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

Complex partial seizure, disruptive behaviours and the Nigerian Legal System

Background: Complex partial seizure is an epileptic seizure which results in impairment of responsiveness or awareness such as altered level of consciousness. Complex partial seizures are often preceded by an aura such as depersonalization, feelings of de javu, jamais vu and fear. The ictal phase of complex partial seizure is often associated with complex activities where an individual may still be able to perform routine task such as walking, though such movements are not planned and are often purposeless. Witnesses' around may not recognize anything wrong.Method: This is a case of a 43 year old commercial motor cycle driver, who was accused of first degree murder in the year 2000. He was convicted and sentenced to death. Prior to commission of crime, he was diagnosed with complex partial seizure with secondary generalization in 1990 at a tertiary hospital in Nigeria.Results: During his 15 years stay on death row at a maximum security prison in Nigeria, he had several episodes of seizure and subsequently developed a depressive disorder. He was placed on medication which includes anticonvulsants and antidepressants by the Forensic Psychiatry team. With regular follow-ups and available medication, he became stable. He was pardoned by the state Governor in 2015 following a recommendation by the Forensic Psychiatry team.Conclusion: Complex partial seizure comes with altered consciousness and  disruptive behaviour, which could result in  commission of a crime. Therefore, the strict adherence to the M'Naghten rule by the Nigerian legal system results in strict reliance by judges and not considering these rules in most cases bothering on  insanity. This is without taking into cognizance the peculiarity of each case.Keywords: complex partial seizure, death row, murder, pardon

Outcomes after perioperative SARS-CoV-2 infection in patients with proximal femoral fractures: an international cohort study

Objectives Studies have demonstrated high rates of mortality in people with proximal femoral fracture and SARS-CoV-2, but there is limited published data on the factors that influence mortality for clinicians to make informed treatment decisions. This study aims to report the 30-day mortality associated with perioperative infection of patients undergoing surgery for proximal femoral fractures and to examine the factors that influence mortality in a multivariate analysis. Setting Prospective, international, multicentre, observational cohort study. Participants Patients undergoing any operation for a proximal femoral fracture from 1 February to 30 April 2020 and with perioperative SARS-CoV-2 infection (either 7 days prior or 30-day postoperative). Primary outcome 30-day mortality. Multivariate modelling was performed to identify factors associated with 30-day mortality. Results This study reports included 1063 patients from 174 hospitals in 19 countries. Overall 30-day mortality was 29.4% (313/1063). In an adjusted model, 30-day mortality was associated with male gender (OR 2.29, 95% CI 1.68 to 3.13, p80 years (OR 1.60, 95% CI 1.1 to 2.31, p=0.013), preoperative diagnosis of dementia (OR 1.57, 95% CI 1.15 to 2.16, p=0.005), kidney disease (OR 1.73, 95% CI 1.18 to 2.55, p=0.005) and congestive heart failure (OR 1.62, 95% CI 1.06 to 2.48, p=0.025). Mortality at 30 days was lower in patients with a preoperative diagnosis of SARS-CoV-2 (OR 0.6, 95% CI 0.6 (0.42 to 0.85), p=0.004). There was no difference in mortality in patients with an increase to delay in surgery (p=0.220) or type of anaesthetic given (p=0.787). Conclusions Patients undergoing surgery for a proximal femoral fracture with a perioperative infection of SARS-CoV-2 have a high rate of mortality. This study would support the need for providing these patients with individualised medical and anaesthetic care, including medical optimisation before theatre. Careful preoperative counselling is needed for those with a proximal femoral fracture and SARS-CoV-2, especially those in the highest risk groups. Trial registration number NCT0432364