Orbital Complications of Rhinosinusitis

Background: Suppurative extension of rhinosinusitis to the orbit is acomplication that often results from delay in diagnosis and, or inadequatetreatment. These complications may range from preseptal cellulitis, orbitalcellulitis, orbital abscesses, and subperiosteal abscesses to intracranial extension with a threat to both vision and life. This study aims to review the clinical profile, treatment modalities and outcome of orbital complications of rhinosinusitis in Ibadan, Nigeria.Method: A retrospective review of the charts of patients with orbital complications of rhinosinusitis managed in the departments of Otorhinolaryngology and Ophthalmology, University College Hospital, Ibadan over a five year period (Feb 2002- Jan 2007) was carried out .The diagnosis of rhinosinusitis was based on history, physical examination, plain x ray and CT scan findings and antral puncture. Demographic data, clinical presentation and treatment were evaluated.Results: A total of 24 patients were reviewed in the study. There were 13males and 11females (M/F, 1:1). The age range was 8months to 75years, 14 (58.3%) patients were children and while 10 (41.7%) patients were adults. 75% of the patients were seen during the dry season (November to February). The duration of symptoms ranged from one day to three weeks. Involvement of one eye occurred in 14 patients (58.3%); right eye (4), left eye (10). Both eyes were involved in 10 patients (41.7%). Non-axial proptosis was seen in 8 patients (33.3%). It was infero-lateral in 6 patients (25%) and infero-nasal in two (8.3%) patients.  Orbitalcellulitis was seen in 10 (41.7%) patients, 6 (25%) patients had preseptal cellulitis while 8 (33%) patients had orbital abscess. Cavernous sinus thrombosis was seen in 3 (12.5%) patients. The cases with preseptal and orbital cellulitis were effectively managed by intravenous antibiotics. Orbital abscesses were drained surgically with complete resolution. Sinus surgical procedures were done in 10(41.7%) patients. This group of patients had preoperative visual acuity of between 6/6 and 6/60. They all had complete resolution of proptosis and good visual outcome.Conclusion: Orbital complications of acute rhinosinusitis are common inchildren. Surgical drainage and aggressive medical management remain the standard to achieve a good prognosis and visual outcome

Modeling of Reservoir Inflow for Hydropower Dams Using Artificial Neural Network

The stream flow at the three hydropower reservoirs in Nigeria were modeled using hydro-meteorological parameters and Artificial Neural Network (ANN). The model revealed positive relationship between the observed and the modeled reservoir inflow with values of correlation coefficient of 0.57, 0.84 and 0.92 for Kainji, Jebba and Shiroro hydropower reservoir respectively. The established model was used to predict 20 years stream-flow for each of the hydropower reservoirs which were found to have similar statistics with the observed values.  The predicted reservoir inflow were subjected to trend analysis which revealed an upward trend with percentage increase of 4.58%, 6.34% and 5.42% for Kainji, Jebba and Shiroro hydropower reservoirs respectively. The upward trend is an indication of increase in water availability for hydropower generation at the three stations given other constraints are brought under control.http://dx.doi.org/10.4314/njt.v34i1.

Prevalence of activated protein C resistance (Factor V Leiden) in Lagos, Nigeria

Objectives: Hereditary resistance to activated Protein C (Factor V Leiden) is the commonest genetic defect known to confer a predisposition to thrombosis. This study aims to determine the prevalence of activated protein C resistance (APCr) in Lagos, and to determine if any association exists between APCr and ABO, Rhesus blood types, and hemoglobin phenotypes.Materials and Methods: A functional APCr test was conducted on healthy adult volunteers to get a Factor-V-related activated protein C ratio (APC-V ratio). APCr due to Factor V mutation was indicated when the APC-V ratio is below a cut-off value that was determined by calibration. Subjects’ hemoglobin, red cell ABO, and Rhesus phenotypes were determined by standard methods.Results: Six (2%) of 297 participants with normal baseline coagulation screening tests had functional resistance to activated protein C (APC-V ratio < 2). None of the six subjects with APCr had history of venous thromboembolism. One of the six subjects was a female but the male sex did not demonstrate a risk of inheritance of APCr (P = 0.39). Four (67%) of the six subjects with APCr were non-O blood group. Whereas only two (0.9%) of 226 non-A subjects (blood groups 0 and B) had APCr, 4 (6%) of 71 subjects with A gene (blood groups A and AB) had APCr. The inheritance of A gene appears to constitute a risk to inheritance of APCr (P = 0.03). No association was demonstrable between APCr and hemoglobin phenotypes.Conclusion: Only 2% of the studied population had resistance to APC. The inheritance of blood group A may be a predisposition to APCr

Major urogenital malformations in Nigerian children

Background:There is scanty data on the pattern of childhoodurogenital malformations in many resource-poorcountries, including Nigeria.Objective:To describe the pattern of occurrence of majorurogenital malformations in children presenting in atertiary health care centre in sub Saharan Africa.Design:Retrospective case review.Patients:All children with major urogenital malformationspresented at the Department of Paediatrics of theUniversity College Hospital, Ibadan, a large tertiaryhealth care institution in South West Nigeria. In theperiod from July 1985 to December 1995.Main results:A total number of 125 cases of major urogenitalmalformations were seen during the study period.The commonest of these malformations were posterior urethral valves (40.0%), hypospedias(18.4%), ambiguous external genitalia (12.8%) andectopia vesicae (11.2%).Prenatal diagnosis was rare and most patientspresented late. Mortality during first admission was14.4% (18/125), mostly accounted for by cases ofposterior urethral valves.Conclusion: Posterior urethral valves accounted for the majority of major urogenital malformations seen in the setting studied. The high mortality probably reflected the severity of the lesions and late presentation of patients (which was related to the rarity of prenatal diagnosis). Increased awareness of these lesions among physicians practising in developing countries and greater use of ultrasonography in the third trimester of pregnancy may improve the prognosis by early detection and management

Cytomegalovirus antibodies among healthy blood donors at Lagos University Teaching Hospital

Objectives. Cytomegalovirus (CMV) is found worldwide in all geographical locations and socio-economic groups and is the virus most frequently transmitted to a developing child before birth. This study aimed to determine the prevalence and risk factors for CMV antibodies among healthy blood donors at Lagos University Teaching Hospital (LUTH).Methods. A cross-sectional study was carried out among consecutively recruited replacement blood donors attending the blood donor clinic at LUTH. A 5 ml blood sample was collected from each consenting participant and serum-assayed for CMV IgG/IgM using an enzyme-linked immunosorbent assay (ELISA)-based kit.Results. A total of 122 healthy donors were recruited; 96% of the donors were IgG anti-CMV positive while 19.5% were IgM anti-CMV positive. Previous history of blood transfusion was not significantly related to CMV positivity.Conclusion. The seroprevalence of CMV appears to be very high in this environment among healthy blood donors. Based on previous studies that showed a decrease in the incidence of CMV disease when blood is screened for CMV (IgM), the incidence of the disease can be decreased in Lagos if blood is screened for CMV

Refining the impact of TCF7L2 gene variants on type 2 diabetes and adaptive evolution

To access publisher full text version of this article. Please click on the hyperlink in Additional Links fieldWe recently described an association between risk of type 2diabetes and variants in the transcription factor 7-like 2 gene (TCF7L2; formerly TCF4), with a population attributable risk (PAR) of 17%-28% in three populations of European ancestry. Here, we refine the definition of the TCF7L2 type 2diabetes risk variant, HapB(T2D), to the ancestral T allele of a SNP, rs7903146, through replication in West African and Danish type 2 diabetes case-control studies and an expanded Icelandic study. We also identify another variant of the same gene, HapA, that shows evidence of positive selection in East Asian, European and West African populations. Notably, HapA shows a suggestive association with body mass index and altered concentrations of the hunger-satiety hormones ghrelin and leptin in males, indicating that the selective advantage of HapA may have been mediated through effects on energy metabolism

Genome-wide association study of prevalent and persistent cervical high-risk human papillomavirus (HPV) infection

Background: Genetic factors may influence the susceptibility to high-risk (hr) human papillomavirus (HPV) infection and persistence. We conducted the first genome-wide association study (GWAS) to identify variants associated with cervical hrHPV infection and persistence. Methods: Participants were 517 Nigerian women evaluated at baseline and 6 months follow-up visits for HPV. HPV was characterized using SPF10/LiPA25. hrHPV infection was positive if at least one carcinogenic HPV genotype was detected in a sample provided at the baseline visit and persistent if at least one carcinogenic HPV genotype was detected in each of the samples provided at the baseline and follow-up visits. Genotyping was done using the Illumina Multi-Ethnic Genotyping Array (MEGA) and imputation was done using the African Genome Resources Haplotype Reference Panel. Association analysis was done for hrHPV infection (125 cases/392 controls) and for persistent hrHPV infection (51 cases/355 controls) under additive genetic models adjusted for age, HIV status and the first principal component (PC) of the genotypes. Results: The mean (±SD) age of the study participants was 38 (±8) years, 48% were HIV negative, 24% were hrHPV positive and 10% had persistent hrHPV infections. No single variant reached genome-wide significance (p < 5 X 10− 8). The top three variants associated with hrHPV infections were intronic variants clustered in KLF12 (all OR: 7.06, p = 1.43 × 10− 6). The top variants associated with cervical hrHPV persistence were in DAP (OR: 6.86, p = 7.15 × 10− 8), NR5A2 (OR: 3.65, p = 2.03 × 10− 7) and MIR365–2 (OR: 7.71, p = 2.63 × 10− 7) gene regions. Conclusions: This exploratory GWAS yielded suggestive candidate risk loci for cervical hrHPV infection and persistence. The identified loci have biological annotation and functional data supporting their role in hrHPV infection and persistence. Given our limited sample size, larger discovery and replication studies are warranted to further characterize the reported associations

A Novel Rank Aggregation-Based Hybrid Multifilter Wrapper Feature Selection Method in Software Defect Prediction

The high dimensionality of software metric features has long been noted as a data quality problem that affects the performance of software defect prediction (SDP) models. This drawback makes it necessary to apply feature selection (FS) algorithm(s) in SDP processes. FS approaches can be categorized into three types, namely, filter FS (FFS), wrapper FS (WFS), and hybrid FS (HFS). HFS has been established as superior because it combines the strength of both FFS and WFS methods. However, selecting the most appropriate FFS (filter rank selection problem) for HFS is a challenge because the performance of FFS methods depends on the choice of datasets and classifiers. In addition, the local optima stagnation and high computational costs of WFS due to large search spaces are inherited by the HFS method. Therefore, as a solution, this study proposes a novel rank aggregation-based hybrid multifilter wrapper feature selection (RAHMFWFS) method for the selection of relevant and irredundant features from software defect datasets. The proposed RAHMFWFS is divided into two stepwise stages. The first stage involves a rank aggregation-based multifilter feature selection (RMFFS) method that addresses the filter rank selection problem by aggregating individual rank lists from multiple filter methods, using a novel rank aggregation method to generate a single, robust, and non-disjoint rank list. In the second stage, the aggregated ranked features are further preprocessed by an enhanced wrapper feature selection (EWFS) method based on a dynamic reranking strategy that is used to guide the feature subset selection process of the HFS method. This, in turn, reduces the number of evaluation cycles while amplifying or maintaining its prediction performance. The feasibility of the proposed RAHMFWFS was demonstrated on benchmarked software defect datasets with Naïve Bayes and Decision Tree classifiers, based on accuracy, the area under the curve (AUC), and F-measure values. The experimental results showed the effectiveness of RAHMFWFS in addressing filter rank selection and local optima stagnation problems in HFS, as well as the ability to select optimal features from SDP datasets while maintaining or enhancing the performance of SDP models. To conclude, the proposed RAHMFWFS achieved good performance by improving the prediction performances of SDP models across the selected datasets, compared to existing state-of-the-arts HFS methods

Missense Pathogenic variants in KIF4A Affect Dental Morphogenesis Resulting in X-linked Taurodontism, Microdontia and Dens-Invaginatus

The etiology of dental anomalies is multifactorial; and genetic and environmental factors that affect the dental lamina have been implicated. We investigated two families of European ancestry in which males were affected by taurodontism, microdontia and dens invaginatus. In both families, males were related to each other via unaffected females. A linkage analysis was conducted in a New Zealand family, followed by exome sequencing and focused analysis of the X-chromosome. In a US family, exome sequencing of the X-chromosome was followed by Sanger sequencing to conduct segregation analyses. We identified two independent missense variants in KIF4A that segregate in affected males and female carriers. The variant in a New Zealand family (p.Asp371His) predicts the substitution of a residue in the motor domain of the protein while the one in a US family (p.Arg771Lys) predicts the substitution of a residue in the domain that interacts with Protein Regulator of Cytokinesis 1 (PRC1). We demonstrated that the gene is expressed in the developing tooth bud during development, and that the p.Arg771Lys variant influences cell migration in an in vitro assay. These data implicate missense variations in KIF4A in a pathogenic mechanism that causes taurodontism, microdontia and dens invaginatus phenotypes