in addition to the Nitrosobis (2-oxopropyl) amine and Docetxel (i.e. groups 4, 5, and 6, respectively) showed statistically significant dose dependent increase in number, with the group treated with 1000mg/kg showing the highest increment (p=.05). The cells in the bone marrow show significant reduction in number in the rats treated with Nitrosobis (2-oxopropyl) amine (group 2) and Nitrosobis (2-oxopropyl) amine plus docetaxel (group 3) when compared with the rats in group 1 (treated with normal saline). With the addition of graded doses of the tannin fractionate, 250 mg/kg, 500 mg/kg, and 1000mg/kg (i.e. groups 4, 5, and 6, respectively), the number of cells in the bone marrow showed statistically significant increase when compared to group 3 (treated with Nitrosobis (2-oxopropyl) amine plus docetxel), with the rats in the group treated with 1000 mg/kg of tannin fractionate (group 6) having the highest increment (p=.05). Conclusion: Tannin obtained from Vitex doniana leaf extract increases the haemoglobin concentration in dose dependent manner. It also increases the white blood cell count, and number of proliferating bone marrow cells, following suppression by Nitrosobis (2-oxopropyl) amine and Docetaxel. So, this tannin obtained from Vitex doniana leaf extract may be useful in clinical practice to cushion the myelosupression, anaemia and leukopenia that are associated with use of docetaxel in treatment of malignancies.

Prevalence, pattern and correlates of work-related musculoskeletal disorders among school teachers in Enugu, Nigeria

Introduction. There is insufficient literature on the prevalence of and risk factors for work-related musculoskeletal disorders (MSDs) among teachers in Nigeria. This study aimed to investigate the prevalence of work-related MSDs and their associations with occupational and socio-demographic factors of Nigerian-based school teachers. Materials and methods. Socio-demographic and occupational characteristics, prevalence and pattern of work-related MSDs of 352 school teachers (age 24-60 years) were investigated using a standard Nordic questionnaire. Data were summarized with descriptive statistics. Univariate and multivariate analyses were used to assess predictors of work-related MSDs. Results. The results showed that 70.2% of the teachers had work-related MSDs predominantly in the shoulder (62.3%) and neck (57.9%) regions. Most of the studied socio-demographic features and anthropometric and occupational characteristics were significantly associated (p < 0.05) with MSDs in at least one body region. Conclusions. There was a prevalence of work-related MSDs among the teachers. Advanced educational qualification, elevated teaching boards, teaching experience over 10 years and age range of 35-50 years were the major predictors of MSDs.

Infant carrying methods: Correlates and associated musculoskeletal disorders among nursing mothers in Nigeria

Infant carrying is an integral part of the mothering occupation. Paucity of data exists on its correlates and associated musculoskeletal injuries. In this study, factors and musculoskeletal injuries associated with infant carrying were investigated in 227 nursing mothers, using a structured questionnaire. 77.1% utilised the back infant carrying methods (ICM). Maternal comfort was the major factor influencing participants' (37.4%) choices of ICMs. Infant's age (p = .000) and transportation means (p = .045) were significantly associated with ICMs. Low back pain (82.8%) and upper back pain (74.9%) were the most reported musculoskeletal discomforts associated with ICMs, especially among women who utilised back ICM. Back ICM is predominantly used by nursing mothers. Impact statement Infant carrying has been associated with increased energy cost and biomechanical changes. Currently, there is a paucity of data on infant carrying-related musculoskeletal injuries. In this study, investigating factors and musculoskeletal injuries associated with infant carrying, the results showed that back infant carrying method is predominantly used by nursing mothers. Age of the infant and mothers' means of transportation were determinant factors of infant carrying methods. Among the several reported infant carrying-related musculoskeletal disorders, low back and upper back pain were the most prevalent, especially among women who utilised the back infant carrying method. There is need for women's health specialists to introduce appropriate ergonomic training and interventions on infant carrying tasks in order to improve maternal musculoskeletal health during the childbearing years and beyond. Further experimental studies on the effects of various infant carrying methods on the musculoskeletal system are recommended.

Musical preferences and learning outcome of medical students in cadaver dissection laboratory: A Nigerian survey

Background music has been reported to enhance learning in the cadaver dissection laboratory. This study was designed to determine the impact of various forms of musical genre and some of their characteristics on students' learning outcome in the dissection laboratory. Some selected musical genre in vocal and non-vocal forms and at different tempi and volume were played as background music (BM) to 253 Medical and Dental students during various sessions of cadaver dissection. Psychological Stress assessment was done using Psychological stress measure-9. Participants love for music, preferred musical genre and other musical characteristics were assessed. The impact of the various musical genre and their characteristics on learning was done via written examination on the region dissected during each musical session. A positive relationship was noted between students' preference for musical genre during leisure with their preference for BM during private study time (P<0.01). Statistically significant differences (P<0.01) were established in the impacts of the selected musical genre on some selected learning factors. Country and Classical music gave the highest positive impact on the various learning factors in CDL followed by R&B. No significant difference was noted between the cognitive values of vocal and non-vocal music. Classical music most effectively reduced the stress induced by dissection in the CDL while Reggae and High life musical genre created a more stressful environment than regular background noise (P<0.01). Moderate volume level and Tempo were most preferred during both cadaver dissection activity and leisure hours. This study shows statistically significant differences in the cognitive values of some of the studied musical genre and their various characteristics. The inability to isolate the particular musical genre with these desired properties could account for the controversies in the reports of the role of music in academic environment.

Use of fetal biometry in the assessment of gestational age in South East Nigeria: Femur length and biparietal diameter

BACKGROUND

Fetal growth is influenced by many factors such as race, socioeconomic status, genetics, geographical location, maternal diseases, and number of babies. Consequent upon these, fetal growth charts may vary from one location to another even within the same geographical entity.

OBJECTIVE

This study was designed to establish the fetal growth chart in antenatal women who had ultrasound scanning at the University of Nigeria Teaching Hospital, Enugu, South East Nigeria.

PATIENTS AND METHODS

This is a descriptive analysis of fetal biometric measurement of antenatal women. Four hundred and seventy pregnant women were studied.

RESULTS

The nomogram for the femur length (FL) and biparietal diameter (BPD) for the different weeks of gestation (from 13th to the 40th week) were established. Correlation coefficients between gestational age and the various fetal parameters were also reported. Growth charts using both FL and BPD were plotted. A regression model for prediction of fetal age using the fetal biometry was also deduced for the studied population.

CONCLUSION

The fetal parameters used in this study were consistently smaller than reported values from European studies up to the 34th week of gestation after which a catch-up growth till the 40 weeks was observed. Fetal parameters observed in this study were larger than most of the reported Asian values.

Sonographic assessment of the normal limits of the spleen in healthy school children in South-East Nigeria

BACKGROUND/OBJECTIVE

Ultrasonogrphy is a good modality for the detection of splenomegaly even when it is not clinically palpable. The objective of this study was to establish the normal values of splenic length in healthy school children in South-East, Nigeria and to correlate them with body indices.

MATERIALS AND METHODS

This is a cross-sectional prospective study of 1315 children (633 boys and 682 girls) between the ages of 5 and 17 years. The splenic length was measured between the most superiomedial and the most inferiolateral margins, at the level of the hilum. Only the spleens that had normal shape and echotexture were measured. The mean splenic length and the 5 th and 95 th percentiles were determined for each age. The length was correlated with the sex, age, weight (WT), height, body mass index (BMI) and body surface area (BSA) of the subjects. A regression model for prediction of spleen dimension from age and body habitus was computed.

RESULTS

There was a significant correlation between splenic length and age, P < 0.001. Males had statistically significant longer spleen length than females. The splenic length correlated best with BSA, followed by body WT and least with BMI.

CONCLUSIONS

This study noted racial variation between the established Nigerian values and results from other countries of the world. For the first time, a baseline value for splenic size for the Nigerian Children of various ages has been established with a regression model for predicting the splenic sizes.

Enhancing learning objectives by use of simple virtual microscopic slides in cellular physiology and histology: impact and attitudes

The impact and perception of students on the use of a simple, low technology-driven version of a virtual microscope in teaching and assessments in cellular physiology and histology were studied. Its impact on the time and resources of the faculty were also assessed. Simple virtual slides and conventional microscopes were used to conduct the same examinations for the same students. Students performed significantly better in the examination with the virtual slide and also showed a significantly higher preference for virtual slides. The time and cost implications of conducting examinations using the simple virtual slides were reduced by >1,400%. The results reemphasize the need for the design and adoption of simple sustainable technological innovations in developing countries to bridge gaps in purposeful learning environments.

Medical students' evaluation of physiology learning environments in two Nigerian medical schools

The expansion of biomedical knowledge and the pursuit of more meaningful learning have led to world-wide evidence-based innovative changes in medical education and curricula. The recent emphasis on problem-based learning (PBL) and student-centred learning environments are, however, not being implemented in Nigerian medical schools. Traditional didactic lectures thus predominate, and learning is further constrained by funding gaps, poor infrastructure, and increasing class sizes. We reviewed medical students' perceptions of their exposed learning environment to determine preferences, shortcomings, and prescriptions for improvements. The results confirm declining interest in didactic lectures and practical sessions with preferences for peer-tutored discussion classes, which were considered more interactive and interesting. This study recommends more emphasis on student-centered learning with alternatives to passive lecture formats and repetitive cookbook practical sessions. The institutionalization of student feedback processes in Nigerian medical schools is also highly recommended.

Impact of education on obesity and blood pressure in developing countries: A study on the Ibos of Nigeria

BACKGROUND

Increase in the prevalence of hypertension, obesity and obesity related diseases has become significant cause of disability and premature death in both developing and newly developed countries, with over bearing demand on national health budgets.

AIM

To evaluate the impact of various levels of education on obesity and blood pressure.

MATERIALS AND METHOD

325 male and 254 female Nigerians of ages 20-80 years of the Ibo ethnicity through random sampling, were selected for this study. The participants were broken into three major groups based on their educational levels; primary, secondary and tertiary levels. systolic and diastolic blood pressure (SBP & DBP) levels, body mass index (BMI), waist hip ratio (WHR), waist height ratio (WHtR), waist circumference (WC),various skin fold thicknesses, and other anthropometric parameters were measured.

RESULT

For all the indicators of subcutaneous fat, general obesity, and central obesity, largest mean deposition was noted to be highest in the lowest education group and least in the highest education group. Mean blood pressure parameters were also highest in the least education group. While fat deposition was noted to be highest in all the females of all the groups, the males showed larger mean BP values. Education was noted to have a significant inverse relationship with most of the fat indicators and blood pressure parameters and cardiovascular disease risk highest in the least education groups.

CONCLUSION

Education showed a significant impact on obesity and blood pressure and could be one of the major tools to reduce the high prevalence of obesity, hypertension and other obesity associated diseases.

Aortic arch diameter and its significance in the clinical evaluation of cardiac and aortic enlargements

OBJECTIVE OF THE STUDY

To determine the relevance of the transverse aortic arch diameter in the evaluation of early aortic and cardiac enlargements.

SUBJECT AND METHOD

A total of 1818 chest radiographs of male and female normotensive and hypertensive Nigerians of age range 4-80 and 10-80 years respectively were used for this study. Ages of subjects were obtained and transverse aortic arch, chest and heart diameters were determined.

RESULTS

Mean aortic arch diameter for the normotensive groups were noted to be 5.0 +/- 0.5cm, 4.5 +/- 0.4cm and 4.7 +/- 0.5cm for males, females and both sexes respectively while 5.9 +/- 0.9cm, 5.4 +/- 0.6cm and 5.6 +/- 0.8cm for males, females and both sexes respectively were noted in the hypertensive group. Mean values were also generated for the chest and heart diameters. The study reports a mean difference in the aortic arch, heart and cardiothoracic ratio of 15% between the two groups.

CONCLUSION

Relationship between aortic arch and heart diameter was established and aortic arch diameter was noted to be significant (p< 0.05) in evaluating aortic and cardiac enlargements.