Background: Alopecia areata (AA) involves oxidative reactions in the hair follicle. Its treatment is difficult due to both the unknown etiology and the adverse drug effects. Aims: This study aimed to evaluate the effects of orally administered ginger powder on the oxidative stress markers of the plasma and blood cells in Iraqi patients with AA. Subjects and Methods: Twenty patients (9 females and 11 males), with a mean age of 26.0 ± 8.0 years, with different lesions of stable alopecia areata localized on the scalp, were enrolled in this pilot study. Exclusion criteria include the use of any medication that may influence the course of the disease. All patients were treated with 500 mg of ginger powder once daily for 60zz days. Blood samples were obtained at zero time, day-30 and day-60 and utilized for the evaluation of the erythrocytes and lymphocytes contents of reduced glutathione (GSH), malondialdehyde (MDA) and total antioxidant status (TAS), in addition to the assessment of serum zinc (Zn) and copper (Cu) levels. The results are compared with those of 20 healthy subjects served as a control group. Results: Treatment of the AA patients with ginger significantly improves the antioxidant/oxidant balance of the erythrocytes and lymphocytes, which is known to be impaired in the patient group as compared with healthy subjects. The ginger powder also elevates the serum concentration of zinc up to that reported in controls and associated with normalizing serum copper levels at the end of the treatment period. Conclusion: Consumption of ginger as a supplement by the patients with AA could improve the oxidant/antioxidant balance of the erythrocytes and lymphocytes and restoring the normal level of serum zinc.

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Aims: The authors have used an in vitro model to appraise the antimicrobial efficacy of diode lasers with two different power outputs on Streptococcus mutans (SM), Lactobacillus casei (LC), and Actinomyces naeslundii (AN). Methods and Materials: The coronal dentin of thirty human mandibular third molars was prepared with four cylindrical cavities left in contact with SM, LC, and AN for 72 h to facilitate bacterial penetration. Diode laser (810 nm for 30 s in two cycles) with 1.5 W (group I), 1 W (group II), and 2% chlorhexidine gluconate solution for 60 s (group III) was applied on three cavities and the fourth cavity was not subjected to any treatment (control). Similar amounts of dentin debris were collected from the cavity into sterile tubes. The bacterial count was determined by serial dilution and plate count method. Percentage of killing was calculated for comparative analysis. Results: The percentage of SM killed after exposure was 73.68 ± 23.37, 51.75 ± 25.45, and 26.78 ± 21.8 in three groups, respectively, (P = 0.002; Kruskal–Wallis) with no significant difference between group I and group II (P = 0.089; Mann-Whitney). The percentage of AN killed after exposure was 37.77 ± 49.52, 22 ± 19.48, and 56.86 ± 23.93 in three groups, respectively, (P = 0.013; Kruskal–Wallis) with significant difference between group II and group III (P = 0.002; Mann–Whitney). The percentage of LC killed after exposure was 51.32 ± 39.07, 36.65 ± 38.48, and 75.41 ± 22.6 in three groups, respectively (P = 0.091; Kruskal–Wallis). Conclusions: Diode lasers exerted antibacterial effect of varying levels against all the three cariogenic bacteria. Although they are recommended as a supplementary antibacterial surface pretreatment technique for efficient removal of cariogenic bacteria, further clinical studies are required to confirm the in vitro findings.

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Background: Multiple Sclerosis (MS) patients should cope effectively with problems of life and with problems originating from the disease. This is important because it affects the course of the disease, psychiatric morbidity, and quality of life. Objective: This study was carried out as an intervention design with a control group to assess the effects of psychoeducation on MS patients' ways of coping with stress, psychiatric symptoms, and qualities of life. Subjects and Methods: A total of 80 MS patients affiliated with the MS Association of Turkey were included and randomly assigned into intervention and control groups. An 8-week psychoeducation program was offered to the intervention group, whereas the control group was not given any treatment during the same period. Data were collected using a Descriptive Information Form, the Ways of Coping Inventory, the Brief Symptom Inventory, and the MS Quality of Life-54 scale. Results: Based on the study, among the ways of coping with stress, problem-focused approach increased, whereas the emotional-focused approach decreased statistically significantly in the intervention group. Among the psychiatric symptoms, the levels of anxiety, depression, and somatization decreased. However, there was no significant change in the negative self-concept and hostility symptoms. The total quality-of-life scores increased significantly (P < 0.05). In the intervention group, these effects continued in the three-month-follow-up measurement. The control group showed no statistically significant change in the same parameters during the same periods. It is recommended that group psychoeducation programs should be carried out extensively in order for MS patients to cope with stress effectively and improve their mental health and quality of life.

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Objective: This study aims to investigate the effects of different antiseptic mouthwash on microbiota around the mini-screw applied to patients undergoing fixed orthodontic treatment. Materials and Methods: From patients who have been undergoing fixed orthodontic treatment and who have mini-screws in their mouth, a total of 38 patients were selected for the study consisting of 4 groups, each of which has 15 mini-screws. The patients were selected from the following groups: no use of mouthwash (Group 1), use of 0.12% chlorhexidine gluconate-containing mouthwash (Group 2), use of essential oils-containing mouthwash (Group 3), and use of 7.5% povidone-iodine-containing mouthwash (Group 4). Plaque indices and gingival indices of the patients were measured at the beginning (T₀) and at their appointments 3 weeks later (T₁). In addition, biological samples were collected from the sulcus around the mini-screw with the help of sterile paper point. Results: The total number of microorganisms around the mini-screw in Group 2, Group 3, and Group 4 decreased significantly compared to Group 1. A significant decrease in Streptococcus oralis, Streptococcus mitis, Candida parapsilosis, total bacteria, plaque index, and gingival index count was observed in T₁compared to T_0. Conclusion: Antiseptic mouthwash in Group 2, Group 3, and Group 4 can be used to reduce the number of microbial microbiota around the mini-screw and to improve oral hygiene.

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Background: Acute postoperative pain after myomectomy can impair patient function. Like all other postoperative pain, it is a challenge requiring solution, particularly in developing countries. Ultrasound-guided transversus abdominis plane (TAP) block and wound infiltration (WI) are both known to be effective in managing postoperative pain. It is not certain if transversus abdominis plain block would be superior to wound infiltration. Aims: It was hypothesized that the TAP block has similar analgesic effectiveness to wound infiltration. Subjects and Methods: This study was a randomized controlled trial involving, seventy-four (74) patients scheduled for myomectomy at the University of Benin Teaching Hospital Benin City, Nigeria under the subarachnoid block, which were randomized into TAP and WI group preoperatively. The ultrasound-guided bilateral TAP block group and wound infiltration group (subfascial and subcutaneous infiltration) each used 40 mL of 0.25% of plain bupivacaine to achieve postoperative analgesia. The time to first analgesic request, numerical pain rating scale (NRS) score at rest, and movement were assessed. Data were analyzed using SPSS version 16 (Chicago Il, USA). Results: The time to first analgesic request was significantly delayed in the TAP block group compared to the wound infiltration group [240 (131, 375) min vs 170 (128, 187) minutes. P = 0.006]. The proportions of patients with NRS score ≤3 at the time of first analgesic requests were significantly more in the TAP block group (P < 0.001). The analgesic consumed by the TAP block group was significantly low compared to the WI group. There were no incidences of complications due to TAP block or wound infiltration. Conclusion: TAP block provided a longer duration of analgesia and a clinically superior quality of analgesia to wound infiltration.

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Background: There are limited data describing different factors that influence survival rate of patients with rectal cancer. Aims: Our aim was to determine the influence of patient gender, American Society of Anesthesiologists (ASA) physical status, the location of the tumor and stage of the disease on the patient survival rates after excision of rectal cancer. Settings and Design: We included 385 patients who were operated between 2004 and 2014 in the University Clinical Center Maribor. The patients were treated due to rectal adenocarcinoma. We assessed survival rates according to gender, ASA physical status, the location of the tumor and stage of the disease with different statistical methods. Subjects and Methods: To find the extent of correlation between factors and survival rate, we used means and medians, Log Rank test, Breslow test and Tarone-Ware test. Results: According to patient gender, survival rate did not differ significantly (P > 0.05), however ASA physical status (P < 0.05), location of the tumor (P < 0.05) and stage of the disease (P < 0.05) significantly affected the survival rates. Conclusions: Our study showed that gender does not have a significant impact on survival rate as oposed to ASA physical status, the location of the tumor and stage of the disease.

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Objective: To compare the use of a piezosurgery expander and conventional chisel/osteotome on primary implant stability. Materials and Methods: Twenty fresh ribs were divided into two main groups; group P and group C. In group P, bone expansion was performed using piezosurgery. In group C, bone expansion was performed using conventional chisel osteotomy. In both groups, the implants were inserted into the ribs after bone expansion. After implant placement, primary stability values were evaluated from the bucco-lingual (B-L) and mesio-distal (M-D) sides of the implant. Results: The primary stability values on the B-L side of both implants in group P were significantly higher than in group C (P < 0.05). Conclusion: The use of piezo-expanders in the alveolar split technique has better effects on primary implant stability compared with the conventional technique.

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Background: Cancer maintains its importance as a major public health issue in the world and developing countries such as Turkey. Determining individuals' knowledge and attitudes about cancer is very important for cancer prevention. Research on knowledge and attitudes plays an important role in the development of targeted policies in the fight against cancer. Aims: The aim of this study was to determine the knowledge and attitudes of adult individuals about cancer and its risk factors. Methods: The study was conducted descriptively in the city center of Trabzon. The study population and sample consisted of 105.071 and 1200 adults aged 40 and over living in the city center, respectively. For the sample selection, multistage randomized sampling method was used. The data were collected using a questionnaire, which was developed by the researchers after reviewing the literature and receiving expert opinions. The findings were presented as descriptive statistics with numbers, percentages, and averages. Results: It was found that 45.7% of the participants smoked, 9.1% consumed alcohol, 40.8% consumed acidic foods, 33.0% had family history of cancer in first degree relatives, and 28.5% had cancer-related death in first degree relatives. The participants stated that cancer was the most fatal disease and listed the first three cancer-causing factors as cigarettes (95.7%), mobile phones (90.4%) and alcohol (90.2%). 62.4% of them did not know the symptoms of cancer, and 86.4% and 76.4% believed that 'sadness and stress cause cancer' and 'cancer is inherited', respectively. Conclusion: The study revealed that adult individuals had a significant level of false and incomplete information about cancer, and their behaviors having risk factors for cancer could not be altered and transformed into appropriate ones. Therefore, it is thought that informative studies on cancer should be carried out continuously to carry out the fight against cancer successfully.

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Background: Congenial educational environment (EE) is paramount to effective impartation of knowledge as required in residency training. In this study EE for residency training is evaluated using Postgraduate Hospital Educational Environment Measure (PHEEM). Objectives: To assess the postgraduate educational environment at the University of Nigeria Teaching Hospital (UNTH), South-East Nigeria, using PHEEM and to determine if there are significant differences in PHEEM scores amongst various sub-groups of resident doctors. Methods: A cross-sectional study, employing a census survey, involving the administration of validated PHEEM questionnaires to residents in the Departments of Internal Medicine, Obstetrics/Gynaecology, Pediatrics and Surgery in the year 2018. Data entry and analysis were done using SPSS. ANOVA assessed significance of total scores and sub-scale scores. Cronbach's alpha was calculated. Results: A total of 114 Males and 46 females; 93 registrars and 67 senior registrars responded giving 71% response rate. Overall PHEEM score was 85.82; Role autonomy (29.27), Perception of teaching (34.80), Perception of social support (21.55). Males scored more than females in total PHEEM score (p = 0.000, F = 148.235), perception of teaching (P = 0.000, F = 420), and perception of social support (p = 0.000, F = 162.95), but not in role autonomy (p = 0.748, F = 0.104). Registrars scored more than senior registrars in total PHEEM (p = 0.000, F = 67.159), role autonomy (p = 0.000, F = 25.123), Perception of teaching (p = 0.000, F = 18.042) but not in perception of social support (p = 0.31, F = 1.045). There were significant differences in total and subscale scores amongst the specialties. Cronbach's alpha was 0.915. Conclusions: Postgraduate educational environment in UNTH has more positives than negatives but with room for improvement. There are significant differences in PHEEM scores among various groups of resident doctors.

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Background: Hypertension is one of the commonest cause of chronic kidney disease (CKD) in Nigerians. We describe blood pressure (BP) control and kidney disease markers in patients with hypertension as part of measures to curb the burden of this chronic debilitating disease. Methods: Patients with hypertension in the main tertiary hospitals in three states in north central Nigeria were evaluated for indicators of CKD, including proteinuria and estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m². Patients had their early morning first void urine tested for proteinuria using Combi-10 test strips. eGFR was estimated using the MDRD equation. Results: A total of 1063 subjects (63.1% females and 36.8% males) with a mean age of 55 ± 11 years were studied. Diabetes mellitus (DM) was present in 214 (20.6%) and 422 (39.7%) had optimal BP control. The median duration of hypertension was 6 years (range 1–44 years). Proteinuria occurred in 130 (12.2%), while 212 (19.9%) had reduced eGFR and 46 (4.3%) had proteinuria and reduced eGFR. The use of calcium channel blockers [adjusted odds ratio (AOR): 0.70, 95% Confidence Interval (CI) 0.50–0.99] and the use of more than two antihypertensive medications (AOR: 0.62, 95% CI 0.40–0.96) were associated with reduced odds of optimal BP control. Male sex (AOR: 1.75, 95% CI 1.14–2.70) and the use of renin-angiotensin-aldosterone system blocking medications (AOR: 2.07, 95% CI 1.18–3.64) were independently associated with proteinuria while DM (AOR: 1.69, 95% CI 1.06–2.55) and treatment with more than two medications (AOR: 1.86, 95% CI 1.09–3.17) were more likely to have reduced eGFR. Conclusion: A large proportion of hypertensive patients in north-central Nigeria have poorly controlled BP. Kidney damage is common among these patients.

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Laparoscopic cholecystectomy is one of the most frequently performed minimally invasive interventions. Inflammation during acute or subacute cholecystitis and fear of biliary duct injury can lead to unintentional remnant gall bladder retention. Diagnosing a remnant gall bladder can be challenging, and misdiagnosis or delayed diagnosis is common. Once diagnosed, completion of the cholecystectomy is recommended, which can be performed laparoscopically.

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This report describes the successful use of two multifunctional mini-implants that were inserted into the palate in the treatment of an 18-year-old woman in whom the maxilla was skeletally narrowed and the molars have migrated mesially on both sides. Three different appliances were used in sequence in the course of treatment: first, an appliance supported by bone and teeth (hybrid hyrax) for surgically-assisted rapid maxillary expansion (SARME); second, a distalization device supported by mini-implants to achieve molar distalization; and third, a transpalatal arch (TPA) stabilized by mini-implants to allow indirect anchorage during retraction of the incisors. The mini-implants in the palate led to a reduction in the adverse effects of the SARME procedure and made treatment with cervical headgear unnecessary. TPA stabilized by the mini-implant was also used to retract the anterior teeth en masse, with no need for alterations in the treatment mechanism and using routine orthodontic methods.

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Background: Although implantable cardioverter-defibrillator (ICD) reduces mortality in heart failure patients with reduced left ventricle function, arrhythmic episodes are related with increased mortality. Aim: The aim of this study was to investigate whether low patient activity predicts arrhythmic events in the heart failure patients with primary prevention ICD. Methods: We examined 206 heart Failure (HF) patients (mean age: 61.3 ± 10.9 years, 77.7% male) with primary prevention implanted ICD who referred to our outpatient clinic for pacemaker control. After pacemaker (PM) controls, the overall study group was categorized into three distinct subgroups: Activity less than 2 h, activity 2–4 h, and activity 4–8 h in a day. Results: Activity less than 2 h had a substantially higher level of arrhythmic episodes in comparison to other groups (P < 0.05). In addition, appropriate shock or ATP (antitachycardia pacing) was detected higher in patients whose activity was less than 2 h in a day than other groups (P < 0.001). Conclusions: Detected low patient activity in ICD control may be a predictor of arrhythmic episodes and appropriate therapies. Increasing physical activity may potentially protect these patients from unwanted events.

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Background: Orofacial clefts (OCs) are one of the most common craniofacial anomalies and are reported to be associated with congenital cardiovascular anomalies (CCAs). However, there is paucity of data in African populations on the risk of CCAs in OC patients compared to the general population. Aims: This study aims to determine the odds of congenital cardiovascular anomalies in patients with OC compared to the general population. Subjects and Methods: A case-control study design was used. Case subjects were non-syndromic OC subjects, while controls were non-syndromic subjects without OC. All subjects were thoroughly assessed by a pediatric cardiologist for CCAs; and grouped by OC phenotypic type (cleft lip and/or alveolus, cleft lip and palate, cleft palate only and Tessier cleft). Statistical analysis was done using STATA version 14 (College Station, Texas), and significance was placed at P value ≤0.05. Results: A total of 120 subjects (60 cases and 60 controls) were enrolled in the study. In total, 23.3% of the subjects had CCAs. Among the case group, 40% had CCAs compared to 6.7% in the control group. Patent foramen ovale (18.3%) and atrial septal defects (10.0%) were the most common type of CCAs in cases, respectively. Further, cases had significantly higher odds of CCAs compared to controls (OR: 9.3; CI: 2.8, 39.4). Conclusions: Our finding reveals that the odds of CCAs are significantly higher in patients with OC than the general population. Future studies could assess the effect of CCAs on surgical outcome.

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Background: Most recent studies in Nigeria have documented high prevalence of hypertension, diabetes, and obesity. Several mechanisms may link hypertension and obesity hence the high prevalences of both disorders in Nigeria. There are however no studies on the prevalence of hypertension among the obese in urban settings. Aims: The aim of this study was to describe the prevalence and pattern of hypertension in overweight/obese individuals in a community. Methods: We conducted a post-hoc analysis on obese subjects 20 years and above from two urban settlements within Enugu metropolis. For database management and statistical analyses, we used the SPSS version 22. Results: Data from a total of 301 individuals with obesity who met the selection criteria were re-analyzed. A total of 198 (65.8%) individuals were found to have hypertension most of whom were newly diagnosed 110 (55.6%). The prevalence of hypertension was 65.8% and increased with age and BMI. Conclusion: Individuals with overweight/obesity have very high rates of hypertension. The prevalence of hypertension also increased with and BMI. Thus, there is need for targeted health education in adults to address the burden of obesity and hypertension to reduce the burden of cardiovascular disease in the community.

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Aims: The present study aimed to evaluate the clinical usefulness of endoscopic treatment of suprasellar arachnoid cysts indenting the third ventricle with obstructive hydrocephalus and discuss the clinical features and outcomes of thirteen children treated at our institution. Method: We treated thirteen pediatric cases of suprasellar arachnoid cysts indenting the third ventricle with obstructive hydrocephalus between January 2012 and September 2018. Five female and eight male patients were enrolled in the study. The patients had increased intracranial pressure symptoms due to hydrocephaly. Endoscopic treatment was performed in all cases. Results: The patients were followed-up for an average of 36.8 months. The postoperative intracranial pressure findings improved. There was a reduction in the size of the cyst and ventricles and enlargement of the cortical sulci. One patient suffered transient oculomotor nerve deficit. No further surgical interventions, such as shunt placement, were required during the follow-up period. The head circumference of two of the patients with macrocephaly were stable during the follow-up. There were no postoperative recurrences detected. Conclusions: Endoscopic cyst fenestration and third ventriculostomy are less invasive, safer, and more effective ways to treat suprasellar arachnoid cysts indenting the third ventricle with obstructive hydrocephalus in children with hydrocephaly.

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Objective: The purpose of this study was to determine the amount of bone available for harvesting from the anterior palate region using IOPA (Intra Oral Peri Apical) radiographs. Materials and Methods: A total of 80 patients visiting the outpatient Department of Periodontics were selected. Two groups of male and female consisting 40 patients each were made. They were further subdivided into two groups based on age, 18-30 and 31-60 years of age, each with twenty patients. The patients were subjected to radiographic examination consisting of IOPA radiographs. All IOPA radiographs were taken using long cone paralleling technique. Availability of bone for harvesting, above the apices of teeth was calculated. Results: The bone available in the incisor region was approximately 6.5 to 6.9 mm in height and 7.4 to 8 mm in width, in canine region 6.35 to 6.65 mm in height and 7.6 to 8.1 mm width, and in the premolar region 3.65 to 3.75 mm in height and width. When the bone height and width were compared gender and age wise for CI (central incisors), LI (lateral incisors), canine and premolars, using Student's t- test the results were not statistically significant. Conclusion: For the purpose of harvesting autogenous bone, from the region of incisor and canine approximately 6.35 to 6.9 mm height and 7.4 to 8.1 mm width of bone may be harvested maintaining a safe distance from the apices of the teeth and the nasal floor. The premolar region does appear to yield sufficient bone at safe distances from the maxillary sinus and the apices of the premolars.

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Background: Presbyacusis is a cause of hearing loss in adults worldwide. It is a type of auditory dysfunction thought to be due to a series of insults over time including agerelated degeneration, noise exposure, and diseases of the ear. It usually affects the high frequencies of hearing. Presbyacusis has a tremendous impact on the quality of life of millions of the aged and is fast becoming an increasingly prevalent disorder as the population ages. Nigerian population is becoming progressively older making it imperative to focus on this area of research. It is worth noting that the Nigerian public health system does not have an effective and sustainable hearing loss screening strategy for lateonset hearing loss in adults. Aim/Objective: This study evaluated the hearing threshold and pure tone audiometric pattern/s seen in participants with agerelated hearing loss (ARHL) in Gwagwalada Area Council of the Federal capital territoryAbuja. Subjects and Methods:The study was a prospective communitybased crosssectional study, and a multistage sampling technique was adopted for this study, conducted at Gwagwalada, Abuja. Individuals from 55 years and above were recruited into the study after signing an informed consent. After a thorough and detailed clinical assessment, tympanometry and diagnostic puretone audiometry were carried out in all the participants. Result: One hundred and fourteen participants were recruited into the study, out of which fourteen were excluded from the analysis on account of various exclusion criteria. The age range of the participants was 55 to 79 years, with a mean age of 65.8 ± 5.6 years.Twentyfive (25.0%) participants had normal hearing threshold, while seventyfive (75.0%) participants had sensorineural hearing loss (SNHL). Conclusion: The study showed that the prevalence of ARHL from age 55 years and above at Gwagwalada Area Council, of FCT, Abuja was 75.0%.

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Objective: To evaluate the relationship between visual acuity (VA) and endocrine status among patients with giant sellar tumors pre and postsurgical treatment. Methods: A 7-year single institution prospective cohort study of patients with giant sellar tumors treated by pterional transylvian microsurgical resection. Patients were evaluated and followed-up by a collaborative team of ophthalmologists and neurosurgeons. Results: Sellar tumors represent 25% of our brain tumors cases (n = 257). Giant sellar tumors were 61 (23.7%) cases. Pituitary adenomas occurred in 40 patients and in 24 of these, the tumor was a functional adenoma. The age range was 16 to 75 years with a mean of 43.7 ± 3.3 years. Visual impairment (n = 60), headache (n = 55), and endocrinopathy (24) were among the common manifestations. VA and visual field defects were experienced by 59 and 39 patients, respectively. For both eyes, endocrine active tumors presented with poorer preoperative VA profile using mean logMAR VA [(χ² = 10.3, P = 0.002 OD) and (χ² = 8.9, P = 0.003 OS)]. Postoperatively, the mean logMAR VA profiles of endocrine active tumors showed a significantly better response when compared to endocrine inactive tumors in both eyes [(χ² = 5.53, P = 0.029 OD) and (χ² = 6.77, P = 0.037 OS)]. Conclusion: Visual acuity defects are almost invariable in patients with giant sellar tumor and may be associated with an endocrine profile. Surgical resection with normalization of hormone status is rewarded with VA improvement.

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Background: Globally, low back pain (LBP) is now the leading cause of disability. Patients often have lumbar spine motion dysfunction (motion decrease/increase), and this may affect the lumbar lordosis (LL). Though the relationship between LL and LBP is controversial, it has immense clinical significance, because it serves as the basis of therapeutic exercises for treating and preventing LBP. An angular measure of LL that consistently detects even a small lordotic change (LC) would be considered reliable. Aims and Objectives: The consistency of some radiographic angles in detecting LC in a potential LBP disorder was evaluated, and LC fulcrum deducted. Materials and Methods: In both normal (control) and spondylotic (test) lateral lumbosacral radiographs of both genders, LL was retrospectively measured using the following angular measures and sample sizes: Lumbosacral angle (LSA, 125), Lumbosacral joint angle (LSJA, 115), Cobb angle (118), and Tangential radiologic assessment of lumbar lordosis (TRALL) angle (101). The angles' consistency in detecting intra-gender LC between control versus test was evaluated. The intervertebral disc (IVD) that sub-tended the most consistent angle represents the LC fulcrum. All cases were ≥17 years of age. Data was analyzed with IBM SPSS Statistics 23.0 (NY, USA); P < 0.05 was considered statistically significant. Results:LSJA detected slight intra-gender LC in both genders, LSA in males only, Cobb and TRALL angles in none. The IVD of L5/S1 sub-tended the LSJA and therefore represents the LC fulcrum. Conclusion: LSJA is a reliable measure of lumbar LC in physical therapy of LBP, especially, the non-specific LBP disorders.

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Objectives: The aim of this study is to evaluate the pattern of presentation, anatomic anomalies, and treatment outcomes in patients presenting with acute testicular torsion in a tertiary health institution in southeast Nigeria. Methods: This was a prospective study of all consecutive patients with acute testicular torsion seen from January 2011 to November 2019 at our institution. Their demographic and clinical data were analyzed. Results: Thirty-one acute testicular torsion cases were seen during the study period. Mean age was 22.6 (±7.3) years. Two peaks of incidence were observed. These were in the 14–19-year and 20–25-year age groups. The left testis was more commonly affected than the right; 15 cases (48.4%) versus 13 cases (41.9%). Past history of intermittent torsion was seen in 48.4% of cases. Abdominal pain was the commonest associated symptom followed by vomiting; 20 (64.5%) and 11 (35.5%). Seven cases (22.6%) of acute torsion occurred during sleep. Delay in presentation and delay in surgical intervention were observed. Only 22.6% of patients presented within 6 h of onset of symptoms and only 32.3% were operated on within 6 h of presentation. Transverse lie of the testes was the most common intraoperative finding (36%). Testicular salvage rate was 87.1%. Conclusions: Acute testicular torsion is a disease of young adults in southeast Nigeria. It is commoner on the left side with transverse lie being the most common predisposing factor. A new peak incidence in the 20–25-year age group is demonstrated. Late presentation is common but did not impact testicular loss in this study.

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Background: The relationships among serum Apelin, Asymmetric- dimethylarginine (ADMA), N-terminal probrain natriureticpeptide (NT-proBNP) levels, and blood pressures in dialysis patients are not well known. Materials and Methods: Age and sex matched 30 hemodialysis (HD), 30 peritoneal dialysis (PD) patients, and 20 healthy controls were recruited. Serum apelin-36, ADMA, NT-proBNP levels, and blood pressures of both patients and healthy controls were measured and compared. Results: Serum ADMA and Apelin levels in HD patients were significantly higher than in PD patients. In multiple regression analyses the predictors of higher serum apelin levels were higher BMI, higher ADMA and lower systolic blood pressure. The predictors of serum ADMA levels were being on HD. The predictors of serum NT-proBNP levels were lower serum albumin and higher systolic blood pressure. Conclusion: Being on HD is a predictor of high ADMA levels. HD might be less effective on ADMA removal than PD. It seems that higher serum apelin levels related with lower sytolic blood pressure levels, whereas higher NT-proBNP levels related with higher sytolic blood pressure levels indicating potential roles as independent prognostic factors for systolic hypertension in dialysis patients.

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Objective: The relationship between sexual functions and infertility remains controversial and there is a limited number of studies reporting the effects of infertility on sexual functions in women with polycystic ovary syndrome (PCOS). Aims: The present study aims to investigate the effects of infertility on sexual functions and depression levels in women with PCOS. Methods: A total of 150 participants who were either fertile patients with PCOS, infertile patients with PCOS, or fertile women without PCOS (control) (n = 50) were included for the study. Sociodemographic data were recorded and the Female Sexual Function Index (FSFI) and Beck Depression Inventory (BDI) were used for evaluation of subjects. Results: Body mass index (BMI) was found to be significantly higher in the PCOS plus infertility group (27.9 ± 2.9, P = 0.01) than the other groups. Total BDI score was higher and total FSFI score was significantly lower in the PCOS plus infertility group than in the other groups. The PCOS plus infertility group showed significantly lower FSFI scores than the PCOS group in terms of desire, lubrication, orgasm, satisfaction, and pain. A significant negative correlation was observed between BMI and BDI scores in the PCOS plus infertility group (r:−0.384, P = 0.04). Conclusion: Our study results show lower sexual functions in PCOS women with infertility and that infertility negatively affects sexual functions with obesity associated depression.

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