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The energy absorption characteristics of composites are developed for applications likely to be subjected to sudden or prolonged impacts. In lightweight applications, the possibilities of Al 6061 composites are being explored with various known materials with similar properties. Three materials of low densities but high strength was combined: hexagonal honeycomb Al 6061 core was sandwiched with polyurethane foam and embedded within two glass fiber-reinforced polymer plates. L-9 orthogonal array Taguchi DOE was adopted for the design of the experiment varying the polyurethane mixture, core height, and face sheet thickness using the three-factor method. From the output of the Taguchi DOE, twenty-seven samples were fabricated. In order to determine the force-displacement relationship for each of the test samples, a three-point bending test was performed on a universal testing machine. Energy absorption (EA) and crushing force (CF) were determined from the force and displacement values. These values were then optimized to minimize the PCF while maximizing EA. Numerical analysis performed correlated with the results from experimental samples after testing. Since energy absorption is a measure of applied force and the resulting displacement on a material, the energy absorption characteristics were discussed. [ABSTRACT FROM AUTHOR]

A coupled Mori-Tanaka/finite element strategy was implemented to capture deformation profiles of aluminum AA 6063 cylindrical and hexagonal tubes reinforced with 60% variable coir-fiber thickness (5 mm, 10 mm) coir-fiber under variable oblique crushing. By a representative volume element (RVE) defined elastic moduli of the reinforcement phase hybrid tubes were simulated for the effect of reinforcement layer thickness under the Johnson-Cook's and Hashin's intralaminar damage with cohesive zone modeling. As, transformations in deformation underscored variabilities in shape, multicellularity and reinforcement thickness, a correlation is found between loading angles and peak crushing forces in evolving a lightweight absorber consistent with extreme oblique impacts. [ABSTRACT FROM AUTHOR]

This article is a book review of "Contemporary issues in Christian marriage: In commemoration of the retirement of Rev. Dr. Samuel Oluwafemi Oladimeji from active ministry of the Nigerian Baptist Convention." The book is a collection of essays on various topics related to marriage, written by different contributors. Each chapter addresses a different aspect of marriage, such as discerning God's will in selecting a partner, making the best of the dating period, and communication in the Christian home. The book also includes a short biography of Rev. Dr. Samuel Oluwafemi Oladimeji. While the book covers many important topics, the reviewer notes that some contemporary issues, such as divorce and artificial intelligence's role in marriage, are not addressed in the book. [Extracted from the article]

Minimizing the breach detection gap (BDG) for cyber-attacks is a big concern for all organizations and governments. Cyber-attacks are discovered daily, many of which have gone undetected for days to years before the victim organizations detect and deploy the cyber defense. Cyber defense solutions are advancing to combat risks and attacks from traditional to next-generation advanced defense protection solutions. However, many individuals, organizations and businesses continue to be hit by new waves of global cyber-attacks. In this paper, we present a blockchain-enabled federated cloud computing framework that uses the Dempster-Shafer theory to reduce BDG by continuously monitoring and analyzing the network traffics against cyber-attacks. We evaluate the proposed approach using numerical results, and the proposed approach outperforms the traditional approaches. [ABSTRACT FROM AUTHOR]

Proteases are important group of enzymes with wide industrial applications including laundry. They have been isolated and characterized from different agro wastes but the use of Citrus sinensis fruit peel as a source of protease has not been reported. In this study, low molecular weight (10-17 kDa) proteases were purified and characterized from C. sinensis fruit peel using a combination of ammonium sulphate precipitation, dialysis and sephadex G150 column chromatography. One unit of protease activity was defined as the amount of the enzyme required to liberate one microgramme (1 µg) of tyrosine from gelatin per minute at 37°C under standard assay conditions. The elution profile obtained from gel filtration chromatography depicted three peaks of protease activity designated as proteases I, II and III. The purification fold obtained for ammonium sulphate precipitation, dialysis and Proteases I, II and III fractions were 1.7, 3.85, 9.47, 9.84 and 8.47 respectively. The activities of Proteases I and II were significantly increased (p<0.5) in the presence of 5-10 % w/v, and 1-10 v/v % Tween 80 respectively. However, the activity of Protease III was not significantly affected (p>0.5) by Tween 80. Triton-X significantly increased (p<0.5) Protease II activity at 5 to 10% v/v concentrations but did not significantly affect (p>0.5) the activities of Proteases I and III between 1 to 10% v/v concentrations. SDS significantly increased (p<0.5) the activities of proteases I and II at 5-10 % w/v, and 1-10 w/v % respectively but did not significantly affect (p>0.5) Protease III activity. Findings from this study suggest that proteases from C. sinensis fruit peel are detergent stable which may be useful in laundry industries. [ABSTRACT FROM AUTHOR]

Background: Achieving guideline-recommended blood pressure is imperative in reducing the rising tide of uncontrolled hypertension and its attendant sequelae, which are major causes of morbidity and mortality globally. The aim of the study was to describe the pattern of blood pressure control and identify the factors influencing blood pressure control among patients with primary hypertension seen at family medicine clinics of FMC, Abeokuta. Methods: This was a descriptive cross-sectional hospital-based study. A systematic random sampling technique was used in selecting 360 hypertensive respondents over four months. Data were collected through a pre-tested interviewer-administered questionnaire. The Statistical Package for the Social Sciences (SPSS) version 17.0 was used to analyse data. Results: Blood pressure was controlled in 167 (46.4%) of the respondents. The independent predictors of blood pressure control were female gender (p = 0.001, OR = 2.494, 95% confidence interval (CI) = 1.477-4.214), regular use of medication (p = 0.001, OR = 2.900, 95% CI = 1.508-5.577), regular clinic attendance (p < 0.001, OR = 3.512, 95% CI = 1.772-6.960), and absence of diabetes mellitus (p < 0.001, OR = 7.357, 95% CI = 3.190-16.966). Conclusions: The rate of blood pressure control among the hypertensive respondents was low. Multiple independent predictors of controlled blood pressure call for a team-based approach as well as multiple approaches including education of patients, expansion of a community-based health insurance programme and intensification of treatment efforts when managing hypertensive patients. [ABSTRACT FROM AUTHOR]

Context: Nonadherence to therapeutic plans has been reported among hypertensive patients. Researchers have also shown that adherence to therapeutic plans improves if motivation in the form of social support is provided. There is a dearth of local studies that explore the influence of family support on treatment outcomes of hypertensive patients. Aims: The aim of the study was to determine the relationship between BP control and perceived family support in patients with essential hypertension seen at a primary care setting in Western Nigeria. Settings and Design: This was a cross-sectional hospital-based study. Subjects and Methods: Systematic random sampling technique was used in selecting 360 hypertensive respondents between April and July 2013. Data were collected through a pretested interviewer-administered questionnaire and a standardized tool, Perceived Social Support Family Scale, which measured the respondents' level of perceived family support. Statistical Analysis Used: Statistical Package for Social Sciences (SPSS) version 17.0 was used to analyze data. Results: The majority of the respondents were middle-aged (61.1%) and female (59.4%). Blood pressure (BP) was controlled in 46.4% of the respondents. Most of the respondents (79.4%) had "strong" perceived family support. Strong perceived family support (odds ratio [OR] 4.778, 95% confidence interval [CI] =2.569-8.887) and female gender (OR 1.838, 95% CI = 1.177-2.869) were independent predictors of controlled BP. Conclusions: The proportion of hypertensive patients with optimal BP control is low in this practice setting. The positive association between BP control and perceived family support emphasizes the need for physicians to reflect on the available family support when managing hypertensive patients. [ABSTRACT FROM AUTHOR]

Objective: Contributing to medical practice in developing countries has become increasingly prevalent. Primary care and preventative health initiatives have been most visible, although attention has recently shifted to surgical disease, which represents a large burden in resource-poor settings. Typically dominated by individual efforts, there is now a more concerted approach, with surgical care being included in the comprehensive primary health care plan set by the World Health Organization. Although ethical dilemmas in international surgery have been discussed sporadically in the context of specific missions from the visiting surgeon/team perspective, we are missing a comprehensive evaluation of these issues in the literature. Here we have chosen to systematically categorize ethical issues confronted while teaching and operating in a developing country into 2 broad categories: venue (i.e., host) and visitor related. Methods: For each category, topics within follow an ordinal sequence that one might use when designing a surgical education mission. Illustrative examples are provided, as well as a depiction of the ethical principles or theories involved. Results and Conclusions: This article provides a discussion written from visiting and host surgeon perspectives on diverse ethical challenges for which there is limited literature, including location selection, unmet needs at home, role of sponsors, and personal gain. In addition to candid discussion and a solutions-focused approach, the reader is provided with an “ethical checklist” for international surgical education, akin to the World Health Organization surgical safety checklist, to serve as a framework for the design of surgical missions that avoid ethical pitfalls. • Peer-Review Article [ABSTRACT FROM AUTHOR]

Objective: The aqueous extract of Celosia argentea var. cristata L. leaves at 100, 200, and 400 mg/kg body weight (b.w.) was investigated against cadmium (Cd)-induced oxidative stress in Wistar rats. The in vitro antioxidant of the extract was evaluated using ammonium thiocyanate, reducing power, and membrane stabilizing models. Materials and Methods: For the in vivo study, 30 male rats (Rattus norvegicus) weighing138.02 ± 7.02 g were completely randomized into 6 groups (A–F) of 5 animals each. Animals in groups A and B received 0.5 ml of distilled water and the same volume containing 8 mg/kg b.w. of Cd, respectively, for 7 days orally. Animals in groups C, D, E, and F were treated like those in group B except that they received 100mg/kg b.w. of ascorbic acid, and 100, 200, and 400 mg/kg b.w. of the extract, respectively, in addition to Cd. Results: Phytochemical screening revealed the presence of alkaloids (0.61%), saponins (2.93%), cardiac glycosides (0.21%), cardenolides (0.20%), phenolics (3.26%), and flavonoids (2.38%). A total of 10 mg/ml of the extract inhibited linoleic acid oxidation by 67.57%. The highest reducing power was 100 mg/ml as against 10 mg/ml for ascorbic acid. In addition, 2 mg/ml of the extract produced a membrane stabilizing activity of 63.49% as against 77.46% forindomethacin. Compared with the distilled water control group, the administration of Cd alone significantly (P < 0.05) decreased the alkaline phosphatase activity of the rat liver and brain. This decrease was accompanied by a corresponding increase in the serum enzyme. The simultaneous administration of the extract and Cd produced an enzyme activity that compared favorably (P > 0.05) with the animals that received Cd and ascorbic acid. In addition, the reduction in the superoxide dismutase and catalase activity of the liver and brain of the animals, serum uric acid, albumin and bilirubin, and also the increase in the serum malondialdehyde content in animals treated with Cd alone was attenuated by the extract; the values compared well (P > 0.05) with those simultaneously administered with Cd and ascorbic acid. Conclusion: Overall, the results indicated that the aqueous extract of C. argentea leaves attenuated Cd-induced oxidative stress in the animals, with the best result at 400 mg/kgb.w. The antioxidant activity of the extract may be attributed to the phenolic and flavonoid components of the extract. The induction of antioxidant enzymes and scavenging of free radicals may account for the mechanism of action of the extract as an antioxidant. [ABSTRACT FROM AUTHOR]

The effect of hydroxyurea, sodium thiocyanate and potassium tellurite on cations content and membrane properties of sickle erythrocyte was investigated in this study. Human sickle blood was incubated with the drugs in vitro at their optimum sickling inhibitory concentration. Mean corpuscular volume (MCV), mean corpuscular haemoglobin concentration (MCHC), cations (Na+, K+ and Ca2+) contents and viscosity were measured. Tellurite and thiocyanate significantly increased (P<0.05) MCV, reduced MCHC and blood viscosity and also significantly inhibited (P<0.05) calcium accumulation by sickle red blood cell. In addition, the two drugs increased red blood cell sodium gain and inhibited potassium loss significantly. Incubation of the drugs with sickle erythrocyte ghost membrane indicated that tellurite and thiocyanate significantly inhibited (P<0.05) Na+-K+-ATPase (EC 3.6.3.9) and Ca2+-Mg2+ ATPase (EC 3.6.3.8) activities. Blood incubated with hydroxyurea also significantly inhibited (P<0.05) calcium ion accumulation but had no effect on all other measured parameters. This result suggests that thiocyanate and tellurite have positive modification effect on sickle erythrocyte membrane and cation transport thereby causing rehydration and improvement in red blood cell deformability. [ABSTRACT FROM AUTHOR]

The anti-inflammatory effect of dexamethasone on the irradiated kidneys of adult Wistar rats (Rattus norvegicus) was studied. Eighteen adult Wistar rats were, after acclimatization, randomly divided into 3 groups of 6 animals per group. The control group had normal saline, receiving neither drugs nor radiation. The second group received normal saline and radiation. The third group received pretreatment with dexamethasone at 1mg/kg body weight/day for 2 days followed by radiation. Radiation was delivered to the animals as a single fraction of 2.5 Gy of gamma rays from Cobalt-60 source, using an AECL Theatron 780-C Teletherapy machine. After exposure to the different interventions, the animals were sacrificed on the I 4th post-irradiation day and the kidneys dissected out from each animal. The renal tissues were subjected to histological processing, and then studied using an eyepiece objective ruler calibrated with a 2mm stage micrometer for histomorphometric studies. The result of the study showed that all irradiated animals suffered weight loss by the 14th day post-irradiation (p<0.05) irrespective of the additional treatment with dexamethasone and this was statistically significant. Histomorphometry showed that the maximum width of the glomerular capsule was significantly greater in the radiation groups than in the control at p<0.05. The maximal glomerular diameter was significantly greater in irradiated animals compared with the control animals at p<0.05. The outcome of this study showed that the intraperitoneal administration of dexamethasone at 1mg/kg body weight/day for 2 days prior to treatment with irradiation did not prevent weight loss nor ameliorate the swelling of the nephrons resulting from the effect of radiation injury to the Wistar rat. [ABSTRACT FROM AUTHOR]

A prospective randomised study of 54 patients undergoing caesarean section was carried out to determine if non-closure of peritoneum at lower segment caesarean section has advantages over suture peritonisation with regard to postoperative morbidity. A total of 27 women were randomised to closure and 27 to non-closure of peritoneum. Management decisions were made without reference to treatment groups. Statistical analysis compared the outcome between the two groups. The results revealed that anaesthesia and operating times were significantly shorter in patients that had the peritoneum left open. The incidence of febrile morbidity, wound infection, duration of postoperative and duration of hospital stay were not significantly different in both groups ( p [ABSTRACT FROM AUTHOR]

Benign intracranial hypertension (BIH) may lead to blindness and rarely deafness. We describe the case of a rapidly deteriorating 14-year-old African girl who presented with headaches associated with complete visual and hearing loss due to BIH. This was managed non-operatively with lumbar cerebrospinal fluid tap, weight reduction, nicotinic acid and acetazolamide. Response to treatment was quite dramatic with resolution of severe headaches and regaining of light perception 8 days after commencing treatment. By 3 months hearing recovered to normal and there was resolution of vision. This to the best of our knowledge is the first reported case of complete visual and hearing loss occurring in a patient with BIH, which was managed successfully non-operatively. When indicated, non-operative management is an effective treatment option even in malignant BIH. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

The spectrum of post-operative infections in neurosurgical practice includes scalp infection, bone flap osteomyelitis, meningitis and intracranial abscesses and is associated with significant morbidity and mortality. There is a wide variation across neurosurgical centres in the use of perioperative antibiotic prophylaxis. The aim of this study was to determine whether intraoperative wound irrigation with ceftriaxone provides additional prevention of surgical site infection (SSI) in patients already receiving the drug parenterally. This was a prospective randomized clinical study of patients 18 years and above scheduled for clean neurosurgical procedures and assigned to either study or control group using table of random numbers. Both groups had parenteral ceftriaxone at the induction of anaesthesia and for 24-h post-operation. In the study group, there was intra-operative wound irrigation with a ceftriaxone-in-normal saline solution while the wound in the control group was irrigated with only normal saline. Clinical and or laboratory evidence of SSI was used as the outcome measure. One hundred and thirty-two patients aged 18 years and above were recruited for this study. There were 66 patients in each group. The overall frequency of SSI was 2.27% (3 out of 132). The frequency in the ceftriaxone group was 3% (2 out of 66) while that in the control group was 1.5% (1 out of 66). These values were not significantly different (p = 1.00). There were four cases of wound edge necrosis, three of which developed SSIs. In this study, intraoperative antibiotic irrigation did not confer additional benefit in the prevention of SSI in clean neurosurgical procedures in which prophylactic intravenous antibiotics were administered to the patient. Wound edge necrosis was the most significant but preventable risk factor for the development of SSI in the setting of this work. [ABSTRACT FROM AUTHOR]

To search for a novel thermostable esterase for optimized industrial applications, esterase from a thermophilic eubacterium species, Thermoanaerobacter tengcongensis MB4, was purified and characterized in this work. Sequence analysis of T. tengcongensis esterase with other homologous esterases of the same family revealed an apparent tail at the C-terminal that is not conserved across the esterase family. Hence, it was hypothesized that the tail is unlikely to have an essential structural or catalytic role. However, there is no documented report of any role for this tail region. We probed the role of the C-terminal domain on the catalytic activity and substrate preference of T. tengcongensis esterase EstA3 with a view to see how it could be engineered for enhanced properties. To achieve this, we cloned, expressed, and purified the wild-type and the truncated versions of the enzyme. In addition, a naturally occurring member of the family (from Brevibacillus brevis) that lacks the C-terminal tail was also made. In vitro characterization of the purified enzymes showed that the C-terminal domain contributes significantly to the catalytic activity and distinct substrate preference of T. tengcongensis esterase EstA3. All three recombinant enzymes showed the highest preference for paranitrophenyl butyrate (pNPC4), which suggests they are true esterases, not lipases. Kinetic data revealed that truncation had a slight effect on the substrate-binding affinity. Thus, the drop in preference towards long-chain substrates might not be a result of substrate binding affinity alone. The findings from this work could form the basis for future protein engineering allowing the modification of esterase catalytic properties through domain swapping or by attaching a modular protein domain. [ABSTRACT FROM AUTHOR]

Protein tyrosine phosphatases (PTPs) of the polymerase and histidinol phosphatase (PHP) superfamily with characteristic phosphatase activity dependent on divalent metal ions are found in many Gram-positive bacteria. Although members of this family are co-purified with metal ions, they still require the exogenous supply of metal ions for full activation. However, the specific roles these metal ions play during catalysis are yet to be well understood. Here, we report the metal ion requirement for phosphatase activities of S. aureus Cap8C and L. rhamnosus Wzb. AlphaFold-predicted structures of the two PTPs suggest that they are members of the PHP family. Like other PHP phosphatases, the two enzymes have a catalytic preference for Mn2+, Co2+ and Ni2+ ions. Cap8C and Wzb show an unusual thermophilic property with optimum activities over 75 °C. Consistent with this model, the activity–temperature profiles of the two enzymes are dependent on the divalent metal ion activating the enzyme. [ABSTRACT FROM AUTHOR]

Objective: The practice of diabetes self-care behaviors has been cited as a foundation for achieving optimal glycemic control. Proper motivation of people with diabetes mellitus is, however, needed for the performance of these behaviors. It is therefore pertinent to know if motivation by the family will improve glycemic control in people with type 2 diabetes mellitus. This study aimed to investigate the relationship between glycemic control and perceived family support among Nigerians with type 2 diabetes mellitus. Methods: A cross-sectional study was conduced on 316 adults with type 2 diabetes mellitus who attended a medical outpatient clinic. Data were collected through a pretested intervieweradministered questionnaire and a standardized tool (Perceived Social Support - Family scale). Hemoglobin A1c level was used as an indicator of glycemic control. Results: The proportion of participants with good glycemic control was 40.6%. Most of the participants (137, 43.8%) had strong perceived family support. Strong perceived family support (P = 0.00001, odds ratio 112.51) was an independent predictor of good glycemic control. Conclusion: This study shows that strong perception of family support is a predictor of glycemic control among the adults with type 2 diabetes mellitus studied. Physicians working in sub- Saharan African countries with rich kinship networks should harness the available family support of people with type 2 diabetes mellitus in their management. [ABSTRACT FROM AUTHOR]

The effects of Moringa oleifera leave extracts on the morphology and behaviour of the postnatal developing rat brain was studied. Twenty pregnant rats of Wistar strain weighing between 160 g and 180 g were used in the study. The pregnant rats were divided into two groups of ten animals per group. Group I animals received distilled water and served as control animals, while group II animals received 200 mg/kg body weight of Moringa oleifera leave extract orally. All the animals were provided with rat cubes and water ad libitum during pregnancy and lactation. After birth, five pups of day 21 were weighed and subjected to behavioural study. Animals of days 1, 7, 14, 21 and 28 of age were sacrificed by cervical dislocation, the brain dissected out, weighed and fixed in 10% formol-saline for microscopic studies. Some congenital malformations such as meromelia, phocomelia and amelia were observed in the Moringa oleifera group only. There was a significant increase in body weight of the Moringa oleifera animals on days 7, 14 and 21, in brain weight on days 1 and 7, and in cerebral weight on days 1, 7 and 21 (p<0.05). The behaviour of the rats was significantly worse in the Moringa oleifera group, especially in the area of motor function. Microscopically, there was significant reduction in the cerebral cortical thickness of Moringa oleifera group on days 21 and 28. Immunohistochemical studies revealed poor myelination in the Moringa oleifera group. The results indicate that maternal consumption of Moringa oleifera significantly affected the general morphology as well as behaviour of their pups, therefore it should be consumed with caution in pregnancy until better knowledge on humans is available. [ABSTRACT FROM AUTHOR]

A case of acute severe noncommunicating hydrocephalus complicating a high cervical arteriovenous malformation (AVM) is presented here. A 29-year-old lady, 4 years after partial microsurgical resection of a high cervical intramedullary AVM, presented with sudden-onset weakness of all extremities, impaired cognition, cervical/occipital pains, and bisphincteric dysfunction. She was drowsy but arousable with a Glasgow coma scale score of 14. She had spastic quadriparesis and cognitive impairment. Cranial computerized tomographic scan showed marked panventriculomegaly. There was some blood residue in the posterior horn of the right lateral ventricle and transependymal spread of cerebrospinal fluid (CSF) indicative of the subacute/chronic nature of the obstruction to the CSF circulation. Cervical spine magnetic resonance imaging also showed the residual upper cervical AVM. She had an emergency ventriculoperitoneal shunting with good neurologic outcome. Spinal AVMs may present with unusual intracranial hemorrhagic complications. Attending physicians should always be mindful of this fact in the total clinical evaluations of each case. [ABSTRACT FROM AUTHOR]

The histology of the middle cerebral artery (MCA) in Nigerian Africans has not been previously studied. One hundred MCAs obtained at autopsy from fifty adult Nigerians were studied. The vessels were processed and stained with Ehrlich's haematoxylin and eosin, elastic Van Gieson and Masson's trichrome stains. Early branches were given off before the perforators in two middle cerebral arteries, and there was one accessory MCA, making an incidence of anomalies of 3%. No aneurysm was observed in any of the cases. The internal elastic laminas were well developed but the external elastic laminas of the vessels were poorly developed. Close to the bifurcations the tunica media tapered gradually and at the bifurcations, the tunica media was completely deficient being replaced by the tunica adventitia (Forbus raphe). The tunica adventitia was thicker at the bifurcations (0.21mm) compared to other sites of the vessel. The average thickness of the MCA tunica media at its origin was 0.12mm while that of the tunica adventitia was 0.10mm. These results are similar to what has been described in the literature for Caucasians. It buttresses the assertion that anatomical anomalies of the MCA are rare. The seemingly low frequency of MCA aneurysms in Nigerian Africans is not due to its anomalies or histology. [ABSTRACT FROM AUTHOR]

Catheter ablation is an established effective approach for the treatment of atrial fibrillation (AF) in patients with heart failure, however, the role of cryoablation in this setting is unclear. Procedural success and left ventricular systolic dysfunction (LVEF) improvement in patients with LVEF ≤ 45% undergoing index catheter ablation with cryoablation were evaluated. Freedom from AF recurrence was seen in 43% rising to 59% following repeat procedure. There were significant improvements in LVEF and functional status at long‐term follow‐up. Results were comparable to a contemporaneous cohort of heart failure patients undergoing index ablation with radiofrequency ablation. Cryoablation is an effective first‐line AF ablation approach in the setting of heart failure. [ABSTRACT FROM AUTHOR]

Kola nut (from Cola nitida) is popular in Nigeria and West Africa and is commonly consumed by pregnant women during the first trimester to alleviate morning sickness and dizziness. There is, however, a dearth of information on its effects on the developing brain. This study, therefore, investigated the potential effects of kola nut on the structure of the developing neonatal and juvenile cerebellum in the rat. Pregnant Wistar rats were administered water (as control) or crude (aqueous) kola nut extract at 400, 600, and 800 mg/kg body weight orally, from pregnancy to day 21 after birth. On postnatal days 1, 7, 14, 21 and 28, the pups were weighed, anaesthetised, sacrificed and perfused with neutral buffered formalin. Their brains were dissected out, weighed and the cerebellum preserved in 10% buffered formalin. Paraffin sections of the cerebellum were stained with haematoxylin and eosin for cerebellar cytoarchitecture, cresyl violet stain for Purkinje cell count, Glial Fibrillary Acidic Protein (GFAP) immunohistochemistry (IHC) for estimation of gliosis, and B-cell lymphoma 2 (Bcl-2) IHC for apoptosis induction. The kola nut-treated rats exhibited initial reduction in body and brain weights, persistent external granular layer, increased molecular layer thickness, and loss of Bergmann glia. Their Purkinje cells showed reduction in density, loss of dendrites and multiple layering, and their white matter showed neurodegeneration (spongiosis) and GFAP and Bcl-2 over-expression, with evidence of reactive astrogliosis. This study, therefore, demonstrates that kola nut, administered repeatedly at certain doses to pregnant dams, could disrupt normal postnatal cerebellar development in their pups. The findings suggest potential deleterious effects of excessive kola nut consumption on human brain and thus warrant further studies to understand the wider implications for human brain development. [ABSTRACT FROM AUTHOR]

We assessed the hypothesis that nonoperative management would be a viable treatment option for patients with underlying degenerative disease who have traumatic cervical spinal cord injury (TCSI) without neurological deterioration and/or spinal instability during hospitalization. Data were collected prospectively from 2011 to 2016. All the patients had been treated nonoperatively with hard cervical collar immobilization. The clinical parameters assessed included the Frankel grade at presentation and discharge, the occurrence of deep vein thrombosis, urinary tract infection, sphincter dysfunction, and pressure sores. The radiographic data collected included magnetic resonance imaging signal cord changes. P ≤ 0.05 represented a significant association between the Frankel grade at presentation and the outcome parameters. A total of 28 patients were included in the present study. Of the patients who had presented with Frankel grade B, 85.71% had improved to a higher grade, 90.91% of the patients with Frankel grade C had improved to a higher grade, and 14.29% of the patients with Frankel grade D had improved to Frankel grade E. All the patients had satisfactory spinal stability, as evidenced by dynamic radiographs, after treatment. The findings from the present study have shown that nonoperative management can result in improved neurological outcomes for patients with underlying degenerative disease who have experienced TCSI without evidence of neurological deterioration and spinal instability. The Frankel grade at presentation was significantly associated with outcome parameters such as the neurological outcome on discharge and the occurrence of urinary tract infection. The results from the present study could be helpful to neurological surgeons in rural and other low-resource settings because the cost savings realized by nonoperative treatment will not sacrifice the provision of adequate care to their patients. [ABSTRACT FROM AUTHOR]

The global challenge to the treatment of malaria is mainly the occurrence of resistance of malaria parasites to conventionally used antimalarials. Artesunate, a semisynthetic artemisinin compound, and other artemisinin derivatives are currently used in combination with selected active antimalarial drugs in order to prevent or delay the emergence of resistance to artemisinin derivatives. Several methods, such as preparation of hybrid compounds, combination therapy, chemical modification and the use of synthetic materials to enhance solubility and delivery of artesunate, have been employed over the years to improve the antimalarial activity of artesunate. Each of these methods has advantages it bestows on the efficacy of artesunate. This review discussed the various methods employed in enhancing the antimalarial activity of artesunate and delaying the emergence of resistance of parasite to it. [ABSTRACT FROM AUTHOR]

Objective: This study was designed to evaluate the relationship between injury severity, admission Random Blood Glucose [RBG] and management outcome in a cohort of Nigerian patients with Head Injury [HI]. Materials and Methods: RBG was determined at admission, twenty four hours as well as seventy two hours after admission in patients with head injury. Severity of injury was graded using Glasgow Coma Scale (GCS). Outcome of management was determined by Glasgow Outcome Score at discharge. Serum glucose level of = 11.1 mmol/l was taken as hyperglycaemia. Analyses of variance [ANOVA] was used to determine level of significance and a P value of < 0.05 was considered significant. Results: There were 146 male and 30 female patients (range: 2 years to 78 years; mean; 34.4 years, SD: 16.4 years). Most (36.4%) of the patients had severe HI. Only 2.5% of the patients had hyperglycaemia at admission. Death occurred in 25% of the patients, moderate disability occurred in 30.1% and good outcome occurred in 35.8%. Hyperglycaemia occurred in one patient each in mild and severe head injuries and in two patients with moderate head injury. All the patients with hyperglycaemia had favourable outcome. Conclusion: Random blood glucose of = 11.1 mmol/l was not common at admission in head injured patients in this cohort of patients and the value was not associated with severe injury or poor outcome. [ABSTRACT FROM AUTHOR]

Background: Basal skull fractures (BSF) in head injury may be missed clinically. Early detection ensures prompt treatment and prevention of complications We compared the clinical and Computed Tomography (CT) features of basal skull fractures in head injured patients in a southwestern Nigerian hospital. Materials and Methods: Head injury patients who had cranial CT at a Southwestern Nigerian hospital were selected. CT images were acquired with a 64-slice Toshiba Aquillion CT scanner using a standard head protocol. The images were evaluated for evidence of skull fractures, and associated complications. The clinical data and CT findings were analyzed. Results: One hundred and thirty patients were evaluated, including 103 (79.2%) males. Their ages ranged between 7 months and 81 years, mean 35 years (SD, 20.3). In 59 patients (45.4%, 59/130) BSF was detected on CT, while 71 (54.6%) had no evidence BSF. Forty-two (71.2%) of the 59 patients detected on CT had clinical suspicion of BSF (P < 0.001) while the remaining 17 (28.8%) were not clinically diagnosed. This equaled a sensitivity of 71.2% and, specificity of 90.1% for clinical determination of BSF in this study. There was no statistically significant difference between clinical and CT diagnosis (P > 0.05). The commonest observed clinical feature in patients with confirmed BSF was otorrhagia (45.8%) and the petrous temporal bone (45.8%) was the most commonly fractured bone. The BSF was caused most commonly by motor bike accidents in 53 (40.8%). The most common associated intracranial injuries were intracerebral haemorrhage (34.6%) and subdural (17.3%) Conclusion: It appears that neurosurgical evaluation is comparatively reliable in evaluating basal skull fractures in this study area even as they are consistently demonstrated by high resolution CT scanners. A clinical suspicion of BSF should warrant a closer detailed CT evaluation and reporting by radiologists. [ABSTRACT FROM AUTHOR]

The mechanism of modulation of vanadate inhibition of alkaline phosphatase activity by catalytic cofactors has not been fully characterized. We investigated the effect of the interaction of catalytic cofactors (Mg2+ and Zn2+) and vanadate (an active site inhibitor) on the rate of hydrolysis of para-nitrophenyl phosphate (pNPP) (monoesterase reaction) by calf intestinal alkaline phosphatase (CIAP). The results showed that vanadate significantly inhibited' cofactor-free' CIAP, and the inhibition was relieved by the presence of the catalytic cofactors in the reaction. Our results show that the absence of the cofactors did not significantly alter the Km of the reaction, but caused a decrease in the Vmax. Kinetic analyses showed that vanadate inhibited CIAP-catalyzed hydrolysis of pNPP by decreasing the Vmax and increasing the KVm of the reaction. The presence of cofactors in the reaction alleviated the effect of vanadate by increasing the Vmax and decreasing the Km. The activity of the dialyzed CIAP was increased by the addition of catalytic cofactors to vanadate-inhibited enzyme. This study provides preliminary data that reversible inhibition of CIAP is subject to the influence of catalytic cofactors. Further studies will reveal detailed mechanistic aspects of this observation and its significance in the biological system. [ABSTRACT FROM AUTHOR]

Introduction: Craniotomy is a neurosurgical operation done to remove brain tumor, repair vascular lesion, and relieve intracranial pressure. Complications can arise which may necessitate re-do craniotomy. The study is planned to find out the relationship between variables such as age, American Society of Anaesthesiologist (ASA), Glasgow coma score (GCS), frequency of re-do craniotomy, and surgical outcome of re-do craniotomy. Materials and Methods: This is a retrospective study of all the patients who had re-do craniotomy over a 4-year period. The data that were collected included age, sex, ASA classification, indication for re-do craniotomy, GCS, frequency of re-do craniotomy, postoperative complications, and outcome. Results: Twenty-five patients had indication for re-do craniotomy within the study period. Forty percent were male and 60% were female, and their mean age was 38.56 ± 17.38 years. The indications for re-do craniotomy were removal of residual tumor, evacuation of clot, and cerebrospinal fluid leakage. Seventy-six percent had good outcome, while 24% had poor outcome. Outcome was good for patients who had redo craniotomy done once, while poor outcome was for patients with second and third craniotomies. Ninety percent of patients with ASA 2 had good outcome, while 9.1% had poor outcome; but 64.3% had good outcome with ASA 3, while 37.7% had poor outcome with a P-value of 0.18. Seventy-five percent had poor outcome in patients with GCS of less than 9, while 25% had good outcome; but 14.3% had poor outcome in patients with GCS above 9, while 85.7% had good outcome with a P-value of 0.031. Conclusions: Increasing frequency of re-do craniotomy and lower GCS were major factors affecting outcome in re-do craniotomy in our center. The outcome of these patients is valuable in the management of other patients with re-do craniotomy in future. [ABSTRACT FROM AUTHOR]

A correction is presented to the article "Long‐term outcomes of index cryoballoon ablation or point‐by‐point radiofrequency ablation in patients with atrial fibrillation and systolic heart failure" which appeared in the February 1, 2021 issue.

Purpose The cerebrum is frequently malformed in children with myelomeningocoele. This anomaly renders them potentially susceptible to cerebral visual impairment. In these patients, hydrocephalus is an important and frequent complicating lesion which compromises intellectual function and may also cause cerebral visual impairment. In this study, we determined whether hydrocephalic patients with lumbar myelomeningocoele (HLM) are at a greater risk of visual impairment than hydrocephalic patients without this lesion (H).Methods In this prospective study, we assessed five parameters of visual function in 20 hydrocephalic children with lumbar myelomeningocoele and compared the total visual function scores (TVFS) obtained with those from hydrocephalic children without overt spinal dysraphism, but similar in age, sex and ventricular size. The parameters, which were assessed with the aid of a quantitative grading scale, were pupillary size and reaction, optic atrophy, visual fixation and tracking.Results The age and sex distributions of the patients in the two groups were similar. The anterior and posterior dimensions of the lateral ventricles were also similar. The mean (SD) of the TVFS were 24.25 (3.63) and 24.20 (3.47) respectively for the two groups (P = 0.90).Conclusions The results suggest that, in hydrocephalic infants with lumbar myelomeningocoele, visual function is not further diminished by the associated dysraphism and that ventricular dilatation is the major determinant of visual impairment.Eye (2002) 16, 739–743. doi:10.1038/sj.eye.6700085 [ABSTRACT FROM AUTHOR]

G-quadruplex DNAzymes are short DNA aptamers with repeating G4 quartets bound in a non-covalent complex with hemin. These G4/Hemin structures exhibit versatile peroxidase-like catalytic activity with a wide range of potential applications in biosensing and biotechnology. Current efforts are aimed at gaining a better understanding of the molecular mechanism of DNAzyme catalysis as well as devising strategies for improving their catalytic efficiency. Multimerisation of discrete units of G-quadruplexes to form multivalent DNAzyes is an emerging design strategy aimed at enhancing the peroxidase activities of DNAzymes. While this approach holds promise of generating more active multivalent G-quadruplex DNAzymes, few examples have been studied and it is not clear what factors determine the enhancement of catalytic activities of multimeric DNAzymes. In this study, we report the design and characterisation of multimers of five G-quadruplex sequences (AS1411, Bcl-2, c-MYC, PS5.M and PS2.M). Our results show that multimerisation of G-quadruplexes that form parallel structure (AS1411, Bcl-2, c-MYC) leads to significant rate enhancements characteristic of cooperative and/or synergistic interactions between the monomeric units. In contrast, multimerisation of DNA sequences that form non-parallel structures (PS5.M and PS2.M) did not exhibit similar levels of synergistic increase in activities. These results show that design of multivalent G4/Hemin structures could lead to a new set of versatile and efficient DNAzymes with enhanced capacity to catalyse peroxidase-mimic reactions. [ABSTRACT FROM AUTHOR]

Objective: Awake craniotomy for brain tumor resection has the benefit of avoiding a general anesthetic and decreasing associated costs (e.g., intensive care unit beds and intravenous line insertion). In low- and middle-income countries, significant resource limitations for the system and individual make awake craniotomy an ideal tool, yet it is infrequently used. We sought to determine if awake craniotomy could be effectively taught and implemented safely and sustainably in low- and middle-income countries. Methods: A neurosurgeon experienced in the procedure taught awake craniotomy to colleagues in China, Indonesia, Ghana, and Nigeria during the period 2007–2012. Patients were selected on the basis of suspected intraaxial tumor, absence of major dysphasia or confusion, and ability to tolerate the positioning. Data were recorded by the local surgeons and included preoperative imaging, length of hospital admission, final pathology, postoperative morbidity, and mortality. Results: Awake craniotomy was performed for 38 cases of suspected brain tumor; most procedures were completed independently. All patients underwent preoperative computed tomography or magnetic resonance imaging. In 64% of cases, patients remained in the hospital <10 days. The most common pathology was high-grade glioma, followed by meningioma, low-grade glioma, and metastasis. No deaths occurred, and no case required urgent intubation. The most common perioperative and postoperative issue was seizure, with 1 case of permanent postoperative deficit. Conclusions: Awake craniotomy was successfully taught and implemented in 6 neurosurgical centers in China, Indonesia, Ghana, and Nigeria. Awake craniotomy is safe, resource-sparing, and sustainable. The data suggest awake craniotomy has the potential to significantly improve access to neurosurgical care in resource-challenged settings. [Copyright &y& Elsevier]