Studies on gender disparities of traditional cardiovascular risks such as anthropometric factors are limited in black Africans. We aimed to examine the relationship between anthropometric parameters and blood pressure (BP) and possible gender differences in hypertensive adult Nigerians. A cross sectional study was carried out involving 261 adult hypertensive patients recruited consecutively at the medical out-patient clinic of Niger Delta University Teaching Hospital. They comprised 118 males and 143 females aged 26years to 94years. Their BP and anthropometric measurements were assessed using standard protocols. More than 70% of subjects were either overweight or obese. Females had significantly higher WC, WHtR and BMI than males. For females, BP had a significant positive correlation with anthropometric measures and a regression analysis showed BMI in females was the most important anthropometric index in predicting systolic BP (SBP) and diastolic BP (DBP). For males, none of the anthropometric measures correlated with SBP or DBP. Female hypertensives were significantly more obese than males. Indices of adiposity in females had a direct relationship with BP but not so in males. Further studies are needed to assess gender disparities in cardiovascular risk factors.

Marine algae are in exhaustible sources of chemical compounds contain bioactive compounds that plays an important role against various diseases against the aging process because they protect cells from oxidation. The present study is aimed to analyze the phenol and flavonoids content of the marine red alga Tolypiocladia glomerulata and their potential of free radical scavenging properties. The free radical scavenging capacity of the red alga was analyzed by inhibiting the 2,2-diphenyl-1-picrylhydrazyl (DPPH) and 2,2'-azino-bis (3-ethylbenzothiazoline-6-sulphonic acid) (ABTS). The maximum percentage of inhibition (61.13 ± 0.02% for DPPH and 50.35 ± 0.00 for ABTS) was observed at the concentration of 900 μg/mL. The free radicals scavenging ability of extracts followed close dependent trend. The results indicate that the red alga T. glomerulata have good free radical scavenging capacity with ABTS and DPPH and it could be used as a potential candidate for natural antioxidants

The aim is to make head and neck surgeons aware of a rare variation in the course of Spinal accessory nerve in relation to Internal carotid artery at higher level of neck dissection, thus minimizing anatomical surprises during neck dissection. Maxillofacial Surgeons often have to perform neck dissection to manage metastatic nodal diseases as in head and neck cancer and it is very important identifying and preserving the good and essentials while removing the pathological ones to the highest precision. Anatomy is the road map to perform a successful surgery. Knowing the variations of neck structures is important as the ignorance of the anatomical variations may lead to iatrogenic injury to vital structures during surgery thus leading to treatment failure. In this article we present a rare variation of SAN crossing ventral to the Internal Carotid Artery, found during a Supraomohyoid Neck Dissection (SOHND) of left side as a part of surgery along with Hemiglossectomy for a Squamous cell carcinoma (SCC) of left tongue. Knowledge of the rare variation of Spinal accessory nerve in neck in rerlation to its adjacent structures is important, as the major nerves and vessels play important roles as landmarks during head neck surgery. Iatrogenic injury to vital structures like Spinal Accessory Nerve (SAN) during neck dissection at Level IIb may lead to morbidity as shoulder syndrome though oncological clearance of this level of lymph nodes is of utmost importance. The SAN is considered as the landmark of the anteroinferior border of Level IIb and may cross the Internal Jugular Vein (IJV) dorsally, ventrally or through the vein. So it is important to know the variations of Spinal accessory nerve in relation to major blood vessels of neck to avoid any anatomical surprises during surgery.

Breast cancer is the commonest cause of cancer related death among women globally. The incidence is lowest but increasing in Africa and accompanied by increased mortality. Different expression patterns of oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth receptor (HER) 2 have been identified. The aim is to determine the molecular subtypes of breast cancer and evaluate their association with tumour characteristics such as age at presentation, stage of disease and grade of tumour. A 2 year prospective study of all patients that presented at University of Port Harcourt Teaching Hospital. Data was collected and analysed using the Statistical Package for Social Sciences (SPSS) version 17.0. Eighty six patients were seen during the study period and they were all females. Their ages ranged from 26 to 83 and the mean was 46.1 ± 14.3 years. Infiltrating ductal carcinoma was the commonest histological type, and seen in 78 (90.7%) patients. Triple negative was the commonest receptor subtype and observed in 40 (46.5%) patients. Breast cancer receptor subtype was significantly associated with stage and grade of tumour but not with age at presentation. Breast cancer in Nigerian women occurs relatively in younger women and most are triple negative and aggressive. Given the young age of onset and aggressiveness of this disease, it will be imperative to identify women at risk and increase the awareness, target screening and develop prevention strategies

The infantile visceral leishmaniose (IVL) is a systemic infection of the reticuloendothelial system due to a flagellate protozoan of the genus Leishmania. It is characterized by its geographical distribution most frequently around Mediterranean area, India, east Africa and South America. In recent years, we are witnessing a significant recrudescence preferentially in the very young child in Morocco . Its occurrence in the infant (<24 month old) remains rare, clinical signs are distinguished by more accentuated than in the child. The authors' work consists on a retrospective study of 17 cases of visceral leishmaniasis in infants admitted to the pediatric department at the University Hospital of Fez over a period from January 2013 till June 2016. The average age was 15.64 months, girls are more affected, The majority come from the regions of Fez, mainly Taounate. The main reasons are abdominal distension (70%), fever (100%) and pallor in 90% of cases. The clinical examination finds an anemia, a fever and a splenomegaly in all cases. The diagnosis is confirmed by the myelogram performed at the Hematology Laboratory at the University Hospital of Fez. Treatment is based on glucantim at the dose of 80 to 100 mg / kg / day for 21 to 30 days. The evolution was favorable in the majority of cases. We deplored a case of death that occurred in association with macrophage activation syndrome. IVL is the most frequent zoonotic disease in Morocco. Fez and its surroundings form a highly endemic focus. Its eradication must first of all be achieved through the improvement of socio-economic conditions and the fight against malnutrition which constitutes a risk factor

Hemophagocytic lymphohistiocytosis (HLH) associated with visceral leishmaniasis (VL) in children is a rare clinicopathological entity, difficult to diagnose, fatal in the absence of treatment. It should be evoked in children with prolonged fever and splenomegaly. We report two cases of HLH caused by visceral leishmaniasis . In the first case, it was a 14-month old infant hospitalized for fever with pancytopenia. The diagnosis of HLH was made in front of a clinical and biological features, a corticotherapy was initiated. The search for an underlying infectious disease had shown the presence of leishmania bodies on the myelogram. The second case was a 15-month old infant hospitalized for fever associated with abdominal distension. The diagnosis of VL was made on the medullogram, during the hospitalization a macrophagic activation report was positive and treatment with meglumine antimoniate was introduced, the two infants had evolved well under treatment

Thromboprophylaxis methods mainly include pharmacological and mechanical options, such as intermittent pneumatic compression devices (IPCDs). In a specific population (post-operative and post-traumatic patients) the risk of VTE is combined with increased risk of bleeding complication which is the side effect of the pharmacological prophylaxis. The aim of this integrative review is to assess the effectiveness and safety of IPCDs as an alternative choice to pharmacological prophylaxis in post-surgery and post-trauma patients. The electronic databases CINAHL, MEDLINE EMBASE, and Cochrane libraries were systematically searched for primary studies. We included studies that had evaluated the effectiveness and safety of the sole use of IPCD against the sole use of pharmacological prophylaxis in post-surgical and post-trauma patients. A total of 13 eligible articles were identified. Post-trauma patients were enrolled only in two studies and the remaining 11 studies were conducted on post-surgery patients. The findings suggest that IPCDs, compared with pharmacological prophylaxis, are equally effective in reducing DVT, PE and mortality rate and offered a reduced risk of bleeding. There were no consistent relations between the types of IPCDs and the clinical outcomes. This review demonstrates that there is lack of strong evidence informing the comparative effectiveness of IPCDs against pharmacological prophylaxis. Additionally, there is very limited evidence that can inform which type of IPCD is more appropriate as a thromboprophylaxis tool. Thus, until further robust research is conducted, it is difficult to conclude that IPCDs can replace pharmacological prophylaxis for post-surgery and post-trauma patients

Etiological factors leading to hyperbilirubinemia vary among different geographic regions. The present study was planned to study the pattern, causes, risk factors, treatment and outcome of neonatal hyperbilirubinemia in a tertiary care setup from northern India. A retrospective cohort of jaundiced neonates seeking care for their illness at this tertiary care centre during formed the study population. All treated cases of neonatal hyperbilirubinemia were analyzed and data on gender, gestation age, mode of delivery, blood group incompatibility, sepsis, parity and birth weight were obtained. The commonest cause of neonatal hyperbilirubinemia was physiological jaundice (41.04%). Mean bilirubin values for pathological cases (18.11± 5.54 mg/dl) were higher than physiological jaundice (12.06 ± 3.59 mg/dl). Top three causes of pathological hyperbilirubinemia were ABO incompatibility (32.55%), Rh incompatibility (11.79%) and breast feeding (6.13%). Mean age of presentation with jaundice was three days. Majority (48.58%) of the cases had their total bilirubin levels equal to or below 15mg/dl. Almost all the neonates showed improvement with phototherapy and exchange transfusion. Hyperbilirubinemia is a commonly encountered problem in our NICUs. ABO and Rh incompatibility are mainly responsible for pathological jaundice. Phototherapy is found to be a safe and cost-effective way to manage neonatal jaundice.

This paper presents the difference between hospital nurses’ and clinical instructors’ experienced job stress as well as their attitude towards performing their work. Results revealed that clinical instructors experience moderate stress in terms of their physical environment, workload and responsibilities, and social relationship. Despite their perception with respect to their stress level, they can still cope with their stressors as evidenced by their good work attitude. Hospital nurses, on the other hand, experience high stress level in terms of physical environment and moderate stress level in terms of their workload and responsibilities and social relationship. Clinical instructors still utilize their coping strategies in dealing with stressors as supported by their fair and good work attitude in terms of their organizational commitment and job satisfaction.

The aim of this study was to estimate the prevalence and risk factors for different neurological disorders. We also aimed to explore the effect of different socio-demographic variables in neurological disorders. Methods: A prospective cross-sectional study was carried out at Neurology Outpatient Clinic of United Hospital Ltd., Bangladesh, from December 2015 to March 2016 to explore the experiences of patients with neurological disorders. A separate questionnaire was used to collate the information. All registered patients medical records were reviewed. Microsoft Office Excel 2007 software package was used for statistical analysis. Data of 438 patients were collected and analyzed of which 239 (54.57 %) were females and 199 (45.43 %) were males. This study showed a high prevalence of epilepsy, stroke and migraine and an overall low prevalence of Parkinsonism, Alzheimer’s and dementia. The values were 121, 97, 52, 43, 23 and 102 for epilepsy, stroke, Alzheimer’s, Dementia, Parkinson’s and Migraine accordingly. Most of the patients (79.95%) were unmarried in our observational study. Only 20.06% were married. 41.03% and 26.18% patients were alcoholic and smoker respectively. Highest percentage of the patients (27.27 %) belonged to the age group 61 - 70 years, 21.23% to the age group 41 - 50 years and 17.05 % to the age group 51 – 60 years. Moreover, 42.98% of the patients were from community colony. The findings from the present study supported some previ¬ous research studies showing that women are more adversely affected by different neurological disorders than men. Therefore, more epidemiological studies need to be conducted to look into the changing pattern of neurological disorders using a uniform methodology.

Streptococcus constellatus is a germ that belongs to the Streptococcus milleri group, it has a particular tropism for the digestive tract and the hepatobiliary region. It is found in deep abscesses in immunocompromised patients. 70-year-old patient admitted to the emergency room for a pain in the right iliac fossa. The abdominal scan showed a retro cecal collection probably related to an appendicular abscess. The cytobacteriological study of abscess sampling in peroperatively demonstrated the presence of Streptococcus constellatus associated with Escherichia coli. The identification of a streptococcus of the milleri group is difficult by ordinary methods and must make search for an abscess.

World is ageing as an obvious consequence of the process of demographic transition and it is happening fastest in the developing world. Simultaneous disintegration of joint family system and changing social values, often obligate the elderly segment of society to live alone or in old age homes which make them increasingly vulnerable to mental health problems and other undesirable effects influencing their quality of life. The study aims to investigate the factors of psychological distress and quality of life among inhabitants of old age homes in Delhi. The cross-sectional study was undertaken in four government administered old age homes (OAHs)) in Delhi. 2 of these were free stay and other 2 being pay and stay OAHs. In all 148 subjects of both sexes and aged 60-85 years constituted study sample. Study tool included a semi structured proforma to assess Sociodemographic profile; WHOQOL-BREF scale and K-10 scale were used for QOL and psychological distress respectively. 2/3rd OAH inhabitants were female and rest 1/3rd being male. WHOQOL-BREF domain scores were higher in pay/stay homes as compared to free stay homes, furthermore all 4 domains score were significantly higher for male residents on t’ test. On K-10 scale 29.7%,7.4%, 2.7% residents were categorised as likely to have mild disorder, likely to have moderate disorder and likely to have severe disorder respectively whereas 60.1% were likely to be well, furthermore female were found to have significantly higher score on t’ test. Educational qualification and monthly income demonstrated significant positive correlation with all domains of QOL and sig negative correlation with psychological distress. Psychological distress was found to be higher in the free stay homes which could be attributed to lower level of education and income in these residents. QOL had significant negative correlation with psychological distress. Programs targeting modifiable risk factors could result in improvement of QOL and reduce psychological distress in OAH residents

Salacia lehmbachii is being used in traditional medicine for the treatment of gastric ulcer, this claim has not been scientifically substantiated or refuted. This work was therefore, designed to validate the antiulcer potential of the aqueous root bark extract of S. lehmbachii on stress induced and ethanol induced gastric lesions in rats. Phytochemical analysis and acute toxicity studies were also carried out. The extract (200 and 400 mg/kg) exhibited significant and dose dependent antiulcer effect in both models. The ulcer protection effect of the root extract is comparable to ranitidine. The root bark extract was found to be non toxic up to 5000 mg/kg dose level in rats. Phytochemical analysis identified flavonoids, tannins, saponis, alkaloids, terpenoides and flavonoids. The study provides strong evidence of antiulcer activity of S. lehmbachii aqueous root bark extract against gastric acid ulceration in rats

Pulsatile Drug Delivery System are the system where in there is a rapid and transient release of an active molecule within a short time period produced immediately after a predetermined off release period. In this present study efforts are made to formulate and evaluate chronotherapeutical drug delivery system of Losartan and Hydrochlorothiazide in the form of bi layered tablets for the treatment of hypertension by using various synthetic polymers. The compatibility study between drug and polymer was done by FTIR. Blend analysis of Losartan and Hydrochlorothiazide layers were studied. Based on the results these were formulated into bi layered tablets. Various evaluation tests of the tablets like weight variation, disintegration test and friability test etc were carried out. In vitro drug releases of the formulated tablets were carried out. Results of these studies indicated that the formulated bi layered tablets achieved a burst release after 3h-4 h lag time and hence can be used as the pulsatile drug delivery for hypertension. From this present work it can be concluded that pulsatile release of drug in the form of bi layered tablet can be achieved for newer chronotherapeutical drug delivery system

Diabetes mellitus is among the major global public health problems and its prevalence is currently increasing at an alarming rate. According to the International Diabetes Federation, about 366 million people are living with diabetes and this figure is projected to increase to 552 million by the year 2030. The study investigated the effect of oral administration of aqueous extract of coconut oil on blood glucose, total protein, kidney function indices, liver function indices, and lipid profile levels in alloxan-induced diabetic rats. The aqueous extract was administered orally at a dose of 400mg/kg body weight to both normal and alloxan-induced diabetic rats. Twenty adult male rats were divided into four groups of five rats each, two groups were made diabetic and the other two groups were non diabetic. One of the diabetic groups was treated with the extract and the other serves as control. The alloxan was administered intraperitoneal at a dose of 120mg/kg per body weight. The administration of the extract lasted for 21 days. Effect of the extract on blood glucose, total protein, albumin, bilirubin, urea, creatinine, total cholesterol, triglyceride, and high density lipoprotein concentrations were analyzed. The toxic effect of the extract was determined using biochemical enzyme markers. Treatment with the extract showed significantly (p<0.05) reduction in elevated blood levels of glucose, cholesterol, and proteins and other biochemical parameters associated with alloxan-induced diabetic rats. The extract possesses no toxic effect as indicated by the lowering of ALP and ALT levels and may be used for the management of diabetes mellitus