Histopathological Evaluation of the Cardiotoxicity of Dihydroartemisinin-Piperaquine on Male Albino Rats

Problem Statement: Malaria’s global impact necessitates effective treatments, like dihydroartemisinin-piperaquine (DHA/PQP), though safety concerns, notably drug-induced cardiotoxicity (DICT), persist. A knowledge gap exists regarding DHA/PQP’s cardiac effects, warranting a comprehensive investigation. Approach: This study aimed to assess KROSH (DHA/PQP) impact on albino rat heart histology, examining structural changes and potential cardiotoxicity. 40 albino rats were grouped by KROSH dosage and duration, monitored for weight changes, and heart tissues were examined using hematoxylin and eosin (H & E) staining. Statistical analysis compared to control and treated groups. Results: KROSH administration led to varying rat weight effects, yet not statistically significant. Histological analysis revealed dose and duration-dependent cardiac tissue alterations, including distortion, adipose deposits, artery hypertrophy, fibrosis, and necrosis. These contrasts with prior research documenting DHA/PQP’s non-toxic effects. Conclusion/Recommendation: This study highlights potential KROSH (DHA/PQP) cardiotoxicity concerns through histological changes, underscoring the need for further research into underlying mechanisms and human health implications. Given DHA/PQP’s wide use, these findings should inform safety evaluations and administration practices.

Regional differences in incidence and mortality trends in cancers of the larynx, thyroid, oral cavity and pharynx in England and Scotland: 1975-2002

Context: There have been significant changes in the epidemiology of head and neck cancers (HNC) in the last three decades worldwide. Documenting these trends helps to facilitate cancer prevention measures and aids resource allocation. Objective: To analyse incidence and mortality trends in Head and Neck Cancers (HNC) in the UK and compare regional differences between England and Scotland. Design: Retrospective quantitative analysis of time trends of HNC cases in the UK recorded in the International Agency for Research into Cancer (IARC) CI5 database and WHO mortality database. Setting: Cancer databases with extraction of UK HNC incidence and mortality time trends. Patients: All patients with cancers of the larynx, thyroid, oral cavity and pharynx in the UK (1975-2002) recorded in the IARC and WHO databases. Main Outcome Measures: HNC incidence and mortality trends in the UK. Results: There has been an increase in incidence of oral and pharyngeal cancer in the UK especially among males with higher rates in Scotland. However mortality has increased in Scotland and reduced in England. Thyroid cancer incidence has increased in the UK especially among females with higher rates in Scotland. Mortality has reduced in both regions. Laryngeal cancer among males has increased in incidence particularly in Scotland with a decline in incidence in England. Mortality has reduced significantly in England among males but increased in Scotland. Conclusions: In the UK, Scotland has higher incidence rates of HNC compared with England. Mortality has reduced in England from all the HNC sub-sites but has increased in Scotland for laryngeal, oral & pharynxgeal cancers. Although socioeconomic deprivation and its relation to higher alcohol and tobacco consumption have been highlighted as drivers, further studies are required.

Utilization of traditional healers for treatment of malaria among female residents in Makurdi city and its environs

Objective:To ascertain the role of traditional healers in malaria treatment and its impact on control of the disease.Methods:The study was cross-sectional in nature.Test-run structured and semi-structured questionnaires were either interviewer or self administered to adult women aged 18 years old and above.House holds were selected using systematic random sampling methods.Information such as age,educational level,marital status,occupation and methods of malaria treatment were obtained.Focused group discussions about beliefs and perceptions on utilization of traditional healers and in depth discussions on treatment and control of malaria were also carried out.Results:Of the 2 075 respondents studied,49.7%(n=1 031) utilized traditional healers for treatment of malaria,including 16.7%(n=172) utilizing traditional healers strictly while 83.3%(n=859) combining it with other treatment methods such as hospital/clinic, pharmacy/chemist shop,herbs or spiritual healing.The major contributors to utilization of traditional healers were:illiteracy and ignorance,poverty,unemployment/underemployment and slow pace of the comprehensive package implementation of the "roll back malaria"(RBM) programme initiate in the community.Conclusions:Health education should be intensified while adequate facilities put in place to commence home management of malaria and probable free distribution of the artemisinin-based combination therapy(ACT).

Factors associated with mortality in neonatal surgical emergencies in a developing tertiary hospital in Nigeria

Background: The outcome of neonatal surgery depends on safe anaesthesia, competent surgery and good nursing care. The University of Uyo Teaching Hospital, Uyo, Nigeria, established in February 2008, has specialist anaesthetic and surgical manpower. The aim of the study was to determine the outcome and contributing factors to mortality in neonatal surgical emergencies at this new tertiary health institution. Method: It was a retrospective descriptive study of neonates that underwent emergency surgery at the University of Uyo Teaching Hospital between June 2008 and May 2011. Data was obtained from the anaesthetic register, ward admission and discharged register, nurses report books and patient case files. Results: Forty-five neonates were operated upon during the three year period. There were 28 males and 17 females with a male to female ratio of 1.7:1. Forty-four (97.8%) of the neonates were referred to the University of Uyo Teaching Hospital. The mean age and body weight at presentation were 47.5 ± 44.4 hours and 2.65 ± 0.61 kg respectively. The mean interval between admission and surgical intervention was 4.9 ± 6.2 days. Malformations of the gut (40%) and anterior abdominal wall (26.7%) were the major pathologies. The overall mortality following surgery was 62.2%. Case fatality rates ranged from 0% for Hirschprung’s disease to 100% for tracheoesophageal fistula. The immediate causes of death among these neonates were peritonitis from gangrenous gut, hypovolaemia and repeat surgery. Contributing factors to mortality were delivery in unorthodox health facilities, delay in presentation as well as surgical intervention and inefficient postoperative monitoring. Conclusion: Emergency neonatal surgeries at the UUTH are associated with unacceptable high mortality. Reduction in such mortality would require campaign for early presentation, a lot more timely surgical interventions and upgrading of monitoring facili- ties to help in improving perioperative monitoring and care.

Heredo-Familial Expression of Ametropia among Siblings of a Nigerian Family

A case series of 4 siblings who had auto-refraction and subjective refraction, refinement was with 0.25 Jackson Cross Cylinder. Presenting complaint was either blurring of distant vision or missing eye glasses. The eldest sibling started using eye glasses at 15 years of age while the other siblings commenced much earlier. Presenting visual acuities in 7 eyes ranged from 6/9 to 6/18, one eye of the eldest sibling had visual acuity of 6/36. Spherical errors had gender bias with the males more likely to be hypermetropic and the females more likely to be myopic. However, cylinder powers and axes were closely related in all siblings. It was concluded that heredo-familial traits could partly account for some of the striking similarities noted in the outcomes of refraction among the siblings.

Socio-cultural factors influencing insecticide treated bed net utilization in a malaria endemic city in north-central Nigeria

Objective:To ascertain the socio-cultural factors influencing the rate of utilization of insecticide treated bed nets(ITNs) in a malaria endemic city of Makurdi,north central Nigeria. Methods:The study was cross-sectional in nature using systematic sampling method to identify households.Both quantitative and qualitative data was generated from adult women using structured and semi structured questionnaires,and focused group discussions(FGDs) to obtain information on rate and patterns of utilization of ITNs.Information such as age,educational level, marital status,awareness or otherwise of the existence of malaria,and factors influencing rate of ownership and utilization of ITNs were obtained.FGDs were used to obtain qualitative information on rate of utilization of ITNs not captured in the questionnaires.Data obtained was analysed using Epi Info 6 statistical software.Results:Among the respondents interviewed,97.0% (2 013/2 075) were aware of existence of malaria and 87.0% of these(1 751/2 013) would associate it with mosquitoes.The rate of ownership of any bed net,ITNs and untreated bed nets(UTNs) was 25.1% ,17.0% and 8.3% ,respectively.Utilization of ITNs among children was 30.0% (112/373) and UTNs 12.9% (48/373).Positive contributors to ITNs utilization were literacy,enhanced economy, experience of marriage,and being gainfully employed(P【0.05);while negative contributors were ignorance,poverty and some cultural beliefs and values.Conclusions:A more synchronized advocacy should be carried out on the potential benefits of ITNs utilization and sustained.Also ITNs should be made available to the people of the community at minimal or no cost.