Prevalence of malaria parasitaemia among pregnant women at booking in Nigeria

Background

Malaria is a major public health concern among pregnant women in sub-Saharan Africa. Within the region, Nigeria has the highest malaria cases. This study aimed to determine the prevalence and factors associated with malaria parasitaemia among pregnant women at a booking clinic in Ibadan, Nigeria.

Methods

A cross-sectional study was conducted between January and April 2021 at the University College Hospital in Ibadan, Nigeria. A sample of 300 pregnant women participated, and anaemia and malaria were diagnosed using packed cell volume and Giemsa-stained blood smears, respectively. Data analysis was done using SPSS 25.0.

Results

The study found that 26 (8.70%) pregnant women tested positive for malaria parasitaemia. Factors such as age, religion, level of education, and occupation were significantly related to the prevalence of malaria parasitaemia among pregnant women with p < 0.05.

Conclusion

Our study identified a high prevalence of malaria parasitaemia among pregnant women with demographic factors such as age, religion, level of education, and occupation significantly associated. Targeted malaria control interventions for pregnant women with low levels of education and low-income occupations are necessary, with more research needed to evaluate their effectiveness.

Luteolin normalizes blood pressure via its antioxidant activity and down-regulation of renal Angiotensin II receptor and Mineralocorticoid receptor expressions in rats co-exposed to Diclofenac and sodium fluoride

This study was designed to investigate the modulatory role of Luteolin (Lut), a flavonoid phytochemical, on haemodynamic parameters and the potential mechanisms involving renal Angiotensin II (AT2R) and Mineralocorticoid (MCR) receptors in renal toxicity induced by co-exposure to Diclofenac (Dcf) and sodium fluoride (NaF) in rats.Male Wistar rats were administered with either vehicle (control), Dcf only (9 mg/kg orally) or concurrently with NaF (300 ppm in drinking water). Other groups were treated with LutA (100 mg/kg) or LutB (200 mg/kg) along with Dcf and NaF exposures. All treatments lasted 8 days, following which blood pressure indices were measured using tail-cuff plethysmography. Renal expressions of AT2R and MCR were studied with immunohistochemistry, while biomarkers of oxidative and antioxidant status were also measured in the kidneys. Systolic, diastolic and mean arterial pressures were significantly (p<0.05) reduced in Dcf-treated rats, compared to control values. However, co-treatment with NaF or Lut restored these parameters. While the expression of AT2R and MCR was high in the Dcf and Dcf+NaF groups, treatment with Lut caused obvious reduction in the renal expression of these receptors. Increased lipid peroxidation (Malondialdehyde) and protein oxidation (protein carbonyls) with a lowering of reduced glutathione levels contributed to the renal toxicity of Dcf, and these were significantly ameliorated in Lut-treated rats. In conclusion, the preservation of haemodynamic indices by Lutin the experimental ratsprobably included mechanisms involving down-regulation of renal expressions of AT2R and MCR, reduction of oxidative stress and an improvement of renal antioxidant status.

Tibia gap nonunion following sequestrectomy treated with a nonvascularized fibula strut graft

Chronic osteomyelitis of the tibia is a common sequela of acute osteomyelitis which may present with a bone defect following sequestrectomy. Treatment of the gap nonunion can be done with the ipsilateral fibula as a strut graft when harvested subperiosteally and this leads to good outcome. A 7-year-old girl presented to our facility with a 25 cm defect of her right tibia following sequestrectomy for chronic osteomyelitis in another facility. X-rays revealed a healthy tibia superiorly and inferiorly with an intact fibula. She subsequently had an ipsilateral subperiosteal nonvascularized fibula harvest which was used to fill the tibia defect as a strut graft. The synostosis healed perfectly and the fibula reossified, time to union was 17 weeks, and the patient commenced full weight-bearing thereafter. Management of bone gap following sequestrectomy for chronic osteomyelitis remains a challenge to the orthopedic surgeon. The subperiosteal fibular harvest and use as a strut graft is a viable option with good outcomes. Our experience with this case may serve as a way out of this usual challenge.

1st metatarso-phalangeal joint arthroplasty with ROTO-glide implant

BACKGROUND

Total joint replacement of the 1st metatarso-phalangeal Joint (MTPJ) has been controversial as arthrodesis remains a good option for patients with end stage 1st MTPJ arthritis. We present a multi centre service evaluation of the ROTO-glide device METHODS: 33 ROTO-glide procedures were carried out in 30 patients across 7 sites within the UK. Exclusion criteria - hallux valgus and arthritis, age below 45 years and over 80 years, inflammatory joint disease. Patient assessed pre and post operatively with AOFAS and Oxford forefoot (MOXFQ) scores and plain radiographs. All patients carried out the same post operative protocol RESULTS: Average age at patients was 58.6 years (45-77). Follow up average was 16.9 months (12-29). Pre-op AOFAS scores average 41.4 (17-67) and post op average 76 (29-100) and the MOXFQ summary index decreased from an average of 43 (20-64) pre op to an average of 17 (0-51) post op. Average total range of motion pre operatively was 32° and post operatively was 61°. There were 2 post operative complications but no revisions were necessary.

CONCLUSIONS

The early results of this multi centre service evaluation of the ROTO-glide 1st MTPJ replacement support its continued use and evaluation of the prosthesis further.

Cardiotoxicity Study of the Aqueous Extract of Corn Silk in Rats

In the ear of corn there are silky strands which run its length and these strands are known as corn silks. Folk remedies show that the corn silks have been used as an oral antidiabetic agent in China for many years and as herbal tea in other world nations for the amelioration of urinary tract infection. The extract is being assessed for safety in this study using histopathological changes, as well as an electrocardiogram (ECG). Graded doses (200, 400 and 800 mg/kg) of aqueous CS extract were administered to rats for seven days. The fourth group which served as control received 3 ml/kg dose of distilled water. On the eighth day, ECG was evaluated in ketamine/xylazine-induced anaesthesia in rats to determine changes in the heart rate, P-wave duration, P-R interval, R-amplitude, QRS duration, QT interval and QTc. Hearts from the experimental animals were collected for histopathological changes. The results showed that there was a significant change in the heart rate (groups B and C), P-wave duration (group D), QT interval (groups B, C and D) and QTc (groups B, C and D) when compared to the control group. Histology also indicated that sections of the heart showed fatty infiltration of inflamed heart and areas of moderate inflammation of the atrium and ventricle. It could therefore be concluded from this study that though folklore indicated that corn silk (CS) is of high medicinal value, one must be careful in using this product as medicinal agent especially in patients with compromised heart conditions.

The treatment of severe flexion contracture of the great toe in a patient with Ledderhose's disease

We present the rare case of a patient with Ledderhose's disease causing severe, disabling flexion contracture of his right great toe. We discuss our treatment regimen relative to descriptions of this condition in the literature.

Liver dysfunction in steady state sickle cell disease

The liver is one of the organs involved in the multiorgan failure that occurs in sickle cell disease, the pathophysiology of liver disease in this condition is complex because of the interrelated multifactorial causes. Liver dysfunction was assessed in both paediatric and adult sickle cell disease patients in the steady state. The transaminases and alkaline phosphatase were analysed by automation while coagulation studies were done manually. The mean (range) of Alanine transaminase (ALT), Aspartate transaminase (AST) and alkaline phosphatase (ALP) were 23.0 (2-77) IU, 48.5 (15-120) IU, 227.5 (37-1200) IU respectively. ALT and AST levels were less than 100 IU in over 95% of the patients. The gender or age of the patients did not significantly affect the level of these three enzymes. There was close association between the liver size and elevation of the liver enzymes except for alkaline phosphatase (ALT=.017, AST=.009, ALP=.056). Twenty-five percent of the patients had normal enzymes while 13% had derangement of the three enzymes, 19%, 50% and 74% had abnormal ALT, AST and ALP respectively. Only 22% and 5% had deranged PT and APTT respectively. In conclusion minimal elevation of the tramsaminases which is not gender or age dependent were observed in steady state sickle cell disease, higher levels of alkaline phosphatase may be due to associated vasoocclussive crises involving the bones rather than a pathology of the liver.