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Background: There is an increased awareness for utilization of tiger nuts, due to its high fiber content which can serve as a substitute for diabetic patients. Diabetes mellitus has been a major challenge in the health system with an estimated prevalence of 2.8% in 2000 and 4.4% by 2030 Objectives: The study aimed to evaluate the proximate composition, mineral and sensory evaluation of cookies made with tiger nut flour Methods: Tiger nut tubers were purchased from mile 12, Lagos state. The cookies were produced with composite flour in this proportion (100:0, 90:10, 80:20, 70:30 and 0:100 tiger nut flour and wheat flour respectively). AOAC procedure was used for the proximate analysis. Results: The proximate composition revealed moisture, ash, crude fiber, crude fat, crude protein, carbohydrate and energy content ranged between 3.91% and 4.94%, 1.30% and 2.50%, 1.04% and 5.25%, 8.13% and 15.50%, 7.87% and 11.11%, 64.99% and 73.50%, 411.5 and 442.20kcal/g respectively. The mineral content (mg/100g) was analyzed for potassium, phosphorus, calcium, iron and sodium ranging from 151.95 to 258.21, 128.88 to 212.83, 26.81 to 119.25, 0.88 to 17.67, and 10.07 to 220.40 respectively. The sensory evaluation was carried out for appearance, taste, mouth-feel and texture. The mean results ranged from 7.48-4.64, 8.06-4.40, 8.20-4.92, and 7.80-5.32 respectively. Conclusion: Cookies made from tiger-nut flour had higher acceptability to that made from wheat flour. Baking industries should be encouraged to make use of tiger nut flour to produce other products like bread and cakes to increase its utilization and consumption.

Ankylosing spondylitis (AS) patients are at increased risk of vertebral compression fractures (VCF). Our objective was to examine the yearly trend of VCF hospitalizations in AS patients as compared to rheumatoid arthritis (RA) and the general population. National Inpatient Sample (NIS) database (2000–2014) was used to identify adult (≥ 18 years) hospitalizations, based on validated ICD-9 diagnosis codes. The rate of VCF hospitalizations, as a primary diagnosis, was assessed in three mutually exclusive groups: AS, RA, and the general population. The prevalence of VCF hospitalization was highest in AS (2.70%), compared to 0.77% in RA and 0.35% in the general population. Over the 15-year period, VCF hospitalization in AS was noted to have an increasing trend (Annual Percent Change (APC) = 4.73, p

We present a case of rapidly progressive granulomatous amoebic encephalitis caused by Balamuthia mandrillaris in an individual with diabetes mellitus. Our patient presented with occipital headache, blurry vision, confusion, and gait imbalance of one week's duration. Brain imaging revealed numerous peripheral ring-enhancing lesions concerning malignancy. Brain biopsy was consistent with Balamuthia mandrillaris infection. He passed away 45 days after presentation despite being treated with a five-drug regimen. This case highlights the importance of considering amoebic brain infections, especially with ring-enhancing lesions on imaging. There are opportunities to design modalities for rapid diagnosis and better treatment.

Background Non-alcoholic fatty liver disease (NAFLD), one of the leading causes of end-stage liver disease, is known to be associated with obesity. However, only a few studies in the United States (US) have described non-obese NAFLD, most of which were on the outpatient population. Aim We aimed to investigate the proportion of hospitalizations in the US with a diagnosis code that included NAFLD in the non-obese population. Methods We analyzed adult discharges from the Nationwide Inpatient Sample with a diagnosis of NAFLD from January 2010 to December 2014. We created two groups: obese (overweight or obese) and non-obese (normal or underweight) groups. Basic demographic and clinical characteristics were compared using the chi-square test and Student’s t-test. Results A total of 194,787 hospitalizations with NAFLD were identified over the five-year period. It was observed that the prevalence of non-obese NAFLD hospitalizations increased yearly. Non-obese NAFLD hospitalizations had a higher mean age (57.5 vs 51.5 years, p < 0.0001) and a higher proportion of males (43.3% vs 36.1%, p < 0.0001) than obese NAFLD hospitalizations. With univariate analysis, non-obese NAFLD hospitalizations had lower odds of hypertension (OR 0.74, p < 0.0001), diabetes mellitus (OR 0.65, p < 0.0001). Non-obese hospitalizations had higher odds of cirrhosis (OR 1.30, p < 0.001) and decompensated cirrhosis (OR 1.30, p < 0.001) after adjusting for age, sex, race, diabetes mellitus, and dyslipidemia. Hospitalizations with non-obese NAFLD had higher odds of death (OR 1.49, p < 0.001) after adjusting for age, gender, race, co-morbidities, cirrhosis, and liver decompensation. Conclusion There is a continued rise in the proportion of non-obese NAFLD among hospitalizations in the US. Non-obese NAFLD hospitalizations were less likely to have hypertension and diabetes, but more likely to have decompensated liver disease. Further studies are needed to better characterize these patients to enable early detection, treatment, and reduction in complications of liver disease.

In developing countries, access to qualified medical personnel especially oral health care specialists by inhabitants of rural and remote areas remain a challenge due to the fact that these personnel are mostly located in urban communities. Teledentistry is an approach that will eliminate the problem of distance between qualified oral health care personnel and potential patients in rural and remote communities. The objective of this review is to investigate the history of teledentistry and its practical application in overcoming the rural-urban oral health care problems. A scoping search of literature using keywords associated with telemedicine and teledentistry and its application was undertaken via PubMed and Scientific Electronic Library Online (SciELO). Literature published in English in the last 10 years (2008 - 2018) were selected. The review summarises the available literature related to origin and method of delivering teledentistry and its use in dental practice and education. It shows that teledentistry has the ability to improve access to and delivery of oral health care at a relatively lower cost as well as supplementing traditional teaching methods in dental education. However, despite the promising nature of teledentistry in improving oral health care provision, it is associated with some attending problems and challenges.

Osmotic demyelination syndrome (ODS) is a clinical syndrome seen following aggressive correction of severe hyponatremia. Chronic alcohol use, malnutrition, and electrolyte derangement are additional risk factors promoting the demyelination in ODS. A 49-year-old female with a history of untreated mood disorder, hypertension, alcohol, and tobacco abuse presented to the emergency department (ED) with a three-month history of generalized body weakness. She also had a history of recurrent falls, difficulty walking, inadequate food and water intake, progressively worsening jaundice, and confusion which started about the same time. Her vital signs were normal; some of the significant physical examination findings were: sclera icterus, abdominal distension, bilateral pedal edema, hand tremors, rotary nystagmus, paraparesis, 1+ bilateral knee jerk, and absent bilateral ankle jerk. She had moderate hyponatremia, mild hypokalemia, deranged liver function test with a cholestatic pattern and transaminitis, hypoalbuminemia, elevated ammonia, lipase, in keeping with alcoholic liver disease and acute pancreatitis. In the ED, she received a normal saline infusion, and her serum sodium rose by just 6 mmol/L within the first 24 hours. She had drainage of her ascitic fluid and treatment with thiamine, folic acid, prednisone, lactulose, rifaximin, furosemide, spironolactone, and Ceftriaxone with improvement in clinical and laboratory abnormalities. Her lower extremity weakness persisted despite physical therapy, prompting neurologic evaluation. MRI of the lumbar spine showed an old compression fracture and lumbar spinal stenosis, while MRI brain findings were consistent with Osmotic demyelination. At the time of discharge to a rehabilitation facility, her serum sodium was 132 mmol/L, but her leg weakness persisted. Although rare, ODS can occur in the setting of moderate hyponatremia if there are additional risk factors that lower the threshold for demyelination.

Bell's palsy is acute peripheral facial nerve palsy; its cause is often unknown but it can be triggered by acute viral infection. Coronavirus disease 2019 (COVID-19) infection commonly presents with respiratory symptoms, but neurologic complications have been reported. A few studies have reported the occurrence of facial nerve palsy during the COVID-19 pandemic. We present a case of Bell's palsy in a 36-year-old man with COVID-19 infection and a past medical history of nephrolithiasis. He presented to the emergency room with a day history of sudden right facial weakness and difficulty closing his right eye four weeks following a diagnosis of COVID-19 infection. Physical examination revealed right lower motor neuron facial nerve palsy (House-Brackmann grade IV). Serologic screen for Lyme disease, human immunodeficiency virus (HIV), and herpes simplex virus (HSV) 1 and 2 were negative for acute infection; however, neuroimaging with MRI confirmed Bell's palsy. He made remarkable improvement following treatment with a course of valacyclovir and methylprednisolone. This case adds to the growing body of literature on neurological complications that should be considered when managing patients with COVID-19 infection.

Patient: Male, 71-year-old Final Diagnosis: Cardiac amyloidosis Symptoms: Diaphoresis • presyncope • shortness of breath Medication: — Clinical Procedure: Electrical cardioversion Specialty: Cardiology Objective: Rare co-existance of disease or pathology Background: Cardiac amyloidosis is an infiltrative cardiomyopathy caused by the extracellular deposition of insoluble precursor protein amyloid fibrils. These depositions of protein amyloid fibrils are found on the atria and ventricles and can cause a wide array of arrhythmias; however, sustained ventricular arrhythmias are quite uncommon. Case Report: A 71-year-old man with a history of hypertension developed a sudden onset of shortness of breath, profuse diaphoresis, lightheadedness, and presyncope. Upon emergency medical services’ arrival, an initial electrocardiogram revealed wide complex tachycardia with a heart rate of 220 to 230 beats per min. He was subsequently given, in succession, magnesium, adenosine, and amiodarone with no change in heart rate or rhythm. Due to ongoing symptoms of diaphoresis and the development of dyspnea, he underwent direct current cardioversion and was converted from ventricular tachycardia to atrial fibrillation at controlled rates. A transthoracic echocardiogram and cardiac magnetic resonance imaging showed features suspicious for cardiac amyloidosis. A subsequent 99m technetium pyrophosphate single-photon emission computerized tomography scan revealed a grade 3 visual uptake and a heart-to-contralateral lung ratio of 1.92, consistent with transthyretin amyloidosis. The patient was treated with tafamidis and an implantable cardioverter-defibrillator for secondary prevention of ventricular arrhythmia. Conclusions: This case highlights the need to consider cardiac amyloidosis in the differential diagnoses of patients with persistent ventricular arrhythmia and no prior history of heart disease.

Research findings conducted in Nigeria have revealed grave misconceptions regarding eruption of maxillary anterior teeth before the mandibular ones in children as affected individuals are believed to be evil, carriers of misfortune and their families are deemed cursed. Such children are stigmatized, abandoned and may be gotten rid of. A twenty three minute culturally appropriate video in the Yoruba language titled “Baba Yoyin” (meaning male tooth extractor -traditional dentist ) was developed to demystify the Nigerian community about misconceptions associated with reversal of eruption sequence of teeth and educate them about hazards associated with patronizing traditional dentists and the need to visit a dentist/doctor for advice. In the pre -production stage, the video was designed and planned and the cast , crew and appropriate locations for shooting the film shooting were selected . In the production stage, filming was done with several wide, medium and close shots. At post production, the film was edited with a sound mix comprising of sound effects and music. Computer graphic effects were added digitally. This video was produced in Yoruba, an indigenous Nigerian language to serve as a culturally appropriate community dental health education tool targeting nursing mothers, pregnant women, and traditional birth attendants from the lower social class in south western Nigeria. The storyline in this video tape will be translated into Igbo and Hausa , the two other major Nigerian languages. This videotape can be repeated in other African settings whose societies experience similar misconceptions about tooth eruption.Keywords: Reversal of eruption sequence, child, health education, videoAfr. J. Biomed. Res. Vol. 22 (January, 2019); 97- 100

Background: The coexistence of over-nutrition and under-nutrition is emerging as a public health problem in many low and middle income countries. This study aimed at determining prevalence of coexisting maternal overweight and obesity with childhood stunting (MOCS) and the associated socio-demographic factors in rural and urban communities of Lagos State, Nigeria. Methods: This was a cross sectional survey conducted using the multistage random sampling technique. A total of 300 mother-child pairs were studied, consisting of 150 each from rural and urban communities. Maternal overweight and obesity and undernutrition in children were determined using standard criteria. Results: The prevalence of overweight and obesity among mothers was significantly higher in urban than rural areas (50.7% vs. 41.3%; p=0.022) while the prevalence of childhood stunting was significantly higher in rural than urban areas (43.3% 12.6%; p

Studies have revealed that Nigerians irrespective of social class have negative attitudes and practices towards children born with natal teeth and those who erupt teeth within the first 30 days of life. This has been associated with the strong cultural myths and beliefs that exist among the populace. Children with natal teeth and their families have been stigmatized and are believed to be cursed. This stigmatization affects their social life and consequently impacts on their quality of life. Therefore, there is a need to develop an intervention such as a video to help dispel these myths. Videotapes have been shown as an intriguing means of communication and valuable tool in health education. To help dispel the myths associated with natal teeth, and neonatal teeth a twenty-eight-minute culturally appropriate video in the a local Nigerian language (Yoruba) titled “Adunni” targeted for people from the low social class was developed. This film has been sent to primary health care centers in suburban and rural areas and will be shown to mothers, pregnant women, nursing mothers and traditional birth attendants with a view to appropriately inform them and the entire communities that eruption of natal or neonatal teeth is not a curse.Keywords: Child, Natal teeth, Neonatal teeth, Health education, Video

Background: School teachers play key roles in imparting appropriate and up-to-date knowledge to pupils and students. However, most teachers in developing countries like Nigeria have poor knowledge and motivation about oral health which may be due to inadequate training in the area of oral health. This might be one of the reasons for the poor oral hygiene among them and their students. Objectives: To evaluate the effectiveness of an oral health care training programme organized for teachers in Eruwa, Oyo state, Nigeria. Methods: An intervention study was conducted among 40 school teachers who attended a two day oral health training workshop at Eruwa, headquarters of Ibarapa East Local Government Area. Training methods included lectures and demonstrations on aetiology, clinical features, treatment and prevention of common oral diseases. Pre- and post- evaluation written tests were administered to the participants to assess the effectiveness of the training. The knowledge scores were rated as poor, fair and good knowledge scoring 60.0% respectively. Frequencies, percentages and means of relevant variables were generated. Paired t-test was used to compare means at P

The development of a video titled “Itoju Eyin” (meaning care of the teeth) was prompted by research findings which revealed poor oral hygiene among Nigerian children from the lower socioeconomic class. Videos have been employed as a medium of dental health education and research has shown them to be useful and valuable visual aids . This may be attributed to the fact that what is seen is usually retained better having a lasting impression on the target population. The video was produced in the Yoruba language which serves as a culturally appropriate dental health education tool for children particularly in south western Nigeria. The video particularly targets children from the lower socioeconomic classKeywords: Dental Health Education Video, Nigeria, Children.

The aim of this study was to assess the acceptability and effectiveness of ART restorations placed without tooth surface conditioning on occlusal caries in the permanent dentition in a primary oral health care centre in Nigeria. A total of 93 ART restorations were placed without tooth conditioning in children and adolescents aged 13.1 (±3.0) years by a dentist trained in the ART approach. This study was carried out in a primary oral health care centre in a low socioeconomic community, Southwestern Nigeria. The restorations were evaluated every 6 months for 2 years by one independent examiner. The cumulative survival rates were determined by the coded scores and standard criteria for evaluation of ART restorations. Over 95.0% of the children reported that the treatment was not painful and 94.8% responded that they would make recall visits. A similarly high proportion reported that they would encourage others with dental caries to come for the ART. The cumulative 2- year survival rate of single surface occlusal ART restorations placed without conditioner was 88.5% (SE=2.9%). The ART restorations placed without tooth conditioning were shown to be acceptable and effective in the management of single-surface occlusal caries in the permanent dentition of children and adolescents in a primary care setting.Keywords: Survival, Occlusal, Tooth conditioning, Primary Oral Health Care Centre, Atraumatic Restorative Treatment

Background: School teachers play key roles in imparting appropriate and up-to-date knowledge to pupils and students. However, most teachers in developing countries like Nigeria have poor knowledge and motivation about oral health which may be due to inadequate training in the area of oral health. This might be one of the reasons for the poor oral hygiene among them and their students.Objectives: To evaluate the effectiveness of an oral health care training programme organized for teachers in Eruwa, Oyo state, Nigeria. Methods: An intervention study was conducted among 40 school teachers who attended a two day oral health training workshop at Eruwa, headquarters of Ibarapa East Local Government Area. Training methods included lectures and demonstrations on aetiology, clinical features, treatment and prevention of common oral diseases. Pre- and post- evaluation written tests were administered to the participants to assess the effectiveness of the training. The knowledge scores were rated as poor, fair and good knowledge scoring 60.0% respectively. Frequencies, percentages and means of relevant variables were generated. Paired t-test was used to compare means at P

Background: Aesthetic problems in adolescence can have a significant effect on their psychosocial development. Abnormalities in tooth color can lead to such problem especially if it affects anterior teeth.Objective: This study therefore assessed the effects of anterior tooth discoloration on the psychosocial well being of adolescents with a view to providing information that will aid the prevention and treatment of this dental problem.Materials and methods: This study was a cross-sectional study involving 384 adolescents aged between 10 and 20years in Igboora southwestern Nigeria. Twenty-six item semi-structured questionnaire comprising variables on demographics and psychosocial effects were researcher-administered. Oral examination of the labial surfaces of the anterior permanent teeth was carried by two examiners. Frequencies and mean were generated. Chi-square and Fischer’s exact tests were used to test associations between categorical variables at (P