Circulating endothelial progenitor cells, endothelial function, carotid intima-media thickness and circulating markers of endothelial dysfunction in people with type 1 diabetes without macrovascular disease or microalbuminuria

AIMS/HYPOTHESIS

Type 1 diabetes is associated with premature arterial disease. Bone-marrow derived, circulating endothelial progenitor cells (EPCs) are believed to contribute to endothelial repair. The hypothesis tested was that circulating EPCs are reduced in young people with type 1 diabetes without vascular injury and that this is associated with impaired endothelial function and increased carotid intima-media thickness (CIMT).

METHODS

We compared 74 people with type 1 diabetes with 80 healthy controls. CD34, CD133, vascular endothelial (VE) growth factor receptor-2 (VEGFR-2) and VE-cadherin antibodies were used to quantify EPCs and progenitor cell subtypes using flow-cytometry. Ultrasound assessment of endothelial function by brachial artery flow-mediated dilatation (FMD) and CIMT was made. Circulating endothelial markers, inflammatory markers and plasma plasminogen activator inhibitor-1 (PAI-1) levels were measured.

RESULTS

CD34+VE-cadherin+, CD133+VE-cadherin+ and CD133+VEGFR-2+ EPC counts were significantly lower in people with diabetes (46-69%; p = 0.004-0.043). In people with type 1 diabetes, FMD was reduced by 45% (p < 0.001) and CIMT increased by 25% (p < 0.001), these being correlated (r = -0.25, p = 0.033). There was a significant relationship between FMD and CD34+VE-cadherin+ (r = 0.39, p = 0.001), CD133+VEGFR-2+ (r = 0.25, p = 0.037) and CD34+ (r = 0.34, p = 0.003) counts. Circulating high-sensitivity C-reactive protein, PAI-1, interleukin-6 and E-selectin were significantly higher in the diabetes group (p < 0.001 to p = 0.049), the last two of these correlating with FMD (r = -0.27, p = 0.028 and r = -0.24, p = 0.048, respectively).

CONCLUSIONS/INTERPRETATION

These findings suggest that abnormalities of endothelial function in addition to pro-inflammatory and pro-thrombotic states are already common in people with type 1 diabetes before development of clinically evident arterial damage. Low EPC counts confirm risk of macrovascular complications and may account for impaired endothelial function and predict future cardiovascular events.

Syntheses and anti-inflammatory activity of Diphenylamine-2,2′-dicarboxylic acid and its metal complexes

Diphenylamine-2,2'-dicarboxylic acid and its Cu(II), Ni(II), Co(II) and Zn(II) complexes have been synthesized and characterized by their elemental analyses, molecular weight determination, molar conductance, infrared and electronic spectra and magnetic measurements. The Zinc complex was tested by different methods for its anti-inflammatory activity and found to be equipotent to naproxen and ibuprofen, though at higher doses.

Antihyperglycemic and antidyslipidemic agent from Aegle marmelos

The plant Aegle marmelos belongs to the family of Rutaceae. From the leaves of A. marmelos an alkaloidal-amide, Aegeline 2, was isolated and found to have antihyperglycemic activity as evidenced by lowering the blood glucose levels by 12.9% and 16.9% at 5 and 24h, respectively, in sucrose challenged streptozotocin induced diabetic rats (STZ-S) model at the dose of 100mg/kg body weight. Aegeline 2 has also significantly decreased the plasma triglyceride (Tg) levels by 55% (P<0.001), total cholesterol (TC) by 24% (P<0.05), and free fatty acids (FFA) by 24%, accompanied with increase in HDL-C by 28% and HDL-C/TC ratio by 66% in dyslipidemic hamster model at the dose of 50mg/kg body weight. The reasonable mapping of compound 2 to validated pharmacophoric hypothesis and 3D QSAR model with an estimated activity (283nM) suggest that the compound 2 might be a beta(3)-AR agonist.

Phaeochromocytomas presenting as acute crises after beta blockade therapy

OBJECTIVE

Phaeochromocytoma crisis is a life-threatening emergency that may be undiagnosed because of its numerous, nonspecific manifestations. We analysed, retrospectively, the presentation, management and outcome of patients who were admitted to our institution with phaeochromocytoma crises over a 5-year period.

RESULTS

Five patients (two males, three females; mean age 34.6 years, range 19-51 years) who presented as emergencies requiring intensive care, with multiple non-specific manifestations and previously undiagnosed pheochromocytoma, were identified. The initial presentation included features of cardiomyopathy (n = 3), atypical pneumonia with myocarditis (n = 1) and acute abdomen (n = 1). Only one of the five cases had a raised blood pressure at the time of the acute presentation. Initiation of beta blockers in four patients was associated with further deterioration in haemodynamic status, labile blood pressure and cardiac arrhythmias, which led to the diagnosis of the underlying phaeochromocytoma. Following intensive supportive therapy and alpha blockade, all five patients recovered and underwent elective surgical removal of phaeochromocytoma, uneventfully.

CONCLUSION

Unexplained cardiopulmonary dysfunction, particularly after the institution of beta blockers, should alert clinicians to the possibility of phaeochromocytoma. A high index of suspicion is essential to reduce morbidity and mortality in these patients through early diagnosis and aggressive management.

Application of bond constraint theory to the switchable optical memory material Ge2Sb2Te5

A new extended x-ray-absorption fine structure spectroscopy study of local bonding identifies for the first time significant concentrations of Ge-Ge bonds in amorphous Ge2Sb2Te5. The study provides a new understanding of the local molecular structure of this phase-change material. Application of bond constraint theory indicates that the amorphous phase is an ideal network structure in which the average number of constraints per atom equals the network dimensionality. Analysis within this framework imparts new and significant insights concerning the nature of the reversible optically driven amorphous-crystalline phase transition of Ge2Sb2Te5.

Pacing to Restore Right Ventricular Contraction After Surgical Disconnection for Arrhythmia Control in Right Ventricular Cardiomyopathy

Ventricular tachycardia in ARVC (arrhythmogenic right ventricular cardiomyopathy) is typically managed by ICD implantation, with a limited role of catheter ablation. Surgical disconnection of the right ventricular (RV) has been used to control ventricular tachycardia (VT) in ARVC, but it often led to refractory RV failure due to loss of RV contraction after surgery. We report multisite pacing to recruit the disconnected RV to prevent ventricular failure.

Orthostatic changes in AV node conduction causing dizziness during paroxysmal atrial tachycardia

Dizziness in the upright posture is a common reason to seek medical advice and is often dismissed as benign orthostatic hypotension. We present an unusual case of dizziness in the upright posture due to possible changes in atrioventricular nodal conduction during atrial tachycardia.

Medieval trabecular bone architecture: the influence of age, sex, and lifestyle

Osteoporosis has become a growing health concern in developed countries and an extensive area of research in skeletal biology. Despite numerous paleopathological studies of bone mass, few studies have measured bone quality in past populations. In order to examine age- and sex-related changes in one aspect of bone quality in the past, a study was made of trabecular bone architecture in a British medieval skeletal sample. X-ray images of 5-mm-thick coronal lumbar vertebral bone sections were taken from a total of 54 adult individuals divided into three age categories (18-29, 30-49, and 50+ years), and examined using image analysis to evaluate parameters related to trabecular bone structure and connectivity. Significant age-related changes in trabecular bone structure (trabecular bone volume (BV/TV), trabecular number (Tb.N), trabecular separation (Tb.Sp), and anisotropic ratio (Tb.An)) were observed to occur primarily by middle age with significant differences between the youngest and two older age groups. Neither sex showed continuing change in trabecular structure between the middle and old age groups. Age-related changes in bone connectivity (number of nodes (N.Nd) and node-to-node strut length (Nd.Nd)) similarly indicated a change in bone connectivity only between the youngest and two older age groups. However, females showed no statistical differences among the age groups in bone connectivity. These patterns of trabecular bone loss and fragility contrast with those generally found in modern populations that typically report continuing loss of bone structure and connectivity between middle and old age, and suggest greater loss in females. The patterns of bone loss in the archaeological samples must be interpreted cautiously. We speculate that while nutritional factors may have initiated some bone loss in both sexes, physical activity could have conserved bone architecture in old age in both sexes, and reproductive factors such as high parity and extended periods of lactation could have played a key role in female bone maintenance in this historic population. The study of qualitative elements (such as trabecular architecture) is vital if we are to understand bone maintenance and fragility in the past.

Apical myocardial injury caused by collateralisation of a septal artery during ethanol septal ablation

In patients who are refractory to medical treatment of hypertrophic cardiomyopathy, surgical myomectomy or percutaneous transluminal alcohol septal myocardial ablation (PTSMA) is appropriate, with both the procedures having comparable results. In PTSMA ethanol is selectively injected into septal arteries supplying the hypertrophied septal myocardium. The authors describe a case of apical myocardial injury caused by passage of ethanol into the distal left anterior descending artery through a septal collateral that developed after double bolus injection of ethanol. They advocate single bolus injection of alcohol to avoid this complication.

Production of L-phenylacetyl carbinol by immobilized cells of Saccharomyces cerevisiae

Conversion of benzaldehyde to L-phenylacetyl carbinol (L-PAC) was achieved with immobilized, growing cells of Saccharomyces cerevisiae in different reactors. Product formation increased (31%) with the subsequent initial reuses of the entrapped cells. Biomass production and PAC formation depleted (40 and 57%, respectively) after 4-5 continuous growth and biotransformation cycles. With the regeneration of the biocatalysts, catalytic activity of the cells was resumed. The highest yields were in a stirred tank reactor (29 g PAC) from 77 g benzeldehyde with 14 repeated uses of entrapped cells.

Trends of Cancer Prevalence in Some Districts of West Bengal

An attempt has been made to understand the cancer prevalence in eight districts of West Bengal. Special emphasis was on the types of cancer most prevalent among the male and female populations. In this study we have represented the frequency by age and sex of different tumors among 9034 cancer cases registered over five years. Our findings indicate that liver cancer is predominant among males and cancer of the cervix uteri is most prevalent among females. The valuesby age indicate that cancer incidence increased during this study period, especially in Kolkatta.

Production of L-phenylacetylcarbinol by free and immobilized yeast cells

Production of L-phenylacetylcarbinol (L-PAC) through biotransformation of benzaldehyde by free and immobilized cells of the yeast Saccharomyces cerevisiae has been attempted. L-PAC production was found to be maximum (0.4 microliter/ml) when anaerobically grown free cells were used as biocatalyst during aerobic biotransformation for two hours with magnetically stirred bioreactor. Growth under oxygen limited conditions led to accumulation of higher amount of pyruvate decarboxylase enzyme and co-substrate, pyruvate, resulting in higher L-PAC formation. L-PAC yield was low when biotransformations were carried out anaerobically either for aerobically or anaerobically grown free cells. Free cells were found to be more efficient biocatalyst for L-PAC production, as compared with the immobilized cells, with the investigated benzaldehyde concentration (0.3% v/v) and cell density (17.5% w/v). The study has explored and indicated the possibility of optimizing the yield of L-PAC by growing the yeast cells under oxygen limited condition for suitable aerobic mode of benzaldehyde biotransformation.

Bone quantity and quality in past populations

BACKGROUND

The study of osteoporosis in past populations offers valuable insight into the patterns and prevalence of the disease in both the past and in the present.

METHODS AND RESULTS

A review is made of different paleopathological studies better to understand bone loss in past populations and to examine the contribution such studies can make to our knowledge of osteoporosis in modern populations. The review includes studies of bone mass in past populations from different geographic regions. Nutritionally based hypotheses, traditionally used to explain bone loss in past populations, are reviewed and assessed against the current clinical and epidemiological findings. In general, the various studies have revealed different degrees of low bone mass in past populations; however, the pattern of bone loss and fragility seen in age-related and postmenopausal osteoporosis today is not evident in the past. Bone loss in earlier populations is often found in both sexes, whereas significant bone loss in females occurs often among the young-age categories. In addition, a prevalence of osteoporotic fracture is absent.

CONCLUSIONS

We suggest that, despite influences that may have reduced bone mass in past populations, a protection of bone quality may have occurred, reducing the likelihood of bone fragility and fracture typically seen in modern osteoporotics. It seems evident that, although reduced bone mass may be prevalent in past history, clinically recognized osteoporosis is not.

Synthesis and characterization of adducts of alachlor and 2-chloro-N-(2,6-diethylphenyl)acetamide with 2'-deoxyguanosine, thymidine, and their 3'-monophosphates

Adducts of the preemergence herbicide 2-chloro-N-(methoxymethyl)-N-(2,6-diethylphenyl)-acetamide (alachlor) and 2-chloro-N-(2,6-diethylphenyl)acetamide (CDEPA) with 2'-deoxyguanosine, thymidine, 2'-deoxyguanosine 3'-monophosphate, and thymidine 3'-monophosphate have been synthesized and characterized. Under mildly basic conditions alachlor and CDEPA form N-1 adducts with 2'-deoxyguanosine and N-3 adducts with thymidine as a result of chlorine displacement. In addition, alachlor formed an N-7 adduct with 2'-deoxyguanosine, 7-[[(N-(methoxymethyl)-N-(2,6-diethylphenyl)carbamoyl]methyl]guani ne. N-1 adducts of alachlor and CDEPA with 2'-deoxyguanosine 3'-monophosphate and N-3 adducts with thymidine 3'-monophosphate are also described. In addition to spectroscopic data, structural proof included the dephosphorylation of each nucleotide adduct to its corresponding nucleoside adduct by nuclease P1. Alachlor and alachlor adducts but not CDEPA and CDEPA adducts exhibited rotational isomerism as evidenced by proton and 13C NMR studies. These rotamers were attributed to hindered rotation about the shortened N-carbonyl bond. Computational methods employing molecular mechanics and quantum mechanics were used to characterize the structures and energies of these rotamers to account for the patterns of duplicate NMR resonances observed.

Morphological transformation and DNA adduct formation by dibenz[a,h]anthracene and its metabolites in C3H10T1/2CL8 cells

The major routes of metabolic activation of dibenz[a,h]-anthracene (DBA) have been studied in transformable C3H10T1/2CL8 (C3H10T1/2) mouse embryo fibroblasts in culture. The morphological transforming activities of three potential intermediates formed by metabolism of DBA by C3H10T1/2 cells, trans-3,4-dihydroxy-3,4-dihydro-DBA-(DBA-3,4-diol), trans-dihydroxy-3,4-dihydro-DBA-anti-1,2-oxide (DBA-3,4-diol-1,2-oxide) and DBA-5,6-oxide were determined. DBA-3,4-diol-1,2-oxide was a strong morphological transforming agent giving a mean of 73% dishes with Type II or III foci and 1.63 Type II and III foci per dish at 0.5 microgram/ml. DBA-3,4-diol produced a mean of 42% dishes with Type II or III foci and 0.81 Type II and III foci per dish at 2.5 micrograms/ml. DBA gave a mean of 24% dishes with Type II or III foci and 0.29 Type II and III foci per dish at 2.5 micrograms/ml. DBA-5,6-oxide was found to be inactive. DNA adducts of DBA, DBA-3,4-diol, DBA-3,4-diol-1,2-oxide, DBA-1,4/2,3-tetrol and DBA-5,6-oxide in C3H10T1/2 cells were analyzed by 32P-postlabeling method. DBA gave 11 adducts, nine of which were observed in the DNA of cells treated with DBA-3,4-diol and seven from cells treated with DBA-3,4-diol-1,2-oxide. Two of these adducts that appear in each of the treatment groups have been identified as the product of the interaction of DBA-3,4-diol-1,2-oxide with 2'-deoxyguanosine. Furthermore, there is evidence for DBA-DNA adducts in cells treated with DBA, DBA-3,4-diol and DBA-3,4-diol-1,2-oxide arising from metabolism to (+,-)-trans,trans-3,4,10,11-tetrahydroxy-3,4,10,11-tetrahydro-DBA (DBA-3,4,10,11-bis-diol). These results are based on co-migration of C3H10T1/2 DNA adducts with skin DNA adducts formed after topical treatment of mice with DBA-3,4,10,11-bis-diol. In C3H10T1/2 cells, DBA is metabolically activated through DBA-3,4-diol, which is further activated via the DBA-3,4-diol-1,2-oxide and DBA-3,4,10,11-bis-diol pathways. No evidence is provided for the metabolism of DBA by the K-region pathway.

Quantitative analysis of the metabolism of 9,10-dihydrobenzo[a]pyrene by induced rat liver microsomes

The ability of reduced polycyclic aromatic hydrocarbons to be converted to their fully aromatic forms by the microsomal cytochrome P-450 mixed-function oxidases may assist in the explanation of the mutagenic and tumorigenic activities of these agents. The metabolic conversion of 9,10-dihydrobenzo[a]pyrene (9,10-DHB[a]P) to benzo[a]pyrene (B[a]P) and 9- and/or 10-hydroxy-9,10-DHB[a]P (OH-9,10-DHB[a]P) was quantitatively measured. In beta-naphthoflavone-induced rat liver microsomes, 9,10-DHB[a]P was metabolized to B[a]P with a specific activity of 1.51 nmol B[a]P formed/min/mg microsomal protein. The formation of B[a]P was directly related to incubation time and microsomal protein concentration. Similarly, 9,10-DHB[a]P was converted to OH-9,10-DHB[a]P with a specific activity of 4.48 nmol OH-9,10-DHB[a]P formed/min/mg microsomal protein. Its formation was directly related to incubation time and microsomal protein concentration. The possibility of OH-9,10-DHB[a]P as a metabolic intermediate to B[a]P is discussed.

Reaction of cyclopenta[c,d]pyrene-3,4-epoxide with DNA and deoxynucleotides

Cyclopenta[c,d]pyrene (CPP) is a widespread polycyclic aromatic hydrocarbon with potent mutagenic and carcinogenic activity. The trans isomer of 3,4-dihydro-3,4-dihydroxy-cyclopenta[c,d]pyrene has been shown to be the major metabolic product of CPP in rat, mouse or human microsomal systems, as well as in peroxyl radical-generating systems, indicating the preferential formation of its obligatory precursor, CPP-3,4-epoxide. The direct mutagenicity of CPP-3,4-epoxide, the inactivity of 3,4-dihydro-CPP and the DNA adduct forming capacity of CPP in vivo has prompted analysis of the DNA adducts produced by CPP-3,4-epoxide to provide information pertaining to: (i) the role this postulated major ultimate mutagenic metabolite may play in the formation of DNA adducts in vivo; (ii) the base selectivity of CPP-3,4-epoxide DNA adducts; and (iii) the role of CPP-3,4-epoxide in the mutagenicity/carcinogenicity of CPP. CPP-3,4-epoxide was reacted with calf thymus DNA, dGp, dAp, dTp, dCp, poly dG-dC, poly dA-dT and poly dG. Adducts were analyzed by the butanol-enhanced version of 32P-postlabeling. Four major and at least three minor adducts formed with DNA in vitro, which were further analyzed for their base selectivity. A similar spectrum of adducts was exhibited by dGp, poly dG-dC and poly dG. dCp, dTp, and dAp formed one, two, and four adducts respectively. The relative binding in adducts per 10(7) nucleotides was in the following descending order: dGp (6000), poly dG-dC (5800), dTp (5300), dAp (4800), calf thymus DNA (3800), poly dA-dT (2300), poly dG (2600) and dCp (20). Adducts derived from either dGp, poly dG-dC or poly dG co-migrated with the DNA adducts in three solvent systems, indicating that CPP-3,4-epoxide forms DNA adducts almost exclusively with deoxyguanosine.

DNA adducts of the antitumor agent diaziquone

We have studied adduct formation of the antineoplastic agent diaziquone (AZQ; NSC 182986) with DNA and nucleotides in vitro. The aziridine moieties of AZQ can be expected to interact covalently with DNA which, in turn, presumably elicits the antitumor activity. We analyzed AZQ-DNA adducts by a modified 32P-postlabeling assay involving purification of the nuclease P1-enriched labeled adducts by high-salt C18 reversed-phase thin-layer chromatography and separation of the eluted adducts on a polyethyleneimine-cellulose layer using non-urea salt solutions. Modification of calf thymus DNA with AZQ produced two major (22% and 40%) and at least eight minor adducts. At equal concentrations of AZQ and DNA (1 micrograms/microliters each), peak binding was observed in about 2 h [1926 +/- 378 (SD) fmol/micrograms of DNA] with the binding levels remaining practically unchanged through 4 h. However, incubation for 24 h resulted in over 40% decline, indicating adduct instability. AZQ was found to be highly reactive in vitro as evidenced by its substantial binding (49 +/- 14 fmol/micrograms of DNA) even at a DNA:AZQ ratio of 100:1. When incubated with mononucleotides, AZQ reacted extensively with adenine, guanine, and cytosine but only slightly with thymine. Cochromatography of the modified DNA and nucleotides revealed that one of the major adducts and several minor adducts were guanine derived. The aziridine rings of AZQ were found to be the main reactive sites as its monoaminoalcohol derivative showed as much DNA reactivity as did the parent compound, but no activity was observed when both aziridine groups were hydrolyzed to diaminoalcohols. The improved 32P-postlabeling assay seems capable of detecting relatively polar adducts such as those formed with AZQ at a level of one adduct/10(9) nucleotides.

Synthesis of a novel fluorinated benzo[a]pyrene: 4,5-difluorobenzo[a]pyrene

The synthesis of 4,5-difluorobenzo[a]pyrene, as a fluorinated probe to investigate the involvement of the K-region in the further metabolic activation of benzo[a]pyrene metabolites, is described. Benzo[a]pyrene-4,5-dione obtained from 2,3-dichloro-5,6-dicyano-1,4-benzoquinone oxidation of cis-4,5-dihydro-4,5-dihydroxybenzo[a]pyrene was fluorinated with dimethylaminosulfur trifluoride to give 4H,5H,4,4,5,5,-tetra-fluorobenzo[a]pyrene. Defluorination using lithium aluminum hydride in tetrahydrofuran gave 4,5,-difluorobenzo[a]pyrene.

Effects of long term feeding of acetone extract of Momordica charantia (whole fruit powder) on alloxan diabetic albino rats

Acetone extract of whole fruit powder of Momordica charantia a given orally daily lowered the blood sugar and serum cholesterol levels to normal range after 15 to 30 days in alloxan diabetic rats. The blood sugar once lowered after 30 days treatment did not increase even after 15 days of discontinuation of the treatment.

Evaluation of specific immunoglobulin E by enzyme-linked immunosorbent assay in hydatid disease

The diagnostic significance of elevated hydatid-specific immunoglobulin E (IgE) as measured by enzyme-linked immunosorbent assay (ELISA) was evaluated against hydatid-specific IgG ELISA and Casoni's intradermal test in surgically proven cases of hydatidosis. A specific IgE ELISA did not correlate with IgG ELISA or Casoni's intradermal test, although its recorded sensitivity was 87%. The specific IgE ELISA was at the same time false-positive in 57.14% of the cases because of its cross-reactions with cases of ascariasis and taeniasis, unlike Casoni's intradermal test and specific IgG ELISA. It is suggested that, in a helminth-infested population, the determination of specific IgE levels is not better than Casoni's intradermal or specific IgG ELISA tests.

Comparative evaluation of enzyme-linked immunosorbent assay for the diagnosis of pulmonary echinococcosis

An enzyme-linked immunosorbent assay was done for the detection of immunoglobulin G and M (IgG and IgM) antibodies to Echinococcus granulosus in surgically proved cases of hydatidosis, especially pulmonary hydatidosis, by use of human hydatid cyst fluid antigen and soluble scolex antigen. This assay was compared with the following standardized techniques: the indirect hemagglutination test, the indirect immunofluorescent antibody test, and Casoni's intradermal test. The enzyme-linked immunosorbent assay, with either of the antigens (human hydatid cyst fluid or soluble scolex antigen), was more sensitive and specific than the other techniques in diagnosing cases of hydatidosis, especially hydatid disease of the lung.

Effect of serotonin on T lymphocyte proliferation in vitro in healthy individuals

The direct effect of different concentrations of serotonin on T lymphocyte proliferation in vitro was seen in 20 normal individuals. It has been observed that the neurotransmitter had a suppressive effect on mitogen-induced lymphocyte proliferation. This study shows that the effect of serotonin on the immune system is direct.

Childhood malignancies of the eye and orbit in northern Nigeria

One hundred four histologically proven malignant tumors of the eye and orbit in children seen in Guinness Eye Clinic, Kaduna, Nigeria between 1975 and 1982 are presented. Retinoblastoma and Burkitt's lymphoma account for the majority of the tumors. The data are compared with those from Ibadan, Nigeria. Burkitt's lymphoma occurs less frequently in Kaduna, whereas the incidence of retinoblastoma is almost the same. Chloroma, which was not seen in Ibadan, accounted for 2.9% of the current series. Factors that may be contributory to the observed differences are discussed.

Mycetoma in northern Nigeria

Fifteen cases of mycetoma were studied during a period of eight years (1976 to 1984) at Ahmadu Bello University Teaching Hospital, Zaria, Nigeria. The commonest aetiological agent seen was Nocardia; the actinomycotic mycetoma was more prevalent as compared to maduromycotic mycetoma.