bluuebunny/crossref_metadata_2025 huggingface dataset:
Community Eye Care Outreaches Through Collaborations with Community-based Organisations in Resource-poor Settings in Ilorin, Nigeria
Authors: Adepoju Feyi Grace , Olokoba Bukola Latefaf , Olatunji Victoria Ayodeji , Obajolowo Tokunbo Sarah , Bolarinwa Tota , Yusuf Ibrahim Abiodun
Published: September 2023

Background:

The access to universal eye health is still poor in many developing countries. There are various initiatives to address this problem, but the initiatives are majorly under the support of external funding. This study reports community outreaches supported by community-based organisations over a 7-year period in resource-poor settings in Ilorin, Kwara State, Nigeria.

Aims and Objectives:

This study aims to describe the processes/procedures, output, and funding of eye care services provided in the rural communities over a 7-year period. The study seeks to present the process, demographical profiles, disease pattern, challenges, and recommendation in finding the core area of development to improving eye care services for these communities as well. The setting of this research work is 65 rural communities around the Ilorin metropolis of Kwara State, Nigeria. The design of the study is a retrospective review.

Materials and Methods:

This is a descriptive study of 7-year community eye outreaches in Ilorin, Nigeria. Data were analysed with IBM-Statistical Package for Social Sciences (SPSS-20).

Results:

A total of 65 communities with 235 visits were carried out between the years 2013 and 2019, with a total of 13,661 persons screened. The major eye diseases seen were refractive errors, allergic conjunctivitis, cataract, and pterygium. Common surgical eye problems were cataract, pterygium, and glaucoma. Community-based organisation direct financial support built up from USD 855 in 2013 and totalled USD 27,250 in 2019. Community-based organisation funding is an alternative and useful means of meeting the unmet needs of eye care in resource-poor communities. Subsidised care was provided to community-sourced patients due to support by local community-based organisations. This subsidy assisted in reaching the outreach numerical goal. However, it was still inadequate to meet the total needs as seen by the lower number of clinical care and surgeries rendered against the total numbers identified.

Conclusion:

To achieve sustainable and wider coverage of care, a combination of local source and external funding is required. This study shows that community eye care programme can be supported by local or indigenous sponsors in a sustainable manner, thereby contributing considerably to addressing prevalent cases of avoidable blindness.
Experience with Liposuction for the Treatment of Subcutaneous Lipoma
Authors: Olawoye Olayinka Adebanji , Michael Afieharo I. , Aderibigbe Rotimi , Iyun Kayode , Ademola Samuel , Oluwatosin Odunayo M.
Published: September 2023

Background:

Lipomas are the commonest benign tumours in the body. Treatment is often by excision biopsy. Liposuction has traditionally been used for body sculpturing, but recently, it was introduced for the operative management of lipomas. The aim of this study was to present our experience with liposuction lipectomy-assisted lipoma aspiration in terms of its efficacy, complications, risk of recurrence, and patient satisfaction.

Materials and Methods:

A retrospective review of 16 patients with solitary or multiple lipomas managed with liposuction over a 5-year period was done. All the patients had a prior fine needle aspiration cytology, which was reported as benign. Informed consent was obtained, and the procedures were performed as a day case under tumescent anaesthesia. Lipo-aspiration was done with manual liposuction device. The patients were discharged on oral analgesics and antibiotics.

Results:

Sixteen patients (10 females and six males) with 21 lesions were managed. The median age was 43 years (23–66 years). All the patients had satisfactory outcomes. The procedure was converted to open-excisional surgery in one patient, and the histology was reported as fibro lipoma. Friction burn at the cannula site occurred in one patient, which subsequently healed with scars. No recurrence was reported in any of the patients.

Conclusion:

In well-selected patients, liposuction-assisted lipectomy may have an advantage over the classical open technique. All patients should have a minimum investigation of fine needle aspiration cytology because of the risk of atypical lipomas or liposarcoma, which might have similar features as subcutaneous lipoma.
Sub-tenon Versus Sub-conjunctiva Anaesthesia for Intraocular Surgery
Authors: Nwosu Sebastian N. N. , Nwosu Victoria O. , Akudinobi Cyriacus Ugochukwu , Uba-Obiano Chizoba Udoka , Nnubia Chinasa A. , Ubaka Christiana O. , Okpala Nonso Ejikeme , Onyiaorah Adaora Amaoge
Published: September 2023

Objective:

To compare the pain relief achieved using sub-Tenon anesthesia with that of sub-conjunctival anesthesia technique in intraocular surgery at the Guinness Eye Centre Onitsha Nigeria.

Materials and Methods:

Consecutive adult patients who had intraocular surgery under local anesthesia were randomized into having sub-Tenon (3 mL) or sub-conjunctival (0.5 mL) injections using xylocaine ± adrenaline. The manual suture-less surgery technique was used for cataract surgery alone and cataract surgery with pterygium excision; the extra-capsular cataract extraction technique was adopted for combined trabeculectomy and cataract surgery. Surgery duration was recorded. Patient’s pain perception graded as none, mild, moderate or severe.

Results:

100 patients made up 51 (51.0%) males and 49 (49.0%) females, age range was 31–88 years, median – 68 years, participated. Sub-Tenon anesthetic technique was used in 52 (52.0%) and sub-conjunctival in 48 (48.0%) participants. Seventy-eight (78.0%) patients had cataract surgery; 10 (10.0%) had trabeculectomy; 7 (7.0%) had combined trabeculectomy and cataract surgery and 5 (5.0%) had pterygium excision with cataract surgery. The mean surgery duration in the sub-Tenon anesthesia group was 31.8 ± 8.5 minutes and 30.2 ± 9.8 minutes in the sub-conjunctival group (P > 0.05). Fifty (96.2%) patients in the sub-Tenon group and 38 (79.2%) in the sub-conjunctival group experienced mild or no pains; 2 (4.2%) patients in the sub-Tenon group and 10 (20.8%) in the sub-conjunctival group experienced moderate to severe pains (P < 0.05).

Conclusions:

Both sub-conjunctival and sub-Tenon anesthetic achieved effective analgesia in intraocular surgery. But sub-Tenon anesthesia is significantly associated with lower incidence of severe pains.
Feedback Culture Among Nigerian Orthodontic Medical Educators
Authors: Etim Sylvia Simon , Arigbede Abiodun O.
Published: September 2023

Background:

Feedback is central to a quality medical and dental education in promoting self-directed learning and enhance progressive sharpening of trainees’ skills, which are applicable in orthodontics. Hence, orthodontic educators must be conversant with the subject of feedback. There is insufficient information concerning this at the moment.

Aim and Objectives:

To determine the prevalence, quality, and barriers to feedback culture among Nigerian orthodontic educators.

Design of the Study:

Cross sectional.

Setting:

Nigerian orthodontists in training institutions.

Materials and Methods:

A descriptive study involving orthodontic educators in Nigeria, was done using a 26-item structured questionnaire distributed face-to-face or through google forms. Simple descriptive data analysis was done to address the study objectives.

Results:

Twenty-five orthodontic educators participated. Sixteen (60%) alluded to existence of a formal feedback culture in their centers, and 10, that is, 40% of the educators were comfortable giving feedback by themselves. Over half, 13, that is, 52% of the educators gave feedback as the need arises, and a few educators (18, 72%) rated the quality of feedback given as “good.” In contrast, 11, that is, 44% of the educators always sought feedback from trainees, and 8, that is, 32% among them never sought feedback from colleagues. Feedback execution was preferred at different times including after teaching (10, 40%), after assessment (3, 12%), during practical (7, 28%), and on observations relating to attitude and professionalism (7, 28%). Feedback was mainly verbal and based on reports/observations. Time constraint was the barrier identified by the majority (13, 52%) of the participants.

Conclusion:

The scope and quality of feedback practice among orthodontic educators in Nigeria were inadequate. Time constraint was the most common barrier to feedback alluded to by the participants. There is a need to improve on feedback culture in orthodontics training in Nigeria.
Biliary Atresia Splenic Malformation
Authors: Elebute Olumide A. , Timo Manuella Talla , Alakaloko Felix M. , Seyi-Olajide Justina O. , Bode Christopher O. , Ademuyiwa Adesoji O.
Published: September 2023

Biliary atresia (BA) is a rare disease characterised by biliary obstruction of unknown origin that presents in the neonatal period. It is classified into syndromic with various congenital anomalies and non-syndromic (isolated anomaly). We present a case of syndromic BA associated with polysplenia and intestinal malrotation, discovered incidentally during the Kasai procedure. The small intestine was found to be non-rotated with the duodenojejunal junction to the right of the vertebral column. The presence of accessory spleens was noted. Kasai portoenterostomy and Ladd’s procedure were performed. The patient had an uneventful postoperative course with the passage of cholic stool from the third postoperative day. At the seventh-month follow-up, the stool remained cholic. A multidisciplinary approach in the care of babies with BA and long-term follow-up is crucial for a successful outcome.
Clinical Profile and Predictors of Early Outcome in Patients with Traumatic Spinal Cord Injury in Jos, North-Central Nigeria
Authors: Alfin Jeneral Dumura , Shilong Danaan Joseph , Bot Gyang Markus , Nwibo Onyemaechi Ereke , Kyesmen Nanpan Isa , Olalere Shina Abidemi , Bakwa Nenkimun Dirting
Published: September 2023

Background/Objectives:

Spinal cord injury is a devastating condition and has been recognised so since antiquity with evolving pattern of presentation and outcome. This study aimed to review the clinical profile and determinants of early outcome in patients with traumatic spinal cord injury (TSCI) in Jos, Nigeria.

Materials and Methods:

This retrospective cohort study, reviewed the health records of all patients with TSCI that were managed, based on the neurosurgical unit protocol for the management of TSCI in our institution from 2011 to 2021. Relevant data were retrieved into a preformed pro forma, analysis was done for determinants of outcome using SPSS and presented in tables and figure.

Results:

A total of 296 patients, aged 20–39 years, with male to female ratio of 5.2:1 were studied. The median time from injury to presentation was 96 h, and the cervical spine was the most (139, 47.0%) affected region. Most of the patients (183, 61.8%) had complete injury (ASIA A) at presentation, the average, first week mean arterial blood pressure (MAP) of 89.98 ± 8.86. Mortality was 73 (24.7%) at 6 weeks post injury and complete TSCI, cervical spinal cord segment and the average “first week” MAP were, independent predictors of mortality. The admission ASIA impairment scale (AIS) and injury to presentation interval were predictive of AIS improvement at 6 weeks and length of hospital stay (LOHs).

Conclusions:

We also found that AIS at admission, level of spinal cord affected and the average first week MAP were early predictors of mortality, while the injury to presentation interval and admission AIS, predicted improvement of AIS at 6 weeks. The LOHs was seen more in patients with severe AIS at admission and those who had delayed presentation.
Conjunctival Fungal Flora in a Tertiary Eye Hospital in Nigeria
Authors: Adukwu Benjamin U. , Nwosu Sebastian N. N. , Emele Felix E. , Uba-Obiano Chizoba , Onyiaorah Adaora A.
Published: September 2023

Objectives:

The aim of this study is to determine the hospital incidence and pattern of conjunctival fungal flora in adult patients at the Guinness Eye Center Onitsha, Nigeria.

Materials and Methods:

New adult patients, without anterior segment disease, were randomly recruited. Using a sterile swab stick, specimen was taken from the inferior conjunctival fornix of each participant’s right eye and inoculated into Sabouraud dextrose agar slant in a test tube and incubated at 27°C. The specimens were examined for fungal growth every 48 h for 4 weeks. Specimens with fungal growth were further examined under a high power microscope for fungal identification and characterization.

Results:

A total of 225 patients (105 males, 120 females) were examined. The age range was 18–75 years; mean age was 41 ± 17.1 years; 62 (27.6%) were culture-positive: 25 (40.3%) were males and 37 (59.7%) were females (P >0.05). Both moulds and yeasts were isolated with moulds constituting 44 (74.2%). Aspergillus [26 (41.9%)] and Candida [16 (25.8%)] were the commonest organisms. Participants >60 years had the greatest burden. Pensioners (61.5%), traders (44.0%), farmers (30.1%), and artisans (27.3%) were occupational groups with significantly higher proportions of culture-positive specimens (P < 0.05).

Conclusion:

Over a quarter of new adult patients without anterior segment disease harbour fungi, some of which are pathogenic, in their conjunctival fungal organisms. While Aspergillus and Candida were the commonest isolates, older participants, pensioners, traders, farmers, and artisans had significantly higher proportion of culture-positive specimens. These findings should be considered when formulating pre-operative guidelines for ocular surgery in our environment.
The Correlation of Sonographic and Histopathologic Findings in the Diagnosis of Palpable Breast Masses in Zaria
Authors: Bello Nafisa , Olarinoye-Akorede Seiya Adebanke , Mohammed Halima Mono , Aliyu Ibrahim , Abdullahi Mubarak Zubair , Ibrahim Muhammad Zaria , Lawal Sulieman , Rasheed Muhammad Haruna
Published: September 2023

Introduction:

Presently, histology is the gold standard in definite diagnosis of breast masses. Ultrasound is a relatively cheap, non-invasive, and non-ionizing imaging modality which is widely available in most hospitals. An assessment of its accuracy in diagnosing breast masses is necessary to minimize unwarranted biopsies.

Aim and Objectives:

This study aims to correlate the ultrasonographic and histopathologic findings in the diagnosis of patients with palpable breast masses.

Materials and Methods:

This was a cross-sectional hospital-based study, which involved 100 consecutive patients who presented with palpable breast masses in Zaria. This was carried out for a period of 7 months (November 2016–June 2017). They had a clinical breast examination to identify the mass, which was then imaged and biopsied via ultrasound-guided fine needle aspiration cytology.

Results:

The generated data were analysed using SPSS version 23.0 (Chicago, IL, USA). There were more benign masses (63%) than malignant masses (29%). On correlating the final diagnosis of ultrasound to that of histology, it was found to have a sensitivity of 89%; specificity of 94%; positive predictive value of 89%; negative predictive value of 94%; and accuracy of 92%.

Conclusion:

This study shows that there was a correlation between ultrasound and histology findings in differentiating between benign and malignant masses. This proves that ultrasound has a significant role to play in evaluating and diagnosing clinically palpable breast masses.
Bilateral Self-enucleation of the Eyes
Authors: Nwosu Sebastian N. N. , Nwosu Victoria O. , Akudinobi Cyriacus Ugochukwu , Onyiaorah Adaora Amaoge , Uba-Obiano Chizoba Udoka
Published: September 2023

Self-removal of the eyeball is an extreme form of self-harm, which is rare especially in a society ill-disposed to self-maiming. We report the case of a 75-year old man who plucked out his own two eyes in obedience to a voice urging him to do so. According to his wife, the patient had been exhibiting symptoms suggestive of a psychiatric disorder just before the incident. But this was overlooked. This case report draws attention to the devastating ophthalmic consequences of neglected psychiatric disorders in the elderly. We recommend greater attention to the mental health of the elderly. Prevention and management of auto-enucleation requires a collaboration between psychiatrists and ophthalmologists.
A Comparative Study between Propofol-fentanyl versus Propofol-suxamethonium for Ease of Endotracheal Intubation in Children
Authors: Mikailu Alfa , Atiku Mamuda , Abdurrahman Ahmad , Salahu Dalhat , Adesope Saheed
Published: September 2023

Background:

Following propofol induction, suxamethonium tremendously improves intubating conditions in children and has been the gold standard agent for this purpose. However, suxamethonium could be absolutely contraindicated in some patients. Fentanyl, a short acting opioid, has been investigated as a suitable alternative with varying results.

Aim and Objectives:

This study compares the ease of tracheal intubation between propofol-suxamethonium (1.5 mg/kg) and propofol-fentanyl (3 mcg/kg) during general anaesthesia among children.

Patients and Methods:

In this double-blind randomised controlled study, 84 ASA I or II patients booked for elective surgery under general anaesthesia requiring tracheal intubation were randomised into two groups (F and S). Induction was with propofol 3 mg/kg over 30 s followed by either fentanyl 3 mcg/kg or suxamethonium 1.5 mg/kg. Two minutes later, there was an attempt at intubation and intubating conditions were assessed using Steyn’s modification of Helbo-Hansen’s score (ease of laryngoscopy, jaw relaxation, coughing, vocal cord position, and limb movement).

Results:

All patients in both groups had successful intubation at the first attempt. Patients in group S (suxamethonium) had significantly better overall intubating conditions compared to those in group F (fentanyl) (p=0.0001), 85.7% in group S compared to 21.4% in group F had excellent intubation condition. None of the patients in the two groups demonstrated fair or poor intubation condition.

Conclusion:

A combination of propofol-fentanyl can be used as an alternative to propofol-suxamethonium to ease intubation in paediatric patients.
Management of Malignant Obstructive Jaundice
Authors: Balogun Olanrewaju Samuel , Atoyebi Oluwole Ayoola
Published: September 2023

Malignant obstructive jaundice (MOJ) constitutes an important surgical problem with high morbidity and mortality worldwide. Presentation is usually delayed with a majority of patients benefitting only from palliative treatment. Surgeons practicing in developing countries face herculean task in managing MOJ due to lack of minimally invasive endoscopic procedures. Palliative surgical procedures are associated with high morbidity and sometimes mortality. Abdominal pain, generalized pruritus, and gastric outlet obstruction are some of the symptoms of MOJ requiring palliation. Successful surgical palliation may improve the overall quality of life in patients with MOJ considered fit for surgery. Bypass procedures and regional nerve blocks constitute the most effective surgical palliation available to surgeons practicing in resource-limited settings. This review article discusses the indications, the role, and types of surgical bypass procedures in the management of MOJ in contemporary surgical practice. This is important for surgeons in countries where expertise and resources for the less morbid endoscopic and radiologic approaches are not available. Relevant articles up to January 2021 published in PubMed, Google Scholar, and Hinari on the surgical management of obstructive jaundice were reviewed for inclusion. We also reviewed some modern surgical textbook topics on obstructive jaundice.
Prosthetic Rehabilitation Following Segmental Maxillectomy Confluent with an Orbital Defect Using a Hollow Orbital Prosthesis Retained Magnetically with an Obturator
Authors: Rathee Manu , Chahal Sujata , Alam Maqbul , Jain Prachi , Divakar S. , Singh Sandeep
Published: September 2023

Loss of a sense organ, such as an eye in situations of orbital involvement, or any other bodily part, such as the maxilla or palate, might make one more dependent on others for care and affect how they perceive themselves in society. The prosthetic rehabilitation of large mid-facial defects is a challenging task due to the varied size and shape of the defect. Confluent maxillary and orbital abnormalities are best restored with prosthetic means by creating a comfortable, aesthetically pleasing prosthesis that allows for the restoration of speech, deglutition, and mastication. The retention of any prosthesis is must for it to be successful. The hollow orbital conformer described in this case presentation aids in reducing the weight of the prosthesis, thereby enhancing the retention of the prosthesis. This clinical case presentation highlights the aesthetic and functional rehabilitation using a combined obturator-orbital prosthesis connected using intraoral magnets.
The use of McGrath MAC Video Laryngoscope Versus McCoy Laryngoscope in Adults with Anticipated Difficult Airway Undergoing Elective Surgery
Authors: Adamu Bilkisu , Yakubu Saidu Yusuf , Muhammad Rabiu Isah
Published: September 2023

Background:

Difficult airway management remains one of the most challenging clinical situations encountered by anaesthetists.

Aim:

The study compared the effectiveness of the McGrath MAC video laryngoscope to the McCoy® laryngoscope in patients with difficult airway.

Materials and Methods:

Following the institution’s ethical approval, the randomised controlled trial was conducted involving 74 adults with American Society of anaesthesiologists’ physical status (ASA) grading of I-III scheduled for elective surgery. The Patients were randomised into either group MVL (McGrath MAC) or group MCC (McCoy) and intubated after preoxygenation with 100% oxygen and administration of IV propofol and suxamethonium. The Intubation Difficulty Score (IDS), success rate of intubation, time to intubation, number of optimising manoeuvres and complications was assessed. Statistical analysis was performed using the statistical Package for Social Sciences (SPSS) version 24.0 computer software (IBM SPSS Statistics, IBM Corp. NY, United States). Numerical and categorical data were compared using the student’s t-test and Chi square (χ2) test respectively. A value of P < 0.05 was considered statistically significant.

Results:

Lower IDS scores were noted in the McGrath group; 54.1% vs. 5.4% of patients had IDS score of 0 in the McGrath and McCoy groups respectively, (P < 0.001). Overall success rate was higher in the McGrath group (100% vs. 89.1%), P = 0.040.

Conclusion:

Lower IDS scores and improved intubation success rate was achieved with the McGrath compared with the McCoy laryngoscope in patients with predicted difficult airway. The McGrath has proved to be useful in managing patients with difficult airway.
Comparative Accuracy and Complications of Palpation-Guided Versus Ultrasound-Guided Core Needle Biopsy of Palpable Breast Lumps in Ahmadu Bello University Teaching Hospital, Zaria
Authors: Gana Stephen Gboya , Yusufu Lazarus , Abur Peter Pase , Olarinoye-Akorede Sefiya Adebanke , Bello Nafisa
Published: September 2023

Background:

Breast lumps are a common complaint by women. Palpable breast lumps are accessible to core needle biopsy (CNB) with the aim of obtaining tissue for histologic diagnosis. CNB is achievable either by palpation guidance or image guidance. The superiority of either technique in returning an accurate diagnosis has not been demonstrated in our centre.

Aim:

This study aimed to compare the diagnostic accuracy and complications of palpation-guided versus ultrasound-guided CNB techniques in palpable breast lumps.

Materials and Methods:

This was a randomised, controlled, comparative study. Consenting patients were randomised into either a palpation-guided or an ultrasound-guided group. All patients subsequently had open surgical biopsy, which represented the control group. Data analysis was done using SPSS, version 21.

Results:

Each CNB group had 40 patients. In the palpation-guided group, 24 (54.55%) lumps were benign and 13 (29.55%) were malignant, whilst seven (15.90%) were inconclusive. In the ultrasound-guided group, 31 (65.96%) lumps were benign and 15 (31.91%) were malignant, whilst one (2.13%) was inconclusive. The sensitivity and specificity for palpation-guided CNB were 92.9% and 100%, respectively. The sensitivity and specificity for ultrasound-guided CNB were 100% each. There was no statistically significant difference in sensitivity between the two groups (P value of 0.4828). One patient (2.5%) in the ultrasound-guided CNB group had a hematoma.

Conclusions:

This study has shown that CNB has high diagnostic accuracy and low complications in the management of breast lumps, either by palpation-guided or ultrasound-guided techniques. There was no significant difference in accuracy or complications of CNB using either technique.
Presentation and Management of Orbito-Ocular Malignancies in a Tertiary Institution in Southwest Nigeria
Authors: Alabi Adewumi Olabimpe , Alabi Adegboyega Sunday , Sowunmi Anthonia Chima , Ololade Kehinde O. , Adegboyega Bolanle Comfort , Habeebu Muhammad Yaqub M. , Fatiregun Omolara Amina , Akinsola Folasade Bolanle
Published: September 2023

Purpose:

The aim of this study was to review the management of orbito-ocular malignancies in the Departments of Radiotherapy and Ophthalmology, Lagos University Teaching Hospital, between January 1997 and December 2011 in comparison to previous and recent studies globally.

Materials and Methods:

This was a retrospective study of orbito-ocular malignancies seen at the Departments of Radiotherapy and Ophthalmology, Lagos University Teaching Hospital from 1997 to 2011. Case files and treatment cards were retrieved through the Medical Records department and the information required was extracted with the aid of a data extraction form.

Results:

A total of 98 cases with histologically confirmed orbito-ocular malignancies seen during the 15-year study period were analysed. Retinoblastoma (51 [52.0%]) was the most common orbito-ocular malignancies seen in children, whereas squamous cell carcinoma of the conjunctiva (25 [25.5%]) was the most common in adults. Seventeen (17%) patients had a combination of radiotherapy, surgery, and chemotherapy. Thirty (33%) had enucleation, whereas 33 (36%) had exenteration. Thirty-six patients had chemotherapy, whereas 44 patients benefited from radiotherapy, and radical treatment was offered to 24 patients. Total radical treatment dose was 35–65 Gy in 20–35 fractions over 4–7 weeks. Most of the patients (84 [85.7%]) were lost to follow up. Five (5.1%) died from disease progression and four (4.1%) are still alive and on regular follow-up.

Conclusion:

This study showed that the use of multimodality treatment was implemented but did not improve survival because the majority of patients presented late. The need for a collaborative effort in early detection and prompt referral for treatment of cancer cases cannot be overemphasised.
Immunohistochemical Profiling of HER-2/neu, Steroid Hormone Receptors and KI-67 Biomarkers in a Cohort of Nigerian Women with Breast Cancer
Authors: Ayandipo Omobolaji O. , Ogun Gabriel O. , Adepoju Olalekan J. , Afuwape Oludolapo O. , Fatunla Ebenezer O. , Orunmuyi Akintunde T.
Published: September 2023

Background:

Progressive improvement in the accuracy of profiling of hormone receptors in breast cancer provides the basis for targeted endocrine therapy, a major pillar of multimodal breast cancer treatment. However, the disparity in findings from comparatively smaller sample-sized studies in West Africa has led to somewhat conflicting conclusions and recommendations.

Objectives:

This study investigates the immunohistochemical (IHC) profile of breast cancer specimens for estrogen receptor (ER), progesterone receptor (PR), human epidermal receptor-2 (HER2)/neu, and Ki-67 in a tertiary hospital in Ibadan, Nigeria over 12 years.

Materials and Methods:

We reviewed 998 IHC reports, documented clinicopathologic parameters, computed patterns of biomarkers, and stratified them based on the American Society of Clinical Oncology/College of American Pathologists recommendations. Descriptive analysis including frequency, mean, and median were generated from the data extracted.

Results:

Out of the 998 cases, 975 (97.7%) were females and 23 (2.3%) were males. The mean age was 48.84 ± 11.99 years. Open biopsies were the most common types of specimens (320, 41.6%): lumpectomy and incisional biopsy of ulcerated, fungating or unresectable tumours. In those cases, 246 (32.0%) were samples of breast-conserving or ablative surgical extirpation (mastectomy/wide local excision/quadrantectomy), and 203 (26.4%) were obtained by core needle biopsies. Invasive ductal carcinoma was the most common histopathological type (673, 94.5%). The majority of graded tumours were intermediate grade (444, 53.5%). Four hundred and sixty-nine (48.4%) were ER positive, 414 (42.8%) were PR positive, and 180 (19.4%) were HER2/neu positive. Three hundred and thirty-four (34.0%) were triple-negative. Eighty-nine cases had Ki-67 staining done, and of these 61 (68.5%) had positive nuclear staining.

Conclusion:

Steroid hormone receptors and HER-2/neu proportions in our cohort are likely to be more representative than the widely varied figures hitherto reported in the sub-region. We advocate routine IHC analysis of breast cancer samples as a guide to personalized endocrine therapy.
Open Ureteric Exploration in Aminu Kano Teaching Hospital
Authors: Sani Auwal , Abdullahi Muzzammil , Yunusa Bashir , Mashi Sharfuddeen Abbas , Aji Sani Ali , Alhassan Sani Usman
Published: September 2023

Background:

Open ureteric exploration is an important procedure in urology employed in the management of ureteric obstruction from various causes. Ureteric obstruction is a common urological problem leading to significant morbidity and may lead to obstructive nephropathy in patient with bilateral obstruction or obstruction in a solitary kidney.

Objective:

The study aims to determine the demographics of patients who underwent open ureteric exploration, indications, and complications associated with open ureteric exploration.

Materials and Methods:

This is a retrospective review of all patients who had open ureteric exploration between January 2012 and September 2015. A total of 41 patients had the procedure within this period. Their case notes were retrieved; relevant information was collected with a structured proforma and analyzed with SPSS version 17.

Result:

In the 41 patients reviewed, the age range was 3 to 70 years with mean age of 33.1 ± 12.14. The commonest age group was 21 – 30years accounting for about 32% (n = 13). Male patients account for 68% (n = 28) while females 32% (n = 13). The indications were ureteric stone 58%, ureteric stricture 23% and external compression 19%. The commonest site of obstruction was the distal ureter 84% (n = 36). Ureterolithotomy was the predominant definitive procedure performed in 58% (n = 24). About 24% (n = 9) of patients developed complications, which includes urinary tract infections (UTI), post-operative intestinal obstruction and surgical site infections.

Conclusion:

The distal ureter was the commonest site of obstruction while the commonest procedure was ureterolithotomy. Open ureteric exploration is still an important option in the management of ureteric obstruction especially in resource constrain areas.
Evaluation of Surgical Glove Perforation and Sharps Injury in Oral and Maxillofacial Surgery
Authors: Osodin Timothy E. , Akadiri Oladimeji A. , Akinmoladun Victor I.
Published: September 2023

Introduction:

The risk of exposure to infections during surgery is partly mitigated by gloving. However, perforation can reduce the effectiveness of gloving as a barrier to exposure. This study aimed at investigating the frequency of surgical glove perforation and factors predictive of these in our oral and maxillofacial surgical practice.

Materials and Methods:

The study was carried out at the National Hospital and the University of Abuja Teaching Hospital, Abuja, Nigeria. Consenting patients requiring oral surgical interventions were consecutively recruited into the study. Similarly, surgeons and their assistants who consented to the study were also enlisted in the study. At the end of every surgical procedure, gloves used by the surgeons and the assistants were tested for perforation. Variables investigated included the rate of perforations, the influence of the type of gloving, single versus double gloving, type of anaesthesia, and duration of surgery on rates.

Results:

At a minimum of three operators per procedure, a total of 154 participants were involved in the study and 895 gloves were used. The number of glove perforations was 117(13.1%) with 82 (70.1%) involving the surgeons. There were 58/117 (49.6%) cases of perforation involving the dominant hand. Forefinger glove perforation accounted for 62 (52.9%) cases. Wire-related perforations were 72 (61.5%). Overall, nine cases of percutaneous injury were recorded. Duration of operation and double gloving were the predictive factors for perforations.

Conclusion:

Risk of sharps injury was relatively high due to the high incidence of glove perforation.
Shear bond strength of thermoviscous bulk-fill composite to sound dentin
Authors: Beheiry Aya M. El , Hasan Mostafa M. A. , Abdalla Ali I.
Published: September 2023

Aim

To evaluate the shear bond strength of Thermoviscous bulk-fill and Nano-hybrid composites to sound dentin surface after application of self-etch adhesive.

Materials and methods

Thirty freshly extracted sound human molars were used. The teeth roots were embedded in self-cure acrylic resin till the cervical line, The occlusal enamel was cut off to expose the sound dentin surface, The prepared specimens were randomly divided into three groups according to the type of composite (n=10 each): Futurabond DC adhesive (one-step self-etch adhesive) was applied in all groups using a disposable micro-brush and light cured for 10 s. The three groups were: G1, in which Grandio without preheating, was used, G2, in which Grandio with preheating, was used and G3, in which Viscalor-bulk, was used. Composite was applied to dentin using Teflon mold surrounded by metallic ring of 3 mm diameter and 4 mm height. All specimens were stored in artificial saliva at 37ºC for one week. All specimens were subjected to thermocycling in water bath at 5ºC and 55ºC with a dwell time of 30 and 20 s transfer time for 500 thermal cycles which corresponds to 6 months of clinical service. The shear bond strength of specimens was measured using an instron machine at a cross head speed of 0.5 mm/min. The debonded surfaces were examined under a stereomicroscope at a magnification 50X to determine the mode of failure. All data were collected, tabulated, and statistically analyzed.

Results

Group 2 recorded a statistically significant highest shear bond strength values (16.19±3.81) Mpa among tested groups, followed by Group 1 recording (12.41±4.89) Mpa while the lowest shear bond strength values were found in Group 3 with mean values of (11.99±4.07) Mpa. One-way ANOVA test was used to compare the three tested groups at a level of significance P less than or equal to 0.05. A negative correlation between cohesive mode of failure and shear bond strength was recorded for the three tested groups.

Clinical significance

We safely recommend using nanohybrid composites than bulk fill ones particularly in stress bearing areas.

Conclusion of the study

Shear bond strength of Nano-hybrid composite better than Thermoviscous bulk-fill composite using self-etch adhesive to sound dentin surface.
The total Betti number of the independence complex of ternary graphs
Authors: Zhang Wentao , Wu Hehui
Published: September 2023

Given a graph

G

, the
independence complex

I(G)

is the simplicial complex whose faces are the independent sets of

V(G)

. Let

\tilde{b}_i

denote the

i

-th reduced Betti number of

I(G)

, and let

b(G)

denote the sum of the

\tilde{b}_i(G)

’s. A graph is ternary if it does not contain induced cycles with length divisible by 3. Kalai and Meshulam conjectured that

b(G)\le 1

whenever

G

is ternary. We prove this conjecture. This extends a recent result proved by Chudnovsky, Scott, Seymour and Spirkl that for any ternary graph

G

, the number of independent sets with even cardinality and the number of independent sets with odd cardinality differ by at most 1.
Study of Indirect Heat Pump for an Electric Vehicle
Authors: Arumugam Prabhakaran , Anandan Ram , Sharma Akash , Sampath Karthikeyan , G Govarddhan
Published: September 2023

Electric Vehicle is the need of an hour, as due to excessive usage of IC Engine vehicles has resulted in the depletion of the ozone layer to a significant level and fuel cost is increasing. With new technologies coming into the market, challenges come hand in hand because of Electric Vehicle.

In comparison to IC Vehicle, areas of thermal management or the number of components for which thermal management needs to be done is higher and rather complex. As the thermal management system is the second highest energy consuming source after the powertrain of the electric vehicle, an efficient and reliable design is mandatory to ensure better range in an Electric Vehicle.

Thermal Management of the Electric Vehicle has been identified as one of the critical parameters for balancing both cabin comfort as well as Battery temperature.

One of the major concerns is meeting the Cabin comfort during colder weather with minimum energy consumption. Using the PTC heater to heat the cabin consumes more energy as compared to Normal Heat pump system for an Electric vehicle. In our study, in-direct Heat pump System helps by taking the heat from the compressor of the refrigerant circuit and transferring it to the coolant circuit. The coolant circuit then heats both the battery and cabin, providing a more efficient and cost-effective method. The use of a water-cooled condenser in this system ensures that the battery & cabin is heated with the coolant, which is energy efficient than using a PTC heater.

The Indirect Heat Pump has several advantages over the PTC heater because it consumes less energy, which means that it is more environmentally friendly and improves the range. Hence study of Indirect Heat Pump shows that the energy consumed by the compressor during the Cabin heating is almost 40% lesser compared to use of Auxiliary PTC heater and improved the Range by 3 ~ 4%.
Innovation as process
Authors: Godin Benoît
Published: September 2023

Two concepts serve to make sense of and rationalize the discourse on technological innovation: process and system. Technological innovation is a process in time, a series of activities whose ultimate purpose is technological innovation. This is the subject of Chapter 4. Technological innovation is also a system, composed of diverse institutions, all acting toward a shared purpose: the use and diffusion of technological invention in practice. The system dimension of technological innovation is addressed in Chapter 5. Both chapters highlight the role of practitioners (engineers, managers, policymakers) as theorists of innovation.
Innovation as system
Authors: Godin Benoît
Published: September 2023

The criticisms raised against the process model of innovation crystallized into the idea of system. Many scholars, particularly from management schools, began to use a system approach to study decisions and choices relating to science, technology and innovation. The chapter documents the pioneering role of the US Department of Commerce and the OECD in applying the idea of system at national and policy levels.
Does the taxpayer have a chance to win against the tax authority?
Authors: Białowska Aleksandra
Published: September 2023

This article concerns the principle of in dubio pro tributario in tax law (Article 2a of the Tax Ordinance). The legal provision regulates the resolution of doubts in favour of the taxpayer. The scope of application of the principle has been narrowed to doubts about the content of tax law provisions that cannot be removed.

The article is divided into five main parts: an introduction, three chapters and a conclusion.
Chapter I covers the genesis normative basis of the in dubio pro tributario principle. The author briefly indicates there that the principle has a longer history, but focuses on the history of the principle in the Polish legal system.

In Chapter II there are analysis of the content of the provision, in order to obtain the fullest possible knowledge on the application of the regulated principle. The views of doctrine are juxtaposed there and the issues of application of the principle are indicated.

Chapter III is a juxtaposition of art. 2a Tax Ordinance with the general principles of tax proceedings selected by the Author and the notion of tax justice.

The author's opinion is revealed in the conclusion, where she also determines how the discussed regulation should be applied. This may be the case when, after linguistic, systemic and functional
interpretation only, doubts remain as to the content of tax law provisions. The principle is a postulate for reliable establishment and application of tax law.

The study uses a dogmatic and legal research method and analysis of the literature on the subject.
Strategic Role of the Pharmaceutical Industry in the Сontext of the Global Pandemic
Authors: Mamedyarov Z. A.
Published: September 2023

The strategic importance of the pharmaceutical industry for the scientific, technological and economic development of countries determines its impact on international processes. The paper traces the current trends in the growth of innovative competition in pharmaceuticals and biotechnology, taking into account the factor of the COVID-19 pandemic. The following areas of increased competition are highlighted: diversification of supply of active pharmaceutical substances, regulators’ permission of the newest drugs to access the market, competition of pharmaceutical companies for capital and competence. The pandemic has also exacerbated long-standing problems: the efficiency of drug distribution to citizens, the dependence of large manufacturers on active substance suppliers from China, drug pricing, and the role of social insurance systems in developed and developing countries. The article analyzes the main problems of the industry and presents possible trajectories of further development of international relations in the context of pharmaceuticals and biotechnology, analyzing the progress of creation and market admission of COVID-19 vaccines. For all the high-tech trends, the pharmaceutical industry is a rather conservative industry in which regulatory issues play a significant role. Therefore, legal, ethical and practical issues related to the collection of sensitive patient health data may slow down the digitalization of the pharmaceutical industry. Much will also depend on the decisions of major regulators – in the U.S. and the EU – regarding telemedicine and digital health in general. A serious barrier for the pharmaceutical industry is also the lack of pharmaceutical companies’ own experience in developing software solutions, which makes them dependent on external suppliers of IT solutions, complicates the problem of sharing clinical patient data and particularly raises the issue of cybersecurity.
Solving the Strategic Equation: Integrating Missile Defense and Conventional Weapons in U.S.–Russian Arms Control
Authors: Baklitskiy A. A.
Published: September 2023

With the New START treaty extension, Moscow and Washington are on course for new arms control negotiations. The unprecedented breadth of the strategic bilateral agenda issues means that any future talks would entail extensive linkages and trade-off s in various spheres. The article explores two of the domains that would inevitably have to be addressed in future negotiations – missile defense and strategic conventional weapons. Missile defense was an integral part of U.S.–Russian arms control from early on, most prominently reflected in the ABM treaty of 1972. However, a deep look into the current state and trajectory of U.S. missile defense developments suggests that instead of focusing on the “strategic” interceptors in the continental U.S., the aim should be on regulating new mobile systems, which pose a more significant threat to the strategic stability and might be more amenable to limitations. Strategic conventional weapons are less clearly defined, and there is less arms control experience with dealing with them. On occasions where they were subject to arms control regulations, they were either banned or included in the strategic nuclear forceslimits. With many types of strategic conventional weapons, it does not seem that a one-size-fits-all approach is feasible. Some of the newer systems might remain too niche to have an impact on strategic stability. With the most ubiquitous strategic conventional weapons – long-range cruise missiles – a framework of asymmetric limits might be considered.
Desafios metamodernos da filosofia da educação
Authors: Reis Carlos , Formosinho Maria
Published: September 2023

Neste artigo discute-se o projeto da Modernidade, na sua relação com os pressupostos antropofilosóficos que o sustentavam, articulando-o com o conceito de Bildung, correlativo da ideia de formação humana por meio da educação. Procura-se de seguida mostrar como a Pós-modernidade operou uma desconstrução deste paradigma, confrontando-se com aporias e limitações que exigem uma reconstrução dos referentes educacionais, de forma a instituir uma nova Razão Pedagógica.
O papel do ouro na cobertura do risco da taxa de câmbio euro-dólar
Authors: Lobão Júlio , Teixeira Juliana
Published: September 2023

Neste artigo é investigado o papel desempenhado pelo ouro na cobertura do risco da taxa de câmbio euro-dólar no período 1999-2011. Para isso, recorreu-se a um modelo EGARCH (2,1,1) aplicado a dados diários. Os resultados mostram que o ouro se revelou útil para a cobertura do risco cambial dos investimentos em dólares levados a cabo pelos habitantes da zona-euro. Durante todo o período considerado, a cotação do ouro mostrou[1]se inelástica em relação à taxa de câmbio euro-dólar tanto no curto como no longo prazo.
Recomendações dietéticas na diabetes: rigor da informação e qualidade dos sites portugueses
Authors: Fernandes António , Menezes Jandira , Sá Sara , Vidal Vanessa , Silva Véronique , Lebres Vera
Published: September 2023

Avaliar a fiabilidade da informação nutricional contida em websites portugueses sobre a diabetes é o principal objetivo deste estudo. Simultaneamente, pretende-se avaliar a qualidade desses websites. Para esse efeito, foi conduzido um estudo transversal, observacional e analítico que envolveu a realização de 4 pesquisas separadas no Google usando a ferramenta de busca avançada. Foi selecionada a língua portuguesa e região de Portugal. Foram utilizadas combinações de palavras-chave como: diabetes e alimentação, nutrição e diabetes, diabetes e dietética, diabetes e dieta. Após a aplicação dos critérios de exclusão, restaram 167 websites que foram avaliados com recurso a uma checklist que tinha por base as diretrizes da American Diabetes Association relativamente a critérios relacionados com a informação nutricional para a diabetes e critérios de avaliação da qualidade de websites. Quanto ao rigor da informação nutricional, verificou-se que os websites portugueses obtiveram um score médio de 24,77 num total de 57 pontos possíveis. A qualidade dos websites registou um score médio de 4,96 pontos num total de 11 pontos possíveis. A escassa fiabilidade da informação nutricional para a diabetes dos websites portugueses coloca em evidência a importância da supervisão e regulamentação legal, bem como a necessidade de campanhas de saúde pública para aconselhar os pacientes a procurarem profissionais de saúde para um atendimento adequado e, neste caso particular, a procurarem dietistas para obterem as recomendações nutricionais na DM.