Background and Objective: The prevalence of hepatitis virus infection in subjects with chronic kidney disease (CKD) has important implications for the etiology of kidney disease, infection safety in hemodialysis, and increases challenges in management consideration. The aim of this study was to determine the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among our patients with CKD before the commencement of dialysis. Methods: All CKD patients (n = 1388) dialyzed between January 1996 and December 2012 were enrolled into the study. Demographic data and etiology of CKD were extracted from case records. Patients were screened for HBV and HCV at initiation of dialysis. Hepatitis B surface antigen (HBsAg), HCV antibodies were measured using specific enzyme-linked immunoassay kits (Bio Rad Monalisa HBsAg ULTRA kit, Marnes–la-Coquette, France; HCV Dia.Pro Diagnostics Milano Italy, respectively). All subjects with HIV infection were excluded from the study. Results: The studied group comprised 511 (36.8%) females; the mean age of the patients was 46.1 ± 15.3 years. Eighty-three (6.0%) patients were HBsAg positive, whereas 16 (1.2%) were HCV antibody positive. No difference was observed in gender occurrence. Patients with chronic glomerulonephritis (GN) were significantly more likely to be HBsAg positive (9%) compared with those with hypertension (5.5%) or diabetes (5.3%) (P = 0.015). Conclusion: The prevalence of HBV in CKD patients was high, whereas HCV was low. HBV was significantly associated with chronic GN. Routine screening of all patients with CKD and before hemodialysis for HBV should be mandatory, especially in HBV endemic regions of the world.

Background: The Lagos University Teaching Hospital's Intensive Care Unit (ICU) was founded in 1975. It was designed as an eight-bedded ICU, a previous review of outcome of surgical admissions in the ICU in 2002 placed mortality at 40.3%, however, presently run as a five-bed unit with new ICU equipment procured in 2012, arterial blood gas machines, patient monitors, and ventilators with sustained multidisciplinary approach to patient management. We compared the number of admissions, mortality, and discharges to the ward 1 year before (Period I) and after the upgrade of the ICU facilities (Period II). Methods: This was a retrospective study of all patients admitted into the ICU between June 2011 and May 2013. We looked at the admission register of the ICU and retrieved biometric data, diagnosis, age, pattern of units admitting patients into ICU, length of stay (LOS), and outcome of ICU care whether the patient died in ICU or was discharged to the ward. Results: There were 122 patients admitted into the ICU in Period I and 156 patients were admitted in Period II with a mean LOS of 6.3 ± 5.4 days and 7.8 ± 7.3 days, respectively. Mortality rate in Period I was 74.6% while mortality fell to 57.7% in Period II (P = 0.005). Conclusion: There was a significant improvement in the ICU outcome with the upgrade of the ICU facilities.

Background: The incidence of noncommunicable diseases (NCDs) is increasing in developing countries, largely due to lifestyle and dietary changes. Adolescents are a nutritionally vulnerable age group; however, poor eating habits are often observed in adolescents. It has been observed that individuals who develop healthy eating habits early on in life are more likely to maintain them into adulthood and have a reduced risk of developing NCDs. This study aimed to assess the knowledge and consumption pattern of fruits and vegetables among junior secondary school students. Materials and Methods: This was a cross-sectional descriptive study of 220 respondents selected using a multistage sampling technique. An interviewer-administered questionnaire was used to collect data, which was analyzed using Epi Info Version 7 statistical software. Results obtained were presented with the use of frequency tables. Results: Results from this study revealed that 84.99% of the respondents displayed good knowledge of the nutritional and health values of fruits and vegetables; however, the consumption of fruits and vegetables was appropriate in only 5.48% of the respondents, having five portions of fruits and vegetables daily. Parental intake, encouragement, and supervision as well as availability and accessibility to fruits and vegetables at home were motivators for appropriate consumption. Conclusion: This study has revealed that the students of Obele Community Junior High School, Surulere, have good knowledge of the nutritional and health values of fruits and vegetables. However, the students have inappropriate daily consumption, as their consumption falls below the World Health Organization recommended five portions daily. Efforts should be made by the students themselves, the family, the School, all and sundry in the community to effect change soonest, so that these adolescents maintain healthy eating habits into adulthood, and hence prevent the occurrence of nutrition-related NCDs later on in life.

Background: The cost of commercial pelvis phantom is a burden to the quality assurance in radiotherapy of small and/or low-income radiotherapy centers. That an algorithm is accurate with short treatment time is a prized asset in treatment planning. Objectives: The purpose of this study was to develop a hybrid algorithm that has balance between accuracy and treatment time and design a pelvis phantom for evaluating the accuracy of a linear accelerator monitor unit. Materials and Methods: A pelvis phantom was designed using Plaster of Paris, styrofoam and water with six hollows for inserting materials mimicking different biological tissues, and the ionization chamber. Computed tomography images of the phantom were transferred to the CMS XiO treatment planning system with three different algorithms. Monitor units were obtained with clinical linear accelerator with isocentric setup. The phantom was tested using convolution (C), fast superposition (FSS), and superposition (S) algorithms with respect to an established reference dose of 1 Gy from a large water phantom. Data analysis value was done using GraphPad Prism 5.0. Results: FSS algorithm showed better accuracy than C and S with bone, lung, and solid water inhomogeneous insert. C algorithm was better in terms of treatment time than S. There was no statistically significant difference between the mean doses for all the three algorithms against the reference dose. The maximum percentage deviation was ±4%, which was below ±5% International Commission on Radiation Units and Measurement minimal limit. Conclusion: This algorithm can be employed in the calculation of dose in advance techniques such as intensity-modulated radiation therapy and RapidArc by radiotherapy centers with multiple algorithm system because it is easy to implement. The materials used for the construction of the phantom are very affordable and simple for low-budget radiotherapy centers.

Aim: The aim of this study was to compare the efficacy of ozonated water and chlorhexidine mouth rinse against plaque and gingivitis. Materials and Methods: A randomized, double-blind clinical trial was conducted. A total of 54 patients suffering from generalized chronic gingivitis were chosen for the study. The trial period of 15 days was divided into three time-intervals, that is, baseline (0 day), 7^th day and 15^th day. The use of ozonated water, 0.2% chlorhexidine, and water irrigation was randomized. The clinical parameters such as plaque and gingival status were assessed using Turkesky-Gilmore-Glickman Modification of Quigley – Hein Plaque Index and Loe and Silness Gingival Index, respectively. The repeated one-way analysis of variance followed by post hoc Bonferroni test was used for statistical analysis. The level of significance was considered at 5%. Results: The analysis was performed on 47 patients at the end of 15^th day. There was a highly significant difference (P < 0.001) when the mean plaque and gingival scores were compared between three different interval of time. There was a significant difference (P = 0.002) when the mean plaque scores for chlorhexidine and water were compared. There was a significant difference when the mean gingival scores for ozonated water and chlorhexidine (P = 0.002) were compared. Conclusion: The results of this study demonstrate that ozonated water was as equally effective as chlorhexidine in reducing plaque and gingivitis with slight edge over chlorhexidine.

Background: Bone remodeling is a biologic process involving an acute inflammatory response in periodontal tissues during orthodontic tooth movement. The early response of periodontal tissues to mechanical stress involves metabolic changes that allow tooth movement. Aim of the Study: The aim of the present study was to evaluate the changes in alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) enzyme activity in gingival crevicular fluid (GCF) when forces are applied during initial alignment (P1) and retraction (P2). Settings and Design: The study was performed in a hospital-based population with an experimental design. Materials and Methods: Seventeen participants (11–21 years) included in the study, all requiring first premolar extractions were undergoing fixed orthodontic treatment. Maxillary canine and mandibular second molar were used as test tooth (TT) and control tooth (CT) in each patient, respectively. On 14^th day after the start of each phase, 2 μL of GCF was collected from mesial side of both TT and CT for ALP and LDH activity determination using a spectrophotometer. Statistical Analysis: The results were subjected for Student's t-test. Results: There was a variation in enzyme activity during orthodontic tooth movement. At TT, there was a statistically significant increase in ALP and LDH activity in P2 as compared to P1 with P = 0.005 and P ≤ 0.001, respectively. At CT, there was no statistically significant difference in ALP and LDH activity in P1 and P2 with P = 0.054 and P = 0.061, respectively. Conclusion: This study concluded that ALP and LDH activity could be successfully estimated in the GCF, and ALP and LDH activity in GCF reflects the biologic activity in the periodontium during orthodontic tooth movements.

This case report highlights the successful combination of operative and nonoperative management of a patient with noncontiguous cervical spine fractures and incomplete spinal cord injury. A case report of a 40-year-old male victim of a motor vehicular accident who presented with noncontiguous cervical spine fractures (Anderson and D'Alonzo Type III odontoid fracture and traumatic spondylolisthesis of C4/C5) and incomplete spinal cord injury. The odontoid fracture was managed nonoperatively, whereas anterior cervical discectomy and fusion were done at the C4/C5 vertebral level. The patient made full neurologic recovery with radiologic evidence of successful fusion and fracture healing at 12 weeks postoperation in both levels of injuries. Operative and nonoperative modalities can be utilized to manage selected patients.

Colorectal carcinoma in childhood is rare in spite of the rising prevalence of the condition in the African population. Even rarer is the occurrence of multiple cranial nerve paralysis simulating Garcin's syndrome in this age group. This report discusses a case of an 11-year-old boy who presented to our unit with histologically confirmed adenocarcinoma of the rectum with cerebral metastasis and multiple cranial nerve paralysis suggestive of Garcin's syndrome. Challenges in management were highlighted, and we reviewed the literature on colorectal carcinoma in children.

Gallbladder cancer is rare worldwide, and presentation is often very late with consequent dismal prognosis. We presented a 60-year-old woman with a history of recurrent right upper quadrant pain, weight loss, and abdominal mass 3 months before presentation. Preoperative diagnosis of gallbladder cholecystitis with hepatic abscess was made. At laparotomy, the gallbladder was ruptured, and an open fundus- first cholecystectomy was performed as well as adhesiolysis. Histological diagnosis of infiltrating adenosquamous carcinoma with Stage T3 disease was made. Postoperative computed tomography scan showed tumor infiltration of the gallbladder bed, stomach, and anterior abdominal wall. She had six courses of intravenous gemcitabine and oral capecitabine but was lost to follow-up 3 months after surgery. Late stage presentation and adenosquamous histological type conferred a poor prognosis on the patient. Radical surgery is typically advocated in such cases, but this has to be matched by standard anesthetic techniques to minimize morbidity and mortality.

The distribution of erythema nodosum leprosum lesions limited to sun-exposed sites is an unusual presentation of a type 2 reaction. We report the case of a 23-year-old female who presented with erythematous papules, nodules and plaques confined to sun-exposed areas over the face, extensor aspect of both arms and forearms, and “V” of chest with fever and joint pains as well as ulnar clawing of the left hand. A diagnosis of type 2 lepra reaction was made which was confirmed by slit skin smear and skin biopsy.