This study was conducted to evaluate the presence and concentration of Oxytetracycline and Penicillin G residues in raw cow and Fermented milk consumed in Maiduguri, Northeastern Nigeria. A total of 172 (86 raw and 86 fermented) milk samples were randomly collected from different milk selling points in Maiduguri. A Spectrophotometer ultraviolet visible spectrum machine was used to detect and quantify the oxytetracycline and penicillin G residues in the milk samples. All samples (raw and fermented milk) tested positive for oxytetracycline and penicillin G residues with a mean residual concentration of 36 µg/L and 20 µg/L in raw and fermented milk respectively for oxytetracycline while the mean residue concentration of penicillin G is 649 µg/L and 397 µg/L in raw and fermented milk respectively. However, the oxytetracycline residues detected were all below the Maximum Residue Level (MRL) standards of 100 µg/L, while the penicillin G residue detected were all above the maximum residue standard of 5 µg/L. The maximum and minimum residue for oxytetracycline detected in raw milk was 79 and 10 (µg/L) respectively while the maximum and minimum residue detected in fermented milk was 42 and 9 (µg/L) respectively. The maximum and minimum residue detected for penicillin G residue in raw milk was 1993 and 767 (µg/L) respectively while the maximum and minimum residue detected in fermented milk was 288 and 164 (µg/L). This study revealed the presence of both oxytetracycline and penicillin G residues in raw and fermented milk consumed in Maiduguri. However, oxytetracycline residues detected in this study were found to be within the acceptable limits, while the penicillin G residues were highly above the MRL standard set by CODEX.

Background: Pregnant women are considered vulnerable to be infected with Covid-19 and it is feared that this will result in unfavorable conditions for the baby and mother. Pregnant women with Covid-19 require special attention and care, because the viral infection caused by Covid-19 does not only attack the mother, but also the baby and adversely affects the outcome of pregnancy. Objective: This study aims to provide an overview of the characteristics of pregnant women with Covid-19 and delivery outcomes at Abdul Moloek Hospital Bandar Lampung. Methods: Searching the medical records of pregnant women with confirmed COVID-19 who gave birth at the Kasih Ibu Hospital in Surakarta.data is presented in the form of a distribution based on gravida, parity, Covid-19 symptoms, degree of Covid-19 symptoms, and delivery outcomes. Results: A total of 104 pregnant women with confirmed Covid-19 delivery at Abdul Moloek Hospital Bandar Lampung. Respondents who gave birth had experienced pregnancy more than once and had given birth two to five times. Of all pregnant women, most experienced asymptomatic symptoms, and 11.5% mild symptoms, of which only 9.6% experienced severe symptoms. Outcome of labor was found not to have preterm delivery. Conclusion: Further research is needed on the transmission of Covid-19 from mother to fetus.

Adherence to (or compliance with) a medication schedule refers to the extent to which individuals take drugs as advised by their medical professionals. Many medical practitioners prefer the term "adherence" over "compliance," as the latter suggests that the patient is merely following orders from their doctor passively and that the treatment regimen is not founded on a therapeutic alliance or partnership between the patient and the provider. Particularly for chronic illnesses, maintaining commitment to a therapy regimen is challenging, which frequently hinders patients from reaping the full advantages of therapies. Negative health effects include treatment failure, more frequent hospital admissions, drug resistance in some circumstances (for example, in HIV or antibiotic regimens), and higher use of healthcare resources as a result of poor adherence. Effective chronic disease self-management and successful health outcomes depend on medication adherence. HIV patients, asthmatic patients, and hypertensive patients can enhance their adherence with the use of DATs. Further analysis of both short- and long-term effectiveness if the costs of these systems will be covered by better results, fewer ER visits, and fewer inpatient stays.

Introduction: Ileo-colonoscopy is considered the method of choice for exploring the terminal ileum. However, the diagnostic value of terminal ileal intubation (IBD) during colonoscopy remains controversial. The objective is to evaluate the frequency, the interest and the results of systematic catheterization of the IBD with biopsies during a total colonoscopy. Patients and Methods: Were included all patients referred to the service for a colonoscopy whatever the indication from July 2006 to July 2022; in whom IBD catheterization was performed whenever possible regardless of the indication for colonoscopy. All colonoscopies were performed under Propofol sedation and all patients were prepared with Polyethylene Glycol (PEG). Results: Out of a total of 5224 colonoscopies, the IBD was catheterized in 2371 patients, i.e. a frequency of 45%. 62% were men and 37% women. The average age was 46 years old. The most common indications were diarrhea in 35% patients and rectal bleeding in 30% patients. IBD was abnormal in 249 patients (11%): congestive ileitis in 88 patients (3.7%), nodular ileitis in 75 patients (3.1%), ulcerated ileitis in 72 patients (3%), stenosis in 10 patients (0.5%), an ulcero-budding tumor in 2 patients (0.1%) and angiodysplasia in 2 patients (0.1%).The histological study of ileal biopsies was pathological in 116 patients (47%): Crohn's disease in 110 patients (94.8%), tuberculosis in 4 patients (3.4%), radiation ileitis in 1 patient (0.8%) and neuroendocrine carcinoma in 1 patient (0.8%). Conclusion: The diagnostic yield of catheterization of the last ileal loop varies according to the indications for colonoscopy. It should be done as often as possible during each colonoscopy to objectify terminal ileitis most often referred to Crohn's disease and therefore requiring adequate medical care.

Introduction: The clinical manifestations of irritable bowel syndrome are not specific. Irritable bowel syndrome (IBS) is a common condition that affects the digestive system. It is usually a lifelong problem. The diagnosis is retained after elimination of an organic cause at colonoscopy. The main objective of this study is to determine the frequency of these disorders and to study the epidemiological characteristics of these patients. Patients and Methods: From January 2016 to January 2022, were included all patients with symptoms of IBS (abdominal pain, transit disorder, abdominal bloating) referred to our department for ileocolonoscopy. Patients with warning signs (rectal bleeding, melena, anemia, altered deteroriation of the general condition) or with incomplete colonoscopy were excluded. The diagnosis of IBS was retained in patients with a normal total ileo-colonoscopy All colonoscopies were done under propofol sedation and all patients were prepared with Polyethylene Glycol (PEG). Results: Of 4530 ileo-colonoscopies performed, 1132 (25%) were indicated for symptoms of IBS without warning signs. The average age of the patients was 47 years (16-89 years), the age group of 40-65 years predominated in 41%. 66.7% were female. The frequency of symptoms was as follows: abdominal pain in 64.3% of cases, chronic diarrhea: 33%, and constipation: 30.7%, alternating diarrhea-constipation: 18.1% and abdominal bloating in 10.75%. 569 patients (50.2%) had a normal ileo-colonoscopy. Ileo-colonoscopy was abnormal in 49.8% of cases: polyps: 47%, diverticula: 19%, congestive or ulcerative colonic and/or ileal mucosa: 18.8%, tumour: 7%, lipoma: 4.7% and colonic melanosis: 3.5%. Tumors were primarily in patients > 40 years old (9%), and IBD lesions in patients < 40 years old (11%). Conclusion: Ileo-colonoscopy remains essential to eliminate an organic cause even in the presence of typical symptoms of IBS. Indeed, half of our patients with symptoms of IBS without warning signs have an organic lesion dominated by tumors primarily in those > 40 years old and IBD lesions in those < 40 years old.

Background: This review evaluates the possible cardiac side effects of general anesthetic agents upon usage. Cardiac as well as non-cardiac surgery may precipitate adverse events including ischaemia, diverse arrhythmias and reperfusion injury. Volatile and non-volatile anesthetic agents possess cardiovascular effects that can lead to depression of cardiac contractility, arterial pressure, ventricular resistance and reflex tachycardia. However, as not all studies have demonstrated improved outcomes, the risk for undesirable haemodynamic effects must be weighed against the possible benefits of using anaesthetic agents either pre-operatively, intra-operatively or post-operatively during both cardiac and non-cardiac surgeries as well as in patients with coronary artery disease. The halogenated agents all have similar circulatory effects as seen in young, healthy volunteers during maintenance anesthesia (Cahalan MK et al., 1991; Eis S & Kramer J, 2022). The effects of anesthetics on the cardiovascular system have a complicated character, and almost all the anesthetic agents have a dose-related myocardial depression and decreases in heart rate and arterial pressure. During anesthesia, individual responses of patients against procedures such as induction, intubation, and surgical stimulation are influenced by many factors, including preoperatively used drugs, anesthesia type, preferred anesthetic agents, and the autonomic nervous system (Fee JPH et al., 1997, Pagel PS et al., 1991; Smith G et al., 2022).

Background: Pierson syndrome comprises of congenital nephrotic syndrome (CNS) and peculiar ocular changes. LAMB2 gene mutation has been reported to be causative reason for this rare autosomal recessive disorder. Methods: An observational case series reports comprising of two children presenting with symptoms like heavy proteinuria, haematuria are being discussed. Physical examination along with ophthalmological assessment, hearing assessment, varied blood investigations, urinalysis, renal biopsy and gene testing were carried out to diagnose the condition. Results: Pearson syndrome was detected with mutations of LAMB2 gene detected by Whole Exom Sequencing test in one of the case study. The Ocular abnormality in both patients comprised of squint hypertropia, a new variant ocular finding related to Pearson syndrome. Conclusions: The clinical finding of squint hypertropia is a novel finding associated with Pearson syndrome, reported here for the first time.

Background: Spinal dysraphism refers to a group of developmental abnormalities that affect the spinal cord and its surrounding structures. The main goals of treatment of spinal dysraphism are to prevent further damage to the spinal cord and to improve the patient's neurological function and quality of life.Aim of the Study: The aim of this study was to assess the management of spinal dysraphism .Methods: This cross-sectional study was conducted in Department of Pediatric Neuro Surgery, Bangladesh Shishu Hospital and Institute, Sher E Bangla Nagar, Dhaka 1207, Bangladesh, during the period from 1st April 2020 to 31st March 2021. Total 1052 patients were admitted under Neurosurgery department (SU IV) from them 93 patients had spinal dysraphism. After excluding patients with encephalocele, lipomeningocele, meningocele and DORB, total 60 patients with myelomeningocele were included in this study.Result: Majority of the subjects (71%) were less than a week old. there was a slight female preponderance (54%) among the study subjects. The most affected (83.33%) region of the spine among the study subjects was lumbosacral. The data showed that 65% of the study subjects had no lower limb movement, while 35% of them had slight movement. In the study, all study subjects had abnormal bowel and bladder habits. In the study, the majority (62%) had a moderate ventricular index level before operation. About 83.33% of the study subjects had a satisfactory outcome after the surgery, while 6.66% had poor outcomes, and 1.66% of the study subjects died after the surgery. The data showed that 80% of the study subjects had a severe Ventricular Index after two weeks of surgery, while 20% had a moderate Ventricular Index. The data also indicated that 85% of the study subjects had a healthy wound after surgery, while 15% had an unhealthy wound.Conclusion:From the findings of our study, it can be concluded that for improving the quality of life of the patients with spinal dysraphism, surgery is the prominent treatment accompanied by optimal post-operative care. Surgery of spinal dysraphism is associated with higher satisfactory rate and lower post-operative complications.

Introduction: EA is characterized by agitation, inconsolable sobbing, disorientation, delusions, and hallucinations, decreased cognition and memory. Sevoflurane is widely used as an anesthetic agent for children because of its less pungent nature, lower solubility but it has a greater incidence of EA in preschool aged children. Propofol is a hypnotic amnestic agent with a short duration of action, commonly used for sedation, induction, and maintaining anesthesia and it has been used to prevent Emergence agitation. Aim of the Study: The aim of this study was to determine the efficacy of low dose propofol in reducing the incidence of EA at the end of face-mask sedation with sevoflurane. Methods: This was a prospective observational study and was conducted in the Department of Pediatric Anesthesia of Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh during the period from July, 2021 to December, 2021.In our study we took 220 children operated for hernia were randomized into two groups – Group A (Control group, n=110) and Group B (Propofol group, n= 110). Result: In total 220 patients from both the groups completed the study. In our study we found the mean age in group A & B was 6.3 ± 1.6 & 6.1 ± 1.9 years respectively. The mean PAED score was 14.41 ± 2.59 & 9.83 ± 3.51, the mean emergence time was 7.1 ± 2.0 & 13.4 ± 2.5, time in PACU was 44.5 ± 5.9 & 46.6 ± 7.6 mins in control & propofol group respectively. In contrast to the control group, no patient in the propofol group experienced EA beyond 15 or 20 minutes of emergence. Conclusion: In our study, we found that 0.5mg,/kg propofol was effective in preventing Emergence Agitation in children underwent herniotomy with caudal block and who’s sedation were maintained with sevoflurane.

Medication mistakes continue to be one of the most serious issues in hospitals. Such mistakes can occur during the prescription, distribution, or administration of medications. Lipid emulsions are commonly utilized in whole or partial parenteral feeding initially, Following convincing results from animal models and effective case reports in humans, the use of intravenous lipid emulsions (ILEs) as an antidote in local anesthetic systemic toxicity has acquired considerable acceptance. Although intravenous lipid emulsion (ILE) was initially employed to treat life-threatening local anesthetic (LA) toxicity, its application has broadened to cover non-LA poisoning and less severe symptoms of toxicity. However, in recent years, the function of lipid emulsions in the treatment of lipophilic chemical toxicity and overdose has been established. In addition to typical poisoning treatment, lipid emulsion therapy was employed. The observed sequence of events provides substantial support for the importance of ILE treatment in the effective management of both instances. However, further study is needed in this area to provide definite guidelines for the use of intravenous lipid emulsions in pediatric lipophilic agent poisoning. The body of data supporting the use of ILEs in acute drug intoxication is growing. The current data supports the use of ILEs only when there is an imminent threat to life from local anesthetic systemic toxicity or lipophilic cardio-toxin poisoning. Lipid emulsion therapy is a potential and less expensive alternative in cases of acute lipophilic poisoning where a specific antidote is unavailable.