Antenatal Diagnosis and Management of Nuchal Cystic Hygroma: A Case Report in the Yaounde Central Maternity, Cameroon

Ultrasonographic evaluation, as a routine component of antenatal care, has significantly contributed to in utero assessment of pregnancy status. The detection of fetal abnormalities by ultrasound, however, has raised clinical questions and created parental dilemmas concerning the outcomes of such pregnancies. A relatively frequent anomaly observed on routine ultrasonographic examination is the posterior nuchal cystic hygroma. Most cases of cystic hygromas are associated with chromosomal abnormalities. Only 2–3% survival rate is reported when fetal cystic hygromas are diagnosed in utero. This information should be helpful when counseling patients whose pregnancies involve fetuses with this anomaly. We report a case of nuchal cystic hygroma diagnosed in the second trimester of pregnancy with the aid of an ultrasonographic morphological analysis. The parents requested termination of the pregnancy.Keywords antenatal; diagnosis; cystic hygrom

Primary umbilical endometriosis: Radical excision (omphalectomy) and laparoscopic management of associated pelvic endometriosis in a low resource tertiary hospital

Primary umbilical endometriosis (PUE) is a rare condition affecting 0.5 – 1% of all extragenital endometriosis cases. We reviewed the data of five women with umbilical endometriosis retrospectively. The age range was 29 – 46 years, and they were all nulligravid at presentation. Common clinical presentation was umbilical pain and masses, dysmenorrhea, and primary infertility. Radical umbilical excision was performed to remove the nodule as a definitive treatment. Diagnostic laparoscopy was performed, followed by varying degrees of operative laparoscopic procedures. They all had endometriosis in the pelvis. Three out of five women operated became pregnant and had live births. Complete resolution of clinical symptoms with a reduction in umbilical and menstrual pain scores occurred. In resource-constrained settings, diagnosis, and treatment of PUE may be challenging. Clinical suspicion and appropriate case management are critical for good reproductive outcomes and quality of life.   L'endométriose ombilicale primaire (PUE) est une maladie rare affectant 0,5 à 1 % de tous les cas d'endométriose extragénitale. Nous avons examiné les données de cinq femmes atteintes d'endométriose ombilicale rétrospectivement. La tranche d'âge était de 29 à 46 ans, et ils étaient tous nulligravides à la présentation. Le tableau clinique commun était la douleur et les masses ombilicales, la dysménorrhée et l'infertilité primaire. Une excision ombilicale radicale a été réalisée pour retirer le nodule comme traitement définitif. La laparoscopie diagnostique a été réalisée, suivie de divers degrés de procédures laparoscopiques opératoires. Ils avaient tous une endométriose du bassin. Trois femmes opérées sur cinq sont tombées enceintes et ont eu des naissances vivantes. Une résolution complète des symptômes cliniques avec une réduction des scores de douleur ombilicale et menstruelle s'est produite. Dans les milieux à ressources limitées, le diagnostic et le traitement du PUE peuvent être difficiles. La suspicion clinique et une prise en charge appropriée des cas sont essentielles pour de bons résultats en matière de reproduction et une bonne qualité de vie

Production of phytase and reduction of phytic acid content in canola meal by solid state fermentation.

A static state technique for fermentation was applied using Aspergillus ficuum NRRL 3135 on canola meal for the production of phytase and for the reduction of the phytic acid content in the meal. Aspergillus ficuum was chosen as a result of its high phytase producing capacity. In the study of the effects of physical and nutritional factors on the enzyme production and the phytic acid content reduction, it was found that moisture content was a critical factor and 64% water in the medium was found to be the optimum moisture content for both enzyme production and phytic acid content reduction. Increasing time of homogenization of inoculum up to 240 seconds improved enzyme production and phytic acid reduction. Increase in both inoculum concentration (biomass) and inoculum age up to 7-days old increased enzyme production and rate of phytic acid content reduction. With increase in initial pH of medium of up to 5.7, increased enzyme production and rate of phytic acid reduction were achieved. In the addition of surfactants to medium, sodium oleate was found to significantly increase enzyme production and the rate of phytic acid content reduction while Triton X-100 gave a negative effect. The addition of 1 mg phosphate remarkably increased the enzyme production and phytic acid content reduction; though a negative effect was obtained for systems containing combined portions of oleate and phosphate. Biomass in the solid culture was found to increase during fermentation up to 144 h of incubation and the protein content of culture also increased to about 18% after 96 h of incubation; hence this method of fermentation could be used to improve the nutritional quality of the meal for animal feed

Congenital Amputation Involving the Hands and Feet: A Case Report

Background: Congenital amputation of the limbs is not uncommon. However, it is very rare when this involves both the upper and lower limbs. Method: This is a case report of a child who presented with congenital amputation involving both the upper and lower limbs. Results: The patient was a 10 day old baby girl that was delivered by a 21 year old woman. She is the first and only child of the woman, whose pregnancy was uneventful and was carried to term. There is no family history of congenital anomalies. The findings on examination were: amputation of the index, middle and ring fingers at the level of metacarpophalangeal joints on both hands and a partial amputation (at the level of the middle phalanx) of the left little finger. There were forefoot amputations on both lower limbs. Scars were noticed over the amputation stumps with no associated congenital anomaly. Conclusion: Congenital amputation involving all limbs as an isolated entity is a rare condition; the cause of which is probably as a result of congenital amniotic bands. Keywords: Congenital amputation, limbs, scar, amniotic bands. Nigerian Journal of Medicine Vol. 17 (4) 2008: pp. 457-45

Notes From the Field: Availability of Satellite Pharmacies and Pharmacy Service Units in Nigerian Hospitals—Implications for Pharmaceutical Care

The optimal provision of pharmaceutical care services requires an adequate number of pharmacists, satellite pharmacies and service units at healthcare facilities. We examined the availability of these requirements at Nigerian hospitals using the 2016 nationwide inspection reports of hospital pharmacies conducted by the Pharmacists Council of Nigeria. Records of 254 hospitals inspected were retrieved, of which 171 (67.3%) were public. The total number of pharmacists across facilities was 753. The most common satellite pharmacy units recorded were antiretroviral 80 (31.5%) and emergency departments 48 (18.8%). The most common service units were drug revolving funds 176 (69.3%) and drug information 112 (44.1%) units. These findings suggest the availability of pharmacists, satellite pharmacies and service units are inadequate for the optimal delivery of pharmaceutical care services at healthcare facilities in Nigeria. Therefore, there is a need for interventions to improve the provision of pharmaceutical care services at health care facilities in Nigeria. </jats:p