Evaluation of In-vivo Antimalarial Activity of Methanol Leaf Extract of Glyphaea brevis in Plasmodium berghei-Infected Mice

Purpose: To evaluate the in-vivo antimalarial activity of the methanol extract of the leaves of Glyphaea brevis in Plasmodium berghei infected mice.Methods: The phytochemical profile of ethylacetate, n-butanol, and residual aqueous fractions of the methanol extract of G. brevis were determined using standard procedures. Mice, weighing between 15 - 30 g, were used for this study. Plasmodium berghei infected blood (0.2 ml) was used to infect each of 55 mice (5 in 11 groups) intraperitoneally. Animals in the infected groups were treated orally with varying doses (200, 300 and 400 mg/kg body weight) of the ethylacetate, n-butanol and residual aqueous fractions daily, using artemisinin (5 mg/kg body weight per day) as standard drug, over a period of four days. The non-infected (normal control, n = 5) received distilled water (0.2 ml) while the infected control group (n = 5) was administered 0.2 ml normal saline. The suppressive antiplasmodial properties of the fractions as well as the serum concentrations of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were determined.Results: Alkaloids, carbohydrates, cardiac glycosides, flavonoids, saponins, tannins, steroids and triterpenes were present in the extract fractions. The suppressive antiplasmodial activity of n-butanol, residual aqueous portion and ethylacetate fractions was 76.64, 73.25 and 72.99 %, respectively, while that of artemisinin was 86.13 %. The serum concentrations of AST, ALT, and ALP in the infected control group were significantly higher (p < 0.05) than those of the treated malaria-infected groups treated with the three fractions.Conclusion: Glyphaea brevis possesses significant antiplasmodial properties and could be a source of lead molecules for the development of new antimalarial agents.Keywords: Antimalarial, Glyphaea brevis, Plasmodium berghei, Artemisini

Morphology and Clinical Presentation of Duplicate External Auditory Canal-Literature Review

First branchial cleft anomalies (FBCA) such as duplication of the external auditory canal are due to failure to obliterate the ventral portion of the 1st cleft while external auditory canal stenosis and atresia are abnormalities of the dorsal portion.The annual incidence is 1:1000,000 and it’s been found to be commoner among females 69% than males 31% with the left ear most affected.FBCA can present as fistula, sinus or cysts located around/along the EAC, periauricular region and the neck above the hyoid bone. Keywords: Duplicate External auditory canal,First branchial anomaly,auditory canal stenosis DOI: 10.7176/JHMN/64-04 Publication date:July 31st 201

Posterior Cerebral Artery Ischemic Stroke in a Patient with Hypoplastic P1 Segment of the Posterior Cerebral Artery

Posterior circulation stroke usually presents with clinical challenges, and symptoms may include blindness. Hypoplastic or atretic cerebral artery may be a risk factor for future ischemic stroke. We present a 75‑year‑old male patient with posterior cerebral artery ischemic stroke who presented with sudden visual deterioration, and brain magnetic resonance angiography showed hypoplastic right P1. Keywords: Hypoplastic artery, ischemic stroke, posterior circulation, visual impairmen

The burden of coexistent allergic rhinitis and allergic conjunctivitis on health‑related quality of life

Background: Allergic rhinitis (AR) is a symptom complex of consisting of nasal congestion, rhinorrhoea, sneezing and nasal itching arising from an IgE‑mediated allergic reaction and inflammation of the mucosal lining of the nose and contiguous mucosal membranes usually due to airborne allergen. AR may occur in isolation or may coexist with allergic conjunctivitis (AC). Aim: The aim of this study is to assess and evaluate the importance of health‑related quality of life (HR‑QoL) in patients suffering from concomitant AC with AR with different types of quality‑of‑life instruments. Methods: A sum of 220 patients who attended the outpatient department of ENT clinic were involved in this study. All patients undertook an ophthalmologic examination for coexistent AC. The rhino conjunctivitis quality of life questionnaire (RQLQ) was used to evaluate the quality of life in all patients. Results: The mean age of the 220 patients (116 females and 104 males) involved in the study was 26.8 years. The male‑to‑female ratio was 1:1.1. Of the 220 patients, 55% studied up to secondary school graduation and 18% dwelt in the rural area. In the assessment of the statistics obtained from the AR and conjunctivitis symptom scoring, the mean total complaint score was found to be 13.2 ± 4.0. Conclusion: AR can vary based on a region’s flora, weather and socioeconomic status. AR could lead to severe impairment in HR‑QoL

Correlation of Features of Allergic Rhinitis and Allergic Conjunctivitis with Treatment Modalities

Introduction: Allergic Rhinitis (AR) is a chronic, symptomatic allergic disorder of the nose that is usually caused by IgE-mediated inflammatory response following exposure to an allergen. The allergen could be in the form of dust, pollen, flower, animal dander, mold, cold, food allergens or insect. Clinically, AR occurs when there are recurrent nasal symptoms which are reversible either spontaneously or with medication in the preceding one year. Such symptoms include at least two of the following; excessive sneezing, running nose, nasal itching, nasal discharge, nasal congestion or obstruction. Previous studies have linked AR to be co-existed with another form of allergic disorders including AC, Atopic dermatitis and Allergic Asthma. This study is aimed at assessing the feature of AR patients with coexistent AC as well as evaluating the effectiveness of the treatments offered to them. Objectives: The study was aimed at finding the correlation between the nasal and eye features in a patient who has co-existing allergic rhinitis and allergic conjunctivitis. Methodology: This was a cross-sectional descriptive study conducted between August 2018 and November 2019 among 38 patients who presented to ENT and Ophthalmology departments of Federal Teaching Hospital Ido-Ekiti, Ekiti State, Southwestern Nigeria and was diagnosed with both allergic rhinitis and allergic conjunctivitis. Relevant data obtained were analyzed using SPSS version 20. P ≤ 0.05 was taken as significant. Results: The patients’ age range between 8 and 81 years with a median age of 33 years. The majority were less than 45 years (63.2%) with the male to female ratio of almost. Eye pain, itching, and redness account for 97.4% of all the eye features, while the presence of Cobblestone-like papillae is the least and accounted for 5%. Nasal itching (92.1%) was the commonest nasal symptom. Sleep disturbance was found to be the most common among those with eye itching (29.7%). Conclusion: This research was conducted to correlate the features of allergic rhinitis with those of conjunctivitis and common management and preventive measures offered to the patients seen in our clinics. The majority of the patients were less than 45 years with almost equal sex ratio. Eye pain, itching, and redness account for the majority of all the eye features, while the presence of Cobblestone-like papillae is the least eye feature. Nasal itching was the commonest nasal symptom and this was seen in the majority of the patients with eye symptoms

A Prospective Analysis of Otomycosis in a Tertiary Care Hospital

Background: Otomycosis is a fungal infection of the external auditory canal, commonly encountered in the general otolaryngology department. Otomycosis is more frequently observed in hot and humid climates and various individual, as well as environmental factors, predispose to this infection. This study aims to explore the prevalence of otomycosis in a tertiary care hospital in Ekiti state, Nigeria, along with a focus on patient demographics, predisposing risk factors, and pathogenic causes. Materials and methods: The study was conducted in the Ear, Nose, and Throat (ENT) department of Federal Teaching Hospital Ido-Ekiti, which is a tertiary care hospital in Ekiti state, Nigeria. The study involved 275 patients above the age of 10, who presented in the ENT department over 5 years period and were clinically diagnosed cases of otomycosis. Certain patient demographics such as age, gender, and clinical presentations were recorded along with possible risk factors and clinically observed findings. Microbiological causes were evaluated via the culture of samples collected from each individual. Results were statistically analysed and the results are presented in a tabulated manner. Results: The results obtained in our study revealed that the majority of the subjects were between the ages of 20 and 30 years, making a total of 38.2% of the study population. Males were observed more commonly then females accounting for 56% of the total study population. 267 patients reported unilateral ear involvement among which the right ear was involved in 82% of the cases. The most frequently observed risk factor was self-cleaning of ears with objects such as q-tips, wooden sticks, metal pickers, etc. seen in 71% of the study population, followed by the use of antibiotic ear drops observed in 57% and instillation of mustard oil in 52% of the study group. The most common presenting symptom in the study population was reported to be pruritus of the ear in 73% followed by otalgia in 66.5%, and sensation of blocked ear observed in 57%. Fungi were established to be the causative organism in 270 out of the total 275 samples and the most commonly isolated fungi were Aspergillus seen in 91% of the total population. The most common species of Aspergillus that was isolated from samples was Aspergillus Niger seen in 56%. The second most commonly isolated fungus was Candida in 13.8% of the group. Bacteria were isolated from 56.4% of the total samples as a concomitant organism, Staphylococcus aureus is the most commonly seen in 58% of the samples. The present study, apart from highlighting the patient population and causative agents of otomycosis, also places stringent focus on the need for education to eradicate the aforementioned predisposing risk factors to hinder the incidence of otomycosis

Immunotherapy for head and neck cancers

Head and neck squamous cell carcinoma (HNSCC) is a frequent tumour which arises from various anatomical areas in the head and neck region. HNSCC has multiple resistance mechanisms through which it evades the immune responses. It is particularly characterized by an immunosuppressive environment which includes the release of immunosuppressive factors, expansion, and expansion of immune cells which have inhibitory activity reduction of tumour immunogenicity. Human papillomavirus positive (HPV+) HNSCC tumours have one of the higher levels of T cells infiltration. Studies which explore this relationship to the prognosis of patients vary, with some showing benefit only with high CD8/Treg ratio as seen with HPV+ disease and others showing improved prognosis with a higher number of TIL Treg. High CD8+ TIL seen in HPV + disease has been shown in several studies to confer improved disease-free survival. The most successful vaccination strategy is preventive vaccination for HPV. Investigations using different approaches have been carried out on therapeutic vaccines for HPV-associated HNSCC. Despite immune responses being seen in a number of studies, these vaccines are still not effective for clinical use as of ye

Diagnosis and Management of Benign Paroxysmal Positional Vertigo in a West African Country

Objectives: Management of benign paroxysmal positional vertigo is inadequate in many developing countries. Also, there is a paucity of literature on benign paroxysmal positional vertigo in developing countries including West African countries. This study aimed at determining the pathological distribution, clinical presentation, comorbid illnesses, patients limitations, prehospital and Specialist treatment of benign paroxysmal positional vertigo in our center. It will also form the basis for further study on benign paroxysmal positional vertigo. Methods: This was a prospective hospital-based study of all patients with the diagnosis of benign paroxysmal positional vertigo. Pretested interviewer assisted questionnaire was administered to obtain data. Otoscopic examination, otoneurologic review, followed by mandatory Dix Hallpike manoeuvre and supine roll test was performed on all patients. All the patients were treated appropriately by Epley manoeuvre and Semont liberation manoeuvre. All the data obtained were collated and analysed by using SPSS version 18.0. Results: The mean age of the patients studied was 48.7. Males accounted for 46.1% with male to female ratio of 1:1.2. There was unilateral benign paroxysmal positional vertigo in 99.4% and right benign paroxysmal positional vertigo in 64.3%. 66.2% was posterior semicircular canal followed by 24.7% lateral semicircular canal. Majority 83.8% had more than 4 episodes before the presentation. Commonest clinical experience among our patients was vertigo, nystagmus, and loss of balance in 85.1%, 81.8%, and 80.5% respectively. Chronic cases (greater than 3 months) of benign paroxysmal positional vertigo occurred in 92.9%. 97.2% of the patients were reviewed ear, nose, and throat outpatient clinic. Associated comorbid illnesses were a visual disorder, hypertension, arthritis and diabetes mellitus in 27.9%, 23.4%, 22.1%, and 2.6% respectively. Patients major sources of referral was a general practitioner in 57.8%. The Commonest affected quality of life among patients was anxiety in 31.8%. It limits the daily activities of patients in 31.8% movement restrictions, 29.9% avoid turning on the bed, 24.7% indoor and 1.9% avoid driving a car. Majority 72.7% of the patients had one or more form of prehospital treatment. These were 46.1% pharmacy consultation, 30.5% over the counter drugs, 44.2% spiritual intervention, 23.4% herbal medication and 5.2% dietary approach. Majority 65.6% of the patients were on one or more form of medication(s) of which labyrinthine sedative was 63.0%. Conservative treatment was offered in 79.2%. Only 59.1% had canalith repositioning manoeuvres at presentation with two or more sessions in 50.6%. Comorbid illnesses were responsible for referral in 9.1% for experts review and management. Conclusion: Benign paroxysmal positional vertigo is a common otologic disorder with significant comorbid illnesses which limits patients daily activities and affect their quality of life. The illness was associated with late presentation and poorly treated by an unskilled hand, thus there is a need for public enlargement on vertigo and treatment

Surgical Outreach as a Tertiary Hospital’s Corporate Social Responsibility: Shall we do more?

Introduction: The underserved populations of the rural and suburban communities of developing countries are challenged by the twin hurdles of low-income earning and out-of-pocket payment for surgical care services. This study aims at appraising the process, outcome, and impact of a free surgical outreach programme carried out by a Federal Teaching Hospital in South-western Nigeria. Methods: A free day-case surgical outreach programme was announced through a popular radio jingle for a period of 1 week to attract would‐be beneficiaries of the programme. A 2-day screening exercise was conducted by the concerted efforts of various specialists in the department of surgery and ophthalmology to select those who are suitable for day-case surgery. Across-sectional survey of patients who participated in the 5-day surgical outreach programme was carried out. A structured questionnaire was used to obtain information on biodata, diagnosis, surgical operations, complications, and level of satisfaction. A 3‐point bipolar satisfaction outcome scale was used to assess the level of satisfaction. The data obtained were analyzed using the SPSS software version 20.0. Results: One hundred and fifty‐eight patients were screened, but only 124 participated. Ophthalmic cases constituted 60.5%, whereas the rest (39.5%) were non-ophthalmic cases. Patients with cataract were 73 (58.9%) of all the surgical lesions operated during the outreach programme. Two (1.6%) patients with pterygium were the other ophthalmic cases, whereas the non-ophthalmic cases were mainly hernias. A total of 129 surgical operations were performed in the 124 patients, with 5 (0.4%) of them having bilateral cases. One hundred and seventeen patients (94.4%) expressed satisfaction with their experience of the programme. Conclusions: Optimal corporate social responsibility of tertiary hospitals can be performed effectively and satisfactorily through a properly organized surgical outreach

Morphology and Clinical Presentation of Duplicate External Auditory Canal-Literature Review

First branchial cleft anomalies (FBCA) such as duplication of the external auditory canal are due to failure to obliterate the ventral portion of the 1st cleft while external auditory canal stenosis and atresia are abnormalities of the dorsal portion.The annual incidence is 1:1000,000 and it’s been found to be commoner among females 69% than males 31% with the left ear most affected.FBCA can present as fistula, sinus or cysts located around/along the EAC, periauricular region and the neck above the hyoid bone