Transurethral resection of the prostate in Northern Nigeria, problems and prospects

<p>Abstract</p> <p>Background</p> <p>Benign prostatic hyperplasia (BPH) is the commonest disease of the urinary tract afflicting the ageing male and is the commonest neoplastic disease in men aged 50 years and above.</p> <p>Transurethral prostatectomy (TURP) is the ultimate treatment of choice for benign prostatic hyperplasia (BPH) due mainly to the preference of minimally invasive surgery, long term relief of symptoms and cost effectiveness. It is however not available to the majority of Nigerians in need of prostatic surgery in Public Health Institutions.</p> <p>Methods</p> <p>The records of patients who underwent prostatectomy in Aminu Kano Teaching Hospital, over the period June 2001 to July 2007 were examined. The bio data of patients and laboratory investigations performed were retrieved.</p> <p>Results</p> <p>Five Hundred and forty two patients were operated upon, out of which 40 were excluded due to open prostatectomy (22 patients), bladder neck stenosis (16 patients) or bladder tumour around the trigon (2 patients). The age range of the patients was 47–110 years with a mean of 67.2 years. 289 patients (80.1%) had urethral catheter in situ at presentation and 11 (3%) patients had suprapubic cystostomy of which only 3 (0.85%) had combined urethral stricture and BPH.</p> <p>Only 131 (26%) had their PSA measured which ranged from 2–100 ng/ml out of which 39(29.8% n = 131) patients had more than 4 ng/ml and cancer of the prostate and 1(0.8%, n = 131) patient had a PSA level of 4 ng/ml and malignant prostate.</p> <p>Hospital stay was 1–32 days (mean 7.9) and the mean follow up period was 5.6 months (range 0–60) and there were 17.5% complications comprising of urinary tract infection (UTI) 7.2%, Orchitis 2.2%, urinary incontinence 0.6%, atonic bladder 1%, erectile dysfunction 0.6%, cerebrovascular accident 0.4%, myocardial infarction 0.4%, deep vein thrombosis 0.4% and disseminated intravascular coagulopathy (DIC) 0.6% and 1.2% mortality. The cost of treatment inclusive of pre-admission investigations was US$615.00 (range US$ 300–1,300)</p> <p>Conclusion</p> <p>Despite advances in minimally invasive therapy for LUTH/BPH, TURP is the optimum treatment of choice for the ageing male of sub-Saharan Africa. It is however not available to the majority of patients in this region due to poor health allocation and inadequate facilities and training.</p

Inhibition of Cell Proliferation and MAP Kinase and Akt Pathways in Oral Squamous cell Carcinoma by Genistein and Biochanin A

High morbidity and mortality associated with oral squamous cell carcinoma (OSCC) are largely attributable to late stage diagnosis. Despite significant advances in therapeutic strategies, the five-year survival rate for oral cancer remains at about 50%. A chemopreventive approach may be an effective alternative or adjunct to current therapies. Previous studies have shown anti-tumor effects of isoflavones in several cancers, including oral cancer. However, their mechanisms of action are still unclear. We hypothesized that isoflavones inhibit multiple signaling pathways implicated in oral carcinogenesis. To address our hypothesis, we investigated the effects of three isoflavone derivatives, genistein, biochanin A and daidzein, on SCC15 and SCC25 squamous cell carcinoma cell lines. In cell proliferation experiments, we found that genistein and biochanin A inhibited SCC15 and SCC25 cell growth with an IC50 of 50 μM. We also investigated the effect of isoflavones on ERK and Akt pathways. Our results, from western blot analysis, suggest that both genistein and biochanin A induced decreases in phosphorylation of ERK and Akt at treatment concentrations of 20, 50 and 100 μM. Taken together, our results clearly demonstrate a differential regulation of signaling pathways by various isoflavones in OSCC cell lines. Thus, tumor progression models can be utilized to study the preventive and therapeutic roles of isoflavones in oral cancer cell lines

Induction of Cancer Cell Death by Isoflavone: The Role of Multiple Signaling Pathways

Soy isoflavones have been documented as dietary nutrients broadly classified as “natural agents” which plays important roles in reducing the incidence of hormone-related cancers in Asian countries, and have shown inhibitory effects on cancer development and progression in vitro and in vivo, suggesting the cancer preventive or therapeutic activity of soy isoflavones against cancers. Emerging experimental evidence shows that isoflavones could induce cancer cell death by regulating multiple cellular signaling pathways including Akt, NF-κB, MAPK, Wnt, androgen receptor (AR), p53 and Notch signaling, all of which have been found to be deregulated in cancer cells. Therefore, homeostatic regulation of these important cellular signaling pathways by isoflavones could be useful for the activation of cell death signaling, which could result in the induction of apoptosis of both pre-cancerous and/or cancerous cells without affecting normal cells. In this article, we have attempted to summarize the current state-of-our-knowledge regarding the induction of cancer cell death pathways by isoflavones, which is believed to be mediated through the regulation of multiple cellular signaling pathways. The knowledge gained from this article will provide a comprehensive view on the molecular mechanism(s) by which soy isoflavones may exert their effects on the prevention of tumor progression and/or treatment of human malignancies, which would also aid in stimulating further in-depth mechanistic research and foster the initiation of novel clinical trials

Inhibition of cancer cell invasion and metastasis by genistein

Genistein is a small, biologically active flavonoid that is found in high amounts in soy. This important compound possesses a wide variety of biological activities, but it is best known for its ability to inhibit cancer progression. In particular, genistein has emerged as an important inhibitor of cancer metastasis. Consumption of genistein in the diet has been linked to decreased rates of metastatic cancer in a number of population-based studies. Extensive investigations have been performed to determine the molecular mechanisms underlying genistein’s antimetastatic activity, with results indicating that this small molecule has significant inhibitory activity at nearly every step of the metastatic cascade. Reports have demonstrated that, at high concentrations, genistein can inhibit several proteins involved with primary tumor growth and apoptosis, including the cyclin class of cell cycle regulators and the Akt family of proteins. At lower concentrations that are similar to those achieved through dietary consumption, genistein can inhibit the prometastatic processes of cancer cell detachment, migration, and invasion through a variety of mechanisms, including the transforming growth factor (TGF)-β signaling pathway. Several in vitro findings have been corroborated in both in vivo animal studies and in early-phase human clinical trials, demonstrating that genistein can both inhibit human cancer metastasis and also modulate markers of metastatic potential in humans, respectively. Herein, we discuss the variety of mechanisms by which genistein regulates individual steps of the metastatic cascade and highlight the potential of this natural product as a promising therapeutic inhibitor of metastasis

Gigantomastia complicating pregnancy: a case report

Background: Mammary gigantism is a rare, cosmetically embarrassing complication of pregnancy that may ulcerate and have potentially fatal bleeding.Methods: A case report of a 20-year old primigravida with bilateral massive breast enlargement is presented to highlight the clinical presentation and management challenges of the condition.Results: She was treated with local debridement, bromocriptine, antibiotics and blood transfusion with good results. The pregnancy however terminated at 27 weeks of gestation.Conclusion: Gigantomastia is a rare complication of pregnancy, which may pose a major management challenge. A favorable outcome may be achieved with prompt recognition of the condition and conservative management in selected cases. Keywords: gigantomastia, pregnancy, Nigeria Nigerian Journal of Medicine Vol. 15(2) 2006: 167-16

Characterization of environmental loads related concrete pavement deflection behavior using Light Detection and Ranging technology

Repeated deflection behavior resulting from temperature and moisture variations across concrete pavement depth causes curling and warping of Portland cement concrete (PCC) pavement systems. Although curling and warping issues have been investigated extensively, there are no standardized methods or procedures currently available to characterize the degree/magnitude of this in situ environmental load-related deflection. This study discusses the development of a detailed procedure for assessing environmental load-related deflection of concrete pavement using a Light Detection and Ranging (LiDAR) system. LiDAR systems have been recognized as an advanced technology for transportation infrastructure inspection but have not been widely investigated for measuring environmental load-related deflection of concrete pavements. In this study, field surveys were conducted on six identified concrete pavement sites in Iowa by scanning the concrete slab surfaces using the stationary LiDAR instrument. Based on dense point cloud data obtained by the LiDAR instrument, a data processing algorithm was developed to obtain the degrees of environmental load-related deflection. The degrees of deflection obtained were correlated to variations in pavement performance, mix design, pavement design, and construction details at each site. The results and findings from this study describe a potentially novel method of using LiDAR system for environmental load-related deflection characterization of concrete pavement.This article is published as Yang, Shuo, Halil Ceylan, Kasthurirangan Gopalakrishnan, Sunghwan Kim, Peter C. Taylor, and Ahmad Alhasan. "Characterization of environmental loads related concrete pavement deflection behavior using Light Detection and Ranging technology." International Journal of Pavement Research and Technology 11, no. 5 (2018): 470-480. doi:https://doi.org/10.1016/j.ijprt.2017.12.003. © 2017 Chinese Society of Pavement Engineering. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)