Relationship between helicobacter pylori infection and endoscopic findings among patients with dyspepsia in north central, Nigeria

Background: There is a dearth of reports on the prevalence rate of Helicobacter pylori from the North-Central zone of Nigeria. This study aimed to determine the prevalence of H. pylori infection and its association with gastro-duodenal pathologies in patients presenting with dyspepsia in a tertiary hospital in North-Central Nigeria.Materials and Methods: One hundred and forty eight adult patients with dyspepsia underwent oesophagogastroduodenoscopy. Antral and corporal biopsy specimens were collected for histological examination. Diagnosis of H. pylori infection was made if Helicobacter-like organisms were identified in the processed specimens using Haematoxilin and Eosin, and Giemsa stains.Results: Of the 148 subjects studied, 68 (46.0%) were males and 80 (54.0%) females. The age range was 18 to 80 years with a mean of 49.5 ±15.1 years. H. pylori infection was found in 70 (47.3%) patients. Gastritis was the commonest endoscopic finding, 52 (35.1%). Others included: gastroduodenitis 42 (28.4%), normal findings 20 (13.5%), gastric cancer 11 (7.4%), duodenal ulcer 10 (6.8%), gastric ulcer 4 (2.7%) and gastroduodenal polyps 4 (2.7%). Twenty (38.5%) of the 52 patients with gastritis were infected with H. pylori compared to 27 (64.3%)of the 42 patients with gastroduodenitis. Seven (35.0%) of the 20 patients who had normal endoscopic findings tested positive for H. pylori infection.Conclusion: H. pylori infection has a moderately high prevalence among dyspeptic patients in Ilorin, irrespective of the gastroduodenal pathology seen at endoscopy. The association between H. pylori infection and endoscopic gastroduodenitis and histologic gastritis was significant (p=0.01 and 0.0006 respectively).Keywords: Helicobacter pylori, Oesophagogastroduodenoscopy, Gastroduodeniti

Prevalence of minimal hepatic encephalopathy among patients with chronic liver disease in Ilorin, Nigeria

Background: Minimal Hepatic encephalopathy is the mildest form of Hepatic Encephalopathy which presents with significant cognitive impairment and affectation of activities of daily living. The literature is scanty on the prevalence of minimal hepatic encephalopathy in Nigerians with chronic liver disease.Aim: This study aimed at determining the prevalence of minimal hepatic encephalopathy among patients with chronicliver disease using neuro-psychometric tests.Methods: The study was a hospital-based cross-sectional study carried out at the University of Ilorin Teaching Hospital, Ilorin from February 2015 to February 2016. Chronic liver disease was diagnosed with the presence of peripheral stigmata of liver disease, liver biochemistry, prothrombin time, and sonographic findings in keeping with liver disease. Minimal hepatic encephalopathy was diagnosed using number connection tests-A and B for patients who were educated while Line tracing test and constructional dyspraxia were used for patients without any formal education. Data obtained were analysed using Statistical Package for the Social Sciences (SPSS) version 20 computer software package.Results: Sixty-four patients with chronic liver disease were recruited. The mean age (SD) of the patients was 47.1±14.6 yrs, and the 30-39 and 40-49 yrs age groups each had the highest frequency of 21(32.8%). There were 54(84.4%) males and 10 (15.6%) females. The prevalence of Minimal Hepatic Encephalopathy was 43.8%.Conclusion: The prevalence of Minimal Hepatic Encephalopathy in this study was similar to previous studies. Significant number of patients with minimal HE were in Child-Pugh class B and C.Keywords: Minimal, Hepatic Encephalopathy, Liver Disease, Neuro-psychometric testFunding: Non

Oesophageal intramural pseudodiverticulosis: a rare endoscopic finding

Oesophageal intramural pseudodiverticulosis is an uncommon condition, characterized by multiple small rounded cavities seen in the oesophageal wall during Oesophagogastroduodenoscopy. It is often associated with gastro-oesophagealreflux disease, achalasia, oesophageal candidiasis and diabetes mellitus. We report a 40 year old Nigerian man who presented with recurrent dysphagia and endoscopic findings typical of oesophageal intramural pseudodiverticulosis.The patient was managed medically with resolution of the dysphagia. This report highlights the occurrence of this rare and benign cause of dysphagia in Nigeria.Keywords: oesophagus, pseudo diverticulosis, endoscopy, Nigeria, dysphagia, MANFunding: None declare

Group polarization effect on decisions by selected Kenyan secondary school disciplinary panels

This study investigated social group phenomenon of group polarization effects on disciplinary hearing decisions in selected Kenyan secondary school. The participants were 78 school personnel (females = 42%and males 58%) from ten secondary schools with both unisex (n = 39) and co-educational schools (n = 39). Both quantitative and qualitative data were collected and analyzed. The results suggested group polarization effects in disciplinary hearing decisions, in that there were shifts from pre to post-disciplinary hearing decisions. Persuasive arguments and social comparisons significantly influenced group polarization decisions.Department of HE and Training approved lis

A Clinicopathological Review of Colonic Polyps in a Tertiary Hospital in North Central Nigeria

Background: Colorectal polyps, especially adenomas, are known as precursors of colorectal carcinomas. This study was aimed at determining the prevalence and histopathologic characteristics of colonic polyps among Nigerians that underwent colonoscopy at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The authors also determined the polyp detection rate and adenoma detection rate. Materials and Methods: This was a hospital-based cross-sectional study of all colonoscopy examinations performed at the University of Ilorin Teaching Hospital, Ilorin from March 2013 to September 2017. The endoscopy register was reviewed, and patients’ biodata, indications for colonoscopy and colonoscopic findings were recorded on a proforma. The histopathologic reports of the polyps were also retrieved and their diagnosis confirmed. Results: A total of 289 patients had colonoscopy carried out on them. The age of the patients ranged from 14 to 90 years with a mean ±SD of 57.0 ± 15.3 years and a median age of 58 years. There were 178 (61.6%) males and 111 (38.4%) females giving a M:F ratio of 1.6:1. The indications for colonoscopy were rectalbleeding 124 (42.9%); suspected colorectal cancer 67 (23.2%); abdominal pain 22 (7.6%); chronic diarrhea 18 (6.2%); surveillance colonoscopy 12 (4.2%); constipation 11 (3.8%); change in bowel habit 9 (3.1%); occult bleeding 6 (2.1%); others 20 (6.9%). Endoscopic findings were normal findings 89 (30.8%); hemorrhoids 88 (30.4%); colonic polyps 50 (17.3%); diverticulosis 34 (11.8%); rectal cancer 29 (10.0%); colon cancer 24 (8.3%); colitis 19 (6.6%); others 13 (4.5%). The findings were not mutually exclusive. The diagnostic yield was 69.2%. The overall polyp detection rate was 17.3%. Of the 50 patients with polyps, 33 (66.0%) were males (p = 0.481). Theadenoma detection rate was 4.8%. Conclusion: The authors conclude that their observed polyp detection rate is consistent with the estimated rates for Africa. Rectal bleeding and adenomatous polyps were the commonest presentation and histopathologic finding, respectively

Healing through culturally embedded practice: an investigation of counsellors’ and clients’ experiences of Buddhist Counselling in Thailand

This thesis is concerned with an exploration of counsellors’ and clients’ lived experiences of Buddhist Counselling, an indigenous Buddhist-based counselling approach in Thailand. Over the past decade, Buddhist Counselling has received a growing interest from Thai counselling trainees and practitioners, and it has also expanded to serve Thai people in various settings. Research on Buddhist Counselling is very limited and most of the existing studies in the field have focused on measuring the effectiveness of the approach. While these studies have consistently indicated the positive effects of Buddhist Counselling on psychological improvement across several population groups, the significant questions of how Buddhist Counselling brings about such outcome and how it is experienced are still largely unanswered. Moreover, existing research is concentrated much more on clients’ views than counsellors’ views, although counsellors’ views of their counselling practice can also serve as a knowledge base of the field. This thesis thus sets out to contribute to rectifying this omission by exploring Buddhist Counselling from the perspectives of both counsellors and clients. The thesis is based on two qualitative studies. The first study addressed Buddhist Counselling from the perspective of five counsellors through a focus group and semi-structured interviews. The second study explored Buddhist Counselling from the perspective of three clients, using two semi-structured interviews with each of them. All data received were analysed using interpretative phenomenological analysis (IPA). The study reveals counsellors’ and clients’ overall positive experience of engaging in Buddhist Counselling. Central to the accounts of the counsellors are the following perceptions: that their practice of Buddhist Counselling is culturally congruent with the existing values and beliefs of both themselves and their clients; that their personal and professional congruence is key to their therapeutic efficacy; and that they enhance such congruence through their application of Buddhist ideas and practices in their daily lives. Key to the clients’ accounts is their emphasis on the significant roles of the counsellors’ Buddhist ideas and personal qualities, and of their religious practices in facilitating healing and change. Key shared findings from both studies reveal that the participants’ accounts of their cultural background and their experiences of Buddhist Counselling are intertwined. Adopting hermeneutics to address this intertwinement, I reveal the cultural and moral dimensions underlying the practice of Buddhist Counselling. Based on such revelation, I suggest that Buddhist Counselling in particular, as well as psychotherapy in general, should be better understood as a historically situated, culturally bound, and morally constituted activity of people who are concerned with improving the quality of their lives and their community, rather than the transcultural and merely relational work of morally-neutral practitioners

Indigenous healing practices in sub-Saharan Africa

Healers seek to help patients understand the sociocultural basis of their health conditions, and how they can recognize, activate, or utilize resources and or support systems necessary to alleviate their suffering. Treatment modalities include relaxation techniques, use of herbs, psychocultural education, dream interpretation, storytelling, use of proverbs, cleansing, libation, music, and ceremonies. In this chapter, we consider the importance of indigenous healing systems, history of research into traditional healthcare in Africa, national and international influences on African indigenous healing systems, current practices, legal and professional issues, and issues for research on African indigenous healing systems.

Helicobacter pylori eradication therapy: A review of current trends

Helicobacter pylori has been implicated in the formation of chronic gastritis, peptic ulcer disease, mucosa-associated lymphoid tissue lymphoma and gastric cancer. Eradication of H. Pylori has been recommended as treatment and prevention for these complications. This review is based on a search of Medline, the Cochrane Database of Systemic Reviews, and citation lists of relevant publications. Subject heading and key words used include H. Pylori, current treatment and emerging therapy. Only articles in English were included. There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure. Primary resistance to clarithromycin or metronidazole significantly affects the efficacy of eradication therapy. This has led to the introduction of second line, third line "rescue," and sequential therapies for resistant cases. Subsequently, new antibiotic combinations with proton-pump inhibitors and bismuth salts are being studied in the last decade, to find out the antibiotics that are capable of increasing the eradication rates. Some of these antibiotics include Levofloxacin, Doxycycline, Rifaximin, Rifampicin, Furazolidone based therapies. Studies are ongoing to determine the efficacy of Lactoferrin based therapy

Relationship between testicular and epididymal biometry compared to semen quality in Yankasa rams

This study examined the relationship between the testicular and epididymal biometry compare to semen characteristics in Yankasa rams. Fifteen apparently healthy rams aged between 1-2 years with average weight of 20 kg were used for the study. They were acclimated for four weeks, screened and treated against endo and ecto parasite. They were kept in small ruminant pens under zero grazing, fed with hay, ground nut leaves/straw ‘harawa’ and wheat offal with water supplied ad-libitum. The scrotal circumference was measured in centimeters using a measuring tape. The testicular length (L), width (W), depth and epididymal head axis, length and tail axis were measured by caliper and testicular volume and weight were calculated by formula methods. Semen samples were collected using an electro-ejaculator and immediately evaluated for colour, volume, motility, pH, sperm concentration, sperm morphology and live/dead ratio. The right testicular and epidydimal biometry were non-significantly greater than that of the left. Semen parameters correlate positively (right testicules, r=0.225) and (left testicles, r=0.346) with testicular volume except for bent tail, coil tail and motility. The left epididymal head’s long axis and right epididymal tail axis showed significant positive correlation (r= 0.55) with semen parameters and right epididymal head’s long axis and left epididymal tail axis showed negative correlation with semen characteristics. It was concluded that testicular and epididymal biometry increase with increase testicular function and output..Keywords: Yankasa ram, testicular biometry, epididymal biometry, and semen characteristic