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Isolated small intestine injury because of blunt trauma is a rarely encountered situation. Because it is difficult to diagnose, this injury can be associated with a prolonged clinical course and delay in treatment. In this article, we present an isolated full-thickness ileal trauma associated with a motor vehicle traffic accident. A 35-year-old male patient was kept under observation at another medical center following the motor vehicle traffic accident and was discharged early because no pathology was detected. He was later referred to our hospital’s emergency clinic with complaints of abdominal pain and vomiting after approximately 12 hours. The patient with acute abdomen was assessed by physical examination, laboratory tests, and imaging and was taken into surgery under emergency conditions. A full-thickness isolated ileal perforation and approximately 300 mm3 of intestinal contents were detected by laparotomy. Resection of necrotic tissues and end-to-end anastomosis was performed. During the post-operative period, he was discharged without complications. Even in situations in which a thorough investigation and examination are performed, considering that there might be an isolated case of small intestine trauma, it is very important to extend the monitoring, imaging, and observation periods of patients with blunt trauma with repeated physical examinations.

Approximately 10%-20% of all systemic lymphomas have central nervous system (CNS) involvement, which has been correlated to a worsened prognosis. It is well known that secondary involvement of the adrenal glands may occur in up to 25% of patients during the course of diffuse lymphoma. Primary adrenal lymphoma (PAL), however, is a different entity, and it is defined as the presence of adrenal lymphoma without evidence of either nodal involvement or leukemia. It has been shown that this occurrence is rarely accompanied by extranodal involvement, such as in the CNS. PAL exhibits a tendency for CNS relapse and this possibility should be examined even before symptoms are present. Herein we present a patient with PAL and secondary CNS involvement.

Doctors and clients sometimes experience interactiveclashes during hospital meetings in South-western Nigerianhospitals because of their divergent culture-constrainedorientation to politeness cues. The goal of this paper is tounpack the discursive elements that characterize interactiveconfluence and divergence in selected consultativeencounters in the hospitals. The findings indicate thatinstitutional and cultural (dis)alignments occur in respect ofadjacency and non-adjacency pair greetings. In bothgreeting types, face support, threat and stasis are conjointlyco-constituted by doctors and Yoruba clients within theaffordances of the cultural, institutional and situationalcontext of the Southwestern Nigerian hospital setting.Adjacency pair greetings attract mutual interpretingsbetween the parties; interactive disalignments aredifferentially pragmatically accommodated by doctors andclients. In non-adjacency pair greeting, doctors’ threats areco-constituted as appropriate by both parties, theinstitutional power of doctor and shared Western culturalorientation playing significant roles.

Unicystic ameloblastoma is not a rare odontogenic tumor in the pediatric population. A significant care should be given to unicystic ameloblastoma if it has mural invasions due to its local aggressiveness, high recurrence rates and radical management options as in conventional ameloblastoma. Fine needle aspiration (FNA) cytology is a rapid, non-traumatic diagnostic method that provides a required attention prior to surgery. We present an excisionsl biopsy proved FNA diagnosed mural type unicystic ameloblastoma in a 9-year-old child recurred as a solid ameloblastoma after 8 years. When distinctive features of ameloblastoma are known, an accurate diagnosis can be made by FNA cytology, in combination with clinicoradiological findings. This method gives benefit to the patients especially the younger ones both for the pre-operative surgical planning and the post-operative follow-up.

On 26th March 2014, a newspaper published an article on the death of a 15 year old female student who attended a private university in Nasarawa state from suspected VHF; presumably Ebola. We investigated to know the cause of death, identified the agent and the source and proposed recommendations. We defined a suspected a case of Viral Haemorrhagic Fever (VHF) as any person with onset of fever and no response to usual causes of fever and at least one of the following signs: bloody diarrhoea, bleeding from gums, bleeding into skin (purpura), bleeding into eyes and urine within and around Abuja from 9th February 2014 to 2nd April 2014. We reviewed the hospital records of the index case and re-tested stored blood samples. We searched actively for contacts with the index case in hospitals where she was treated before her demise. Hospital staff were line listed at the various hospitals. We confirmed one death (index case) a 15 year old female who died on 15th March 2014. Serum sample tested positive for Dengue virus serotypes 1,2,3 and 4 using ELISA and PCR. We implemented VHF detection, management and reporting for health professionals in the country. We recommended sero-surveillance and entomological surveys be done to determine the prevalence of Dengue virus and its vector in Abuja and Nasarawa state. Dengue and other VHFs are emerging diseases that can easily be missed or misdiagnosed in early stages. Equipping laboratories and improving surveillance can help in early detection, management and epidemic aversion.

Introduction Pre‐treatment HIV drug resistance (PDR) is an increasing problem in sub‐Saharan Africa. Children are an especially vulnerable population to develop PDR given that paediatric second‐line treatment options are limited. Although monitoring of PDR is important, data on the paediatric prevalence in sub‐Saharan Africa and its consequences for treatment outcomes are scarce. We designed a prospective paediatric cohort study to document the prevalence of PDR and its effect on subsequent treatment failure in Nigeria, the country with the second highest number of HIV‐infected children in the world. Methods HIV‐1‐infected children ≤12 years, who had not been exposed to drugs for the prevention of mother‐to‐child transmission (PMTCT), were enrolled between 2012 and 2013, and followed up for 24 months in Lagos, Nigeria. Pre‐antiretroviral treatment (ART) population‐based pol genotypic testing and six‐monthly viral load (VL) testing were performed. Logistic regression analysis was used to assess the effect of PDR (World Health Organization (WHO) list for transmitted drug resistance) on subsequent treatment failure (two consecutive VL measurements >1000 cps/ml or death). Results Of the total 82 PMTCT‐naïve children, 13 (15.9%) had PDR. All 13 children harboured non‐nucleoside reverse transcriptase inhibitor (NNRTI) mutations, of whom seven also had nucleoside reverse transcriptase inhibitor resistance. After 24 months, 33% had experienced treatment failure. Treatment failure was associated with PDR and a higher log VL before treatment initiation (adjusted odds ratio (aOR) 7.53 (95%CI 1.61–35.15) and 2.85 (95%CI 1.04–7.78), respectively). Discussion PDR was present in one out of six Nigerian children. These high numbers corroborate with recent findings in other African countries. The presence of PDR was relevant as it was the strongest predictor of first‐line treatment failure. Conclusions Our findings stress the importance of implementing fully active regimens in children living with HIV. This includes the implementation of protease inhibitor (PI)‐based first‐line ART, as is recommended by the WHO for all HIV‐infected children

This paper investigates technical and economically efficiency of 62 organic and 62 conventional olive producing farms in Turkey. According to the study results; by using the CRS model which is input and output-oriented, the average technical efficiency of organic olive farms is 67.68%, the average technical efficiency of conventional olive farms is 47.93%. The technical efficiency of the output-oriented VRS model is 74.78%, and the technical efficiency of the input-oriented VRS model is 93.46%. Also, considering the same model, the average efficiency of the conventional olive farms in the input and output are 59.58% and 94.97%, respectively. Therefore, according to the Data Envelopment Analysis, the technical efficiency in conventional olive farms is less than in the organic ones. When the farms have been evaluated one by one in the light of the total potential improvement values, inputs and outputs, improvement is needed in all values.

Bu çalışmada, dünyada ve ülkemizde önemli tarımsal potansiyele sahip üçgül türlerinden olan İran üçgülü hatlarının tohum verimi ve verim komponentleri incelenerek en yüksek tohum verimini sağlayan bitkilerin ortaya konulması amaçlanmıştır. Araştırma 2005 yılında Ankara Üniversitesi Ziraat Fakültesi Tarla Bitkileri Bölümü deneme tarlasında yürütülmüştür. Çalışmadan elde edilen verilere göre, bitkisel ve tarımsal özellikleri incelendiğinde kömeçte çiçek sayısı en çok 5400 numaralı hatta 27.61 adet, en uzun bitki boyu 5400 numaralı hattan 74.47 cm, en geniş sap çapı 5464 numaralı hattan 6.36 mm, ana dalda kömeç sayısı en fazla 5480 numaralı hattan 34.80 adet, en geniş kömeç çapı 5453 numaralı hattan 8.97mm, kömeçte tohum sayısı en fazla 5461 numaralı hattan 20.07 adet, çiçekte tohum sayısı en fazla 5453, 5456 ve 5461 numaralı hatlardan 1.2 adet, bin tohum ağırlığı en fazla 5475 numaralı hattan 1.40 gram, en fazla tohum verimi 5480 numaralı hattan 59.23 kg/da, en fazla çimlenme oranı 5480 numaralı hattan % 95.93, en fazla sert tohumluluk 5456 numaralı hattan % 1.83 elde edilmiştir. Araştırma sonuçlarına göre, tohum üretmek amacıyla yapılacak İran üçgülü yetiştiriciliğinde 5480 ve 5475 numaralı hatlar Ankara koşullarında öne çıkmıştır

l\'1 o bil sistenllerin tra nsınisyon u alanında, • tah ri k nıotoru ndan alınan güciin değişken siirüş şartları altındaki araca iletilmesi için düşünülmüş başhca çöziinılerden birisi de, değişken deplasmanh hi d rol ik ponıpa ve nıotorların kullanımına dayalı olan hidrostatik tah ri k ya klaşıınıdır. Bu çahşnıada, hidrostatik tahrik vüntcnıinin ternet tasarım kriterleri • i n c e 1 e n nı i� ' e 5 t. ta ş ı nı a kapa s it e 1 i b i r ç ata ll ı �·ii kle� icin in transınisyon sistenıine uygulannııştır. Bu ineelenlenin sonurunda, sadece tahrik motorunun devir sayısı ile tUrn çalışnıa alanının kontrolüne imkan \'erınesi; tahrik rnoınentini, kesintisiz ve kademesiz olarak, ihti�·aç duyulan çckiş kuvveti ve araç hızı kornbinas�·on la rı na dön iiştiirebilnıesi; kavrama., vites k u t us u ,.e d i fe ra nsiyel gibi nı eka ni k giiç a ktarma organ la n na o 1 arı i h ti� acı o rtada n ka ldı rnıası'l hidrostatik tahrik yönteıninin dikkat çekici özellikleri o la ra k değrrlcıı d i ril nı iştir.

The causative agent of hydatid cyst disease is Echinococcus granulosus. Hydatid cysts are usually located in the liver and the lungs; they are very rarely seen in the breasts. Herein, a 62-year-old woman with isolated left breast hydatid cysts is presented. The patient had the complaint of painless mass in the left breast for one year. Imaging methods revealed a mobile lesion with smooth margins. Under local anesthesia, the mass was totally removed. Pathological examination made the diagnosis of hydatid cyst. The patient received mebendazole treatment for 3 months. During follow-up visits, no recurrence was found.

Breast cancer usually metastasizes to bone, lungs, liver and central nervous system. Rarely, atypical metastases may occur. Isolated peritoneal metastasis of breast cancer is very uncommon. On systemic examination of a 50-yearold woman who presented to our outpatients’ clinic with the complaints of abdominal pain and distention, abdominal ascites and a breast mass were found. Biopsy from the breast mass revealed invasive ductal carcinoma and laparoscopic peritoneal biopsy showed peritoneal metastasis of the breast cancer. Palliative chemotherapy was planned. The patient rejected the treatment and has been under follow-up for 6 months does not have any other metastasis now.

INTRODUCTION: Nigeria has one of the highest tuberculosis (TB) burdens in the world with estimated incidence of 133 per 100,000 populations. Multi-drug resistant TB (MDR-TB) is an emerging threat of the TB control in Nigeria caused mainly by incomplete treatment. This study explored factors that affect adherence to treatment among patients undergoing direct observation of TB treatment in Plateau state, Nigeria. METHODS: Between June and July 2011, we reviewed medical records and interviewed randomly selected pulmonary TB patients in their eighth month of treatment. Information on patients' clinical, socio-demographic and behavioral characteristics was collected using checklist and structured questionnaire for knowledge of treatment duration and reasons for interruption of treatment. We conducted focus group discussions with patients about barriers to treatment adherence. Data were analyzed with Epi Info software. RESULTS: Of 378 records reviewed, 229 (61%) patients were male; mean age 37.6 ,13.5 years and 71 (19%) interrupted their treatment. Interruption of treatment was associated with living 5 km from TB treatment site (AOR: 11.3; CI 95%: 5.7-22.2), lack of knowledge of duration of treatment (AOR: 6.1; CI 95%: 2.8-13.2) and cigarette smoking (AOR: 3.4; CI 95%: 1.5- 8.0). Major reasons for the interruption were lack of transport fare (40%) and feeling well (25%). Focused group discussions revealed unfriendly attitudes of health care workers as barriers to adherence to treatment. ONCLUSION: This study revealed knowledge of the patients on the duration of treatment, distance and health workers attitude as the major determinants of adherent to TB treatment. Training for health care workers on patient education was conducted during routine supportive supervision.

The concept or a group is of rundan1cntal itnportance in the study of algebra. Crroups which arc, f1·on1 the point of view of algebraic structure. c~~cntially the san1e are said to be ison1orphic. The ideal ain1 of finite group theory is to find all linitc group : that i ~. to ';hO\\ ho\\' to construct finite groups or every possible type. and to establish effective procedures '' h ich wi 11 detcnn i ne \\het her t \\O given fin itc groups are of the san1e type. W c added a ne\v one on all present techniques: Group Matricc". This technique is easier and shorter than the all present techniques to obtain all finite groups of the san1c finite order. Since this technique includes n1atrices, the theory can be translated to cornputational progratntning in the ruturc.

INTRODUCTION: Between February and October 2009 an increase in morbidity and mortality in dogs in a national kennel in Abuja, Nigeria, was observed with signs indicative of leptospirosis. Concurrent illness was observed in some kennel workers which had high titres of leptospira antibodies. METHODS: An unmatched case-control study was conducted to identify associated factors. Fifteen cases and fifteen controls were recruited. A probable case was defined as any person working at the kennel with history of fever, chills, headache, myalgia with either conjunctivitis or sore throat between February and December 2009. Controls were healthy kennel workers within the same period. Inclusion criteria were any person meeting the definition (for both cases and controls). Kennel workers who were sick but did not fit into the case definition were excluded. RESULTS: Bivariate analysis showed that wounds or cuts on either hands or legs of kennel workers during the period of the outbreak and contact with sewage at the kennel together (p = 0.001) was associated with leptospirosis among kennel workers. CONCLUSION: The findings revealed the importance of environmental hygiene in the prevention and control of leptospirosis. Sanitation and hygiene improvements were recommended.

One of the factors restricting the functions of active prostheses is limited charge times and weights of the batteries. Therefore, some biomechanical energy harvesting studies are conducted for reducing the dependence on batteries and developing the systems that produce energy by utilizing one's own actions during daily living activities. In this study, as a new approach to meet energy needs of active-controlled lower limb prostheses, the design of a biomechanical energy harvester that produces electrical energy from the movements of the knee joint during gait were carried out. This harvester is composed of the generator, planetary gear system and one-way clutch that transmit just the knee extension. Low weight, low additional metabolic power consumption requirement and high electrical power generation are targeted in design process. The total reduction ratio of the transmission is 104, and the knee joint reaction torque applied by the system is 6 Nm. Average electrical powers that can be obtained are 17 W and 5,8 W for the swing extension phase and the entire cycle, respectively. These values seem to be sufficient for charging the battery units of many prostheses and similar medical systems, and portable electronic devices such as mobile phones, navigation devices and laptops.

The objectives of this study were to determine the prevalence and pattern of Kola nut use among secondary school students in Osogbo, Osun State, Nigeria. The study also aimed to determine the association of sociodemographic variables (of the students and their parents) with kola nut chewing. A questionnaire consisting of socio-demographic variables, the stimulant use section of the WHO Students Drug Use Questionnaire was administered on three hundred and eighty-five (385) randomly selected students of the two Local Government Areas of Osogbo. The prevalence rate of kola nut use was calculated and some socio demographic variables were determined. The 30-day prevalence rate of kola nut use was 11.2%. The one-year prevalence of kola nut use was 29.1 percent and the lifetime rate was 74.8 percent. Majority of users started at age 14 years or below. Kola nut use was associated with lower age group, poor school attendance, polygamous background, low education of mother, high education of father and the description of mother as being too permissive. The findings suggest the need to increase the awareness of the dangers of kolanut use among adolescents. Control program are urgently needed to prevent student wastage.

Duplication cysts are rare gastrointestinal congenital abnormalities and can occur anywhere within the gastrointestinal tract. Duplication cysts are firmly attached to or share the wall of the alimentary tract and have a common blood supply with the adjacent segment of the bowel. Completely isolated duplication cysts are an extremely rare variety of gastrointestinal duplications with their own exclusive blood supply, and they do not communicate with the intestine. These cysts are usually diagnosed during early childhood, and very rarely detected in adults, mostly incidentally, due to a lack of symptoms. A 28-year-old male was admitted to our hospital with a chief complaint of lower abdominal pain and distention and a palpable mass for 1 month. Based upon computed tomography and sonographic findings, a small bowel duplication cyst was tentatively diagnosed. The cyst had no connection to the gastrointestinal tract. Herein we report the case of a noncommunicating isolated ileal duplication cyst in an adult. Resection of the cyst was performed safely without requiring bowel resection.

Nigeria has a record of high newborn mortality as an estimated 778 babies die daily, accounting for a ratio of 48 deaths per 1000 live births. The aim of this paper was to show how a deteriorating neonatal delivery system in Nigeria may have, in part, been improved by the application of a novel recycled incubator technique (RIT). Retrospective assessment of clinical, technical, and human factors in 15 Nigerian neonatal centres was carried out to investigate how the application of RIT impacted these factors. Pre-RIT and post-RIT neonatal mortalities were compared by studying case files. Effect on neonatal nursing was studied through questionnaires that were completed by 79 nurses from 9 centres across the country. Technical performance was assessed based on 10-indices scores from clinicians and nurses. The results showed an increase in neonatal survival, nursing enthusiasm, and practice confidence. Appropriately recycled incubators are good substitutes to the less affordable modern incubators in boosting neonatal practice outcome in low-income countries.

This paper sets out to study pragmatic strategies of diagnostic news delivery in Nigerian hospitals, an area that has received extremely little attention in the linguistic literature. It ultimately aims to see how these strategies are similar to or are different from those used in Western hospitals, especially as studied by Maynard (1991a, 1991b, 1991c, 1992, 2003, 2004). The hospitals sampled were stratified into teaching, state-government owned and private hospitals, and a random selection of five hospitals from each group was made. Data were collected through tape recordings, and personal observation of hospital interactions. The analysis of data was based on insights from Levinson's (1979) notion of activity type and Maynard's (1991a, 1991b, 1991c, 1992, 2003, 2004) devices of diagnostic news delivery. The findings reveal that three strategies are used to declare diagnostic news. Two of these are the main strategies identified by Maynard, namely asserting the condition and citing the evidence, but the third, mitigating the blunt news through veils and hedges, is largely peculiar to Nigerian hospitals. The paper concludes that a study of pragmatic strategies of diagnostic news delivery contributes to a better understanding of hospital interactions, and provides insights into doctors' verbal outputs in diagnostic meetings.

The paper examines the pragmatic functions that crisis-motivated proverbs play in Ola Rotimi's The Gods is not to Blame. It picks its inspiration from the little attention hitherto paid, in the linguistic literature, to both the specific proverbs that are spurred by crisis in the play and the pragmatic roles of such proverbs. For data, only the proverbs that are necessitated by the crisis-situations in the text are sampled, and these are analysed, using the recent theory of pragmatic acts (Mey 2001). The study reveals that crisis-motivated proverbs in The Gods are not to Blame, which are of two types: social and political, are characterized by practs such as those of counselling, cautioning, challenging, veiling, persuading, prioritizing, encouraging, threatening and admitting. These are psychological acts which exploit contextual features such as reference, metaphor, inference, shared situation knowledge, shared cultural knowledge and relevance. The paper concludes that studying literary proverbs used in crisis situations, from a pragmatic perspective, both throws additional insights into the paremiological pool and promises to provide a veritably helpful tool for language teaching.

This study describes discourse tact in diagnoses in doctor-patient interactions in English in selected hospitals in South-western Nigeria. Using recorded conversations between doctors and patients in those hospitals as data, the mutual contextual beliefs of participants, speech act patterns, including linguistic patterns, and other pragmatic features are analyzed from the perspective of the pragmatics of discourse. The findings indicate the predominance of doctor-initiated spoken exchanges in which doctors elicit and confirm information and give directives to patients, while the patients give information and attempt to respond appropriately to the doctors’ moves. It is also observed that conversation maxims are flouted and politeness maxims exploited in order to enhance successful diagnosis in the interaction. Finally, it is observed that doctor-patient interaction is only one out of many aspects of medical communication that require the attention of language scholars in order to gain insight into language as an act of social behaviour and action, especially with respect to the institution of medicine.

A letter to the editor is presented in response to the article "Dowling-Degos disease classic clinical and histopathological presentation" by C.C. Zimmermann and colleagues in a 2011 issue.

Presents a letter to the editor regarding intralesional tuberculin for treatment of refractory warts.

Background: Men of African descent have the highest incidence and mortality rates of prostate cancer (PrCa) worldwide. Notably, PrCa is increasing in Africa with Nigerian men being mostly affected. Thus, it is important to understand risk factors for PrCa in Nigeria and build capacity for cancer research. The goals of this study were to determine the feasibility of conducting an epidemiological study of PrCa and to obtain preliminary data on risk factors for PrCa in Nigeria.Methods: A case-control study (50 cases/50 controls) was conducted at the University College Hospital (UCH) in Ibadan, Nigeria, between October 2011 and December 2012. Men aged 40 to 80 years were approached for the study and asked to provide informed consent and complete the research protocol. Logistic regression models were used to examine associations between demographic, social and lifestyle characteristics and risk of PrCa.Results: The participation rate among cases and controls was 98% and 93%, respectively. All participants completed a questionnaire and 99% (50 cases/49 controls) provided blood samples. Cases had a median serum diagnostic PSA of 73 ng/ml, and 38% had a Gleason score 8-10 tumor. Family history of PrCa was associated with a 4.9-fold increased risk of PrCa (95% CI 1.0 - 24.8). There were statistically significant inverse associations between PrCa and height, weight and waist circumference, but there was no association with body mass index (kg/m(2)). There were no associations between other socio-demographic and lifestyle characteristics and PrCa risk.Conclusion: This feasibility study demonstrated the ability to ascertain and recruit participants at UCH and collect epidemiological, clinical and biospecimen data. Our results highlighted the advanced clinical characteristics of PrCa in Nigerian men, and that family history of PrCa and some anthropometric factors were associated with PrCa risk in this population. However, larger studies are needed to better understand the epidemiological risk factors of PrCa in Nigeria. [ABSTRACT FROM AUTHOR]

Abstract Background Peroxisome proliferators-activated receptor alpha (PPARα) activation modulates cholesterol metabolism and suppresses bile acid synthesis. This study aims to evaluate the effect of short-term administration of fenofibrate, a PPARα agonist, on proinflammatory cytokines, apoptosis, and hepatocellular damage in cholestasis. Methods Forty male Wistar rats were randomly divided into four groups: I = sham operated, II = bile duct ligation (BDL), III = BDL + vehicle (gum Arabic), IV = BDL + fenofibrate (100 mg/kg/day). All rats were sacrificed on 7th day after obtaining blood samples and liver tissue. Total bilirubin, aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP), gamma-glutamyl transferase, (GGT), tumor necrosis factor alpha (TNF-α), interleukin 1 beta (IL-1 β), and total bile acid (TBA) in serum, and liver damage scores; portal inflammation, necrosis, bile duct number, in liver tissue were evaluated. Apoptosis in liver was also assessed by immunohistochemical staining. Results Fenofibrate administration significantly reduced serum total bilirubin, AST, ALT, ALP, and GGT, TNF-α, IL-1 β levels, and TBA (P < 0.01). Hepatic portal inflammation, hepatic necrosis, number of the bile ducts and apoptosis in rats with BDL were more prominent than the sham-operated animals (P < 0.01). PPARα induction improved all histopathologic parameters (P < 0.01), except for the number of the bile duct, which was markedly increased by fenofibrate therapy (P < 0.01). Conclusion Short-term administration of fenofibrate to the BDL rats exerts beneficial effects on hepatocellular damage and apoptosis.