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Background: This study evaluates the performance of logistic regression (LR) and random forest (RF) algorithms to model obesity among female adolescents in South Africa., Methods: Data was analysed on 375 females aged 15-17 from the South African National Health and Nutrition Examination Survey 2011/2012. The primary outcome was obesity, defined as body mass index (BMI) ≥ 30 kg/m 2 . A total of 31 explanatory variables were included, ranging from socio-economic, demographic, family history, dietary and health behaviour. RF and LR models were run using imbalanced data as well as after oversampling, undersampling, and hybrid sampling of the data., Results: Using the imbalanced data, the RF model performed better with higher precision, recall, F1 score, and balanced accuracy. Balanced accuracy was highest with the hybrid data (0.618 for RF and 0.668 for LR). Using the hybrid balanced data, the RF model performed better (F1-score = 0.940 for RF vs. 0.798 for LR)., Conclusion: The model with the highest overall performance metrics was the RF model both before balancing the data and after applying hybrid balancing. Future work would benefit from using larger datasets on adolescent female obesity to assess the robustness of the models.

Background: Antibiotic resistance, an increasing challenge, is not only a national threat but also a global threat. Carriage of resistance genes is not limited to adults alone, various microbiota niches present in the body system of children have been found to harbor bacteria carrying resistant genes, especially, their gut microbiota. This study aims to identify selected antibiotic-resistant genes from the fecal samples of infants and the association of antibiotics use with the occurrence of resistant genes in the infant's gut., Methods: A total number of 172 metagenomic DNA samples previously extracted from stool samples of 28 Nigerian babies longitudinally within their first year of life were screened for the presence of ESBL genes ( bla SHV, bla TEM, and bla CTX-M), PMQR genes ( qnrA , qnrB , qnrS , qepA ), ribosomal protection protein tetracycline resistance gene, (RPP) β-lactamase ( blaZ ), macrolide ( ermA , ermB , mef A/E), aminoglycoside modifying enzymes gent R (aac(6')/aph(2″)) and dfrA genes by PCR. Nineteen (19) of the 28 babies used antibiotics during the study. The association between antibiotic use by the babies within the first year of life and occurrence of resistant genes were analyzed by Spearman rank correlation., Results: One hundred and twenty-two (122) samples (71%) out of the 172 isolates had antibiotic-resistance genes. PMQR genes were absent in all the samples. Three isolates had bla TEM gene, nine isolates had bla SHV gene, six isolates had bla CTX-M gene and 19 isolates had dfrA gene, 31 samples had tet gene, 29 samples had mef gene, 27 samples had ermB gene, four samples had ermA gene, 13 samples had blaZ gene and 16 samples had aac gene. The babies whose samples had resistant genes used antibiotics in the same months the samples were collected. Interestingly, the 11 babies whose samples had the dfr A gene all used antibiotics in the same months their samples were collected but none of them used trimethoprim/sulfamethoxazole antibiotic. The overall correlation matrix of the babies showed a strong association between antibiotic use (AU) and antibiotic use presence of resistance genes (AUPRG) with a coefficient of 0.89. Antibiotic-resistant genes are present in the gut of infants and their occurrence is strongly connected with antibiotic use by infants., Competing Interests: The authors declare that they have no competing interests., (© 2023 Fadeyi et al.)

Introduction: Periodic evaluations are an indispensable part of any training programme. This study assessed ophthalmology residency training in Nigeria from the perspective of ophthalmology trainers., Materials and Methods: This was a nationwide web-based survey of ophthalmology trainers at the 30 institutions accredited by the National Postgraduate Medical College of Nigeria from April 2021 to June 2021. Trainers were invited to complete a Google form via E-mail and WhatsApp. Data were collected on the characteristics of trainers and the training programme., Results: One hundred and fifty-eight (71.2%) out of 222 trainers responded to the survey comprising 67 (42.4%) males and 91 (57.6%) females, amongst whom were 97 (61.4%) subspecialists. The mean age (±standard deviation) was 51.47 ± 8.61 years (range, 38-75 years). Most respondents rated human resources (trainers and support staff) as 'much more' than adequate (n = 30, 19%), the volume of surgery as 'less or much less' than adequate (n = 82, 51.9%), the conduct of examinations as 'good' or better than good (n = 120, 75.9%) and impact of emigration of ophthalmologists on training as 'very negative' (n = 36, 22.8%). Overall, 94 (59.4%) respondents rated the quality of training as 'good' or better than good. Respondents recommended improving funding and training resources, revising the current conduct of examinations, increasing the use of appropriate technology and improving remunerations and national security., Conclusions: The majority of ophthalmology trainers rated ophthalmology residency training in Nigeria as 'good' but rated 'volume of surgery' as inadequate for training. Recommendations were made to improve the quality of training, revise examination practices and reduce the negative impact of emigration., Competing Interests: None

Purpose: To determine the trends in eye removal surgeries at a tertiary hospital in Nigeria over 26 years., Methods: A retrospective comparative review of clinical records of all patients who had eye removal surgery at a tertiary hospital in Ile-Ife, Nigeria, between 2014 and 2019 was done. Patients' demographic and clinical data, including indication for eye removal and type of surgery were analysed and compared with two earlier studies at the same hospital between 1994 and 2013., Results: There was an average of 14.3 surgeries per year between 2014 and 2019. Patients' ages ranged from 2 to 102 years, M:F was 1.5:1, the commonest indication for eye removal was infection (n=30, 34.9%), and the most common surgery was evisceration (n=70, 81.4%). Studies from 1994 to 2003 and 2005 to 2013, reported an average of 9.2 and 10 surgeries per year; ages ranging from 4 days to 88 years and 3 months to 88 years; with a M:F of 2.1:1 and 3.4:1 respectively. In both studies, the commonest indication for eye removal was trauma (43.4% and 43.8% respectively) and the most common surgery was enucleation (57.6% and 55% respectively). Trend data showed a progressive increase in eye infections (12% vs 15% vs 34.9%) and eviscerations (19.6% vs 31.2% vs 81.4%) over time., Conclusion: There was a change in trend towards an increase in eviscerations and infective indications for eye removal at the hospital over three decades. Prompt and optimal treatment of orbito-ocular infections is recommended to reduce the incidence of eye removal surgeries., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2022 by West African Journal of Medicine.)

Purpose: To describe the epidemiology and management of oculoplastic disorders at a tertiary hospital in Nigeria., Methods: This was a retrospective review of patients with oculoplastic disorders at the Department of Ophthalmology, Obafemi Awolowo University Teaching Hospitals Complex, IleIfe, Nigeria from January 2013 to December 2016. The general ophthalmology service records were reviewed to identify patients with oculoplastic disorders. Data retrieved from patient records included date of initial visit, age at presentation, gender, oculoplastic diagnosis and aetiology, modality of treatment given, and indications for patient referrals., Results: There were 563 (7.4%) patients with oculoplastic disorders, out of 7,575 ophthalmology department patients. They had 573 oculoplastic disorders in all. There were 281 (49.9%) males and 282 (50.1%) females. The median age at presentation was 28 years (range, 1 day to 100 years). Eyelid laceration (n=68; 11.9%) and chalazion (n=63; 11%) were the commonest disorders. Trauma (n=125; 21.8%) was the commonest aetiology, followed by inflammatory (n=121; 21.1%) and infective (n=108; 18.8%) causes. There were 162 (28.3%) surgical interventions; eyelid repair (n=67; 41.4%) was the commonest, followed by evisceration (n=25; 15.4%), and excisional biopsy (n=25; 15.4%). No patient had ptosis or lacrimal surgery. Orbital disorders (n=21; 42.9%) were the commonest indication for a referral elsewhere., Conclusion: Eyelid laceration was the commonest oculoplastic disorder, trauma was the commonest aetiology, and eyelid repair was the commonest oculoplastic surgery done. Further training in oculoplastics with emphasis on ptosis, lacrimal and orbital surgery, as well as the provision of equipment needed for optimal oculoplastic service delivery are recommended., Competing Interests: The Authors declare that no competing interest exists., (Copyright © 2022 by West African Journal of Medicine.)

Purpose: To describe the pattern of quantitative parasympathetic cardiovascular autonomic function among patients with normal-tension glaucoma (NTG) and high-tension primary open-angle glaucoma (HTG) patients., Methodology: This was cross-sectional study of ninety-two subjects enrolled into three groups: HTG (31 patients), NTG (31 patients) and Control (30 patients). All the participants had anthropometric assessment, ophthalmic examination, baseline cardiovascular examination and the three parasympathetic components of Ewing's battery of autonomic cardiovascular function tests namely heart rate (HR) response to deep breathing, HR response to Valsalva manoeuvre and HR response to standing., Result: The baseline PR intervals were significantly prolonged in HTG (0.18 ± 0.03 s) and NTG (0.18 ± 0.04 s) groups compared with control (0.15 ± 0.03 s) (p = 0.008). The HTG group had a significantly longer mean RR interval (1.09 ± 0.17 s) than the NTG group (1.03 ± 0.20 s) and control (0.97 ± 0.17 s) during the expiratory phase of the HR response to deep breathing test (p = 0.037). The HTG group also had significantly longer mean RR intervals around the 15th beat (p = 0.033) and 30th beats (p = 0.202) post-standing during the HR response to standing test. The HR response to Valsalva manoeuvre test showed a significantly higher mean Valsalva ratio in the NTG group (1.65 ± 0.48) compared to the HTG group (1.45 ± 0.31) and control (1.43 ± 0.25) (p = 0.034)., Conclusion: This study demonstrated that normal-tension and high-tension primary open-angle glaucoma have higher parasympathetic cardiovascular activity than normal individuals., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Aim: The aim of this article was to obtain measurements of the eyeballs/globes and lacrimal glands in normal subjects using cranial computed tomography (CT) scan. Understanding the normative approximations of these measurements could help in diagnosing and evaluating orbito-ocular pathologies., Materials and Methods: This retrospective study examined 220 globes/eyeballs and 220 lacrimal glands of 110 consecutive participants. The eyeball volume was calculated using both the ellipsoid and spherical formulas, whereas lacrimal gland volume was approximated using the ellipsoid formula only., Results: The mean age of the subjects was 51.18 ± 14.85 years and ranged from 22 to 85 years. The study population was 53.6% male ( n = 59) and 46.3% female ( n = 51). The mean volumes of all globes in this study were 5.82 ± 0.77 and 5.98 ± 0.75 cm3 using the ellipsoid and spherical formulae, respectively. The mean volume of all lacrimal glands was 0.42 ± 0.14 cm3 using the ellipsoid formula. The mean globe volumes using the ellipsoid and spherical formulae (6.02 ± 0.84 and 6.02 ± 0.84 cm3) in males were significantly larger than the corresponding mean globe volumes in females (5.59 ± 0.62 and 5.80 ± 0.65 cm3) ( P < 0.0001 and P = 0.001, respectively). There was no significant difference between the lacrimal gland volumes of males (0.42 ± 0.14 cm3) and females (0.42 ± 0.14 cm3) ( P = 0.84)., Conclusion: Males have larger eyeball/globe volumes than females. Eyeball and lacrimal gland volumes did not correlate significantly. Eyeball volume showed an inverse relationship with age. Age did not affect lacrimal gland volume., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Journal of the West African College of Surgeons.)

Objective: The objective of this study was to evaluate the thyroid glands' radiation dose and the risk of thyroid cancer induction from head or neck computed tomography (CT) examinations., Methods: In a prospective study, we evaluated all participants of all ages and sex referred for Head or Neck CT Scan at the University College Hospital, Ibadan and Me Cure Healthcare Limited, Ibadan, Oyo State, Nigeria. Thyroid radiation dose was estimated with impact scan calculator, and real-time dose measurement with thermoluminescent badge dosimeters (TLDs). Data were analysed and P < 0.05 was considered statistically significant., Results: One hundred and sixty-three participants (128 adults and 35 children) participated in the study. In most participants (74%), the tube voltage was 120 kVp. The estimated median thyroid gland dose by the imPACT scan calculator was 4.95 mGy (range = 1.20-30.0 mGy) and 4.40 mGy (range = 3.0-5.10 mGy), while the real-time dose measured by the TLD was 4.79 mGy (range = 1.73-96.7 mGy) and 2.33 mGy (range = 1.20-3.73 mGy) at Centre A and B, respectively. The estimated median thyroid cancer risk was 2.88 × 10 -6 (maximum range of 52 × 10 -6 ) at centre A and a median value of 3.20 × 10 -6 with a cancer risk estimate that may reach 17.9 × 10 -6 recorded at centre B, compared to a cumulative thyroid cancer risk of 0.12 × 10 -5 among the general Nigerian population., Conclusions: Scanner specifications and technique may significantly contribute to variations seen in thyroid radiation doses. There may be a need to optimise centre protocols and apply dose reference levels for head and neck CT examinations to reduce thyroid cancer risk in Nigeria., Competing Interests: None

Background: With Nigeria being one of the countries with the highest neonatal mortality rate globally, identifying the risk factors associated with neonatal mortality is essential as we strive to proffer sustainable solutions., Aim: This retrospective hospital-based survey aimed to bridge this gap by evaluating the trends and risk factors associated with neonatal mortality in a teaching hospital in Southwestern Nigeria., Methods: Records of newborns admitted at the special care baby unit from January 2018 to December 2019 (n = 1098) were accessed, and available data were extracted. Descriptive analysis and inferential statistics were performed at 0.05 level of significance., Results: The mortality rate was determined to be 16.9% (inborn babies- 12.9% and out-born babies- 22.3%), with 83.3% of the newborns dying within the first week. Some of the factors associated with neonatal mortality were proximity of newborns' mothers home to the hospital [p = 0.041; Odds Ratio (OR) = 0.670; 95% Confidence Interval (CI) = 0.455-0.985], maturity of the baby at delivery (p < 0.001; OR = 0.514; CI = 0.358-0.738), place of delivery-inborn or out-born (p < 0.001; OR = 0.515; CI = 0.375-0.709), place of delivery-in a hospital or a non-hospital setting (p = 0.048; OR = 0.633; CI = 0.401-0.999), and baby's weight (p < 0.001; CI = -0.684 to -0.411)., Conclusion: Findings from the study indicate that newborns delivered at home, traditional birth attendant centres or hospitals without essential healthcare facilities have a higher mortality risk. This suggests that measures to improve the accessibility of pregnant women to essential healthcare services are a prerequisite to reducing the neonatal mortality rate in Nigeria., (© The Author(s) [2021]. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.)

Background/objectives: Brazil, Russia, India China and South Africa have prioritized cooperation regarding health, including malnutrition. Anaemia in children, adolescents and women of reproductive age has been on the increase in these countries, placing a huge strain on healthcare systems. This study aimed to map the scientific perspective and research publications on anaemia in children and adolescents in the BRICS countries., Methods: Bibliometric analyses were employed to map scientific publications related to anaemia in children and adolescents in BRICS countries using VOSviewer software. Research documents from 1990 to 2020 were imported from PubMed. Descriptive statistics was used to analyse trends in research publications, authorship and keywords over the 30-year period., Findings: BRICS countries accounted for 15% of all publications on the subject within the last three decades. While India had the highest number of publications, China had the author with the highest number of research publications and co-authorship links. Of all article types, India had the highest number of letters, while China and South Africa published the highest number of RCT/clinical trial and review articles, respectively., Conclusion: The review of all scientific studies on anaemia in BRICS nations for the past 30 years revealed gaps in research collaborations on anaemia between authors in BRICS nations. However, collaborative research projects may contribute to building a shared base of evidence, innovations, data and methodologies for a more comprehensive understanding of the risks and vulnerabilities of child and adolescent anaemia. This will aid in the development and evaluation of interventions and policies to alleviate anaemia and nutrient deficiencies.

Purpose: To assess morphological optic disc dimensions using spectral-domain optical coherence tomography (OCT) in a Nigerian population., Materials and Method: Good quality SD-OCT scans of the optic disc of 147 eyes of 88 participants were selected, enrolled, and retrospectively reviewed. All subjects had optic nerve head and retinal nerve fibre layer OCT imaging, as well as analysis, done using the Topcon 3D OCT-1 Maestro ® . The age, sex, and some OCT-generated optic disc dimensions namely disc area (DA), vertical disc diameter (VDD), horizontal disc diameter (HDD) were retrieved from the database and analyzed., Results: The mean age of the study subjects was 52.6±20.9 years with a range of 8-90 years; male to female ratio was 1:1.3. The right eye and left eye accounted for 75 and 72 of the 147 scans respectively. The mean DA, VDD, and HDD were 2.54 ± 0.48 mm 2 , 1926.5 ± 189.6 μm and 1673.9 ± 173.9 μm, respectively. Males had significantly larger DA than females (2.56 ± 0.53 mm 2 vs 2.51 ± 0.44 mm 2 , p  = 0.043). The mean DA and VDD of eyes of subjects aged 21-40 years were significantly higher compared to subjects aged 60 years and more ( p  = 0.008 and 0.001, respectively)., Conclusion: The mean optic disc area and diameters are larger than those reported in similar studies involving blacks and other races. The mean disc area reduces with increasing age.

Background: Automobile spray painters in Nigeria are exposed to organic solvents due to the hazardous nature of their work. Inadequate use of personal protective equipment (PPE) may intensify exposure to high levels of chemical hazards with resultant health problems., Objectives: The present study assessed PPE use and work practices and compared work-related health problems of spray painters and controls in Ile-Ife, Nigeria., Methods: A cross-sectional study was conducted among 120 spray painters and 120 controls (electronic technicians). Data on socio-demographics, work practices, knowledge about organic solvent-related hazards and self-reported health symptoms were obtained using a semi-structured questionnaire. Clinical examinations were performed for all respondents and the composition of organic solvents in paints and paint products were derived from material safety data sheets., Results: All respondents were male, and the mean age was 32.7±13.8 years for painters and 33.9±15.5 years for controls. Few (7.5%) painters perceived their use of PPE to be adequate. All spray painters worked in enclosed workshops and N-butyl acetate was the most commonly used organic solvent. Spray painters reported excessive tear production, recurrent cough, and short-term memory loss more frequently than controls (P<0.05). In addition, 89% of painters noticed paint-stained sputum immediately after spray painting. The prevalence ratio of respiratory symptoms was higher in spray painters than controls (prevalence ratio=21.0, CI=2.9-153.6). On clinical examination, more spray painters had corneal opacity and dry skin when compared with controls (P<0.05)., Conclusions: Spray painters in the study area worked amidst chemical hazards and had poor use of PPE. Exposure to organic solvents may be responsible for the higher prevalence of self-reported health problems among spray painters. Interventions to enforce the use of PPE and improve the knowledge of organic solvent-related hazards among spray painters are essential., Participant Consent: Obtained., Ethics Approval: Ethical approval to conduct the study was obtained from the Health Research and Ethics Committee of the Institute of Public Health, Obafemi Awolowo University, Ile-Ife Nigeria (HREC No: IPHOAU/12/463)., Competing Interests: The authors declare no competing financial interests., (© Pure Earth 2020.)

Corona virus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first detected in the city of Wuhan, China in December 2019. Although, the disease appeared in Africa later than other regions, it has now spread to virtually all countries on the continent. We provide early spatio-temporal dynamics of COVID-19 within the first 62 days of the disease's appearance on the African continent. We used a two-parameter hurdle Poisson model to simultaneously analyse the zero counts and the frequency of occurrence. We investigate the effects of important healthcare capacities including hospital beds and number of medical doctors in different countries. The results show that cases of the pandemic vary geographically across Africa with notably high incidence in neighbouring countries particularly in West and North Africa. The burden of the disease (per 100 000) mostly impacted Djibouti, Tunisia, Morocco and Algeria. Temporally, during the first 4 weeks, the burden was highest in Senegal, Egypt and Mauritania, but by mid-April it shifted to Somalia, Chad, Guinea, Tanzania, Gabon, Sudan and Zimbabwe. Currently, Namibia, Angola, South Sudan, Burundi and Uganda have the least burden. These findings could be useful in guiding epidemiological interventions and the allocation of scarce resources based on heterogeneity of the disease patterns.

Objective: The objective of this study is to determine the burden of visual impairment and blindness from vitreoretinal diseases in the retina unit of a Nigerian tertiary hospital., Methodology: A prospective, cross-sectional study on all consecutive new patients presenting with vitreoretinal diseases (VRD) at the vitreoretinal (VR) clinic at Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife from May 2011 to April 2014. Patient's bio-data, presenting complains, Snellen's or tumbling E-chart visual acuity unaided, slit-lamp examination of the vitreous and fundus with +90/+78D, binocular indirect ophthalmoscopy as well as slit-lamp examination of anterior segment, and applanation tonometry findings were recorded in predesigned pro forma. Visual acuity was categorized using WHO/ICD. The data were analyzed using the SPSS software version 16 for simple frequencies and presented., Results: Of 2025 eyes reviewed, 112 (49.8%) eyes were visually impaired and 67 (29.8%) were blind. Eight (5.2%) patients were bilaterally blind. Diabetic retinopathy was the most common cause of bilateral blindness (25%), and concurrently, the most common VRD (29.8%). All categories of visual loss were more prevalent among the aged ≥65 years. More males (62.2%) were blind from VRD. Cataract was the most common ocular comorbidity seen (43.6%)., Conclusion: The burden of visual impairment and blindness from VRD is large; eye health education for early presentation for eye care as well as the development of VR care with infrastructure upscale to include optical coherence tomography, laser, and surgical care for prompt diagnosis and treatment will be of benefit in reducing the burden., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Nigerian Medical Journal.)

Purpose: The purpose of this study was to describe the prevalence and pattern of ocular surface disease (OSD) in glaucoma patients using preserved topical antiglaucoma medications in a Nigerian population., Methodology: A comparative study of patients who had used topical preserved antiglaucoma medications for 6 months or more with age- and sex-matched individuals who were not on any other form of topical eye medication was carried out using fluorescein tear breakup time (FTBUT), Schirmer I test, and ocular surface staining with fluorescein and lissamine green. The right eyes of 103 eligible patients with primary open-angle glaucoma and that of 103 age- and sex-matched individuals (controls) were included in the study., Results: The prevalence of OSD among users of preserved topical antiglaucoma medications was significantly higher than among nonusers as assessed by FTBUT (83.5% vs. 57.3%;P < 0.001), Schirmer I (30.1% vs. 17.5%; P = 0.033), and ocular surface staining (62.1% vs. 31.1%;P < 0.001). Users of preserved topical antiglaucoma medications also had worse grades of OSD evaluated by FTBUT ( P = 0.001), Schirmer I ( P = 0.023), and ocular surface staining ( P < 0.001)., Conclusion: The prevalence of subjective OSD was significantly higher among users of topical antiglaucoma medications than nonusers. Hence, preserved topical medication use is a serious concern for increased ocular surface morbidity among glaucoma patients. This calls for more attention to be paid to the consequences of OSD among glaucoma patients on topical medications., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Nigerian Medical Journal.)

Introduction: intraocular pressure changes have been reported following the various cataract surgical technique. This study aims to compare the intra-ocular pressure (IOP) variation following conventional extra-capsular cataract extraction (ECCE), manual small incision cataract surgery (MSICS) and phacoemulsification in an indigenous black population., Methods: a comparative cross-sectional study of adult patients aged 40 years and above who had pressure was measured with Goldman's applanation tonometer pre-operatively and 1 st day, 1 st week, 1 st month as well as 3 rd month post-operative periods and recorded. Data was analyzed using SPSS version 21. Mean IOP changes between study groups were compared using ANOVA. P-value of < 0.05 was taken as statistically significant., Results: total of 82 patients consisting of 20(24.4%) ECCE, 32(39%) MSICS and 30(36.6%) phacoemulsification with mean preoperative 13.4mmHg, 13.5mmHg and 14.1 mmHg (p = 0.657) respectively was studied. Mean IOP increased from baseline at 1st day post-operative period in the ECCE and MSICS groups (13.4 ± 3.0mmHg to 13.7 ± 4.5mmHg (p = 0.84) and 13.5 ± 3.1mmHg to 15.3 ± 5.1mmHg (P = 0.48) respectively), and decrease in the phacoemulsification group (14.1 ± 2.6mmHg to 13.9 ± 3.5mmHg (p = 0.378). There was a decline in IOP in all the 3 study groups by one week post-operative period; the difference was significant only in the ECCE group (p = 0.032). By 3 rd month postoperatively, there was a reduction in mean IOP when compared with pre-operative IOP the difference being greatest in the ECCE group., Conclusion: ECCE, MSICS, and Phacoemulsification cause a decline in IOP below preoperative levels at 3 rd month postoperatively in the MSICS group., Competing Interests: The authors declare no competing interests., (© Oluwatoyin Helen Onakpoya et al.)

Context: Albinism is an inherited disorder of hypopigmentation involving the skin, eyes, and hair. This disorder results in the absence or reduction in melanin production. There are two main types of albinism which are ocular albinism and oculocutaneous albinism. It could also be classified as syndromic or nonsyndromic the melanin, which protects from the harmful effect of ultraviolet radiation of the sun on the normal skin, is deficient in the albino, predisposing them more, to cutaneous malignancies., Aim: This study is to highlight the epidemiology of cutaneous cancers in albinos in sub-urban Nigeria., Methodology: This is a retrospective review of all albinos with histological diagnoses of cutaneous malignancies that presented to Irrua Specialist Teaching Hospital, Irrua Edo State, Nigeria between September 2010 and August 2016. The following details were extracted from the patients' case-notes, operation register, and the histopathology register. These data include age, gender, site of the lesion, the diagnosis, no of lesions excised, and duration of the lesion (s). These were collated and analyzed using SPSS version 22., Results: There were 22 albinos with histopathologically diagnosed cutaneous malignancies. There were 11 males and 11 females with male:female of 1. The age range is from 25 to 55 years with the mean of 34.68., Conclusion: Albinism is one of the most common causes of cutaneous malignancies, and majority of them present with locally advanced lesions that will need excision biopsy resulting in disfigurement. This problem can be prevented in many cases with proper community education, support, and free health care. There is also need for them to present early whenever they noticed any skin changes., Competing Interests: There are no conflicts of interest.

Background and Objectives: Pneumoperitoneum during laparoscopy can produce changes in intraocular pressure (IOP) that may be influenced by several factors. In this study, we investigated changes in IOP during laparoscopy with different positioning., Methods: We recruited adult patients without eye disease scheduled to undergo laparoscopic operation requiring a reverse Trendelenburg tilt (rTr; group A; n = 20) or Trendelenburg tilt (Tr; Group B; n = 20). IOP was measured at 7 time points (T1-T7). All procedures were performed with standardized anaesthetic protocol. Mean arterial pressure (MAP), heart rate (HR), peak and plateau airway pressure, and end-tidal carbon dioxide (ETCO 2 ) measurements were taken at each time point., Results: Both groups were similar in age, sex, mean body mass index (BMI), duration of surgery, and preoperative IOP. A decrease in IOP was observed in both groups after induction of anaesthesia (T2), whereas induction of pneumoperitoneum produced a mild increase in IOP (T3) in both groups. The Trendelenburg tilt produced IOP elevations in 80% of patients compared to 45% after the reverse Trendelenburg tilt ( P = .012). A significant IOP increase of 5 mm Hg or more was recorded in 3 (15%) patients in the Trendelenburg tilt group and in none in the reverse Trendelenburg group. At T7, IOP had returned to preoperative levels in all but 3 (15%) in the Trendelenburg and 1 (5%) in the reverse Trendelenburg group. Reversible changes were observed in the MAP, HR, ETCO 2 , and airway pressures in both groups., Conclusions: IOP changes induced by laparoscopy are realigned after evacuation of pneumoperitoneum. A Trendelenburg tilt however produced significant changes that may require careful patient monitoring during laparoscopic procedures.

We present a retrospective cohort study on the outcome of patients with foraminal disc herniations (FDH) treated with partial pars resections using minimally invasive surgery (MIS) through a tube. FDH present a challenge due to the more lateral trajectory needed for their excision and thereby more muscle dissection and possibly facet resection. Forty patients, 19 women and 21 men with a mean age ± standard deviation of 58 ± 12 years, underwent MIS for FDH. Data on length of hospital stay, body mass index and outcomes were collected prospectively and reviewed retrospectively. Average length of stay following surgery was 1 ± 1 days. There was one wound infection and four unsatisfactory results. Using the Macnab score, good to excellent results were achieved in 89% of the patients. Based on these results, MIS surgery with partial pars resection is an attractive option in the treatment of FDH with low morbidity and short hospital stays., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Several different enteric viruses have been identified as the causes of gastrointestinal infections in poultry. Enteric virus infections are well characterized in poults, but limited studies have been conducted in older birds. The susceptibility of 2-, 7-, 12-, 30-, and 52-wk-old turkeys to turkey coronavirus (TCoV) and turkey astrovirus (TAstV) was evaluated, as well as the effect of combined infection of TAstV and TCoV in 2-wk-old poults and turkey hens. From cloacal swabs and intestines, TCoV was consistently detected by reverse transcriptase-PCR throughout the experimental period (1-21 days postinoculation [DPI]) from all age groups. In contrast, the last detection point of TAstV gradually decreased to 21, 16, and 12 DPI in birds inoculated at 2, 7, and 12 wk of age, respectively, and viral RNA was rarely detected from cloacal swabs or intestinal contents in turkey hens within 3 DPI. Infection with TAstV alone did not affect body weight in poults or egg production in hens. The combined infection of TAstV and TCoV did not induce more severe clinical signs and pathology than the TCoV infection alone. However, a severe prolonged decrease in egg production (about 50%) was observed in turkey hens in the combined infection group compared with a transient egg production drop in the TCoV-infected hens alone. The underlying mechanism regarding the age-related TAstV susceptibility and the pathogenesis of the TAstV and TCoV coinfection in layer hens needs to be further elucidated.

Object: Spinal deformity in pediatric patients with intramedullary spinal cord tumors (IMSCTs) may be either due to neurogenic disability or due to secondary effects of spinal decompression. It is associated with functional decline and impairment in health-related quality-of-life measures. The authors sought to identify the long-term incidence of spinal deformity in individuals who had undergone surgery for IMSCTs as pediatric patients and the risk factors and overall outcomes in this population., Methods: Treatment records for pediatric patients (age < 21 years) who underwent surgical treatment for histology-proven primary IMSCTs between 1975 and 2010 were reviewed. All patients were evaluated in consultation with the pediatric orthopedics service. Clinical records were reviewed for baseline and follow-up imaging studies, surgical fusion treatment, and long-term skeletal and disease outcomes., Results: The authors identified 55 patients (30 males and 25 females) who were treated for pediatric IMSCTs between January 1975 and January 2010. The mean duration of follow-up (± SEM) was 11.4 ± 1.3 years (median 9.3 years, range 0.2-37.2 years). Preoperative skeletal deformity was diagnosed in 11 (20%) of the 55 patients, and new-onset postoperative deformity was noted in 9 (16%). Conservative management with observation or external bracing was sufficient in 8 (40%) of these 20 cases. Surgical fusion was necessary in 11 (55%). Posterior surgical fusion was sufficient in 6 (55%) of these 11 cases, while combined anterior and posterior fusion was undertaken in 5 (45%). Univariate and multivariate analysis of clinical and surgical treatment variables indicated that preoperative kyphoscoliosis (p = 0.0032) and laminectomy/laminoplasty at more than 4 levels (p = 0.05) were independently associated with development of spinal deformity that necessitated surgical fusion. Functional scores and 10-year disease survival outcomes were similar between the 2 groups., Conclusions: Long-term follow-up is essential to monitor for delayed development of spinal deformity, and regular surveillance imaging is recommended for patients with underlying deformity. The authors' extended follow-up highlights the risk factors associated with development of spinal deformity in patients treated for pediatric IMSCTs. Surgical fusion allows patients who develop progressive deformity to achieve long-term functional and survival outcomes comparable to those of patients who do not develop progressive deformity.

Object: Radical resection is recommended as the first-line treatment for pediatric intramedullary spinal cord tumors (IMSCTs), but it is associated with morbidity, including risk of neurological decline and development of postoperative spinal deformity. The authors report long-term data on clinical and treatment determinants affecting disease survival and neurological outcomes., Methods: Case records for pediatric patients (< 21 years of age at presentation) who underwent surgery for IMSCTs at the authors' institution between January 1975 and January 2010 were analyzed. The patients' demographic and clinical characteristics (including baseline neurological condition), the treatment they received, and their disease course were reviewed. Long-term disease survival and functional outcome measures were analyzed., Results: A total of 55 patients (30 male and 25 female) were identified. The mean duration of follow-up (± SEM) was 11.4 ± 1.3 years (median 9.3 years, range 0.2-37.2 years). Astrocytomas were the most common tumor subtype (29 tumors [53%]). Gross-total resection (GTR) was achieved in 21 (38%) of the 55 patients. At the most recent follow-up, 30 patients (55%) showed neurological improvement, 17 (31%) showed neurological decline, and 8 (15%) remained neurologically stable. Patients presenting with McCormick Grade I were more likely to show functional improvement by final follow-up (p = 0.01) than patients who presented with Grades II-V. Kaplan-Meier actuarial tumor progression-free survival rates at 5, 10, and 20 years were 61%, 54%, and 44%, respectively; the overall survival rates were 85% at 5 years, 74% at 10 years, and 64% at 20 years. On multivariate analysis, GTR (p = 0.04) and tumor histological grade (p = 0.02) were predictive of long-term survival; GTR was also associated with improved 5-year progression-free survival (p = 0.01)., Conclusions: The prognosis for pediatric IMSCTs is favorable with sustained functional improvement expected in a significant proportion of patients on long-term follow-up. Long-term survival at 10 years (75%) and 20 years (64%) is associated with aggressive resection. Gross-total resection was also associated with improved 5-year progression-free survival (86%). Hence, the treatment benefits of GTR are sustained on extended follow-up.

We discuss the successful saving of a male neonate with necrotizing fasciitis of the chest following a hot fomentation of the umbilicus with exposure of the ribs and the pleural space on the right side. He recovered 5 weeks after admission. We stressed the need to recognize necrotizing fasciitis extending from the upper anterior abdominal wall to the chest following hot fomentation of the umbilicus. The need for multidisciplinary cooperation for excellent outcome is very important, that is, neonatologist, medical microbiologist, and plastic and chest surgeons.

Turkey coronavirus (TCoV) infection causes enteritis in turkeys of varying ages with high mortality in young birds. In older birds, field evidence indicates the possible involvement of TCoV in egg-production drops in turkey hens. However, no experimental studies have been conducted to demonstrate TCoV pathogenesis in turkey hens and its effect on reproductive performance. In the present study, we assessed the possible effect of TCoV on the reproductive performance of experimentally infected turkey hens. In two separate trials, 29- to 30-wk-old turkey hens in peak egg production were either mock-infected or inoculated orally with TCoV (Indiana strain). Cloacal swabs and intestinal and reproductive tissues were collected and standard reverse-transcription PCR was conducted to detect TCoV RNA. In the cloacal swabs, TCoV was detected consistently at 3, 5, 7, and 12 days postinoculation (DPI) with higher rates of detection after 5 DPI (> 90%). All intestinal samples were also positive for TCoV at 7 DPI, and microscopic lesions consisting of severe enteritis with villous atrophy were observed in the duodenum and jejunum of TCoV-infected hens. In one of the trials TCoV was detected from the oviduct of two birds at 7 DPI; however, no or mild microscopic lesions were present. In both experimental trials an average of 28%-29% drop in egg production was observed in TCoV-infected turkey hens between 4 and 7 DPI. In a separate trial we also confirmed that TCoV can efficiently transmit from infected to contact control hens. Our results show that TCoV infection can affect the reproductive performance in turkey hens, causing a transient drop in egg production. This drop in egg production most likely occurred as consequence of the severe enteritis produced by the TCoV. However, the potential replication of TCoV in the oviduct and its effect on pathogenesis should be considered and further investigated.

Since the first reported isolation of swine influenza viruses (SIVs) in turkeys in the 1980s, transmission of SIVs to turkeys was frequently documented. Recently, the 2009 pandemic H1N1 virus, that was thought to be of swine origin, was detected in turkeys with a severe drop in egg production. In this study, we assessed the infectivity of different mammalian influenza viruses including swine, pandemic H1N1 and seasonal human influenza viruses in both juvenile and layer turkeys. In addition, we investigated the potential influenza virus dissemination in the semen of experimentally infected turkey toms. Results showed that all mammalian origin influenza viruses tested can infect turkeys. SIVs were detected in respiratory and digestive tracts of both juvenile and layer turkeys. Variations in replication efficiencies among SIVs were observed especially in the reproductive tract of layer turkeys. Compared to SIVs, limited replication of seasonal human H1N1 and no detectable replication of recent human-like swine H1N2, pandemic H1N1 and seasonal human H3N2 viruses was noticed. All birds seroconverted to all tested viruses regardless of their replication level. In turkey toms, we were able to detect swine H3N2 virus in semen and reproductive tract of infected toms by real-time RT-PCR although virus isolation was not successful. These data suggest that turkey hens could be affected by diverse influenza strains especially SIVs. Moreover, the differences in the replication efficiency we demonstrated among SIVs and between SIV and human influenza viruses in layer turkeys suggest a possible use of turkeys as an animal model to study host tropism and pathogenesis of influenza viruses. Our results also indicate a potential risk of venereal transmission of influenza viruses in turkeys., (Copyright © 2012 Elsevier B.V. All rights reserved.)

Introduction: Congenital cleft lip and palate (CLP) defects usually present in childhood, especially in places with available and affordable care. In Nigeria, their incidence is low but late presentation in Adult life have been reported. This article aims at reviewing adolescent and adult CLP patients in our center, with the advent of free and available care, and to document the patterns and management outcomes of these patients as an addition to existing literature on the subject of adult CLP., Materials and Methods: A retrospective review of adolescent and adult CLP patients managed from May 2006 to April 2010. Demographic data as well as clinical information were retrieved from the hospital records and include the type of cleft deformity, surgical intervention prior to presentation, the type of surgery performed and postoperative outcomes. Some pertinent clinical photos were also reviewed., Results: Adolescent and adults constituted 24% of the 137 patients, their age ranged from 13 to 76 years, with a mean, median and modal age of 28, 22 and 20 years respectively. Unilateral cleft of primary palate was commonest with female preponderance. Most never had surgery, others desired revision surgery or secondary procedures. The outcomes were satisfactory in the 37 procedures performed on 33 patients., Conclusion: A relatively high ratio of adolescent and adult clefts is observed. Most of them have never had surgical intervention. Some had failed surgical intervention prior to presentation. Satisfactory outcomes were achieved despite late intervention but failed initial intervention was associated with poorer outcomes.

Purpose: We hypothesized that the Model for End-Stage Liver Disease (MELD) score at admission to the intensive care unit (ICU) can predict in-hospital mortality for patients with liver cirrhosis. We also tested the MELD-natremia (Na) score and compared the predictive value of the 2 models., Materials and Methods: This is a retrospective cohort study. A total of 441 consecutive patients with liver cirrhosis admitted to the ICU were included. The MELD and MELD-Na scores and other variables were obtained upon patients' admission to the ICU., Results: The area under the receiver operating characteristic curve to predict in-hospital mortality was 0.77 (95% confidence interval, 0.73-0.82) for the MELD score and 0.77 (95% confidence interval, 0.73-0.81) for the MELD-Na score., Conclusion: The MELD scoring system provides useful prognostic information for critically ill patients with liver cirrhosis admitted to an ICU. The MELD and MELD-Na scores had similar predictive value., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objective: This study tests the hypothesis that injury to the somatosensory cortex is associated with periorbital allodynia and increases in nociceptive neuropeptides in the brainstem in a mouse model of controlled cortical impact (CCI) injury., Methods: Male C57BL/6 mice received either CCI or craniotomy-only followed by weekly periorbital von Frey (mechanical) sensory testing for up to 28 days post-injury. Mice receiving an incision only and naïve mice were included as control groups. Changes in calcitonin gene-related peptide (CGRP) and substance P (SP) within the brainstem were determined using enzyme-linked immunosorbent assay and immunohistochemistry, respectively. Activation of ionized calcium-binding adaptor molecule-1-labeled macrophages/microglia and glial fibrillary acidic protein (GFAP)-positive astrocytes were evaluated using immunohistochemistry because of their potential involvement in nociceptor sensitization., Results: Incision-only control mice showed no changes from baseline periorbital von Frey mechanical thresholds. CCI significantly reduced mean periorbital von Frey thresholds (periorbital allodynia) compared with baseline and craniotomy-only at each endpoint, analysis of variance P < .0001. Craniotomy significantly reduced periorbital threshold at 14 days but not 7, 21, or 28 days compared with baseline threshold, P < .01. CCI significantly increased SP immunoreactivity in the brainstem at 7 and 14 days but not 28 days compared with craniotomy-only and controls, P < .001. CGRP levels in brainstem tissues were significantly increased in CCI groups compared with controls (incision-only and naïve mice) or craniotomy-only mice at each endpoint examined, P < .0001. There was a significant correlation between CGRP and periorbital allodynia (P < .0001, r = -0.65) but not for SP (r = 0.20). CCI significantly increased the number of macrophage/microglia in the injured cortex at each endpoint up to 28 days, although cell numbers declined over weeks post-injury, P < .001. GFAP(+) immunoreactivity was significantly increased at 7 but not 14 or 28 days after CCI, P < .001. Craniotomy resulted in transient periorbital allodynia accompanied by transient increases in SP, CGRP, and GFAP immunoreactivity compared with control mice. There was no increase in the number of macrophage/microglia cells compared with controls after craniotomy., Conclusion: Injury to the somatosensory cortex results in persistent periorbital allodynia and increases in brainstem nociceptive neuropeptides. Findings suggest that persistent allodynia and increased neuropeptides are maintained by mechanisms other than activation of macrophage/microglia or astrocyte in the injured somatosensory cortex., (© 2012 American Headache Society.)

Gastric duplications are uncommon developmental abnormality reported to present with different clinical scenarios. We present a 2-1/2-year-old Nigerian female who started having intermittent massive lower gastrointestinal haemorrhage at 5 months of age. She subsequently developed a lower chest wall mass and enterocutaneous fistula. She was found to have gastric duplication with fistulous communication with the descending colon, spleen, and lower chest wall. To the best of our knowledge, this is the first paper on gastric duplication resulting in intermittent massive lower gastrointestinal bleeding mainly from splenic capsular erosion and fistula and enterocutaneous fistula resulting from erosion of anterior abdominal wall. Gastric duplication is hence an important rare cause of intermittent massive lower gastrointestinal haemorrhage and spontaneous enterocutaneous fistula in the paediatric population.

Object: Factors determining choice of an academic career in neurological surgery are unclear. This study seeks to evaluate the graduates of medical schools and US residency programs to determine those programs that produce a high number of graduates remaining within academic programs and the contribution of these graduates to academic neurosurgery as determined by h-index valuation., Methods: Biographical information from current faculty members of all accredited neurosurgery training programs in the US with departmental websites was obtained. Any individual who did not have an American Board of Neurological Surgery certificate (or was not board eligible) was excluded. The variables collected included medical school attended, residency program completed, and current academic rank. For each faculty member, Web of Science and Scopus h-indices were also collected., Results: Ninety-seven academic neurosurgery departments with 986 faculty members were analyzed. All data regarding training program and medical school education were compiled and analyzed by center from which each faculty member graduated. The 20 medical schools and neurosurgical residency training programs producing the greatest number of graduates remaining in academic practice, and the respective individuals' h-indices, are reported. Medical school graduates of the Columbia University College of Physicians and Surgeons chose to enter academics the most frequently. The neurosurgery training program at the University of Pittsburgh produced the highest number of academic neurosurgeons in this sample., Conclusions: The use of quantitative measures to evaluate the academic productivity of medical school and residency graduates may provide objective measurements by which the subjective influence of training experiences on choice of an academic career may be inferred. The top 3 residency training programs were responsible for 10% of all academic neurosurgeons. The influence of medical school and residency experiences on choice of an academic career may be significant.

Background: The incidence of subarachnoid hemorrhage is increasing, especially in the elderly as life expectancy increases. Aggressive treatment of aneurysms in the elderly is usually avoided because of a presumed poor prognosis., Objective: The aim of this study was to assess the outcome of treatment in patients older than 70 years old., Methods: We performed a retrospective chart review of 150 patients aged 70 years and older who were treated at Jefferson Hospital from 2004 to 2009. Data including World Federation of Neurological Surgeons grade and Hunt and Hess classification, specific management components, and treatment outcome on discharge were analyzed., Results: One hundred ten patients had aneurysms coiled, 9 patients had aneurysms clipped, 11 patients had aneurysms that were not treated, and 20 patients had no visible aneurysms. Overall, increased World Federation of Neurological Surgeons grades correlated strongly with poor clinical outcome. Statistical tests indicate that patients who died (mean, 78.8, n=35) or who went into rehabilitation (mean, 76.5, n=81) were significantly older than patients who were discharged home (mean, 73.1, n=20). However, day of presentation after initial symptom(s) of subarachnoid hemorrhage and placement of ventriculoperitoneal shunt also influenced clinical outcome. Patients who had a ventriculoperitoneal shunt were more likely to go into rehabilitation than patients who did not, and patients without a ventriculoperitoneal shunt were more likely to die., Conclusion: Older age should not preclude a patient from aneurysm treatment. Factors such as low Hunt and Hess or World Federation of Neurological Surgeons grades, earlier presentation to the hospital after initial symptoms, early shunting, prompt interventions, and tailored postoperative management can result in favorable clinical outcomes.

Background: Spinal fusion is the most rapidly increasing type of lumbar spine surgery for various lumbar degenerative pathologies. The surgical treatment of lumbar spine degenerative disc disease may involve decompression, stabilization, or arthroplasty procedures. Lumbar disc athroplasty is a recent technological advance in the field of lumbar surgery. This study seeks to determine the clinical impact of anterior lumbar disc replacement on the surgical treatment of lumbar spine degenerative pathology. This is a retrospective assessment of the Nationwide Inpatient Sample (NIS)., Methods: The NIS was searched for ICD-9 codes for lumbar and lumbosacral fusion (81.06), anterior lumbar interbody fusion (81.07), and posterolateral lumbar fusion (81.08), as well as for procedure codes for revision fusion surgery in the lumbar and lumbosacral spine (81.36, 81.37, and 81.38). To assess lumbar arthroplasty, procedure codes for the insertion or replacement of lumbar artificial discs (84.60, 84.65, and 84.68) were queried. Results were assayed from 2000 through 2008, the last year with available data. Analysis was done using the lme4 package in the R programming language for statistical computing., Results: A total of nearly 300,000 lumbar spine fusion procedures were reported in the NIS database from 2000 to 2008; assuming a representative cross-section of the US health care market, this models approximately 1.5 million procedures performed over this time period. In 2005, the first year of its widespread use, there were 911 lumbar arthroplasty procedures performed, representing 3% of posterolateral fusions performed in this year. Since introduction, the number of lumbar spine arthroplasty procedures has consistently declined, to 653 total procedures recorded in the NIS in 2008. From 2005 to 2008, lumbar arthroplasties comprised approximately 2% of lumbar posterolateral fusions. Arthroplasty patients were younger than posterior lumbar fusion patients (42.8 ± 11.5 vs. 55.9 ± 15.1 years, P < 0.0000001). The distribution of arthroplasty procedures was even between academic and private urban facilities (48.5% and 48.9%, respectively). While rates of posterolateral lumbar spine fusion steadily grew during the period (OR 1.06, 95% CI: 1.05-1.06, P < 0.0000001), rates of revision surgery and anterior spinal fusion remained static., Conclusions: The impact of lumbar arthroplasty procedures has been minimal. Measured as a percentage of more common lumbar posterior arthrodesis procedures, lumbar arthroplasty comprises only approximately 2% of lumbar spine surgeries performed in the United States. Over the first 4 years following the Food and Drug Administration (FDA) approval, the frequency of lumbar disc arthroplasty has decreased while the number of all lumbar spinal fusions has increased.

Iron is deposited in perihematomal tissue after an intracerebral hemorrhage (ICH), and may contribute to oxidative injury. Cell culture studies have demonstrated that enhancing ferritin expression by targeting iron regulatory protein (IRP) binding activity reduces cellular vulnerability to iron and hemoglobin. In order to assess the therapeutic potential of this approach after striatal ICH, the effect of IRP1 or IRP2 gene knockout on ferritin expression and injury was quantified. Striatal ferritin in IRP1 knockout mice was similar to that in wild-type controls 3 days after stereotactic injection of artificial CSF or autologous blood. Corresponding levels in IRP2 knockouts were increased by 11-fold and 8.4-fold, respectively, compared with wild-type. Protein carbonylation, a sensitive marker of hemoglobin neurotoxicity, was increased by 2.4-fold in blood-injected wild-type striata, was not altered by IRP1 knockout, but was reduced by approximately 60% by IRP2 knockout. Perihematomal cell viability in wild-type mice, assessed by MTT assay, was approximately half of that in contralateral striata at 3 days, and was significantly increased in IRP2 knockouts but not in IRP1 knockouts. Protection was also observed when hemorrhage was induced by collagenase injection. These results suggest that IRP2 binding activity reduces ferritin expression in the striatum after ICH, preventing an optimal response to elevated local iron concentrations. IRP2 binding activity may be a novel therapeutic target after hemorrhagic CNS injuries., ((c) 2010 Elsevier B.V. All rights reserved.)

Hemoglobin breakdown produces an iron-dependent neuronal injury after experimental CNS hemorrhage that may be attenuated by heme oxygenase (HO) inhibitors. The HO enzymes are phosphoproteins that are activated by phosphorylation in vitro. While testing the effect of kinase inhibitors in cortical cell cultures, we observed that HO activity was consistently decreased by the MEK inhibitor U0126. The present study tested the hypothesis that MEK/ERK pathway inhibitors reduce HO activity and neuronal vulnerability to hemoglobin. The MEK inhibitors U0126 and SL327 and the ERK inhibitor FR180204 reduced baseline culture HO activity by 35-50%, without altering the activity of recombinant HO-1 or HO-2; negative control compounds U0124 and FR180289 had no effect. Hemoglobin exposure for 16h produced widespread neuronal injury, manifested by release of 59.2+/-7.8% of neuronal lactate dehydrogenase and a twelve-fold increase in malondialdehyde; kinase inhibitors were highly protective. HO-1 induction after hemoglobin treatment was also decreased by U0126, SL327, and FR180204. These results suggest that reduction in HO activity may contribute to the protective effect of MEK and ERK inhibitors against heme-mediated neuronal injury.

Background & Objectives: Olfactory cues play an important role in the attraction of major disease vectors towards their host. Hence we intend to investigate the contribution of selected parts of the human host on the behavioural biting preference of Culex quinquefasciatus., Methods: Two volunteers were trained to collect host seeking female mosquitoes landing to feed on different parts of the lower limbs. The Cx. quinquefasciatus were collected in paper cups with the aid of a flash-light and aspirator. Each paper cup was labeled to represent the selected parts where the mosquitoes were collected., Results: The composition of Cx. quinquefasciatus from the total mosquitoes collected showed that Cx. quinquefasciatus was more predominant (90%) over other species present. The average minimum and maximum atmospheric temperature recorded during the night catches were 27 and 29.5 degrees C while the average relative humidity range was 78-81.6%. The behavioural biting preference results obtained showed that the density of Cx. quinquefasciatus mosquitoes preferring the foot region (298) was significantly higher (p > 0.05) when compared with other different parts of the human host such as the ankle, calf and the thigh., Interpretation & Conclusion: The study indicates that the foot region of the human host has a stronger influence in orientating mosquitoes towards the human host. Hence, the exploitation of the characteristic human odour will add to the existing vector control strategies.