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Chronic inflammation in HIV infection and antiretroviral therapy have been shown to cause balance disorders due to neuromusculoskeletal damage, sensorimotor deficits, failure of foot mechanoreceptors and/or plantar lipoatrophy. However, despite evidence of plantar lipoatrophy in HIV patients, there is a dearth of information on how this relates to walking balance. This study sought to investigate how plantar fat thickness affects dynamic balance in HIV infected persons.Can plantar lipoatrophy significantly affect walking balance in HIV infected persons?This is a cross sectional study of 367 persons (106 HIV seronegative control subjects, 211 HIV seropositive subjects on antiretroviral therapy (HIV_ART) and 50 HIV ART naïve subjects (HIV_NonART)). Plantar fat thickness (PFT) was measured using diagnostic ultrasound. Subjects were asked to walk at 5 self-selected speeds, from very slow to very fast on a level 15-meter walkway. Average number of steps and time taken to complete the study distance were obtained, used to calculate gait parameters and plot the velocity field diagram for gait analysis.Findings from this study showed significant reduction in plantar fat thickness, velocity of travel, stride frequency and a significant increase in stride and double support duration (p 0.01) in HIV-seropositive individuals compared to healthy controls but none were observed between HIV_ART and NonART groups.HIV infection significantly affects dynamic balance and increases the risk of falls, fracture and mobility impairment in this patient population.This study will help clinicians to recognize plantar lipoatrophy as a significant cause of gait pathology in HIV infected persons and thus, make targeted interventions to minimize deformity and impairment, promote functional independence and improve quality of life.

Background The Hall technique (HT) is popular with UK paediatric dentists (PDs). Global PDs perception/use of HT is unknown.Aim To investigate global PDs opinions/use of HT.Materials and methods A cross-sectional questionnaire of 26 questions was sent to specialist PDs across the globe.Results Responses of 709 PDs from six continents were obtained. The majority (n = 654, 92.32%) had heard about HT but only 50.6% (n = 358) used it, with wide country variations. Respectively, 37.5%, 31.5% and 31% were neutral, against or supportive of HT when they initially heard about it. Only 17% of HT users said it was always the treatment of choice for non-pulpal asymptomatic carious primary molars (NPACPMs), 62% would take a pre-operative radiograph, 65% would consider using high speed drills before HT, 63% would never consider HT under general anaesthesia, 56% would use HT under N2O sedation. Finally, in a clinical scenario of a NPACPM in a cooperative 6-year-old, 75% of PDs would choose conventional restorative methods over the HT.Conclusion The HT is recognised, but not used, by an outright majority of PDs across the globe. Identifiable barriers such as lack of training, perception as substandard dentistry and perceived lack of evidence reduced its use.

Crude aqueous and methanol extracts of Khaya senegalensis wood dust were employed as histological stains for the demonstration of general tissue architecture. Preliminary phytochemical screening of the extracts was conducted. Mixtures of the extracts of K. senegalensis in acidic, alkaline and neutral solutions were used to stain tissue sections. Preliminary phytochemical screening revealed that K. senegalensis extracts contains flavonoids, saponins, tannins, glycosides and reducing sugars. Optimum staining time was 15 minutes for both extracts and they stained the tissues in different shades of red and brown in the various media used. The best and worst stain uptake of tissues was observed with both extracts in alkaline and neutral media respectively. Mordant preparation of the extracts produced no significant staining difference from the non-mordant preparations. Staining solutions of the extracts have better affinity for the cellular cytoplasm and hence gave a good contrast when compared with Hematoxylin and Eosin control sections. In conclusion, Khaya senegalensis wood extract is a promising histological stain for the demonstration of general tissue architecture.Keywords: Khaya senegalensis, wood dust, stain, histology, mordant

Global differences in the observed causes of chronic kidney disease (CKD) in children are well documented and are attributed to dissimilarities in clime, race, hereditary, and ancestry. Thus, familial clustering and disparities in CKD prevalence rates across ethnic and racial groups indicate that the progression of renal disease has a strong genetic component. Mammalian studies have demonstrated a feasible nexus between nutrition and non-genetic exposure (around the time of conception and in epigenetic changes) in the expression of major genes identified in renal organogenesis. The major consequence is a reduction in the number of nephrons, with subsequent predisposition to hypertension and CKD. Identifying these epigenetic changes is crucial (due to their potentially reversible nature), as they may serve as future therapeutic targets to prevent kidney fibrosis and CKD. Despite progress in the field of epigenetics in oncology, research in other subspecialties of medicine is largely experimental with few existing studies regarding the clinical implication of epigenetics in renal disease. Therapeutic trajectories for CKD in children based on the influence of epigenetics may eventually revolutionize the management of this disease. The aim of the current narrative review is to appraise the role of epigenetics in CKD, and highlight the potential future therapeutic pathways.

Introduction Clinical practice guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances. Despite abundance of asthma guidelines, prevalence has continued to increase globally. There is need to assess how the contents of asthma guidelines are put to clinical use by doctors in the management of children with asthma. This study aims at evaluating the clinical practice of paediatric residents in applying GINA guidelines. Methods Cross-sectional descriptive study of paediatric residents from 23 university teaching hospitals in Nigeria using structured questionnaire. Data analyses were with Statistical Package for Social Sciences (SPSS) version 19 (Chicago IL). Chi square was used to assess for any significant associations between categorical variables. A p < 0.05 was regarded to be statistically significant. Results Sixty-six paediatric residents aged 27- 40 years were enrolled into the study (37 females and 29 males). One-third had spent more than three years in residency training. Fifty-eight residents (87.9%) were aware of the GINA guidelines while 46 (69.7%) were familiar with its contents. Only 39 (59.1%) residents adhered to the GINA guidelines. Twenty of the 35 junior residents (57.1%) compared to 26 of 31 (83.9%) senior residents were familiar with the GINA guidelines (p=0.031) while 15 of 35 junior residents (42.9%) compared to 24 of 31 senior residents (77.4%) consistently follow the GINA guidelines (p=0.006). Adherence to GINA guidelines was not influenced significantly by years of graduation or training (p>0.05). Conclusion The use of the GINA guidelines was poor among paediatric residents. Application of contents rather than just availability of asthma guidelines may partly account for increasing asthma prevalence globally.