Furrowed tongue, fatten lip and facial droop

Melkersson-Rosenthal syndrome (MRS) is a rare, neuro-mucocutaneous syndrome characterized by recurrent facial nerve palsy, swelling of the upper lip, and fissured tongue. Young adults in the second and third decades are more predisposed. We report a case of a 23-years old female Chinese who presented with 5 days history of right facial weakness; her second event in one year (first weakness was on the left). On examination, she had right peripheral facial nerve palsy (House-Brackmann stage IV) and, mild swelling of the upper lip (Image-Arrow A). Her tongue revealed two central furrows. The anterior central furrow (Image-Arrow B) measured about 2cm and the posterior one measured about 1.5cm with lateral grooves and few posterior perpendicular furrows measuring about 1-2 mm in depth. Her complete blood count, blood sugar, urine routine, C-reactive protein, serum angiotensin-converting enzyme level was all normal. Her brain magnetic resonance imaging revealed no abnormal signals. She was commenced on oral prednisolone 60mg daily for 5 days, acyclovir 800mg 4 times daily for 5 days, vitamin B capsules and methylcellulose drops to prevent scleritis. She was commenced on physiotherapy with steady clinical improvement. Although fissured tongue is a common clinical condition with a long list of differential diagnosis, the presence of recurrent facia nerve palsy and swollen lip should raise the suspicion of MRS. Other causes of recurrent facial nerve palsy and buccal mucosa involvement like sarcoidosis, system lupus erythematosus, Bechet disease and Crohn disease should be considered

F-wave parameters and body mass index in carpal tunnel syndrome

Background Severe carpal tunnel syndrome (CTS) readily lends itself to both clinical and electrophysiological recognition. The uncertainty sometimes is in identifying and quantifying motor involvement in mild and, perhaps, in moderate CTS. Our study aimed to evaluate F responses in mild and moderate CTS and determine the contribution of BMI to the F-wave parameters. Methods A retrospective review of the clinical and electrophysiological data of patients with CTS seen at the clinical neurophysiology laboratory of Aga Khan Hospital, Dar es Salaam, between 1 August 2017 and 31 July 2019 was retrieved. Carpal tunnel syndrome was graded according to the electrophysiological criteria of Padua. The F-wave parameters of patients with mild-to-moderate CTS were analyzed and compared with asymptomatic controls. Result We studied 91 hands. Twenty-two hands were asymptomatic controls, 30 hands had mild CTS, and 39 hands had moderate CTS. Patients with moderate CTS were more obese (p =.011), had more females (p =.044), and were older (p= Conclusion Although a clear difference exists between F-wave parameters in asymptomatic controls and those with CTS, the F-wave study is inadequate in distinguishing mild and moderate CTS even in the context of BMI. Median–ulnar F-wave latency difference (FWLD) appeared to be a promising discriminant parameter between obese patients with mild CTS and those with moderate CTS

ACE-I induced angioedema: a case report and review of literature

Although rare, angioedema has been documented to occur following the administration of angiotensin-Converting Enzyme Inhibitors. Angiotensin-converting enzyme inhibitors are the leading cause of drug induced angioedema. Angiotensin-converting enzyme inhibitors induced angioedema is a class effect that can affect between 0.1% and 0.5% of patients taking the drug. It is rarely documented in Nigeria. Lisinopril is a commonly prescribed angiotensin-converting enzyme inhibitors-I which is considered to be generally safe and well tolerated. We report a case of angioedema following the use of lisinopril

Developing a Signal Booster for Improved Communication in Remote Areas

A GSM mobile phone signal booster basically consists of a bidirectional amplifier created to boost weak cell phone signals in remote or hard-to-reach areas. The purpose of boosting signals is to promote clearer reception for cellular phone users in difficult locations. It is meant to solve the problem of bad network in offices, camps, recreational centers, homes and in vehicles. The device brings improved network signal to a relatively poor network area. This work intends to develop a device which can provide users with relatively high signal strength in a poor network area and at a lower cost. This is done in order to provide them with seamless, uninterrupted and reliable communication and in the final analysis, make GSM network available everywhere irrespective of height, terrain and location. To effect this, three major components are utilized, they include: an external antenna to capture the weak signal, a signal amplifier to boost the captured signal and an internal antenna to redistribute the signal for users around the area where enhanced signal is required. Keywords: Amplifier, Antenna, Base Station, GSM, Mobile Phones and Signal Booster DOI: 10.7176/NCS/10-06 Publication date:August31st 201

Components of Government Spending and Economic Growth in Nigeria: An Error Correction Modelling

This paper examined the linkage between the components of government spending and economic growth in Nigeria. In contrast to existing studies, this study examines the relationship between the components of government expenditure (that is, agriculture; education; health and transport and communication) and economic growth with data spanning from 1970 to 2010. The result of the study showed that expenditure on agriculture had a significant influence on economic growth while expenditure on education, health and transport and communication had insignificant influence on economic growth. Based on the findings, this study suggests the need for a reversal in declining budgetary allocation to the educational and health sector in order to provide the sectors with the needed revenue which is necessary in influencing aggregate output of the economy. In addition, this study recommends the need to redirect the excessive expenditures of government on its officials in both the house of senate and house of representative to these pivotal sectors that is capable of stimulating economic growth of the Nigerian economy. In addition, it is highly recommended that the government and relevant stake holders should ensure that funds which are meant for development of the aforementioned sectors should be properly managed. However, the foregoing can be achieved by increasing funds that are meant for anti-corruption in order to enhance economic growth and sustainable development in Nigeria

Menstrual-Related Headaches Among a Cohort of African Adolescent Girls

Introduction: Migraine attacks associated with menstruation are generally perceived as more severe than attacks outside this period. Aim and Objective: The study aimed at determining the frequency of menstrual-related headaches among a cohort of senior secondary school girls in Abeokuta, Nigeria. We also determined its burden among these school girls. Methodology: This study was cross-sectional using a validated adolescent headache survey questionnaire. A self-administration of the instrument was done during a school visit. A headache was classified using the ICHD-II criteria. Results: Of the 183 students interviewed, 123(67.2%) had recurrent headaches. Mean age ±SD, 16.18± 1.55 (range 12– 19). The prevalence of definite migraine was 17.5% while the prevalence of probable migraine was 6.0%. The prevalence of tension-type headache was 41.0%. Migraine was significantly menstrual-related (p=0.001, 95% CI=1.06– 6.63). Median pain severity score was higher among MRH group (p=0.043). The median number of days of reduced productivity and missed social activities was significantly higher in the MRH group; p= 0.001 and p=0.03, respectively. Subjects with MRH were more incapacitated by their headaches (p= 0.003). Conclusion: Menstrually related headache is prevalent even among the adolescent and it has adversely affected their productivity and social life. Care of adolescent with headaches should be intensified

Post-Vaccination Pharyngeal-Cervical-Brachial Variant of Guillain-Barré Syndrome

The pharyngeal-cervical-brachial (PCB) variant of Guillain-Barré syndrome (GBS) is very rare. It is characterized by weakness of the upper extremities associated with bulbar symptoms and facial diplegia. Documented cases were post-infectious, a post-vaccination occurrence has not been documented in the available literature. Even rarer is the occurrence of any variant of GBS following the mumps measles rubella (MMR) vaccine. The neurophysiological hallmark of PCB variant of GBS is a combination of myelinopathy and axonopathy, hence, its consideration as a subtype of the acute motor axonal neuropathy (AMAN) variant. It should be suspected in any case of acute-onset flaccid symmetrical weakness of the upper extremities, as early diagnosis and treatment are key to preventing fatal bulbar weakness. Here we report a case of a middle-aged man, who presented with features of PCB a fortnight after being vaccinated for MMR

H2S donor GYY4137 ameliorates paclitaxel-induced neuropathic pain in mice

Paclitaxel-induced neuropathic pain (PINP) is a dose-limiting side effect that largely affects the patient’s quality of life and may limit the use of the drug as a chemotherapeutic agent for treating metastatic breast cancer and other solid tumors. Recently, a putative role for the gaseous mediator hydrogen sulfide (H2S) in nociception modulation has been suggested. The aim of the present study was to investigate the potential efficacy of the slow release H2S donor GYY4137 to alleviate and prevent PINP. Female BALB/c mice that were intraperitoneally (i.p.) injected with paclitaxel (2 mg/kg) for 5 consecutive days developed thermal hyperalgesia, cold and mechanical allodynia and had reduced of H2S, generation in the spinal cord and paw skin. Treatment of mice with established thermal hyperalgesia with GYY4137 or the analgesic positive control drug gabapentin produced antihyperalgesic activities. The antihyperalgesic activity of GYY4137 was antagonized by the ATP sensitive potassium channels (KATP channels) blocker glibenclamide. Co-treatment with GYY4137 and paclitaxel prevented the paclitaxel-induced decrease in H2S, generation as well as the paclitaxel-induced thermal hyperalgesia, cold allodynia and mechanical allodynia. GYY4137 enhanced paclitaxel\u27s anti-proliferative effects against the breast cancer cell line MCF-7. The present results suggest that GYY4137 alleviates paclitaxel-induced thermal hyperalgesia, via KATP channels. GYY4137 prevents PINP possibly by blocking the paclitaxel-induced reduction in the generation of H2S, in the tissues, while enhancing the anti-cancer activity of paclitaxel, and therefore warrants further research as a candidate for prevention of PINP in clinical settings

COVID-19 and Teleneurology in Sub-Saharan Africa: Leveraging the Current Exigency

tion residing in rural areas that have poor access to medical experts. Despite having a ridiculously huge, underserved population, very few African countries currently have any form of sustained and organized telemedicine practice, and even fewer have dedicated tele-neurology services. The ongoing COVID-19 pandemic has proved to be one of the most significant disruptors of vital sectors of human endeavor in modern times. In the healthcare sector, there is an increasing advocacy to deliver non-urgent care via telemedicine. This paper examined the current state of tele-neurology practice and infrastructural preparedness in sub-Saharan Africa. Currently, there is over 70% mobile phone penetration in most of the countries and virtually all of them have mobile internet services of different technologies and generations. Although the needed infrastructure is increasingly available, it should be improved upon. We have proposed the access, costs, ethics, and support (ACES) model as a bespoke, holistic strategy for the successful implementation and advancement of tele-neurology in sub-Saharan Afric

A case of Parkinsonian symptoms secondary to chronic subdural hematoma

Chronic subdural hematoma is a known neurosurgical entity often associated with a spectrum of neurological manifestations. While primarily recognized for its characteristic accumulation of blood between the dura mater and arachnoid membrane, emerging literature suggests a rare association between chronic subdural hematoma and Parkinsonian symptoms. This report aims to underscore this unique neurological relationship by presenting a case of a 70-year-old male who developed Parkinsonism following chronic subdural hematoma post-head trauma. This case underscores the rare association between chronic subdural hematoma and Parkinsonian symptoms, emphasizing the importance of timely diagnosis and intervention in managing such cases