Search

Objective To explore the gaps in the safe handling, administration, preparation and disposal of chemotherapy agents in low and middle-income countries.Design Two surveys comprising a needs assessment survey and an American Cancer Society (ACS) ChemoSafe Facility Assessment.Setting 2019 African Research Group for Oncology Symposium in South-West Nigeria (needs assessment) and the 2021 virtual engagement (ChemoSafe Assessment).Participants Health professionals (n=50 of 98) from multiple institutions across Nigeria (needs assessment survey) and a designated task force of health professionals (n=10) from one teaching hospital in Southwest Nigeria(ChemoSafe Facility Assessment).Results In 2019, 75% of survey respondents (n=50) reported a lack of training resources for safe handling of chemotherapy. Additionally, 61% felt dissatisfaction with assessment practices for preparing and administering chemotherapy. ChemoSafe is a programme developed by the ACS to assess the ability of a facility to handle hazardous drugs. The 2021 ACS ChemoSafe survey administered at one teaching hospital indicated several areas for improvement to promote concordance with international standards for safe handling. Thirty-three (19.5%) items received a ‘Yes’ response (ie, met compliance with international standards).Conclusion There is a need for the implementation of training resources for handling, administering and disposing of chemotherapy at sites across Nigeria. Strategies to identify and prioritise areas of need must be implemented in the context of available resources.

Abstract Objectives Transcranial Doppler imaging (TCDI) of the cerebral arteries is the method of choice to predict patients with sickle cell disease (SCD) at risk for stroke. This study reports TCDI follow‐up of cerebral blood flow in a cohort of Kuwaiti children with SCD after a 10‐year interval. Methods Twenty‐one pediatric patients with SCD, aged 16.0 ± 1.6 years were initially studied when they were aged 6.5 ± 1.2 years. TCDI scanning was carried out using a phased‐array transducer of 1–3 MHz through the trans‐temporal window. Peak systolic velocity (PSV), end‐diastolic velocity (EDV), time‐averaged mean of the maximum velocity (TAMMV), resistive index (RI), and pulsatility index (PI) were obtained in the anterior and posterior Circle of Willis vessels. Results The follow‐up indices were mostly lower than in the initial study although they remained within the normal range in all the arteries. TAMMV was less than 170 cm/s, and PSV did not exceed 200 cm/s in all vessels. The initial and follow‐up TAMMV (mean ± SD) were: 77.3 ± 20.9 and 71.6 ± 9.9 in the terminal internal carotid artery, 94.3 ± 25.8 and 82 ± 18.2 in the middle cerebral artery, 76.6 ± 25.6 and 70.6 ± 10.7 in the anterior cerebral artery, and 59.1 ± 15.8 and 63.9 ± 8.5 in the posterior cerebral artery, respectively. The mean differences between the old and follow‐up data for RI, and PI were statistically significant (p

Background: Breast cancer is a global burden and has become a major public health concern. Early diagnosis through screening is the best way to achieve cure, reduce morbidity and mortality from breast cancer. Many of the women in this environment have little or no knowledge about breast cancer and the attitude and orientation of health-care professional are important determinants of the use of breast screening program. Aim: The aim of the study was to evaluate the knowledge and practice of breast cancer screening among female nurses in the Bida, Niger state. Materials and Methods: This study was a cross-sectional conducted among female nurses in Federal Medical Centre, Bida, between May and August 2021. The questionnaire contained 20 questions on the knowledge of breast cancer. Each correct answer had a score of 1 and 0 for an incorrect answer or “don't know.” The overall score was calculated for each respondent by summing up the symptom and risk score. It was graded as 0–9 = Poor and 10–20 = Good. Data collected were analyzed by computer analysis using the SPSS version 25. Results: A total of 150 female nurses participated in the study with mean age of 41.7 ± 8.1 years. Overall assessment of the respondent's knowledge of breast cancer revealed that 112 (74.7%) of them had good knowledge and 38 (25.3%) had poor knowledge. Only 59 (38.3%) practice breast self-examination monthly. Concerning clinical breast examination, 22 (14.7%) of them have had their breast examined before by a health professional while 12 (8%) of the participants had done mammography before. Conclusion: Our findings highlight that the knowledge of breast cancer among female nurses was good but it has not really translated into practices of the preventive measures for early detection of breast cancer.

Abstract Atypical teratoid rhabdoid tumor (ATRT) is an aggressive embryonal brain tumor among infants and young children. Two challenges exist for preclinical testing in ATRT. First, genetically quiet, ATRT is a difficult tumor to target molecularly. Tumor cells need to divide to propagate tumor growth—intercepting the common crossroads in cell cycle progression is a feasible strategy. KIF11 is needed for bipolar spindle formation in metaphase. We identified KIF11 as a universal target of all ATRT-molecular-subtypes. Ispinesib, a KIF11-inhibitor, effectively inhibited tumor proliferation in all seven cell lines. A second challenge—a major challenge in preclinical drug testing in-vivo among aggressive tumor models, is the narrow therapeutic window to administer drugs within the limited murine lifespan. Our most aggressive ATRT tumor model was lethal in all mice within ~ 1 month of tumor implantation. Such short-surviving mouse models are difficult to employ for preclinical drug testing due to the narrow time window to administer drugs. To overcome this time restriction, we developed a clinical staging system which allowed physically-fit mice to continue treatment, in contrast to the conventional method of fixed drug-dose-duration regimen in preclinical testing which will not be feasible in such short-surviving mouse models. We validated this approach in a second embryonal brain tumor, medulloblastoma. This is a clinically relevant, cost-efficient approach in preclinical testing for cancer and non-cancer disease phenotypes. Widely used preclinical mouse models are not the most accurate and lack the aggressive tumor spectrum found within a single tumor type. Mice bearing the most aggressive tumor spectrum progress rapidly in the limited murine life-span, resulting in a narrow therapeutic window to administer drugs, and are thus difficult to employ in preclinical testing. Our approach overcomes this challenge. We discovered ispinesib is efficacious against two embryonal brain tumor types.

Abstract Moyamoya is a progressive cerebrovascular disease associated with stenosis or occlusion of the arteries of the Circle of Willis. It is uncommon in thalassemia. We present a 9‐year‐old girl with HbEβ‐thalassemia who presented with headache, vomiting, and episodes of transient hemiparesis with complete occlusion internal carotid arteries.

Background: Haemorrhoids are common anorectal conditions seen in surgical practice, with various treatment modalities. This study compared the short-term outcome of injection sclerotherapy with 50% dextrose in water and rubber band ligation in the management of second-and third-degree haemorrhoids, in terms of symptoms improvement, complications, recurrence rate, retreatment rate and acceptability. Methodology: This was a prospective comparative study that was carried out in the endoscopic unit of the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, in southwestern Nigeria. Sixty consecutive patients with second- and third-degree haemorrhoids, who consented, were recruited into the study and were randomised into two groups. Group A had endoscopic injection sclerotherapy and Group B had endoscopic rubber band ligation. Results: With regard to anal protrusion, more patients consistently reported either complete (16 [64.4%]) or partial (9 [40.9%]) resolution of symptoms in Group B, compared to Group A which had 7 (28.0%) and 5 (22.7%) cases, respectively (P = 0.03). Resolution of anal bleeding was initially more in Group B than A (22 [95.7%] vs. 17 [77.3%] patients, respectively), in the first 24-h post-treatment; however, within the 1st week, this ratio was reversed (P = 0.07). The retreatment rate for Group A and B was 23.3% and 13.3%, respectively,P = 0.34. More patients in Group B experienced severe pain post-treatment compared to Group A (P = 0.01). Three-month post-treatment, two (11.8%) patients in Group A and one (4.5%) in Group B had recurrence of anal bleeding (P = 0.42). There was no recurrence in anal protrusion in both treatment groups. Conclusion: Endoscopic rubber band ligation had a significantly higher success rate than endoscopic injection sclerotherapy, in terms of resolution of anal protrusion, but with higher pain score.

Objective: Sickle cell disease (SCD) is a haemoglobinopathy that causes several clinical complications. Unripe Carica papaya has been shown to possess antisickling activity that could reduce these complications. This study aimed to examine the presence of antisickling and sickling-reversal activities of aqueous extracts and ethyl acetate fractions of C. papaya fruit at different stages of ripening. Methods: Unripe, partly ripe, and fully ripe fruits were quantitatively screened for some phytochemicals using standard methods. Blood samples from sickle cell patients were used to investigate antisickling and sickling reversal activities of aqueous extracts and ethyl acetate fractions of the fruits. Data were analysed using one-way ANOVA. The p-value was set at 0.05. Results: Phytochemicals such as alkaloids, saponins, tannins, flavonoids and polyphenols were found in varying concentrations in C. papaya fruit at the different stages of ripening. All extracts and fractions showed antisickling and sickling-reversal activities with the ethyl acetate fraction of partly ripe C. papaya being most effective. Conclusion: The study showed that C. papaya fruit at different stages of ripening contains antisickling and sickling-reversal activities which may help reduce the associated complications of SCD when consumed by affected individuals.