Aorto-ventricular tunnel

Aorto-ventricular tunnel is a congenital, extracardiac channel which connects the ascending aorta above the sinutubular junction to the cavity of the left, or (less commonly) right ventricle. The exact incidence is unknown, estimates ranging from 0.5% of fetal cardiac malformations to less than 0.1% of congenitally malformed hearts in clinico-pathological series. Approximately 130 cases have been reported in the literature, about twice as many cases in males as in females. Associated defects, usually involving the proximal coronary arteries, or the aortic or pulmonary valves, are present in nearly half the cases. Occasional patients present with an asymptomatic heart murmur and cardiac enlargement, but most suffer heart failure in the first year of life. The etiology of aorto-ventricular tunnel is uncertain. It appears to result from a combination of maldevelopment of the cushions which give rise to the pulmonary and aortic roots, and abnormal separation of these structures. Echocardiography is the diagnostic investigation of choice. Antenatal diagnosis by fetal echocardiography is reliable after 18 weeks gestation. Aorto-ventricular tunnel must be distinguished from other lesions which cause rapid run-off of blood from the aorta and produce cardiac failure. Optimal management of symptomatic aorto-ventricular tunnel consists of diagnosis by echocardiography, complimented with cardiac catheterization as needed to elucidate coronary arterial origins or associated defects, and prompt surgical repair. Observation of the exceedingly rare, asymptomatic patient with a small tunnel may be justified by occasional spontaneous closure. All patients require life-long follow-up for recurrence of the tunnel, aortic valve incompetence, left ventricular function, and aneurysmal enlargement of the ascending aorta

Are laws the appropriate solution: The need to adopt non-policy measures in aid of the implementation of sex discrimination laws in Nigeria

Gender inequality is a social problem facing women all over the world and is a barrier to human development. The United Nations commits to achieving gender equality and empowering women and girls and have adopted the Sustainable Development Goals to achieve gender equality by 2030. Nigeria, a Member State of the United Nations has ratified international and regional instruments which advocate for the protection and promotion of the rights of women and girls. Though some progress has been made to reduce inequality, discrimination remains a problem to women and is exacerbated by factors such as culture, religion, social practices and discriminatory laws. This study seeks to add to the discourse on gender inequality in Nigeria and examine the effectiveness of available domestic and international provisions against sex discrimination when considered against ingrained cultural attitudes, beliefs and discriminatory laws. The study found that amongst other determinants, culture and religion were constant features in the different forms of discrimination Nigerian women face and they were the primary reasons the proposals to pass gender equality laws were opposed and failed. The study proposes the need to adopt non-policy measures such as education and awareness-raising as additional measures to eliminating discrimination and promoting equalit