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Insulin resistance is at the core of the well recognised metabolic syndrome and possibly many other ailments commonly seen in the modern society. While the quantification of insulin resistance remains a difficult task, the problems associated with it are increasing in epidemic proportions. Need of the hour therefore is to develop concise dietary and pharmacotherapeutic guidelines for prevention and management of insulin resistance

We report a case of acute popliteal artery occlusion in a young male farmer as a result of prolonged squatting

The purpose of this study was to determine the availability and adequacy of antidote stocking at hospitals in north Palestine based on published guidelines for antidote stocking. Methodology: This study is a cross sectional survey of all hospitals at north Palestine (n=11) using a questionnaire which was completed by the director of the pharmacy department at each hospital. The questionnaire was divided into 2 parts. The first part contained a list of 25 antidotes while the second part contained a list of 12 antidotes. This classification is based on the guideline proposed by the British Association for Emergency Medicine (BAEM). The net antidote stock results were compared with the American guidelines as well. Result: The overall availability of each antidote in the first list varied widely from zero for glucagon to 100% for atropine. The number antidotes of the first list that were stocked in the 11 hospitals ranged from 5 to 12 antidotes but none of the hospitals stocked all the 25 antidotes. Additionally, availability of antidotes in the second list varied widely from zero for polyethylene glycol to 100% for dobutamine. The number of antidotes stocked ranged from 5 to 9 but none of the hospitals stocked all the 12 antidotes. Discussion and Conclusion: hospitals in north Palestine do not have adequate stock of antidotes. Raising awareness of the importance of antidotes by education, regular review of antidote storage, distribution plans, and appropriate legislation might provide solutions. Coordination between Palestinian hospitals and the PCDIC at An-Najah National University is also important.

There is a low papillary to follicular ratio in iodine deficient areas. A study of malignant thyroid tumors done over a period of 4 years in Goa shows that the ratio of papillary to follicular carcinoma in Goa conforms to a iodine deficient status of the population.

Background: Transmission of microorganisms from the hands of health care workers is the main source of cross-infection in hospitals and can be prevented by hand washing. The aim of this study was to identify predictors of noncompliance with hand washing during routine patient care. Materials And Methods: This is an observational study. The participants in the study were Health Care Workers (HCWs). Doctors, nurses and ward aides working in different wards of the hospital who were observed for compliance with hand washing. Results: In 270 observed opportunities for hand washing, average compliance was 63.3%. Noncompliance was highest among doctors followed by nurses. Ward aides were most compliant. Conclusions: Compliance with hand washing was moderate. Variation across the hospital ward and type of HCW suggests that targeted educational programs may be useful. Noncompliance suggests that understaffing may decrease quality of patient care.

The study aims at analyzing economic and policy factors impinging upon population stabilization measures at the district (sub-state level) in India. It reflects upon popularly debated notions, namely, that development is the best contraceptive or whether contraceptive is the best development. In order to reflect upon this notion, we hypothesize that the factors determining the success of population stabilization measures are likely to be different across rich and poor states. It is more likely that in a rich state economic development becomes a significant factor for population stabilization relative to a direct intervention by the state. By contrast, in a poorer state, direct intervention acquires main significance relative to supporting influence of economic development. To test the validity of our assumption, we have the district level data for the three categories of Indian states belonging to different income levels relative to overall average of the country. Thus we focus on the district level information of the three states, namely, Maharashtra, Madhya Pradesh and Orissa, which in terms of per capita income, belong to rich, middle income and poor category of states respectively. Our regressions using district level data for three states depict the significance of difference in influential variables across the categories. The results thus confirm our hypothesis that direct intervention acquires main significance at a lower level of per capita state income and economic development becomes a major influential factor at higher levels of per capita state income. The results also support our earlier results using state level data. In the light of these results, it could be emphasized that in the long run development is the best contraceptive. However, in the short run, a considerable achievement could be made by improving basic health and family planning services and by increasing the level of facilities including basic amenities, media and infrastructure development.

Amebic liver abscess is reported worldwide and can present with a a wide spectrum of clinical manifetations. Similar to the other liver diseases, the prothrombin time abnormality can be seen in the patients with amebic liver abscess. We retrospectively studied the prothrombin times among 30 Thai hospitalized patients with amebic liver abscesses and did not find any correlation between the prothrombin time and any other studied manifestation

The incidence of venomous snake bites, especially by green pit viper, has been increasing every year in Thailand. The bite of green pit viper causes bleeding because of thrombin–like property of the venom and it has been reported that the mean platelet volume decreases in those bitten by this snake. The objective of this study was to study the effect of green pit viper venom (Trimeresurus albolabris) on platelet volume (MPV), number of platelets and platelet morphology in vitro. The test was carried out by washing platelet in phosphate buffer pH 7.2 so as to get rid of fibrinogen, then the washed platelets were mixed with green pit viper venom. The mean platelet volume and number of platelets were determined by flow cytometry. The results showed that there was a decrease in the number of platelets (216±101 x 109/l and 78.1±43.4 x 109/l; P< 0.05) and also the MPV (8.9±1.2fl and 4.8±1.3fl, P< 0.05). The platelet size was smaller than normal, ranging from 1.1-1.2 micrometers. In conclusion, the green pit viper venom had a direct effect on platelet morphology, especially by decreasing platelet volume and numbers.

Growth suppression of antibiotic-resistant Salmonella typhimurium DT104 by a non-DT104 strain was investigated in vitro. Chromosomal mutants of eight antibiotic-resistant DT104 strains were generated by sub-culturing on desoxycholate hydrogen sulfide lactose agar containing 25 µg/ml of nalidixic acid. Low counts of each of these mutants (designated as “minority cultures”) were inoculated into 24-h cultures of a non-DT104 S. typhimurium strain (designated as “majority culture”) to test the ability of the majority culture to suppress the multiplication of the minority culture. Multiplication of small numbers of the antibiotic-resistant DT104 strains was significantly (P < 0.05) prevented when the DT104s were added to 24-h brain heart infusion cultures of the non-DT104 strain. This observation has practical implications for the control of the menacing antibiotic-resistant Salmonella typhimurium DT104.

A survey of 1431 gram-negative bacilli from June 2001 to September 2005 were obtained from the faeces of 920 HIV/AIDS patients attending some Clinics and Hospitals in Benin City, Nigeria, were screened for quinolones resistance gene. The HIV/AIDS patients CD4 cells range was ≤14/mm3 ≥800/mm3 of blood. Out of the 1431 isolates, 343 (23.9%) were resistance to quinolones with a MIC ≥4μg/ml for norfloxacin, ciprofloxacin and pefloxacin while a MIC of ≥32 µg/ml for nalidixic acid. The screened isolates include Pseudomonas aeruginosa 64(18.7%), E coli 92(26.8%), Klebsiella pneumoniae 53(15.4%), Salmonella typhi 39(11.4%), Shigella dysenteriae 36(10.5%), Proteus mirabilis 34(9.9%) and Serratia marcescens 25(7.3%). The average resistance of the isolates to the various quinolones ranged from 42.7% to 66.7%. Klebsiella were the most resistant isolates with a mean resistance of 66.7% while Proteus were the less resistant isolates with a mean resistance of 42.7%. Most isolates were resistant to Nalidixic acid followed by norfloxacin while the less resistant were to the pefloxacin. The frequency of qnr genes transfer to EJRifr as recipient ranged from 2 x 10-2 to 6 x 10-6 with an average of 2 plasmids per cell. The molecular weight of the plasmids ranged from <2.9kbp to <5.5 kbp. This indicated that plasmids allowed the movement of genetic materials including qnr resistant genes between bacteria species and genera in Benin City, Nigeria

Microsporidia are eukaryotic, spore forming obligate intracellular parasites, first recognised over 100 years ago. Microsporidia are becoming increasingly recognised as infectious pathogens causing intestinal and extra-intestinal diseases in both immuno-competent and immuno-suppressed patients. They are characterised by the production of resistant spores that vary in size depending on the species; and poses a unique organelle, the polar tubule (polar filament), which is coiled inside the spore as demonstrated by its ultra structure. Other unusual characteristics are the lack of mitochondria and the prokaryotic-like ribosomes, which indicate the primitive nature of the group. Presently there are seven genera, Enterocytozoon, Encephalitozoon, Nosema, Pleistophora, Trachi pleistophora, Brachiola, vittaforma species which have been reported from human hosts as agents of systemic, ocular, intestinal and muscular infections, are described and the diagnosis, treatment, and source of infections discussed.

Background: Inborn metabolic disorders (IMDs) form a large group of rare, but often serious, metabolic disorders. Aims: Our objective was to construct a decision tree, based on classification algorithm for the data on three metabolic disorders, enabling us to take decisions on the screening and clinical diagnosis of a patient. Settings and Design: A non-incremental concept learning classification algorithm was applied to a set of patient data and the procedure followed to obtain a decision on a patient’s disorder. Materials and Methods: Initially a training set containing 13 cases was investigated for three inborn errors of metabolism. Results: A total of thirty test cases were investigated for the three inborn errors of metabolism. The program identified 10 cases with galactosemia, another 10 cases with fructosemia and the remaining 10 with propionic acidemia. The program successfully identified all the 30 cases. Conclusions: This kind of decision support systems can help the healthcare delivery personnel immensely for early screening of IMDs.

Syphilis has acquired new potential for morbidity and mortality through association with increased risk for HIV infection. Case-control survey was conducted using Rapid Plasma Reagin test and confirmatory Immunochromatographic test among HIV-positive (cases) and HIV-negative (control) Nigerians. A total of 35(14.0%) of 250 HIV-positive and 5(2.0%) of 250 HIV-negative individuals studied were seropositive for syphilis, the difference was statistically significant (P<0.05). The prevalence was higher among females than males of HIV-positive (15.0% versus 12.7%) and of the HIV-negative (2.1% versus 1.9%) individuals. Syphilis seroprevalence was highest among HIV-positive individuals aged 21-30 years (20.5%) and 41-50 years old HIV-negative individuals (4.5%). Sex education, promotion of safer sexual behaviour, prompt diagnosis of STDs and provision of effective, accessible treatment are recommended

A 12-weeks feeding trial was conducted to evaluate the effects of Neem (Azadirachta indica) leafmeal (NLM) on body weight gain, carcass and organ characteristics and haematological values of laying hens. The leaves were harvested, chopped to facilitate drying in the sun until they became crispy but still greenish in coloration. The Sun-dried leaves were milled using a hammer mill to produce the leaf meal. Four layers diets were formulated to contain the NLM at 0%,5%, 10% and 15% dietary levels respectively and were used to feed 120 Shikka brown layers already 10 months in lay. The birds were divided into 4 groups of 30 each and randomly assigned to the 4 treatment diets in a completely randomized design (CRD). NLM did not show any appreciable difference in weight gain between the birds at 0% and those at 5%, 10% dietary levels. Carcass weight, dressed weight, liver, heart and gizzard weights were significantly (P<0.05) increased at 5% dietary level of NLM. There were no significant difference in Hb and PCV between birds on O% and 5% treatment diets. However, these differed significantly (P<0.05%) from those of birds on 10% and 15% treatment diets. There were variations in the differential WB count , marked lymphocytopenia adversely affected the total leucocyte counts in the birds on 5%, 10% and 15% treatment diets. The results of this study suggest that laying birds could tolerate 5%- 15% dietary levels of NLM without deleterious effects.

This study was conducted to determine the frequency of isolation of salmonella and their microbial resistance profiles across different commercial poultry feeds sold in Imo State, Nigeria. Thirty-six bulk feed samples were colleted from 154 bag across different feed types and brands which included Guinea (GF), Top (TF), Vital (VF), Extra (EF), Animal care (AF) and livestock (LF) feeds. The salmonella isolated were tested against 14 anti-microbial drugs using the disc diffusion method. Bacterial load enumeration of the samples indicated a range of <30 colony forming unit (CFU) to overgrowth at 104 serial dilutions. Eight feed samples (22.2%) which cuts across the entire feed brands expect EF were positive for salmonella. The highest prevalence of 28.8% and 25.0% were recorded for LF and TF respectively, while VF, GF and AF had 11.1 and 10.0% respectively. Salmonella isolates showed high rates of resistance (51-100%) against nitrofurantoin, ampicillin, tetracycline and ceftriazole, while moderate rates (31-50%) were recorded for chloramphenicol, oxfloxacin and cotrimoxazole. Low resistance rates (1-30%) were on the other hand recorded against ciprofloxacin and amoxycillin clavulanate (Augumentine), whereas zero resistance was demonstrated against pefloxacin, gentamycin, streptomycin and nalidixic. Commercial feeds form important channels for the dissemination of multi-drug resistant salmonella in Imo State, Nigeria.

Information on livestock movement, animal food products processing facilities, meat inspection methods, official meat inspection records and distribution and marketing systems for processed products in Imo state, Nigeria needed for policy development interventions in the sector are not fully understood. The primary data generated with the aid of personal interviews, field observations and secondary data obtained from records accumulated by the department of veterinary services Imo state from 2001 to 2004 were used to investigate the environmental and public health issues of animal food products delivery system in state. Majority of trade animals supplied to the state originated from the northern states of the country and were brought in with trucks by road. Only two veterinary control posts served the whole state thus resulting in non-inspection and taxing of a large proportion of trade animals. Official record of trade animals supplied to the state from 2001 to 2004 ranged from 45000 – 144000 for cattle, 23000 – 96000 for goats and 11000 – 72000 for sheep per annum, with supplies increasing steadily across the years. Official slaughter points in the state were principally low-grade quality slaughter premises consisting of a thin concrete slab. Meat handling was very unhygienic with carcasses dressed beside refuse heaps of over 2 years standing. Carcasses were dragged on the ground and transported in taxi boots and open trucks. Meat inspection at these points was not thorough because of stiff resistance of butchers to carcass condemnation. Official meat inspection records for the state from 2001 to 2004 revealed that overall totals of 159,000 cattle, 101,000 goats and 67,000 sheep were slaughtered. This accounted for about 56, 57 and 57% shortfall of cattle, goat and sheep respectively supplied to the state and represents the volume of un-inspected animals during the study period. Fascioliasis and tuberculosis were the most common infections encountered in cattle and recorded percentage occurrences of 16.7 and 7.5 respectively, whereas mastitis was common in goats and sheep at percentage occurrences of 5.8 and 5.0 respectively. Overall prevalence rates of 4.4, 8.0, 3.2, 3.3 and 1.5% were recorded for tuberculosis, fascioliasis, streptotricosis, mastitis and worms respectively. Animal food products delivery in Imo state needs to be improved upon in order to safeguarded the health of consumers

A descriptive KAP study about smoking was conducted in all the ten secondary schools in Hadramout coastal districts during October 2004 – April 2005 and a total of 317 teachers were enrolled in the study (182 male, 135 female teachers). The findings revealed that about 8% of the teachers were smokers; all smokers were males (prevalence 14%). Only 10% of teachers had received training to limit smoking among students, and 27% had educational materials about harmful effects of smoking. The study concluded that low smoking prevalence, good knowledge and attitudes of teachers, especially female teachers, toward smoking may offer a chance for smoking prevention strategies in secondary schools.

A 38 years old male patient presented with a large painless swelling in the right palm with ultrasound examination suggestive of fatty nature of the swelling MRI showing a well-circumscribed soft tissue swelling in the deep palmar space. The giant tumor of 6.5 X 4 cm was excised and the patient was symptom free two years following the surgery.

Aim: To investigate the effects of pulsed Ultrasound (US) in recovery from Delayed Onset Muscle Soreness (DOMS). Methods: Twelve healthy male athletes (mean age 23.83±1.697 year) performed an eccentric exercise protocol of non-dominant elbow flexors to induce muscle soreness on 2 occasions separated by 3 weeks. Subjects in experimental group received pulsed US (1 MHz, intensity 0.8 W/cm2, mark space ratio 1:10), whereas control group received sham US after 24 h, 48 h and 72 h. Perception of muscle soreness, active ROM and muscle strength were the parameters measured at 0 h, 24 h, 48 h and 72 h with the help of VAS, manual goniometer and JONEX muscles master instrument respectively. Results: Post hoc t test analysis revealed significant differences (p <0.05) between 0 h and 72 h in the parameter of ROM (t = 6.18) and muscle power (t = 2.54) as well as between 24 h and 48 h in the parameter of muscle soreness (t = 3.13) in control group. Similar differences were also observed in the experimental group. No significant inter-group differences at α level of 0.05 was observed in any parameter at any level. Conclusion: The pattern of recovery from DOMS was not influenced by the application of pulsed Ultrasound at the parameters discussed here.

The present study was planned to find out the incidence of accessory muscle arches in the axilla of 68 upper limb (38 right and 30 left) dissections. Langer’s arch was observed in one right limb out of the 68 limbs, total incidence was 1.47%. The arch extended from the latissimus dorsi to the fascia covering the biceps brachii. The incidence is low in South Indian population (Dravidians) compared to the various other populations reported in literature. A branch from the lateral cord of brachial plexus supplied it in contrast with the previous reports. The surgical significance of this muscle is reviewed

Information on the resistance profiles of normal intestinal flora of extensively reared chickens that hardly receive antibiotics in the developing countries can serve as important means of understanding the human/animal pathogens drug resistance interactions in the zone. Three hundred and fifty E. coli isolates, comprising 133 from urban and 217 from rural sites in Imo state, Nigeria, were screened for anti-microbial resistance profile against 10 antibiotics using the disc diffusion method. Overall percentage anti-microbial resistance of the isolates against cotrimoxazole, ampicillin, nalidixic acid, chloramphenicol and nitrofurantoin (72–92%) were very high. The organisms were highly sensitive to other antibiotics, especially gentamicin and ciprofloxacin. The 59.5% overall mean percentage resistance recorded at the urban area was significantly higher than the 46.8% recorded at the rural area (p<0.05). With the exception of the figures for cotrimoxazole and ampicillin, resistance values obtained against the other antibiotics at the urban sites were statistically higher than those obtained at the rural sites (p<0.05). Zero resistance was recorded against the fluoroquinolones, norfloxacin and ciprofloxacin at all the rural sites except at Enyiogwugwu where a 28.6% resistance was obtained against norfloxacin. Since free-range chickens rarely receive antibiotic medication, it is concluded that the highly resistant E. coli organisms isolated from them may be reflecting consequences of human drug use in the study areas

Background: To investigate importance of fasting insulin (FI) as a diagnostic test for insulin resistance (IR) and to compare with other standard methods McAuley (McA), HOMA and QUICKI indices in Diabetes Mellitus (DM). Method: 42 diabetic patients who have been already diagnosed were used in our study. They were investigated for fasting blood glucose (FBS), FI, LDL, Triglycerides (TG), total cholesterol (TC) and HDL levels. IR was calculated by McA, HOMA, QUICKI indices and by FI. Results: 81% of patients were insulin resistant by McA and FI in our study group. 93% were detected as insulin resistant by HOMA and QUICKI. IR by FI was further compared with HOMA and QUICKI and 81% of patients were found to be insulin resistant by FI, HOMA and QUICKI. Results showed that there was a significant correlation between FI and McA in expressing IR in our study group (p <0.01, r = -0.849). Further, FI had a statistically significant correlation with HOMA and QUICKI indices (p <0.01, r = 0.906 and p <0.01 r = -0.822 respectively). Conclusion: FI measurement alone in diabetic patients has detected IR in 81% of patients, similar to the other standard methods (McA; 81%, HOMA and QUICKI; 93%). We further identified that FI as a diagnostic test of IR had substantial correlation with McA. Our results recommend further studies to see the possibility of taking fasting insulin to determine IR in type 2 diabetic population

We describe a case of drug induced parkinsonism (DIP) that presented with isolated mandibular tremors despite prophylactic anticholinergic therapy. Varied presentations of DIP may be explained by anatomical & functional neuro-circuitry of striatum.

Osteomas are slow growing bony tumors common in fronto-ethmoid regions and rare in temporal bone. These are usually asymptomatic and require treatment mainly for cosmetic reasons. We describe a case of temporal bone osteoma in a female.

Oestradiol which induces the proliferation of the vaginal epithelium is used in the oestrogen replacement therapy for menopausal and postmenopausal disorders. The exact onset of induced cell proliferation and recovery to the controlled level has not been reported before. Hence this study was done in ovariectomised mice and the period of cellular response to ethinyl estradiol, a semisynthetic ester (0.025mg/kg) was recorded. The vaginal epithelium was studied for histological changes and incidence of mitotic figures. The onset of proliferation started at 4h after exposure and reached its maximum at 32h and declined gradually thereafter to reach the base level at 60h.

Microsporidia are intracellular spore-forming protozoa that are increasingly being recognized as pathogens in humans. Faecal samples were taken from 2250 HIV/AIDS and 1050 HIV-negative patients from Kano and Makurdi in Northern Nigeria, and were investigated for microsporidial infections by Giemsa staining technique (Light microscopy). In Kano, Enterocytozoon bienuesi was detected in 8 (14.17%) and Encephalitozoon intestinalis in 5 (2.60%) out of 192 HIV/AIDS patients screened. A mixed infection of both 0.52% was observed. Results from Makurdi showed that Enterocytozoon bienuesi was detected in 13 (0.65%) and Encephalitozoon intestinalis in 96 (4.78%) out of 2008 HIV/AIDS patients examined. No mixed infection was observed. Microsporidial spores were not found in 1050 HIV-negative patients screened from both areas. There was a significant difference (X2, p<0.05) in infection rates between the HIV/AIDS and HIV-negative patients. This study aimed at detecting the prevalence of intestinal microsporidia to provide baseline data on the status of this disease in Nigeria. Detection of Microsporidia in Immuno-compromised patients has not been described previously in this area.

Normal intestinal flora of humans and animals constitute enormous reservoir of resistance genes for potentially pathogenic bacteria and may serve as major indictors of selection pressure exerted by anti-microbial use in a given population. A study was conducted in September 2003 at 3 purposively selected peri-urban sites spread across 3 senatorial zones of Imo state, Nigeria to determines the anti-microbial resistance profile of commensal E. coli isolated from free range chickens. The isolates were screened for anti-microbial resistance profile against 10 antibiotics using the disc diffusion method. E. coli strains from local fowls, recorded 100 and 78.9% resistances against ampicillin and cotrimoxazole respectively, while resistance rates against ciprofloxacin, gentamycin and norfloxacin were 0.0, 5.3 and 5.3% respectively. Isolates from free-range cockerels recorded 100% resistance against norfloxacin, cotrimoxazole and ampicillin and 83.3% against nitrofurantoin. Similarly, isolates from old layers, recorded 100% resistance against nitrofurantoin, cotrimoxazole, tetracycline, chloramphenicol and ampicillin and 80% against nalidixic acid. Similar resistance trends were observed in E. coli isolates from free-range turkeys and broiler roosters against the inexpensive broad-spectrum first line antibiotics (ampicillin, nalidixic acid, cotrimoxazole, nitrofurantoin and chloramphenicol), although values varied slightly across poultry types. Resistances against gentamycin were consistently low in isolates from the different types of poultry. Twenty-nine resistance patterns were observed in the E. coli isolates with predominant patterns being distributed widely across poultry types indicating a striking diversity of resistance patterns in the areas.

Presently, the screening of syphilis is dependent mainly on serological tests. In the sexually transmitted disease clinic, syphilis serology is a basic screening test. The results VDRL test among of 150 HIV (82 males, 68 females) infected, regardless to immune status (CD4+ count), were studied. It was found that in 2 cases, the VDRL was biologically false reactive (VDRL positive, TPHA negative), who had CD4+ count >200 /L, giving the incidence rate equal to 1.3 % (1.2 % for male and 1.5 % for female).

Serological tests for syphilis may show varying results in association with HIV infection.Thus care should be taken to interpret these results

Hepatitis B, Hepatitis C and Human Immunodeficiency Virus infections have become a formidable challenge globally due to the chronic nature of the infection and life threatening complications. The common mode of transmission has led to co-infections and increased morbidity and requires concerted control efforts.

One of the major challenges of Reproductive and Child Health Programme in India is addressing the barriers in communication and improve dialogue between diverse stakeholders, particularly women in the community. Through a qualitative study conducted in one of the rural districts of India, it was attempted to understand the factors affecting women's decision-making process. It is observed that most of the factors are affected by strong intrinsic environment and hence it becomes important for programme managers to understand the environment first in order to design an acceptable and effective communication strategy. In this study, knowledge, tradition, stigma and accessibility of services are identified as the key primary factors affecting decision making of women in the community, particularly on their health related issues. These in turn are governed by various supporting factors. Finally, it is observed that communication strategies can achieve their desired objective only when the local intrinsic environment is taken into cognisance.

The menarchial age of 859 secondary school girls consisting of 508 from urban and 351 from rural area of Rivers State, Nigeria were determined, using questionnaires and interview method. Data collation revealed that 69.2% (243) of the rural population were menstruating, while 70.1% (356) of the urban population were menstruating. Mean ages of menarche were 13.19±1.32 years and 14.22±1.47 years for urban and rural areas respectively .A statistically significant lower mean menarchial age was observed in urban area girls, compared to their rural counterparts. Girls from families of high socio-economic class has significantly lower mean menarchial age in both urban and rural area. The mean age of menarche was significantly higher in girls involved in vigorous sporting activity in rural areas compared to their non-sporting counterparts. Urban school girls attain menarche earlier than those in rural area. High socio-economic class and vigorous sporting activity can be predisposing factors to low and high age of menarche respectively. There is need for redefinition of high socio-economic class in Nigeria.

We investigated Generalized Gradient Vector Flow Active Contours as a suitable boundary mapping technique for Chromosome spread images which have variability in shape and size, expecting to yield a robust segmentation scheme that can be used for segmentation of similar class of images based on optimal set of parameter values. It is found experimentally that a unique set of parameter values is required for boundary mapping each chromosome image. Characterization studies have established that each parameter has an optimal range of values within which good boundary mapping results can be obtained in similar class of images. Statistical testing validates the experimental results.

Nigeria belongs to the group of countries highly endemic for viral hepatitis; unfortunately information on the prevalence of hepatitis C amongst patients with HIV in Nigeria is very scarce. This hospital-based investigation was conducted at two major hospitals in Jos, Nigeria from June 2002 through May 2003. Serum samples from 490 confirmed HIV infected patients were assayed for the presence of antibodies to HCV, using a third generation enzyme linked immunosorbent assay. Twenty eight (5.7%; 95% CI 3.66-7.76%) of the patients had antibodies to HCV. The prevalence of HCV antibodies was higher among the males (7.5%; 95% CI 3.83-11.09%) than the females (4.5%; 95% CI 2.10-6.88%). Statistical analysis showed no significant difference (x2 = 1.917, df =1, p=0.05). Individuals of the age group 41-50 years had the highest prevalence of HCV antibodies (15.4%; 95% CI. 7.37-23.29%), followed by those of age group 31-40 years (7.4%; 95%, CI 3.70-11.20%). A significant difference was observed in the association between age and prevalence of HCV antibodies (x2 = 24.151, df = 4, p =0.05). Early diagnosis of HCV in people with HIV infection is advocated to reduce risk of HCV related advanced liver disease.

Endometrial stromal sarcomas are rare uterine tumours usually seen in perimenopausal females. We report here a case of low grade malignant endometrial stromal sarcoma in an adolescent girl, presenting as puberty menorrhagia. She underwent total hysterectomy with bilateral salpingo-oophorectomy and pelvic node sampling. She also received adjuvant chemotherapy and radiotherapy. She is disease free at completion of one year of follow-up.

Uterine perforation is the well known complication of induced abortion. We report a rare case of uterine perforation with subtotal prolapse of small bowel following first trimester abortion by an unqualified physician. Early surgical exploration with resection and anastomosis of bowel performed. Patient discharged uneventfully after postoperative recovery.

A study was carried out to determine the influence of mucilage viscosity on the globule structure (i.e. size and number) of certain starch emulsions. The starches investigated were cassava, potato and maize. The emulsions were prepared by mixing the starch mucilage of a predetermined concentration 4%w/v with arachis oil in the ratio 50:50, using a silverson mixer fitted with a dispersator head. The emulsions were stored at room temperature (28±20C) for 7 days. Changes in globule size were monitored by photomicroscopy. Viscosities of the mucilage and those of resulting emulsions were determined using a capillary flow method. The viscosities of the emulsions expressed as time of flow (seconds), were 680 (cassava starch), 369 (potato starch) and 270 (Maize starch), and for the mucilage 510 (cassava), 336 (potato) and 248 (maize). The corresponding mean globule sizes of the fresh emulsions were (µm) 28±6, 42±6 and 45±5 respectively. The increase in globule size during storage (measure of globule coalescence rate) was 1.8±0.2µm day -1 (cassava), 3.5±0.2µm day -1 (potato) and 4.6±0.3µm day -1 (maize). Thus, a higher viscosity of the dispersion medium is associated with the production of finer and more stable emulsions.

We investigated the degree of genetic association between insulin resistance (IR) with type 2 diabetes mellitus (DM) and abnormalities in lipid metabolism in 42 patients. IR was assessed by fasting insulin test (FI), McAuley (McA), HOMA and QUICKI methods. IR was detected in 34 (81%) patients by FI, McA and in 39 (93%) patients by HOMA and QUICKI. 26 (62%) patients had family history of DM and 23 (89%) of them displayed IR by FI & McA. 24 of them (92%) displayed IR by HOMA and QUICKI. Our results suggest that association between the family history of DM and IR were statistically significant by chi-square test (P<0.05). Further, 29 (69%) patients had elevated total cholesterol levels. Association between elevated total cholesterol and IR as assessed by FI test was also statistically significant (x2=4.6; p<0.05). Results of our study indicate the statistically significant genetic association of IR with abnormal cholesterol metabolism and family history of DM

Blood samples of 160 children, ranging age between 3 months and 6 years were selected from five different parts of Amritsar district of Punjab (India) and were analyzed for Zn, Cd, Pb and Cu using anodic stripping voltammetry. Large variations in the results have been correlated to the area inhabited, age differences and other factors. It was found that the areas, more prone to environmental stress, had shown more quantities of these metals in blood samples in comparison to those which were taken from safer sites. Similarly the younger children lesser exposed to environmental pollution had shown comparatively lesser quantity of these metals in comparison to older objects.

Understanding the effects of trace metals on human health is as complex as it is fascinating. As mentioned earlier, the high concentrations may prove toxic, as also, depletion in the concentration of the essential trace elements may cause various metabolic instabilities due to enzyme dysfunction. In the era of rapid industrialization and technological advances, it is imperative to watch keenly for contamination of the environment and its vital composition from heavy metal wastes emanating out of industries. Many metabolic disorders in man are accompanied by alterations in the concentration of one or more trace elements in some body fluid, especially blood serum or plasma It is thus important to update ourselves with various techniques available for such determinations, their operational aspects, advantages / disadvantages etc. More recently, element analysis from hair and nail has been stated as the best indices of such contamination and has also been discussed in this article.

The present study investigates the occurrence of R-plasmid in Salmonella typhi isolates from enteric fever cases in and around Kolkata (1991-2001), India following in vitro conjugation experiments, isolation of plasmid DNAs and agarose gel electrophoretic analysis. The multidrug resistant (MDR) S. typhi strains contained a transferable plasmid conferring resistance to ampicillin, chloramphenicol, cotrimoxazole and tetracycline. The plasmid encoding ACCoT-resistance of Escherichia coli, Klebsiella pneumoniae and Proteus vulgaris were conjugative and co-migrated with the plasmid of MDR S. typhi isolates. The antibiotic sensitive S. typhi isolates did not contain any plasmid. Thus the findings of the present study confirmed the instability of the R-plasmid in S. typhi, and that the antibiotic sensitive S. typhi strains acquired the R-plasmid from other enteric bacteria such as E. coli, K. pneumoniae and P.vulgaris to undergo a suitable adaptation for survival in the changing antibiotic environment.

A career in psychiatry is challenging and rewarding. Psychiatric training in the United Kingdom is well structured and run by twenty-one deaneries across England and Wales. The Royal College of Psychiatrists who also conduct the MRCPsych examination, sets standards for training and approves the hospitals for training purposes. Training includes basic specialist training at the grade of a senior house officer for a period of at least three years and helps obtain the MRCPsych examination. Higher specialist training is at the grade of a specialist registrar and is also for at least three years. The emphasis is on competence based learning which helps realize a trainees potential to the hilt. At the end of training, a trainee would be awarded a Certificate of Completion of Training (CCT) and enables one to work independently as a consultant. There are various specialties of psychiatry one can train in which is a unique opportunity.

Salmonella typhi is one of the most resistant organisms with multi-drug resistant strains reported from many countries. Initially, individual plasmids were known to code for resistance,but since 1988 a single plasmid has been identified to code for multidrug resistance. It has been found that in certain areas, S. typhi has lost this acquired resistance.

We report an observation made about the differences between right and left side in case of total knee and unicondylar knee replacement. It was found that unicondylar knee replacement was performed more commonly on the left side (66%), as compared to only 34% on right side, where as total knee replacement was more common on the right side (64%) as compared to 36% on left side. The exact clinical utility of this difference is yet to be known.

A comparative study of HIV associated pulmonary tuberculosis (HIV-PTB) was carried out in Chest Clinics situated in Benin and Irrua environs of Edo State, Nigeria, using microscopical and serological methods. In Irrua environs, HIV-PTB co-infection is higher in females (12.5%) than in males (9.2%) but not statistically significant (P > 0.05). In Benin, HIV-PTB is also higher in females (11.3%) than in males (7.2%) but not statistically significant (P > 0.05). In Benin, PTB is statistically high among <20 years and 21–30 years old subjects (50% and 28.7% respectively, P < 0.05), while HIV is statistically high among age group 31–40 years and 41.50 years (23.5% and 27.9% respectively, P < 0.05). HIV-PTB co-infection is also statistically high among drivers and traders (13.8% and 12.6% respectively, P < 0.05) in Benin. Generally, there is no significant difference in the prevalence of HIV, PTB and HIV-PTB infection rate in the two regions when sex and occupation of the subjects are considered (P > 0.05). However, subjects of > 60 years old have a significantly higher PTB disease in Benin than their counterpart in Irrua (28.6% and 0% respectively, P < 0.05)

Serum activities of Acid Phosphatase (ACP) and Prostatic Acid Phosphatase (PAP) are still employed in most hospitals in Nigeria for the diagnosis of prostate cancer, because of lack of resources for prostate specific antigen (PSA) assay. Serum PSA and activities of phosphatase isoenzymes ACP and PAP, Alkaline Phosphatase (ALP) and Heat stable Alkaline Phosphatase (HSAP) were studied in 71 apparently healthy male controls and 47 proven prostate cancer patients. There were statistically significant increases in the mean serum levels of PSA, PAP, ACP, ALP and HSAP in the prostate cancer patients compared to the controls (P<0.001). PSA level was increased above the cut-off level in 85.1% of patients, PAP in 66.0%, ACP in 57.5%, ALP in 34.0% and HSAP in 21.3% of cases. Serum levels of PSA, ACP and PAP were lower and of ALP and HSAP higher in patients with longer duration of the disease (P<0.05). The study confirms the relevance of PSA assay over ACP, PAP, ALP and HSAP in the diagnosis of prostate cancer patients. It highlights the need for the inclusion of PSA assay in hospitals for accurate diagnosis of prostatic carcinoma.

It is unclear whether the different histologic subtypes of epithelial ovarian carcinoma have different risk factors. We investigated the relationships between selected epidemiologic variables (i.e., parity, family history of ovarian cancer, oral contraceptive use, a history of tubal ligation and noncontraceptive estrogen use) and the major histologic subtypes of epithelial ovarian cancer in a hospital-based case-control study of adult women at Roswell Park Cancer Institute in Buffalo, NY, USA. Multivariate unconditional logistic regression models were used for statistical analysis. We observed a pattern of increased risk associated with family history and a pattern of risk reduction associated with parity, noncontraceptive estrogen use and tubal ligation across all histologic subtype groups. However, we did not observe a consistent pattern of risk associated with oral contraceptive use. These results provide some additional support for the hypothesis that the effects of various ovarian cancer risk factors may differ according to the histologic subtype.

Cancer screening is a means to detect cancer early with the goal of decreasing morbidity and mortality. At present, there is a reasonable consensus regarding screening for breast, cervical and colorectal cances and the role of screening is under trial in case of cancers of the lung, ovaries and prostate. On the other hand, good screening tests are not available for some of the commonest cancers in India like the oral, pharyngeal, esophageal and stomach cancers.

The disease burden of rural Indian women is reviewed by utilizing the data from the 'Survey of Causes of Death (rural)' annual reports of Registrar General of India supplemented with National family health survey (NFHS-II). The review indicates that bronchitis and asthma are the leading causes while prematurity and heart attacks are second and third respectively. Most of the maternal deaths are concentrated in the age group 20-24 and bleeding is the main cause of maternal death. Tuberculosis of the lungs, malaria and burns are also important causes of death in the early reproductive ages. Rate of suicide, burn, and anaemia diminishes with age. Though nationwide health plans have succeeded in reducing the fatality of women's diseases to a entrain extent, there is however, a great need for improved and effective area-specific health programs to achieve the desired goals

A case of orbital MALT (mucous associated lymphoid tissue) lymphoma is reported for its rarity. It presented as a large tumor obscuring the whole eye with loss of vision, without any signs of dissemination and remained free of recurrence or metastasis 12 months after undergoing simple surgical excision.