Musculoskeletal Disorders: Epidemiology and Treatment Seeking Behavior of Secondary School Students in a Nigerian Community

Background:Epidemiological information paucity exists on musculoskeletal disorders (MSD) among secondary school students in Nigeria. We aimed to determine the prevalence, pattern, and treatment seeking behaviors (TSB) of MSD in Southwest, Nigeria.Results:A total of 133 students had 204 MSD representing a 3.0% prevalence among the 4,441students screened. Eighty-one (60.9%) students had congenital disorders and 52 (39.1%) were acquired. The lower limbs (93.1%) were most commonly affected and 87 (65.4%) students presented with a knee deformity. Other abnormalities were limb length discrepancy 6.8%, scoliosis 4.4%, Pes planus 3.9%, and poliomyelitis 2.9%. A total of 100 students (75.2%) had no form of treatment, 18.8% receive treatment in the hospital, 3.7% received treatment in a traditional healing home and 2.3% received treatment in a church. Age, family, and school type were significant factors (P<0.05) in health-seeking behavior. The factors affecting treatment outcome were the place of treatment, hospital specific treatment, and reasons for stopping treatment.Conclusion:Treatable cases constitute a large proportion of MSD among secondary school students, but TSB was generally poor. Parental socio-economic and health services factors were related to the health-seeking behavior. Strengthening of school health services and improved linkage with orthopedic services, community education on MSD, and education of all cadres of health professionals are recommended.     

Pattern of rhabdomyosarcoma in Nigerian children

BACKGROUND: Soft-tissue sarcomas are uncommon tumors that are infrequently seen in most surgical practices. They represent 6.5% of all cancers in children < 15 years of age and are the fifth leading cause of cancer death in that age group. This study was conducted to show the prevalence and pattern of distribution of rhabdomyosarcoma among children in a black African population. METHODS: We retrospectively reviewed 232 cases of soft-tissue sarcomas that were managed for a period of 22 years (1985-2006). Materials were obtained from the clinical records, operation notes and histopathology reports of the patients. The records of patients with rhabdomyosarcoma were analyzed in details. RESULTS: The result showed the age peak incidence for the total soft-tissue sarcomas occurring between the third and sixth decades of life. Rhabdomyosarcoma constitutes 9.5% of the total number of patients managed, and 54.5% of these patients are age < 20 years. CONCLUSION: We conclude that parents must be educated about the need to look out for any mass on their children that persists for > 4 weeks so as to reduce the delayed and advanced stage of presentation.     

Pelvic adhesion formation at second-look surgery after laparoscopic partial and total peritoneal excision for women with endometriosis

The purpose of this study was to determine the incidence of pelvic adhesion formation at second-look surgery after laparoscopic excision of the pelvic peritoneum for pelvic endometriosis. The setting was a district hospital in the UK with a specialised unit for laparoscopic surgical treatment of endometriosis; this was a retrospective study. We used data from the hospital computer database to identify patients who had undergone laparoscopic excision of pelvic endometriosis from April 1998 to March 2004. All subsequent admissions for surgery (laparoscopic or open) were reviewed for the presence of pelvic adhesions as documented in the records and collaborated with photographs from surgery. Forty-eight cases were identified from a cohort of 236 patients who initially had laparoscopic excision of pelvic peritoneum affected with endometriosis. Forty-six had laparoscopic surgery and two had open surgery. At second look surgery, 44 patients (91.7%) had no de-novo pelvic adhesions in the areas where the initial excision was performed. Four patients (8.3%) had filmy adhesions in the pelvis; these patients had other surgical procedures (two had LAVH) or on-going disease (one with recto-vaginal endometriosis nodule and the other with ovarian endometrioma at initial surgery). There were no dense or significant pelvic adhesions. Laparoscopic excision of the pelvic peritoneum as a treatment for pelvic peritoneal endometriosis is not associated with significant pelvic adhesion formation.     

Prevention of garlic-induced hemolytic anemia using some tropical green leafy vegetables

Garlic (Allium sativum) is popularly consumed in Nigeria because of its health benefit in treatment and management of several disease conditions. However, excessive intake of garlic may cause hemolytic anemia. This project sought to investigate the ability of some commonly consumed tropical green leafy vegetables-namely, Amaranthus cruentus, Baselia alba, Solanum macrocarpon, Ocimum gratissimum, and Corchorus olitorius-to prevent garlic-induced hemolytic anemia. Wister strain albino rats were fed diet containing 4% garlic with or without 40% vegetable supplement. The study showed that there was a decrease in daily feed intake (6.7-7.2 g/rat/day), daily weight gain (0.7-1.5 g/rat/day), and digestibility (70.4-91.5%) of rats fed diet with garlic (4%), with or without vegetable (40%) supplement, compared with those rats fed the basal diet without garlic (4%) and vegetable (40%) supplement (digestibility, 95.5%; daily feed intake, 7.5 g/rat/day; and daily weight gain, 2.0 g/rat/day). However, there was a significant decrease (P < .05) in the packed cell volume (PCV) (31.0%), hemoglobin (Hb) (10.2 g/dL), red blood cells (RBCs) (4.3 x 10(6)/microL), and white blood cells (WBCs) (3.5 x 10(6)/microL) of rats fed diet with garlic (4%) but without vegetable compared with those rats fed diet without garlic (4%) and vegetable (40%) supplements (PCV, 38.2%; Hb, 13.0 g/dL; RBCs, 5.5 x 10(6)/microL; and WBCs, 4.0 x 10(6)/microL). Conversely, there was a significant increase in the PCV (33.5-35.6%), Hb (12.0-12.5 g/dL), and RBCs (4.9-5.3 x 10(6)/microL) of rats fed diet with garlic (4%) and vegetable (40%) supplement compared with rats fed diet with 4% garlic supplement (except S. macrocarpon and C. olitorius). Furthermore, there was a significant decrease (P < .05) in mean corpuscular volume (69.2-72.0 fL) of rats fed the basal and those fed diet with garlic and vegetable (except C. olitorus and S. macrocarpon) supplement compared with the rats fed diet with garlic but without vegetable supplement (74.5 fL). This therefore implies that garlic could induce hemolytic anemia in rats. However, such anemia could be prevented by some tropical green leafy vegetables such as A. cruentus, B. alba, and O. gratissimum.     

Coagulants modulate the antioxidant properties & hypocholesterolemic effect of tofu (curdled soymilk)

The recent increase in Soymilk and tofu (coagulated soymilk) consumption especially in Western Country is due to the recognition of the health benefits of soy foods; consumption of soybean would prevent heart diseases. In Nigeria Calcium salt, alum and steep water from pap production are usually used as coagulant in tofu production. The effect of those coagulants on the antioxidant properties of tofu and serum cholesterol, high-density lipoproteins (HDL) and low-density lipoproteins (LDL) level of albino rats fed tofu for 14 days is been assessed. The result of the study revealed that there was no significant difference (P > 0.05) in the tofu yield (17.6-18.3%), however steep water coagulated tofu had a significantly higher (P < 0.05) total phenol (12.0 g/kg) content, reducing power (0.6 OD700) and DPPH free radical scavenging ability (69.1%) than tofu produced using other coagulants. Furthermore, feeding albino rats with tofu and water ad libitum for 14 days caused a significant decrease (P < 0.05) in the serum cholesterol and low-density lipoproteins when compared with the control, while there was no significant difference (P > 0.05) in the average daily feed intake of the rats. Conversely, there was a significant increase (P < 0.05) in the serum high-density lipoproteins when compared with the control. However, rats fed steep water coagulated tofu had the lowest serum level of cholesterol and LDL level followed by those fed CaCl2 and alum coagulated tofu respectively, while those fed with calcium chloride coagulated tofu had the highest serum HDL level, and closely followed by those fed steep water coagulated tofu. It was therefore concluded that of all the coagulant, steep water appeared to be the most promising coagulant with regard to the production of tofu with higher antioxidant and hypocholesterolemic effect.     

Soft-tissue sarcoma in black Africans: pattern, distribution and management dilemma

BACKGROUND: Soft-tissue sarcomas (STS) are a heterogeneous group of rare tumors that arise predominantly from the embryonic mesoderm. Currently, >70 different histologic types of STS have been identified. There is no identifiable etiology in most cases of STS even though a variety of predisposing or associated factors have been identified. The American Cancer Society estimated that approximately 8,680 new cases were expected to be diagnosed, and 3,660 deaths in the United States were a result of STS in 2004. This study shows the pattern, distribution and problems of STS in a black African population. METHODS: We retrospectively reviewed 209 patients that were managed for STS between the periods of January 1985 to December 2004. Materials for the study were obtained from the case notes as well as the histopathology reports of the patients. RESULTS: Two-hundred-nine patients were treated for STS during the 20-year study period. The peak incidence of age occurred between the third and sixth decades of life with a slightly male preponderance. Fibrosarcoma was the commonest STS, followed by malignant fibrous histocytoma, liposarcoma and rhabdomyosarcoma. Fibrosarcoma, malignant fibrous histocytoma and liposarcoma are more common in the extremities while leiomyosarcoma is more common in the intra-abdominal region. CONCLUSION: The treatment of STS is a multidisciplinary approach, and patients have benefited from multimodality treatment. In the western countries, STS most commonly present as asymptomatic masses with tumors in the distal extremities, often small in size when discovered. In our own environment, delayed and advanced stages of the disease are the rule. Modern imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRIJ and magnetic resonance angiography (MRA) are not commonly available-and where they are available, they are usually not affordable for the majority of our patients. We need to establish good interdisciplinary relationships among the managing physicians and educate our patients on early presentation to the hospital.     

Co‐administration of caffeine and caffeic acid alters some key enzymes linked with reproductive function in male rats

This study assessed the effects of caffeine combined with caffeic acid on some biomarkers of male reproductive function using normal albino Wistar rats. Rats were divided into four groups (n = 6) and treated for seven successive days; group 1 represents the control rats; group 2 rats were treated with 50 mg/kg body weight (BW) of caffeine only; group 3 rats were treated with 50 mg/kg BW of caffeic acid, while the rats in group 4 were cotreated with an equal combination of caffeine and caffeic acid. The results revealed significant increase in reproductive hormone, testicular and epididymal nitric oxide levels of the rats. Moreover, decreased oxidative stress in the testes and epididymides of the treated rats was evidenced by significant increase in total and nonprotein thiol levels, catalase and superoxide dismutase activities. Similarly, decreased testicular cholesterol level with concomitant elevation in testicular steroidogenic enzyme activities, glycogen and zinc levels were observed in the treated rats. No morphological changes were observed as revealed by the photomicrographs from light microscopy in treated rats. Nevertheless, the combination therapy exhibited additive/synergistic effect on these biochemical indices than when they were administered singly. This study suggests the combination therapy of caffeine and caffeic acid at the dose tested for improving male reproductive function.     

Leucocyte migration and nitroblue tetrazolium assay in Nigerian children with bacteremia and malaria parasitemia

The prevalence of malaria parasitemia, bacteremia, certain hematological parameters, leucocyte migration index and nitroblue tetrazolium dye reduction were determined in 147 Nigerian children (4.24+/-2.88 years of age). Sixty (40.8%), 28(19.1%) and 26(17.7%) had malaria parasitemia only, bacteremia only and both malaria parasitemia and bacteremia, respectively. Four genera of bacteria, i.e E. coli, Proteus, Staphylococcus and Salmonella, were detected in subjects with both malaria parasitemia and bacteremia. The 4 bacterial genera and Klebsiella were detected in subjects with bacterial infection only. P. falciparum (68%), P. malariae (25%) and P. ovale (7%) were the species of malaria parasites identified in our subjects. Bacteremia was most prevalent in subjects with hemoglobin AA (HbAA) (60.7%) followed by HbAC (21.45%). Packed cell volume (PCV) and Hb concentration were similar in all groups but mean counts of red blood cells (RBC) and white blood cells (WBC) were statistically significantly lower in subjects with malaria parasites only compared to the controls. Leucocyte migration was significantly reduced in children with bacteremia only or both malaria parasitemia and bacteremia compared to controls, while the nitroblue tetrazolium assay was significantly reduced in children with bacteremia only. It may be concluded that malaria parasitemia significantly affects both leucocyte migration and nitroblue tetrazolium assay.     

Cyperus esculentus L. and Tetracarpidium conophorum Müll. Arg. Supplemented Diet Improved Testosterone Levels,Modulated Ectonucleotidases and Adenosine Deaminase Activities in Platelets from L-NAME-Stressed Rats

In hypertensive individuals, platelet morphology and function have been discovered to be altered, and this has been linked to the development of vascular disease, including erectile dysfunction (ED). The impact of nutritional supplementation with Cyperus esculentus (tiger nut, TN) and Tetracarpidium conophorum (walnut, WN) on androgen levels, ectonucleotidases, and adenosine deaminase (ADA) activities in platelets from L-NAME (Nω-nitro-L-arginine methyl ester hydrochloride) challenged rats were investigated. We hypothesized that these nuts may show a protective effect on platelets aggregation and possibly enhance the sex hormones, thereby reverting vasoconstriction. Wistar rats (male; 250–300 g; n = 10) were grouped into seven groups as follows: basal diet control group (I); basal diet/L-NAME/Viagra (5 mg/kg/day) as positive control group (II); ED-induced group (basal diet/L-NAME) (III); diet supplemented processed TN (20%)/L-NAME (IV); diet supplemented raw TN (20%)/L-NAME (V); diet supplemented processed WN (20%)/L-NAME (VI); and diet supplemented raw WN (20%)/L-NAME (VII). The rats were given their regular diet for 2 weeks prior to actually receiving L-NAME (40 mg/kg/day) for ten days to induce hypertension. Platelet androgen levels, ectonucleotidases, and ADA were all measured. L-NAME considerably lowers testosterone levels (54.5 ± 2.2; p < 0.05). Supplementing the TN and WN diets revealed improved testosterone levels as compared to the control (306.7 ± 5.7), but luteinizing hormone levels remained unchanged. Compared to control groups, the L-NAME-treated group showed a rise in ATP (127.5%) hydrolysis and ADA (116.7%) activity, and also a decrease in ADP (76%) and AMP (45%) hydrolysis. Both TN and WN supplemented diets resulted in substantial (p < 0.05) reversal effects. Enhanced testosterone levels and modulation of the purinergic system in platelets by TN and WN could be one of the mechanisms by which they aid in vasoconstriction control.     

Tetracarpidium conophorum Müll. Arg modulates sexual behaviour and biochemical parameters relevant to sexual function in male Wistar rats

Walnut (Tetracarpidium conophorum Müll. Arg) has been reported to be an essential ingredient in folklore medicine for sexual enhancement with little scientific validation. Hence, this study investigated the effects of walnut supplemented diet on sexual behaviour and biochemical parameters relevant to erection in male Wistar rats. Forty animals used in this study were divided into five groups (n?=?8); Group 1 – normal control rats fed with basal diet, Group II – rats fed diet supplemented with 10% processed walnut, Group III – rats fed diet supplemented with 10% raw walnut, Group IV – rats fed diet supplemented with 20% processed walnut and Group V – rats fed diet supplemented with 20% raw walnut. Behavioural studies (copulation tendency and anxiety) associated with sexual function, measurement of nitric oxide (NO) levels, adenosine deaminase (ADA), arginase and acetylcholinesterase (AChE) activities in the Corpus cavernosum as well as characterization of bioactive components of the nut were evaluated. Marked reductions in ADA and arginase activities and a concomitant increase (% inclusion dependent) in the level of NO as well as enhanced sexual behaviours were observed in rat fed supplemented walnut when compared to the control. Furthermore, analysis of the walnut using high performance liquid chromatography indicated the presence of some polyphenols. From our findings, it showed that walnut improves sexual behaviour and modulates activities of key enzymes relevant to erection in male rats which may justify its used in traditional medicine.