Client Satisfaction with Antenatal Care Services in Primary Health Care Centres in Sabon Gari Local Government Area, Kaduna State Nigeria.

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Sero-prevalance of anti-R7V antibody in HIV infected patients in the Federal Capital Territory (FCT), Nigeria

Studies in some parts of the world have shown that Anti-R7V antibodies, which neutralize 100% of the different variant’s panel (targeted against a beta2-microglobulin epitope acquired when the virus is released by budding) in vitro, are found in 30 to 50% of naïve HIV positive patients, but even more in socalled “long-term survivor’’ patients with a close to 90% correlation. The seroprevalence of Anti-R7V antibody was therefore investigated in HIV patients attending clinic within the Federal Capital Territory (FCT) and compared with HIV negative patients. Correlation between the presence of the antibody and the clinical status of patients was also investigated. The HIV positive patients were categorized intodrug naïve and drug experienced subjects and their Anti-R7V antibody together with CD4 counts were determined using Anti-R7V ELISA kits and BD FACS count, respectively. About 47.2% of the HIVinfected patients tested positive for the Anti-R7V antibody while 25.2% were negative for this antibody. Patients with Anti-R7V antibody had a mean CD4 count (355 ± 19.2) significantly (P < 0.05) higher than that of Anti-R7V antibody negative patients (215 ± 42.6). Also it was observed that Anti-R7V antibody was significantly (P < 0.05) lower in drug experienced patients as compared to drug naïve patients. The significance of these findings is discussed. It was concluded that Anti-R7V antibody may be a naturalimmunity against HIV-infection in drug naïve HIV patients and that the synthesis and release of this antibody may decrease with ARD treatment

The Effect of Aqueous Extract of Garcinia Kola Seed On The Liver Histology

Background: Various parts of Garcinia kola plant are used for a wide range of medicinal purposes in Africa where it is indigenous. The kernels of the nut are widely traded and are eaten as bitter stimulant while extract of the seed have been used traditionally for the treatment of cough and liver diseases. This study is done to evaluate the possible histological effect(s) of aqueous extract of Garcinia kola seeds on the liver of albino rat.  Twenty (20) matured wister rats were grouped into four (A, B, C and D). Each group contained five(5) rats. Group A received 125mg/kg of the extract while groups B and C received 200mg/kg and 500mg/kg respectively. Group D served as control. The results obtained revealed that the treated sections of the liver showed no evidence of degenerative changes or cyto-architectural distortions of the hepatic parenchyma. It was concluded that intake of Garcinia kola in itself does not cause any acute morphological changes in the liver. Keywords: Garcinia kola seed, Liver, histology

A prospective observational study comparing proficiency of obstetrics & gynaecology trainees with general surgical trainees using simulated laparoscopic tasks in Health Education England, North-West

BACKGROUND: Training programmes for obstetrics and gynaecology (O&G) and general surgery (GS) vary significantly, but both require proficiency in laparoscopic skills. We sought to determine performance in each specialty. DESIGN: Prospective, Observational study. SETTING: Health Education England North-West, UK. PARTICIPANTS: 47 surgical trainees (24 O&G and 23 GS) were sub-divided into four groups: 11 junior O&G, 13 senior O&G, 11 junior GS, and 12 senior GS trainees. OBJECTIVES: Trainees were tested on four simulated laparoscopic tasks; laparoscopic camera navigation (LCN), hand eye co-ordination (HEC), bimanual co-ordination (BMC) and suturing with intracorporeal knot tying (suturing). RESULTS: O&G trainees completed LCN (P <0.001), HEC (P <0.001) and BMC (P <0.001) significantly slower than GS trainees. Furthermore, O&G found fewer number of targets in LCN (P =0.001) and dropped a greater number of pins than the GS trainees in BMC (P =0.04). In all three tasks, there were significant differences between O&G and GS trainees but no difference between the juniors and senior groups within each specialty. Performance in suturing also varied by specialty; senior O&G trainees scored significantly lower than senior GS trainees; O&G 11.4 ± 4.4 vs GS 16.8 ± 2.1, P = 0.03. Whilst suturing scores improved with seniority among O&G trainees, there was no difference between the junior and senior GS trainees; senior O&G 11.4 ± 4.4 vs junior O&G 3.6 ± 2.1, P = 0.004. DISCUSSION: GS trainees performed better than O&G trainees in core laparoscopic skills and the structure of obstetrics and gynaecology training may require modification

Surgical Stress: The Muscle and Cognitive Demands of Robotic and Laparoscopic Surgery

Introduction: Surgeons are among the most at-risk professionals for work-related musculoskeletal decline and experience high mental demands. This study examined the electromyographic (EMG) and electroencephalographic (EEG) activities of surgeons during surgery. Methods: Surgeons who performed live laparoscopic (LS) and robotic (RS) surgeries underwent EMG and EEG measurements. Wireless EMG was used to measure muscle activation in 4 muscle groups bilaterally (biceps brachii, deltoid, upper trapezius, and latissimus dorsi), and an 8-channel wireless EEG device was used to measure cognitive demand. EMG and EEG recordings were completed simultaneously during (1) noncritical bowel dissection, (2) critical vessel dissection, and (3) dissection after vessel control. Robust ANOVA was used to compare the %MVCRMS and alpha power between LS and RS. Results: Thirteen male surgeons performed 26 LS and 28 RS. Muscle activation was significantly higher in the right deltoid (P = 0.006), upper trapezius (left, P = 0.041; right, P = 0.032), and latissimus dorsi (left, P = 0.003; right, P = 0.014) muscles in the LS group. There was greater muscle activation in the right biceps than in the left biceps in both surgical modalities (both P = 0.0001). There was a significant effect of the time of surgery on the EEG activity (P < 0.0001). A significantly greater cognitive demand was observed in the RS than in the LS with alpha, beta, theta, delta, and gamma (P = 0.002 – P <0.0001). Conclusions: These data suggest greater muscle demands in laparoscopic surgery, but greater cognitive demands in RS. This trial was registered at Clinicaltrials.gov (NCT04477746)

Bicornuate Uterus-A Case Report And Literature Review

An interesting case of Bicornuate Uterus which was found at Surgery for twisted ovarian cyst in a 28 year old para 3+0 woman. This anatomical delight is presented because of the dilemma it gives the obstertrician and gynaecologist in the management of infertility. This particular case had caeserian section for her second pregnancy due to pre eclampsia and had ultrasonographic scan done without being detected. The rarity of this condition also makes it a worthwhile reporting. Keywords: Bicornuate uterus, infertility, obstetrician and gynaecologist.Highland Medical Research Journal Vol. 4 (2) 2006 pp. 49-5

Should All Minimal Access Surgery Be Robot-Assisted? A Systematic Review into the Musculoskeletal and Cognitive Demands of Laparoscopic and Robot-Assisted Laparoscopic Surgery

Background: Surgeons are among the most at risk of work-related musculoskeletal health decline because of the physical demands of surgery, which is also associated with cognitive fatigue. Minimally invasive surgery offers excellent benefits to patients but the impact of robotic or laparoscopic surgery on surgeon well-being is less well understood. This work examined the musculoskeletal and cognitive demands of robot-assisted versus standard laparoscopic surgery. Methods: Medline, Embase and Cochrane databases were systematically searched for ‘Muscle strain’ AND ‘musculoskeletal fatigue’ AND ‘occupational diseases’ OR ‘cognitive fatigue’ AND ‘mental fatigue’ OR ‘standard laparoscopic surgery’ AND ‘robot-assisted laparoscopic surgery’. Primary outcomes measured were electromyographic (EMG) activity for musculoskeletal fatigue and questionnaires (NASA-TLX, SMEQ, or Borg CR-10) for cognitive fatigue. A systematic review was conducted in accordance with the Synthesis Without Meta-analysis (SWiM) Guidelines. The study was preregistered on Prospero ID: CRD42020184881. Results: Two hundred and ninety-eight original titles were identified. Ten studies that were all observational studies were included in the systematic review. EMG activity was consistently lower in robotic than in laparoscopic surgery in the erector spinae and flexor digitorum muscles but higher in the trapezius muscle. This was associated with significantly lower cognitive load in robotic than laparoscopic surgery in 7 of 10 studies. Conclusions: Evidence suggests a reduction in musculoskeletal demands during robotic surgery in muscles excluding the trapezius, and this is associated with most studies reporting a reduced cognitive load. Robotic surgery appears to have less negative cognitive and musculoskeletal impact on surgeons compared to laparoscopic surgery

Blood Corpuscular Pattern Of Keloid Patients In North Central Nigeria

Background: Keloid has been reported to be preponderant in Africans, non-existent before one year of age and its cause still unknown. Aim: In search for the possible cause of this condition, differential white blood cell count in keloid patients in north centm1 Nigeria is studied. .Materials and Method: Eighty (80) Keloid subjects were matched with control subjects by age and sex. 5ml of venous blood was taken from each of these subjects. Using thin blood films stained with Leishman\'s stain, total white blood cell count and differential white cell count for each subject was done and the findings analyzed by parametric statistical methods. Student t test was used to determine whether there was any significant difference between leukocytes of keloid and control subjects. Results: When the mean percentage leucocytes in Keloid and control subjects was compared, women with Keloid had significantly higher mean percentage monocytes than those in the control group (