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Background Ileoileal knotting is one of the rarest causes of intestinal obstruction. The pathology involves knotting of the ileum around itself, leading to mechanical intestinal obstruction that can rapidly evolve to gangrene. Case presentation Here we will discuss the case of an 18-year-old Oromo girl who presented with sudden onset of severe abdominal pain and signs of generalized peritonitis.Ultrasound examination showed massive peritoneal and cul-de-sac fluid. Explorative laparotomy was done, with a tentative diagnosis of ruptured ovarian cyst. Intraoperative finding was a gangrenous ileoileal knot. The gangrenous segment was resected and ileotransverse anastomosis done. Postoperative course was uneventful, and the patient was discharged improved on the sixth postoperative day. Conclusion We present this case to highlight the diagnostic difficulty that one can face in females of child-bearing age and to create awareness of this rare cause of intestinal obstruction, as morbidity and mortality are very high because of rapid progression to gangrene.

OBJECTIVES: The aim of this study was to sonographically measure and compare the pronator quadratus muscle thickness (PQMT) in apparently healthy volunteers between two occupational groups and to assess the influence of hand dominance on the PQMT. METHODS: A total of 180 apparently healthy volunteers were enrolled in the study. The volunteers were grouped into repetitive (90) and nonrepetitive (90) workgroups. They were scanned with a B-mode ultrasound machine and linear transducer. RESULTS: The mean PQMT was significantly higher (P < 0.05) in the repetitive workgroup than in nonrepetitive workgroups. Similarly, a significant difference in mean PQMT was observed between dominant and nondominant hands in the repetitive workgroups (P < 0.05). CONCLUSION: The mean PQMT among repetitive workgroup is significantly higher when compared with nonrepetitive workgroups in the study area.

Introduction. T-helper cells (Th)-1& -2 cytokines homeostasis control orpredict clinical outcome of infected persons, especially those with HIV /AIDS. This case-control study evaluated the leucocytes differentials, TNF-alpha, interleukin (IL)-2 and -10 levels among HIV infected persons with serological evidence of leishmaniasis attending University of Abuja Teaching Hospital, Nigeria. Material and Methods. Blood samples from 28 HIV infected persons who had Leishmania donovani rK39 and IgG positive (group 1), 30 age- & -sex matched HIV infected persons without Leishmania antibodies (group 2) and 30 apparently healthy persons without HIV and Leishmania antibodies (group 3). Full blood counts, TNF alpha, IL-2 and -10 levels were analyzed using automated hematology analyzer and ELISA, respectively. Structured questionnaires were used to collate biodata and clinical presentations of participants. Results. Ten (35.7%) participants in group 1 were on ART, 15 (50%) in group 2 were on ART, while group 3 were ART naïve. There were significantly higher values in basophil (4.4 ± 2.5%) and eosinophil counts (12.9 ± 3.8%) in HIV/leishmania coinfected persons (p ˂ 0.005). However, other white cells subpopulation was significantly lower in HIV/leishmania co-infected participants (p ˂ 0.05). There was significantly reduced CD4+ T cell counts ([119 ± 26 versus 348 ± 63 versus 605 ± 116 cells/mm3]), TNF-alpha ([36.82 ± 8.21 versus 64.67 ± 12.54 versus 254.98 ± 65.59 pg/mL]) and IL-2 levels ([142.14 ± 20.91 versus 507.6 ± 84.42 versus 486.62 ± 167.87 pg/mL]) among HIV/Leishmania co-infected participants compared to group 2 and group 3 participants, respectively. However, higher IL-10 level (80.35 ± 14.57 pg/mL) was found in HIV/Leishmania co-infected participants as opposed to the HIV mono-infected (62.2 ± 10.43 pg/mL) and apparently healthy persons (23.97 ± 4.88 pg/mL) (p ˂ 0.001). Conclusion. Eosinophil, basophil counts and serum IL-10 level were high in HIV/Leishmania coinfected persons, demonstrating parasite-induced hypersensitivity and immunosuppression.

This study examined the ‘efficient breach’ theory and its possible application under Jordanian Civil Law. The theory says the promisor has the right to breach a contract and pay damages whenever his profit from breach exceeds his expected profits from performance. As a prerequisite for its application, the theory requires the general remedy for breach to be the payment of damages, rather than forced performance. Thus, the main area for its application is the common law system, since it favours damages as a primary remedy. This study reached the conclusion that the theory cannot work under Jordanian Civil Law, where the primary remedy for breach of contract is specific performance, that forces the promisor to complete the contract. In addition, it contradicts the good faith principle that Jordanian law is based upon, amongst other principles, and goes against the history of Jordanian legal rules.

Background: Phenotypic detection of methicillin-resistant Staphylococcus aureus(MRSA) has been problematic ever since its discovery in the early 1960s. The emergence of low-level resistant MRSA clones acquired in the community has only added to these difficulties. In 2005, the Clinical and Laboratory Standards Institute (CLSI) published zone diameter (10), breakpoint guidelines for cefoxitin. However, a number of technical issues remain regarding the use of cefoxitin as a predictor for methicillin resistance. Materials and Methods: In these studies, 252 nonduplicate samples of staphylococcal isolates were collected from various clinical samples obtained from patients attending Aminu Kano Teaching Hospital. The isolates were subcultured and identified using standard bacteriological procedure according to CLSI (13). Antibiotic susceptibility testing was done using a modified form of the Kirby–Bauer method. Methicillin resistance was screened using disk-diffusion method with cefoxitin 30 μg and oxacillin 1 μg. Results: High percentage of the isolates were recovered from patients of age groups of 1–9 years and

Background A transfusion transmissible infection (TTI) is any infection that is transmissible from person to- person through parenteral administration of blood or blood products. The magnitude of transfusion-transmitted infections (TTI) varies from country to country depending on TTI’s load in that particular population. Measuring their severity, WHO (World Health Organization) has recommended pre-transfusion blood test for Human immunodeficiency virus (HIV), Hepatitis B virus (HBV), Hepatitis C Virus (HCV) and Syphilis as mandatory. The aim of the current study was to assess the trend and prevalence of TTI among blood donors in Jijiga Blood Bank between 2010 and 2013. Methods A Retrospective cross-sectional study was conducted by reviewing the records from 2010 to 2013 at Jijiga Blood Bank. All blood donors who presented to the blood bank and screened for TTI during the study period were included. The data was collected, entered and analyzed using Epi Info 3.5.1 & Microsoft Excel 2007. The descriptive statistics were determined in means of percentages. Chi-square was used for trend analysis and p-value was used to declare the statistical significance between the variable. Result There were a total of 4224 people donated blood during study period. Males formed the majority of the donor population accounting for 4171 (98.7 %). Majority 4139 (98 %) of donors were Replacement donors. The overall prevalence of transfusion-transmitted infection was 487/4224 (11.5 %). The prevalence for HBsAg, HCV, HIV, & Syphilis antibodies was 460 (10. 9 %), 17 (0.4 %), 6 (0.1 %) and 4 (0.1 %) respectively. Majority 460/487 (94.5 %) of infection was HBsAg. Statistically significant difference was observed in number of donation as well as sero-positivity from year 2010 to 2013 (Chi-square 9.24, p value = 0.02), in Trends of HBsAg from year to year (Chi-square 11.14, p value = 0.01), HIV virus was seen as the age of donors increases (Chi-square 8.37, p value = 0.01) and There was also statistically significance difference (p value = 0.01) in prevalence of HBsAg distribution by sex. Conclusion The present study clearly documents high Seroprevalence (487 out of 4,224, 11.5 %) of TTI, low percentage of voluntary donors and low participation of female donors. Promoting the culture of voluntary donors, recruitment of female blood donors and proper testing of donor’s blood by using standard methods are recommended.

Aim To determine the pattern of expression of selected bio-markers in nasopharyngeal carcinoma (NPC) and correlate it with stage at presentation and prognosis Methods In a prospective study, formalin fixed paraffin embedded (FFPE) tumour tissues from patients with NPC were stained using immunohistochemistry (IHC) for selected bio-markers, namely E-cadherin, beta catenin, EGFR and cyclin D1 Results Forty patients were included in the analysis and had IHC. Age ranged from 17-65 years with a mean age of 48 years. About 80% of our cases had TNM stage III while the rest had stage IV disease at presentation. Also all our cases were either WHO histologic type III or IV tumours. Beta catenin expression was present in about 50% of patients. E-cadherin expression was present in all cases in about 50-60% of tumour cells. Cyclin-D1 was also present in all cases in 20-30% of tumour cells. EGFR expression was strong and in a minimum of 70% of tumour cells in all cases. Conclusion The expression pattern of E-cadherin, beta catenin, EGFR and cyclin D1 in this study correlates with accelerated progression, early metastasis, advanced disease and high probability of local recurrence even after radiotherapy and chemotherapy.

BACKGROUND: Malnutrition among children remains common in many parts of the world, particularly in developing countries. In Ethiopia, it is one of the most important health and welfare problems among infants and young children. Ethiopian Somali regional state is one of the most underserved regions in terms of access to essential services and characterized by a high level of child malnutrition, food insecurity, and vulnerable livelihoods. Therefore, the current study was undertaken to assess the magnitude and factors associated with malnutrition among children aged 6–59 months in Shinille Woreda, Ethiopian Somali regional state. METHODS: Community-based cross-sectional survey, involving 694 study participants selected by multistage sampling technique, was conducted in Shinile Woreda from February to March, 2014. Data were collected using structured questionnaire and anthropometric measurement. Anthropometric indices were calculated using ENA for SMART software 2011, and SPSS V.16 was used for data analysis. Associations were computed using the OR and 95 % CI. P-value less than 0.05 were considered as statistically significant. RESULTS: The overall prevalence of stunting, underweight and wasting were 33.4 %, 24.5 % and 20 %, respectively. The main associated factors of stunting and wasting were family size, child’s sex and monthly income of the households. Immunization status was the only variable associated with all forms of malnutrition. Non-immunized children were 2.5 times more likely become underweight than their counterparts. The prevalence of stunting was 3.8 times higher in households with large family size. Female children were 1.5 times more likely become wasted than their counterparts. CONCLUSION: Prevalence of malnutrition among under five children in Shinile Woreda is still high. Our finding highlighted the importance of childhood vaccination, family planning and poverty alleviation as potential targets for intervention.

Background Sub-Saharan countries including Nigeria have the highest burden of Human Papillomavirus (HPV) infection in the world. Most studies on HPV surveillance in Nigeria were done in the southern part of the country. Geographical and socio-cultural diversity of Nigeria makes these data unlikely to be universally representative for the entire country. Northern Nigeria especially the North-East carries a higher prevalence of cervical cancer and many of its risk factors. The region may be harbouring a higher prevalence of HPV infection with a possibility of different genotypic distribution. This study was carried out to determine the burden and confirm the predominant HPV genotypes among women presenting for cervical cancer screening at the Federal Teaching Hospital Gombe (FTHG), North-eastern, Nigeria. Methods The study was an observational hospital based cross sectional study among women who presented for cervical cancer screening in FTHG. A total of 209 consenting women were tested for cervical HPV infection using PCR. DNA sequencing was carried out on positive samples to determine the prevalent HPV genotypes. Results The prevalence of cervical HPV infection among the participants with mean age of 39.6 ± 10.4 years was 48.1 %. The five most predominant genotypes were 18, 16, 33, 31 and 35, with prevalence of 44.7 %, 13.2 %, 7.9 %, 5.3 % and 5.3 % respectively. Other genotypes observed were 38, 45, 56, 58, 82 and KC5. Multiple HPV infections were detected among 7.9 % of participants. Risk factors such as level of education (X2 = 15.897; p = 0.007), age at sexual debut (X2 = 6.916; p = 0.009), parity (X2 = 23.767; p = 0.000), number of life time sexual partners (X2 = 7.805; p = 0.005), age at first pregnancy (X2 = 10.554; p = 0.005) and history of other malignancies (X2 = 7.325; p = 0.007) were found to have a statistically significant association with HPV infection. Conclusion This study identified a high burden of HPV infection in Northern Nigeria while also confirming HPV 18 and 16 as the most predominant genotypes. It further justifies the potential benefit of the currently available HPV vaccines in the area. A larger and community based study is however recommended for better representation of the area. Electronic supplementary material The online version of this article (doi:10.1186/s13027-015-0035-8) contains supplementary material, which is available to authorized users.