Background: Orff Music Therapy improves auditory processing, language, and cognitive functions in children who have Intellectual Disability (ID). Aims: In literature, there are no studies from the auditory processing skills reviewing perspective. The current study examined the role of Orff Music Therapy in terms of auditory processing skills of children who have ID. Method: Twenty-nine children who have ID were subjected in a 6-week Orff Music Therapy program. Results: The mean musical assessment scores improved after Orff Music Therapy. The total Listening Inventory (TLI) scores before Orff Music Therapy were considered to be risky above the cut-off level for children who have ID. The criterion cutoff scores show if the child's behaviors may indicate a disorder or dysfunction. The TLI scores were reduced after Orff Music Therapy, which means there was an improvement in auditory processing skills. Conclusion: Auditory processing skills are essential for children who have ID. If a child who has ID has been identified as having auditory processing disorder (APD), there is a need for a proven therapeutic approach, like Orff Music Therapy. It has been considered that ID and APD can be linked in the same category of neurodevelopmental disorders.

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Background: Self-care practices in individuals with diabetes are important skills required to effectively prevent, manage, and limit complications associated with diabetes since patients spend considerably less time with health care providers than spend alone to manage their diabetes condition. Aims: The aim of the study was to assess self-cate practices and their determinants among patients with type 2 diabetes. Hence, this study aimed at assessing self-care practices and their determinants among patients with type 2 diabetes. Materials and Methods: This cross-sectional, descriptive, multi-center study was conducted among 348 type 2 diabetes patients selected from six tertiary hospitals in Southwest Nigeria. Descriptive statistical analysis was employed for categorical and continuous variables and multivariable logistic regression assessed association between determinant factors and adherence to self-monitoring of blood glucose (SMBG). Results: Of the study participants, 83.1%, 66.9%, 28.4%, and 27.9% adhered to prescribed medications, physical exercise, had meal plans incorporated into their diabetes management and SMBG, respectively. There was a statistically significant association between male gender, duration of diabetes, and previous episode of hypoglycemia with adherence to SMBG practices while lower educational level and use of insulin were associated with less likelihood of adherence to prescribed medications. Conclusion: The degree to which individuals with diabetes adhered to recommended self-care practice components were less than satisfactory especially SMBG, physical activity, and having meal plans.

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Background and Aims: Since the amendments to the Regulation of Patients' Rights in May 2014, the concept of euthanasia and the validity of the decisions taken towards the end of life have been protected by the “Regulation Amending the Regulation of Patients' Rights.” This research study was carried out using a triple Likert scale to record the opinions of patients, who were staying at the University Hospital, and doctors and nurses on the issues of the “euthanasia ban” and “taking personal decisions and requests into an account.” Methods: A descriptive cross-sectional design using self-report questionnaires was used. This survey was carried out using a triple Likert type scale to determine the views of the patients receiving inpatient treatment, as well as the opinions of doctors and nurses on the subject of patients' rights. Results: Four hundred and forty patients receiving inpatient treatment, 171 doctors, and 162 nurses in the University Hospital participated in the survey. Although the patients desired that their personal decisions be taken into consideration most, the nurses attached more importance than the other two groups to the issue of the right to the termination of treatment. Conclusions: It was found that more than half of the doctors, nurses, and patients expressed that it is important for a patient to have the right to make decisions regarding his/her own life. *This was presented as an Oral Presentation at the 7^th National Congress of Ethics and Medical Law on March 21, 2017.

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Root canal therapy in teeth with root fenestrations can present with pain on apical palpation or persistent pain. The signs and symptoms of root fenestration in the absence of mucosal fenestration may be misleading, which may be misdiagnosed as non-odontogenic pain. Although CBCT is superior to periapical radiographs for the diagnosis of root fenestration, it failed to detect the intact cortical plate in the middle third in our cases. Therefore, the type was different in CBCT from its actual size surgically. Repeated non-surgical root canal treatment would not alleviate pain in the presence of root fenestration and may lead to apical root fracture. Root-resection relieves pain, unless the fenestration is accompanied by fracture. The aim of these two case reports was to describe the diagnosis and treatment of endodontically treated teeth with a persistent pain. Also, the difference of root fenestration type between CBCT and its actual size was described.

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Background: Third molar impaction, if left untreated, has the potential to cause several complications. The evaluation of surgical difficulty of impacted third molar extraction aids in better formulation of treatment plan by minimizing surgical complications. Objective: This study aimed to determine the prevalence of third molar impaction and related pathologic conditions in a cohort of patients living in North-eastern Peninsular Malaysia. Methods: In this retrospective study, 490 orthopantomograms (OPGs) of patients who were referred to the Oral and Maxillofacial Surgery department between January 2010 and December 2019 were assessed. Data including age, gender, ethnicity, frequency of third molar impactions, their angulations and levels of eruption, retromolar space, and associated pathologic conditions were collected. Statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 24.0. The significance level was set to P < 0.05. Results: A total of 490 patients with a mean age of 28.87 years (range: 20–64) demonstrated 1957 impacted third molars (1022 mandibular + 935 maxillary). Impacted third molars were more likely present in females than males (1:2.20) (p < 0.05); and in Malay-ethnic (44.49%) patients followed by Chinese (34.45%) and Indians (21.02%). Mesioangular was the most common angulation of impaction both in the maxilla (24.68%) and mandible (18.34%). The most common pattern of third molar impaction was IIA (61.67%), and the retromolar space was significantly larger in males (13.6 mm; P < 0.05) than females (11.6 mm). The most frequently occurring pathological condition associated with third molars impaction is dental caries in the second or third molar (15.38%). Conclusions: This study highlights mesioangular impaction with their occlusal plane at the same level as the occlusal plane of the adjacent tooth being the most prevalent pattern of third molar impaction in North-eastern Peninsular Malaysia.

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Objectives: To measure dental implant stability by two noninvasive methods which are vibration characteristics of the periodontium Periotest® and resonance frequency analysis Osstell. The objective of this comparative study was to assess the correlation of these 2 techniques in clinic. Materials and Methods: Implant stability of 54 clinically stable unloaded implants in 10 males and females (mean age: 52.05 ± 8.42) was measured in triplicate by Osstell and Periotest^®. The measurements were taken first in the same day of the surgery and the second was 4 weeks later. Statistical analysis was performed with SPSS 22.0 (P < 0.05). Results: The mean values were 75.90 ± 5.13 ISQ for the resonance frequency analysis and − 4.31 ± 1.43 PTVs for Periotest. There was no significant difference in first and the second measurements accordance with gender. However, a significant difference was shown in ratio of percentage change for both PTV and ISQ values in female patients. There was a positive strong correlation between mean percentage changes of PTV and ISQ values (P = 0.811, P = 0.001). The only significant difference between ISQ values and implant length was observed at 4 weeks (P = 0.037). Conclusions: Although Periotest^® values appear to be more susceptible to clinical conditions, both measuring techniques are applicable in the assessment of implant stability.

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Background: Keloid is a fibroproliferative disorder of dermal origin, common and severe in the dark-skinned individuals. The patients suffer from pain and pruritus with poor body image. Aims: We compared the efficacy and side effects of intra-lesional verapamil and triamcinolone in patients with keloids. As most treatments are cumbersome, recurrence is a major problem despite the many treatment modalities. There is need for effective monotherapy with minimal complications. Materials and Method: This is a prospective, randomized study of intralesional injection of verapamil and triamcinolone in keloids conducted in the Burns and Plastic unit of a tertiary hospital. There were two groups; triamcinolone treatment group (TTG) and verapamil treatment group (VTG). A total of 115 patients with keloids <10 cm were diagnosed, 37 (32.2%) were excluded, and 78 were included into the study. There were 40 patients in the TTG and 38 patients in the VTG. Eventually, 70 patients completed the study. Triamcinolone 40 mg and 2.5 mg of verapamil were used for TTG and VTG respectively. The changes in the dimensions of keloids were measured using an electronic caliper. The symptoms were assessed using the visual analog score for pain and the pruritus score was adapted from the 5-D pruritus score. Results: Triamcinolone completely resolved pain and pruritus in 6 and 12 weeks, respectively, while there was no complete resolution among VTG patients. However, verapamil injection was comparably effective to triamcinolone for small-size keloids. Conclusion: Verapamil as monotherapy is less efficaceous in the resolution of symptoms of keloids but is comparable to triamcinolone in reducing the size of small-sized keloids.

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Background: Segmental Assessment of Trunk Control (SATCo) is a scientific evaluation measure used to assess trunk control in subjects with cerebral palsy (CP). Aims: The present study aimed at assessing the psychometric properties of SATCo in children with spastic quadriplegic CP. Methodology: This was an observational study in which we validated a test instrument in 31 children (aged 1–5 years) with spastic quadriplegic CP. Children were assessed for trunk control by principal rater (R1) using SATCo. Each assessment was video recorded, scored retrospectively, and independently by principal rater (R2) and secondary rater (R3) for intra-rater and inter-rater reliability, respectively. Concurrent validity was assessed by comparing the SATCo scores with sitting component scores of Gross Motor Functional Measure -88. Results: Intra-class correlation coefficient values for intra-rater and inter-rater reliability for various components of the scale ranged from 0.82 to 0.98. The concurrent validity was calculated for various components of the scale using the Pearson correlation coefficient and they ranged from 0.72 to 0.77. Conclusion/Recommendation: SATCo is a reliable and valid scale that can be used for examining trunk control in children with spastic quadriplegic CP aged 1–5 years.

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Background: IL-13 is the key cytokine in the regulation of inflammatory with an autoimmune disease and has an anti-inflammatory effect. Aims: This study aimed to compare IL-13 (-1112 C/T and -1512 A/C) gene polymorphisms in patients with aggressive periodontitis (AgP), chronic periodontitis (CP), and periodontally healthy group (C) and evaluate the effect of nonsurgical periodontal therapy on gingival crevicular fluid (GCF) IL-13 levels in patients. Materials and Methods: One hundred thirty patients with AgP, 120 patients with CP, and 70 periodontally healthy subjects were included in this study. Clinical parameters were recorded (plaque and gingival index, probing pocket depth, clinical attachment level), and GCF and blood samples were taken at baseline and 6-week. Nonsurgical periodontal therapy was performed in patients with periodontitis. Gene analyses (IL-13 − 1112C/T (rs1800925) and − 1512 A/C (rs1881457) were performed with real-time polymerase chain reaction (PCR) and cytokine levels were determined by an enzyme-linked immunosorbent assay method. Results: AgP and CP patients showed significant improvement in clinical parameters after periodontal therapy (P < 0.05). According to results, genotype distributions and allele frequencies in IL-13 variants − 1112C/T and − 1512 A/C were found similarly in all groups (P > 0.05). In the AgP group, GCF IL-13 cytokine level is statistically significant and increased in 6 weeks; however, in the CP group, there is no statistically significant difference between baseline and 6 week. In the AgP group, baseline GCF IL-13 cytokine level is lower than those of the CP group and C group (P < 0.05). Conclusion: Within the limits of this study, IL-13 -1112 and -1512 gene polymorphisms have not been associated with AgP and CP, and GCF IL-13 cytokine level is increased after treatment in the AgP group.

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Objective: To evaluate the knowledge, attitude, and practice of general population for Corona virus disease 19 (COVID-19). Methods: A total of 950 participants submitted an online self-administered questionnaire, which was developed through literature search and validated. The online survey link was distributed through various social media platforms (WhatsApp, Instagram, Facebook, LinkedIn, Twitter, Snapchat, Pinterest, and Tumblr). And 861 forms were included in the study after checking for completion of relevant response from participants, whereas 89 forms were excluded. The data were analyzed through Statistical Package for Social Sciences. Descriptive statistics were performed for percentage and frequency determination of quantitative and qualitative variables. Spearman's correlation and Chi square test were performed to control confounders and association of knowledge, attitude, and practices with gender and education level. The P value <0.05 was considered as statistically significant. Results: More than two third of the population was aware of COVID-19 and three fourth had had bachelor's degrees, whereas 18% had master level education. 85% have not attended any courses, awareness campaigns, and lectures to inculcate recent and updated knowledge. 83% believed that COVID-19 is a serious threat to the community; hence, prevention strategies should be adopted. There was no significant relationship (p = 0.23) between knowledge, attitude, and practice levels with gender, whereas a significant relationship (p = 0.01) was noted with education of participant. Similarly, a significant relationship (p = 0.00) was seen between knowledge and practices of participants toward COVID-19. Conclusion: The studied population displayed adequate knowledge, attitude, and practice to combat COVID-19. However, we also find a knowledge gap between information source and perception of COVID-19 among our study participants. Therefore, there is a critical need for effective education and widespread public campaigns aiming to enhance relevant and contemporary information related to prevention and management of COVID-19.

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Aim: This investigation aimed to compare the accuracy of Bolton's analysis on plaster models of various malocclusion groups by utilizing digital calipers and iTero scanner. Materials and Methods: The data consisted maxillary and mandibular plaster study casts of 61 patients (Class I-20, Class II-20, Class III-21) there were 31 males and 30 females. iTero®element scanner was utilized to scan the models and Bolton's analysis was performed on digital models. Also, the Digital caliper was utilized to perform the Manual measurements. Mesiodistal tooth widths, Anterior and Overall Bolton ratio was measured utilizing OrthoCAD™ software on digital models and plaster models with digital calipers. Statistical analysis was performed utilizing One-way ANOVA and independent T-test. Results: Results revealed anterior and overall Bolton ratios showed significant differences (P < 0.05) for the measurements performed utilizing digital models. Anterior ratio for (Group 1) iTero measurements depicted the statistical significant value (P < 0.03) and overall ratio for (Group 2) digital caliper measurements depicted the statistical significant value (P < 0.02). Conclusion: With the introduction of intra-oral laser scanners it has become more convenient for the practitioner to perform the intra-oral digital scanning and carry out the model analysis digitally and iTero scanner can also be utilized extra-orally to perform the scanning and model analysis. Our study concludes that intra-oral laser scanner like iTero is more convenient for an orthodontist, and can be utilized for extra-oral scanning of orthodontic dental models as the measurements obtained on digital models was as accurate as the conventional method.

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Background: Methicillin-resistant Staphylococcus aureus (MRSA) has been a widespread problem in Turkish hospitals. Aims: The aim of this study was to investigate the staphylococcal toxin genes of the clinical and nasal MRSA isolates, and their antibiotic resistance profiles. Materials and Methods: Isolation of nasal and clinical bacteria was done following standard microbiological methods. The presence of antimicrobial resistance genes (mec A, pvl, tsst-1, and SEs genes) was determined using the real-time polymerase chain reaction (PCR) assay. Results: Among nasal MRSA isolates, 66.7% were toxigenic. The distribution of genes was as follows: pvl 26.7%, tsst-1 3.3%, and SEs 36.7%. Therefore, the nasal MRSA isolates had a rate of 23.3% multidrug resistance (MDR) pattern to the non-beta-lactams antibiotics. All (100%) clinical MRSA isolates were found to be toxigenic. The distribution of genes was as follows; pvl 10%, tsst-1 6.7%, and SEs 100%. The clinical MRSA isolates had a rate of 60% MDR. Conclusions: Following detection of pvl, tsst-1, and SEs among nasal and clinical MRSA isolates, and the presence of high antimicrobial resistance, the spread of these strains may be an additional factor contributing to the emergence of community-acquired (CA)-MRSA and hospital-acquired (HA)-MRSA. This study is the first to determine the resistance to linezolid and tigecycline in both nasal and clinical MRSA isolates, for the first time in Turkey. All nasal and clinical MRSA isolates were uniformly susceptible to vancomycin and quinupristin-dalfopristin. Our findings show that MRSA infections in Turkey can be empirically treated with vancomycin and quinupristin-dalfopristin based on the lack of demonstrable resistance to these drugs.

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Background: Inguinal hernia is a common pathology seen by the general surgeon in the outpatient clinic. Its spectrum of clinical features on presentation significantly varies from the asymptomatic to the complicated. Objective: To identify and audit the common clinical presentation and presence of known risk factors for inguinal hernia among adult patients with inguinal hernias presenting to an outpatient clinic. Methods: The study involved adults presenting over 1 year at a surgical clinic with a clinical diagnosis of inguinal hernia. Data on age, sex, family history, abdominal pain, constipation, chronic cough, previous hernia surgery as well as features of bladder outlet obstruction and intra-abdominal mass were recorded into a format. Analysis into a simple percentage, mean, and standard deviation was done with SPSS version 17 (SPSS Inc. Chicago, IL, USA). Results: Sixty-five patients were enrolled in the study, comprising 49 males (75.4%) and 16 females (24.6%), M:F = 3:1. The mean age was 45.6 years (SD ± 16.9). The 16–40-year age group had the highest incidence of 29 cases (44.6%) of inguinal hernia. A family history of inguinal hernia (31 cases [47.7%]) and history of previous inguinal hernia surgery (15 cases [23.1%])) was observed. Ten patients with previous surgery presented with a contralateral hernia and 5 with a recurrence. Other factors were chronic constipation 10 cases, smoking 9 cases, chronic cough 8 cases, dysuria 7 cases, enlarged prostate 6 cases, abdominal mass 4 cases, and urethral stricture 1 case. Conclusion: Inguinal hernia is common among young and middle-aged adults in our series. Many patients have features suggestive of complications at presentation. Family history and past inguinal hernia surgery were important risk factors.

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Background: Colonoscopy is an investigation modality used for colorectal examination; it is the most accurate technique for the diagnosis and surveillance of important colorectal diseases such as cancers (colorectal cancer) and polyps. Aims: Most studies on colonoscopy in Nigeria were conducted in southwest such as Ilorin, Ife, Ibadan, and Lagos. We therefore feel the need to get information from other regions such as northwest, the area of this study. The aim of this study was to identify the common indications as well as colonoscopic findings among patients who had colonoscopy in Aminu Kano Teaching Hospital, Kano. Methodology: It was a 10-year retrospective descriptive study of patients who had colonoscopy between January 2008 and December 2017 at the study center. Colonoscopy register was used to extract information concerning the patient's age, gender, symptoms that necessitated the request for the procedure, and the endoscopic findings. Results: A total of 839 patient records were reviewed, males constituted 62.2% of the patients. The mean age ± standard deviation was 43.86 ± 18.36 years, with a range of 8–96 years. The 30–39 years constituted the modal age group, followed by 40–49 years and 50–59 years. The commonest indications for the procedure were rectal bleeding (52.4%), chronic abdominal pain (51.3%), and diarrhea (48.8%). The cecal intubation rate was 98.2% with hemorrhoids as the commonest finding (42.3%) followed by suspected inflammatory bowel disease lesions (18.1%) and suspected colorectal tumors (16.2%). Conclusion: The commonest reason for colonoscopy was rectal bleeding while the commonest colonoscopic finding was hemorrhoids.

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Background: Body mass index is a major determinant of cardiac annular valvar dimension and left ventricular mass index in children with sickle cell anemia. Objectives: The study is aimed at ascertaining the impact of Body Mass Index on Left ventricular mass index, right ventricular function and cardiac dimension of children with sickle cell anemia. Methods: A case control study in which echocardiographic measurement of cardiac function and structures were ascertained among children with sickle cell anemia compared with hemoglobin AA genotype. Results: There were 51 subjects and 50 controls. The subjects comprised 54.9% males and controls, 52.0% male. There was a strong positive correlation between BMI and most cardiac structure diameters among children with normal hemoglobin genotype (Pearson's correlation coefficient value, P < 0.001) There was also statistically significant positive correlation between BMI and LV mass among the subjects (n = 50, r = 0.5, P < 0.001). There was significant positive correlation between BMI and TAPSE in both subjects and controls as well as between BMI and RVSP among the subjects, but not the controls (p < 0.001). There was no significant difference in the number with left ventricular hypertrophy (LVH) based on their nutritional status (n = 51, χ^2 = 7.03, P = 0.32). The BMI correlated negatively with left ventricular mass index (LVMI) among the subjects, but the correlation was not statistically significant (r = -0.1, P = 0.53) Conclusion: There was significant positive correlation between BMI and TAPSE in both subjects and controls as well as between BMI and RVSP among the subjects, but not the controls. Body mass index correlated negatively with left ventricular mass index (LVMI) among the subjects.

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Aims: We aimed to determine the normal immunoglobulin values of Turkish new-borns by studying IgG, IgA, IgM, and IgG subgroups (IgG1, IgG2, IgG3, and IgG4) from term, healthy neonates born in the Sakarya province of Turkey. Subjects and Methods: In our study, IgA, IgM, IgG, and IgG subgroup levels were measured nephelometrically in 54 new-borns (15–21-day-old). They were born between 39 and 41 weeks of gestation by problem-free delivery and with Apgar scores >8 at 1 and 5 minutes. The enrolled neonates were singletons and were free of congenital diseases/anomalies, history of perinatal infection, and with no known history of transfusion or chronic disease in the mother. The study findings were also evaluated in terms of differences based on delivery mode, feeding type, gender, and demographic characteristics. Results: This study enrolled 54 new-borns, 42 (77.8%) of whom were born by cesarean section and 12 (22.2%) by spontaneous vaginal delivery. Of the new-borns, 41 (75.9%) were only breastfed, and 13 (24.1%) were fed with combined breast milk and baby formula. The 95% confidence intervals of serum immunoglobulins and IgG subgroups were as follows: IgG, 652–722 mg/dL; IgA, 6–8 mg/dL; IgM, 27–35 mg/dL; IgG1, 495.7–544.3 mg/dL; IgG2, 139.6–169.5 mg/dL; IgG3, 22.7–27.7 mg/dL; and IgG4, 21.5–33.7 mg/dL. There was no significant correlation between any demographic characteristic and any immunoglobulin type. A low-moderate but significant negative correlation (r: –0.34) was found between birth length and IgA and a low-moderate but significant positive correlation (r: 0.32) was found between head circumference and IgM level. Conclusion: Our study provided usable data on the normal values of serum IgG, IgA, IgM, and IgG subgroups among healthy Turkish new-borns. This study is thought to be one of the most standardized and reliable reference sources for our country.

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Background: Fat accumulation in the visceral and subcutaneous regions can trigger fat necrosis during acute pancreatitis (AP). Aims: We investigated the role of visceral and subcutaneous fat in acute pancreatitis. In this study, we investigated the role of visceral and subcutaneous fat to understand the efficiency of adipose tissue in the AP. Materials and Methods: Computed tomography of 68 patients and 68 healthy at the level of L4-5 intervertebral disc were analyzed for body adiposity composition using designated software. Body subcutaneous and visceral composition was measured by using the designated software of the CT. Results: Visceral fat was higher in the control group (198 ± 146) than the group of the AP (155 ± 118) (P = 0.038), whereas the subcutaneous fat was found higher in the AP instead (292 ± 133 to 139 ± 102; P = 0,001). Visceral fat (B = 0,29; P = 0,0013), gender (male) (B = -0.3; P = 0.0122), age (B = 0.274; P = 0.0087), and complication (B = -0.229; P = 0.007) predicted the subcutaneous fat as the dependent variable. In the receiver operating characteristic (ROC), the area under curve was 0.562 (0.402–0.636; 95% CI, P = 0.038) for the visceral fat, while it was 0.906 (0.824–0.962; 95% CI, P < 0.0001) for the subcutaneous fat. Its cutoff was calculated as 183.7 for subcutaneous fat. Conclusion: Visceral fat analysis showed a contradiction according to subcutaneous fat that AP was strongly associated with subcutaneous one. The result supports that visceral and subcutaneous fat tissues should have different path of inflammation affecting the AP.

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Background: Drug interactions in oncology are of clinical importance owing to the inherent use of multiple medications in cancer treatment which predisposes patients to drug-related problems. Aim: This study aimed to compare two electronic databases based on the frequency, mechanism and severity of drug-drug interactions (DDIs) in cancer treatment at Near East University Hospital. Method: A retrospective observational study of hospitalized cancer patients who had received more than one chemotherapy and/or supportive-care drugs from April 2017 to April 2019. Lexi-interact tool by Lexicomp and Drugs.com databases were used to check (DDIs and all detected interactions were categorized based on the severity-level and mechanism of interaction. Results: A total of 681 prescriptions were evaluated and the median medication per patient was 4 (IQR 3-6). Drugs.com identified potential DDIs in 129 (84.9%) patients while Lexicomp identified potential DDIs in 113 (74.3%) patients. Drugs.com reported DDIs of 394 pairs while Lexicomp reported DDIs of 313 pairs. More than 50% of the potential DDIs were classified as pharmacodynamic interactions in both databases. There were varied reports of severity of potential DDIs, but the test of agreement using kappa index was 0.592 (95% CI: 0.502-0.682, P = 0.0001) and this was interpreted as a moderate agreement between the two databases. Conclusion: Lexicomp documented more detailed information relevant to clinical practice. However, Drugs.com with more sensitivity, detected more potential DDIs. Therefore, we suggest the use of at least two drug databases for quality screening, especially for patients predisposed to polypharmacy.

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Chronic osteomyelitis of the tibia is a common sequela of acute osteomyelitis which may present with a bone defect following sequestrectomy. Treatment of the gap nonunion can be done with the ipsilateral fibula as a strut graft when harvested subperiosteally and this leads to good outcome. A 7-year-old girl presented to our facility with a 25 cm defect of her right tibia following sequestrectomy for chronic osteomyelitis in another facility. X-rays revealed a healthy tibia superiorly and inferiorly with an intact fibula. She subsequently had an ipsilateral subperiosteal nonvascularized fibula harvest which was used to fill the tibia defect as a strut graft. The synostosis healed perfectly and the fibula reossified, time to union was 17 weeks, and the patient commenced full weight-bearing thereafter. Management of bone gap following sequestrectomy for chronic osteomyelitis remains a challenge to the orthopedic surgeon. The subperiosteal fibular harvest and use as a strut graft is a viable option with good outcomes. Our experience with this case may serve as a way out of this usual challenge.

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Desmoid tumours are rare and locally invasive neoplasms that originate from the muscles and their aponeurosis. Incomplete excision causes recurrences; therefore, patients require aggressive resection that essentially entails tumour excision with a clear surgical margin. After radical resection, the resultant wide defect may lead to difficulty in closure of the anterior abdominal wall. Here, we report a case having surgery for large desmoid tumour of the anterior abdominal wall through an abdominoplasty incision followed by an abdominal wall reconstruction with a dual-sided composite mesh.

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Background: The relationship between body mass index (BMI) and health-related quality of life (HRQoL) in adolescence is important but there is a dearth of this information among developing countries such as Nigeria. To assess the relationship between BMI and HRQoL among healthy schooling adolescents in Southwestern Nigeria. Aims: We assessed the relationship between BMI and HRQoL among healthy schooling adolescents in southwestern Nigeria. Methods: In a cross-sectional study design, 650 adolescents were selected and interviewed about their quality of life in the preceding 1 month using a validated instrument with contents adapted from the Pediatric Quality of Life Inventory (PedsQL^TM) questionnaire. The BMI was calculated and plotted on the Center for Disease Control and Prevention percentile chart to categorize as underweight, normal, overweight, or obese. Comparisons were made using Student's t-test, ANOVA, and linear regression model at P = 0.05. Results: Participants mean BMI and overall HRQoL score was 19.0 ± 3.0 kg/m² and 73.7 ± 11.7, respectively. The prevalence of underweight, overweight, and obesity was 6.9%, 2.3%, and 0.6%, respectively. Females (72.3 ± 12.2) had a significantly lower overall mean HRQoL score than males (75.0 ± 11.1), P = 0.048. Post-hoc ANOVA showed that obese adolescents had significantly lower mean HRQoL in school functioning domain (55.0 ± 20.8) than underweight (83.5 ± 14.), and normal BMI (81.3 ± 16.3) participants (P < 0.05). Conclusion: Obesity reduces HRQoL in the school functioning domain among adolescents in Ibadan, Nigeria. Our finding buttresses the need to monitor body mass and size in high schools for enhancing quality of life.

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Background: Infertility is a public health challenge and it is a distressing personal tragedy for couples, more so for the female partners. Risk factors and causes of infertility vary from region to region. Reactive species is of current interest in the pathogenesis and management of infertility, especially in the Niger-Delta Region of Nigeria where environmental hazards of oil exploration exists. Aim: The overall goal of this study was to determine and compare the serum reactive species levels (nitric oxide) in fertile and infertile women attending the infertility clinic at the Delta State University Teaching Hospital, Oghara, and Central Hospital, Warri. Methods: This was a prospective case-control study in which 70 women evaluated for infertility were recruited into the study. A fertile patient matched for age and body mass index (BMI) attending family planning clinic was selected as control. Serum nitric oxide estimation was done using the BioVision Nitric Oxide Colorimetric Assay Kit. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS). Student's t-test was applied to compare the serum levels of nitric acid and the differences were considered significant if P < 0.05. Results: Infertile women had significantly higher mean serum nitric oxide levels than fertile women: 34.33 (SD 5.93) μmol/L versus 18.27 (SD 2.63) μmol/L (P < 0.001). Women with secondary infertility had significantly higher mean levels of nitric oxide than those with primary infertility: 38.13 (SD 3.39) μmol/L versus 22.72 (SD 4.36) μmol/L (P < 0.001). Conclusion: The study showed that serum nitric oxide level was significantly elevated in women with infertility compared to women of proven fertility. Hence, oxidative stress from reactive species may be a contributory factor to infertility in women in the Niger-Delta Region of Nigeria.

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There has been a slow but steady decline in the frequency of contrast fluoroscopic studies performed all over the world, including oesophagography. This trend is attributed to the increasing availability of endoscopy, computed tomography (CT), and magnetic resonance imaging (MRI). Other diagnostic modalities that are continually supplanting oesophagography are manometry and oesophageal pH monitoring. As a result, contrast oesophageal imaging as a diagnostic modality is gradually being relegated to the background by both the radiologists and other physicians. The aim of this paper is to consider some of the reasons responsible for the general decline, especially as it relates to the third world, and to review, in general terms, the role of contrast oesophageal imaging studies in the diagnoses of gastro-intestinal diseases, and the reasons for continuous use of this modality in modern medical practice.

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