Background: Health care professionals are commonly identified as being at risk for work-related musculoskeletal disorders (WMSDs) from patient handling and from providing direct care during the course of a patient's stay in the hospital. However, the pattern of occurrence of WMSDs and its relationship with ergonomic hazards among health care professionals has not been widely reported. Objective: The aim of this study was to determine the pattern of WMSDs and its relationship with ergonomic hazard among health care professional who work in a Teaching Hospital in North Eastern Nigeria. Materials and Methods: A cross-sectional study conducted among Dentists, Nurses, Physicians and physiotherapists working at the University of Maiduguri Teaching Hospital. Different combinations of validated and standardized questionnaires were used for collecting data on pattern of WMSDs and ergonomic hazards among the health care professionals. Descriptive (mean, standard deviation and percentages) and inferential (Chi-square test and logistic regression analysis) statistics were used to analyse data. Alpha level was set at P < 0.05. Results: A total of 151 of 162 questionnaires were completed and returned and used for data analysis. The patterns of WMSDs showed higher occurrence among nurses (84.5%) and physiotherapists (83.3%) than physicians (25.3%) and dentist (45.4%). Low back pain was the most complaint (71.6%) among health care professionals followed by shoulder (46.8%) and then neck (42.2%). The upper back (14.7%) and the elbow (8.3%) were the less affected. Prolonged sitting and standing and working in an awkward posture were most common ergonomic hazards among participants. Multiple regression analysis reported statistically significant relationship between all areas of WMSDs and ergonomic hazards identified (P < 0.05). Conclusion: Occurrence of WMSDs among health care professionals was much higher among physiotherapist and nurses than physicians and dentists. Lower back, neck and shoulder were the three most reported WMSDs areas. Work-related ergonomic hazards showed relationship with WMSDs.

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Background: Azadirachta indica A. juss (AI; Family: Meliaceae) is one of the most useful medicinal plants containing different alkaloids that includes nimbitin, azadirachtin and salanin whose individual effects contribute to the general medicinal properties of the plant. In Nigeria, pregnant and lactating women have been observed consuming aqueous extract of AI and anecdotal reports from them suggest that they consume the extract because of the folkloric belief that it is potentially harmless, it is hematopoietic and protects them from malaria. Aim: This study was designed to investigate the effects of consumption of AI during pregnancy and lactation on some hematological parameters and blood glucose level. Materials and Methods: Sixty female rats weighing 150-200 g were used for this study. The rats were divided into three groups (non pregnant, pregnant and lactating groups) of 20 rats each. Each group was subdivided into four subgroups based on the dose of AI administered. Subgroup I served as control and received distilled water throughout the experiment while subgroups II-IV received 200 mg/kg, 400 mg/kg and 600 mg/kg body weight of the extract respectively for 21 days. On day 20 of extract administration, blood samples were withdrawn from each rat in each group after an overnight fast for the estimation of some hematological parameters and blood glucose level. Results: There were significant increases (P < 0.05 for each) in the packed cell volume (PCV), hemoglobin concentration (Hb), red blood cell (RBC), white blood cell (WBC), and platelet (PLT) and a significant dose-dependent decrease (P < 0.05) in blood glucose level in all groups. Conclusion: It is concluded that the results of the present study seem to justify the folkloric use of AI as a hematopoietic agent with the potential of ameliorating the burden of anemia and hyperglycemia in women especially during pregnancy.

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Background: The aim of this study was to investigate the effects of mobile phone radiation and exercise on testicular function in male Wistar rats. Methods: Twenty male Wistar rats weighing 150–198 g were used for this experiment. The animals were divided into four groups (n = 5). The first group was the control group, the second group was exposed to mobile phone radiation for 6 h daily, the third group was subjected to swimming >three times a week and >30 min each session or >90 min a week, and the fourth group containing five rats was exposed to mobile phone radiation for 6 h daily and was subjected to swimming for >three times a week and >30 min each session or >90 min a week. This experiment lasted for 30 days. A Nokia 1280 cell phone was used to emit electromagnetic waves, and the cages of Groups 2 and 4 were surrounded by aluminum foils to focus and limit the waves to the interior of the cages, with the phone being placed 0.5 cm under the cage. A radiofrequency radiometer was kept close to the cages to detect the cell phone radiation. Results: Short-term exposure of male Wistar rats to mobile phone radiation (6 h/day × 30 days at 1.6 W/kg specific absorption rate) led to a statistically insignificant (P > 0.05) decrease in the serum testosterone levels and testicular weight, whereas exercise (> three times a week and >30 min each session or > 90 min a week) in male Wistar rats led to statistically nonsignificant (P > 0.05) increase in the testosterone levels and testicular weight. Conclusions: The findings of this study indicated that short-term exposure of mobile phone radiation leads to a statistically nonsignificant decrease in serum testosterone levels and testicular weight, whereas regular exercise leads to a statistically nonsignificant increase in the testosterone levels and testicular weight.

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Sedentary behavior is one of the major risk factors for cardiovascular mortality; hence there is a need to promote physical activity (PA) among adults aged 60–86 years. The aim of this narrative review was to evaluate the role of PA in the prevention and treatment of chronic diseases among older adults. Relevant studies (original articles, systematic reviews, and meta-analyses) that reported on the effects of PA in older adults from 1998 to 2019 were selected. The following electronic databases were searched: PubMed, ScienceDirect, PsycINFO, Embase, Medline, Sports Discus, Web of Science, and Cochrane database. Physical exercise at different intensities was shown to be effective in the prevention and treatment of overweight, functional decline, and mood disorders in older adults. Moderate-to-high intensity endurance exercise can be effective in the prevention of diabetes type 2, hypertension, and cancer in older adults. Resistance training at different intensities was shown to be effective in the prevention and treatment of obesity in the elderly. Mobility and balance training were effective in preventing falls in older individuals. Combined exercise training regimen comprising moderate-to-vigorous intensity aerobic and resistance exercise is beneficial in the prevention of disability, osteoporosis, hypertension, and falls among older adults. Moreover, combined exercise training improves immune function and antioxidant capacity in older adults. Based on the studies reviewed, PA was found to be an effective tool for the prevention and treatment of chronic diseases among older adults.

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Background: Thrombo-embolic disorders are one of the major causes of 'morbidities and mortality' worldwide. Antithrombotic therapy which comprise use of anti-platelet agents, fibrinolytic agents and anti-coagulants seem to be ineffective in the treatment of thrombi due to side effects and delayed onset of effects, along with chances of hemorrhage. Euphorbia neriifolia Linn is a large succulent shrub, with stipular thorns and is found throughout the Deccan peninsula of India. The plant is known for its medicinal value. A number of evidence about resins and flavonoids has demonstrated potent antithrombotic effects in vitro and in vivo due to prevention of the actions of 'cyclooxygenase and lipoxygenase pathways'. Aim: The present work was designed study antithrombotic potential of this E. neriifolia Linn. Materials and Methods: The whole plant of E. neriifolia Linn were shade dried at 37 ^o C to 40 ^o C and coarsely powdered through mesh 20. Powder was defatted with petroleum ether and extracted with ethanol by soxhlet apparatus and subjected to phytochemical analysis. Acute toxicity of extract was determined by Organization for Economic Cooperation and Development guideline No 423. Carrageenan-induced rat tail thrombosis model was used to study the anti-thrombotic effect by measuring thrombosis of tail and bleeding time as well as clotting time. Result: The extract was found to be rich in flavonoids, polyphenols, alkaloids, tannins and resins. Swelling and redness were observed within 2-3 h after intravenous injection of carrageenan, and the tail appeared auburn after 6 h, indicating that thrombosis had formed in the tail. Extract significantly (*P < 0.05, **P < 0.01) increased the bleeding and clotting time of the animals subjected to the test. Discussion and Conclusion: In the present work, phyto-constituents like flavonoids and polyphenols could be responsible to demonstrate protective effect on experimentally induced thrombosis in murine model.

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Background: The transfusion of blood and its components is therapeutic and always associated with some level of risk, which if not well-screened, could lead to several complications. Laboratory tests such as a complete blood count are performed to find out if the patient's symptoms are likely to be relieved. Aim: To evaluate the hematological profile of screened blood donors at a tertiary hospital, Enugu (THE), South East Nigeria. Subject and Methods: Sixty subjects comprising 30 apparently healthy blood donors and 30 non-donors were recruited for the investigation of hematological profile from THE. After obtaining an informed consent, 2 ml venous blood was aseptically collected from the subjects and dispensed into tri-potassium ethylene di-amine tetra-acetic acid anticoagulant bottles and mixed by gentle inversion. Complete blood count was determined by hematology autoanalyzer-Symex-Kx-21N, while thin blood film was prepared for examination of blood cell morphology. Results: The blood picture revealed that 29 donors (96.7%) had normal blood picture while the control recorded 22 (73.3%). There were statistically significant increases in the red blood cell count (P = 0.0115), hemoglobin concentration (P = 0.0047) and packed cell volume (P = 0.0005), total white blood cell (WBC; P = 0.0483), and eosinophil (P = 0.0252) counts in the donors group when compared with the control group. In addition, the erythrocyte sedimentation rate and lymphocyte count recorded a statistically significant decrease (P < 0.001) in the donors when compared with the control group. Conclusion: The result of this present study suggests that the screening procedures for potential blood donors at THE may be regarded as effective in detecting suitable blood donors.

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Background: Medicinal plants have played a key role in the world healthcare with about 80% of Africans depending on phytomedicine, which has shown a wide range of uses in the treatment of diseases especially priority diseases of Africa. The objective of this study was to investigate the sub-acute effects of methanolic seed extracts Telfairia Occidentalis on prothrombin time (PT), activated partial thromboplastin time (APTT), and platelet values in Albino Wistar rats. Materials and Methods: Thirty rats were equally divided into groups A (control), B, C, D, and E (test). Groups B, C, D, and E were gavaged with 20, 40, 80 and 160 mg/kg body weight, respectively, of the extract for 9 days. Four milliliters of venous blood was collected from each animal and 2 ml delivered into 0.25 ml tri-sodium citrate and K ₃ ethylene diamine tetra acetic acid (EDTA) anticoagulant bottles for the determination of PT, APTT, and platelet values, respectively. Results: APTT showed a statistically significant increase in groups D (P < 0.01) and E (P < 0.05) when compared with the control on Day 3. Platelet value demonstrated a time-dependent statistically significant decrease (P < 0.05). Conclusion: In conclusion. T. occidentalis demonstrated sub-acute inhibitory effects on coagulation.

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Objective: To evaluate the antidiabetic activity of ethanolic extract of bark of Cedrus deodara. Materials and Methods: Ethanolic extract of the Cedrus deodara (EECD) at dose levels of 250 mg/kg and 500 mg/kg body weight was subjected to the streptozotocin induced diabetes mice. The biochemical parameters, serum glutamic oxaloacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT), cholesterol and triglycerides were also assessed in the experimental animals. Results: The EECD exhibited significant antihyperglycemic activity and also lowers the biochemical parameters like SGPT, SGOT, cholesterol and triglycerides. The ethanolic extract at dose level of 500 mg/kg was found to be more potent than 250 mg/kg in lowering the blood glucose level, almost near to the effect of the standard drug. Conclusion: This study supports the traditional claim and the ethanolic extract of this plant could be added in traditional preparations for the ailment of various diabetes-associated complications.

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Background: Having regular exercise has been linked to healthy living. However, exercise is also a stressor. How the body maintain homeostasis in the phase of changing blood chemistry during exercise has been the subject of many discussions. Aim: This study investigated the changes in blood pressure parameters, changes in blood glucose, cortisol, lipids, testosterone and blood free radicals, in exercise-trained young female adults and those living a sedentary lifestyle during a treadmill exercise test. Materials and Methods: Trained and untrained-participants were recruited for this study using predetermined criteria. Basal parameters such as height waist circumference, blood pressure, heart rate, blood glucose, lipid profile as well as antioxidant status were measured prior to and immediately after treadmill exercise test. Results: The results showed a significant (P ≤ 0.05) reduction in plasma level of glutathione (trained 0.040 ± 0.006, untrained 0.088 ± 0.035 ΅mol/ml), catalase (trained 0.909 ± 0.057, untrained 1.079 ± 0.024 mg/ml), malondialdehyde (MDA) (trained 0.062 ± 0.012, untrained 0.088 ± 0.011 nmol/ml), cardiac risk index (trained 1.96 ± 0.19, untrained 5.88 ± 0.33) and testosterone cholesterol ratio (TCR) (trained 0.40 ± 0.02, untrained 0.50 ± 0.04 × 10⁻² ) in trained-participants compared to untrained-participants. Post-exercise level of superoxide dismutase (before-trained, 0.116 ± 0.005 after-trained, 0.093 ± 0.014 mg/ml) and MDA (before exercise 0.067 ± 0.007, after exercise 0.062 ± 0.012 nmol/ml) were also significantly reduced in trained-participants compared with the pre-exercise level in the same group unlike what was obtained in untrained-participants. A significant decreased pre-exercise test level of total cholesterol (TC), triglyceride, low density lipoprotein (LDL) and ratio of LDL to high density lipoprotein (HDL) was recorded in trained compared to untrained-participants. Post-exercise test level of LDL, TC/HDL, LDL/HDL ratios were all significantly lowered in trained-participants compared with the untrained-participants. Conclusion: Involvement of young female adults in exercise training promotes body antioxidant response system and also reduced the TCR during treadmill exercise test compared to untrained young female adults living a sedentary lifestyle. Prior involvement in exercise training also promoted healthy blood lipid and lipoprotein profile in this group of participants compared to the untrained-participants.

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Background: Diabetes mellitus (DM) is one of the most common metabolic disorders, afflicting over 415 million people worldwide. It has been associated with several complications mainly due to hyperglycemia and dyslipidemia. L-Citrulline, a nonessential amino acid may be an efficient alternative therapy owing to its hypolipidemic and other beneficial effects which have not been extensively explored in type-2 DM (T2DM). Objective: We investigated the effect of L-citrulline supplementation on fasting blood glucose (FBG) level and lipid profile in high-fat-diet (HFD) and dexamethasone-induced T2DM in male Wistar rats. Materials and Methods: Thirty male Wistar rats, 10–12 weeks old, each weighing between 200 and 250 g were randomly assigned into six groups of five rats each. Group I was fed normal diet while diabetes was induced in the other groups with HFD and dexamethasone intraperitoneally (1 mg/kg) for 21 days. Group III which was confirmed diabetic, received metformin 100 mg/kg orally, and Groups IV, V, and VI which were also confirmed diabetic, received 200 mg/kg, 400 mg/kg, and 800 mg/kg L-citrulline, respectively, for 21 days. Serum FBG and lipid profile were obtained after humanely sacrificing the rats at the end of the treatment. Values at P < 0.05 were considered statistically significant. Results: At the end of the treatment, L-citrulline significantly reduced the FBG levels in a dose-dependent manner to 192.5 ± 3.4 mg/dL, 181.8 ± 1.2 mg/dL, and 174.8 ± 2.8 mg/dL at 200 mg/kg, 400 mg/kg, and 800 mg/kg, respectively. The total cholesterol level was significantly lowered by L-citrulline 200 mg/kg (55.2 ± 0.64 mg/dL), 400 mg/kg (57.8 ± 1.19 mg/dL), and 800 mg/kg (63.1 ± 1.50 mg/dL) compared to the diabetic control (149.8 ± 2.68 mg/dL). Similar findings were obtained for the low-density lipoprotein and triglyceride levels. There were also significant elevations in the high-density lipoprotein levels by L-citrulline at all doses compared to diabetic control (24.6 ± 1.1 mg/dL). Conclusion: L-Citrulline supplementation possesses antihyperglycemic and antidyslipidemic effects in diabetic Wistar rats.

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Introduction: Asymptomatic bacteriuria (ASB) in pregnancy is associated with acute pyelonephritis, premature deliveries, low birth weight, still birth, pre-eclampsia, hypertension, anaemia, and postpartum endometritis. Early detection and treatment of this condition reduces the incidence of these complications. Objective: To determine the prevalence, associated bacteria agents and susceptibility, and risk factors of ASB among pregnant women at the University of Benin Teaching Hospital. Materials and Methods: Two hundred and sixty five respondents were selected using systematic sampling method, between November 2011 and October 2012. These subjects provided clean catch midstream urine samples that were cultured, significant bacteriuric isolates were identified through biochemical tests and sensitivity against regular antimicrobial agents carried out. Data were analysed using SPSS version 16. Results: Of the 265 urine samples cultured, 28 (10.6%) had asymptomatic bacteriuria. Isolates were predominantly Escherichia coli (46.4%), Proteus species (14.3%), Enterococcus faecalis (10.7%), and Staphylococcus aureus (10.7%). These organisms were generally susceptible to tested antibiotics at different degrees. Risk factors included maternal age, parity, and level of education of the woman, as well as spouse's level of education. Occupation of the woman and that of the spouse, gestational age, religion, and ethnicity were not risk factors. Conclusion: Prevalence of ASB among pregnant women in University of Benin Teaching Hospital was 10.6%. Age, parity, and levels of education of both the women and the spouses were risk factors. Periodic surveillance of prevalence, etiology and antibiotics susceptibility is recommended.

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Introduction: Enteric parasitic diseases are common in the developing counties and are of major health problem due to their high prevalence rate, and effect on both nutritional and immune status of the population. This study was conducted to determine enteric parasitic infections among pregnant women in Benin City, Edo State, Nigeria. Materials and Methods: A total of 332 participants which consisted of 232 pregnant women and 100 nonpregnant adult females were recruited in this study. Blood and fecal specimens were obtained from each participant. The blood sample was analyzed for hemoglobin concentration and the fecal sample used for investigating intestinal parasites. Results: An overall prevalence of 2.2% of enteric parasitic infections among pregnant women was observed while no parasite was reported among the nonpregnant women. Age, not always washing hand, occupation, source of food and anemia were significantly associated with enteric parasitic infections among pregnant women. The enteric parasites recovered among pregnant women were Ascaris lumbricoides and hookworm. A. lumbricoides had a prevalence of 80% of enteric parasitic infection while hookworm had 20%. Conclusion: Measures to reduce the effect of enteric parasitic infections among pregnant women are advocated.

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Background: Bacteriuria in potentially complex group of patients (those including geriatric population and patients with an anatomically abnormal urinary tract or with significant medical or surgical co morbidities) needs to be managed appropriately. In such clinical settings, polymicrobial bacteriuria is frequently considered remarkable especially due to its adverse effects on the subject. Aim: The aim of the study was to report the common pathogens and to evaluate the clinical significance of polymicrobial bacteriuria (mixed flora) from urine samples of elderly and hospitalized (catheterized) patients and study the drug resistance mechanisms revealed by the isolates from mixed flora and possibly reassessing the current diagnostic standard procedure. Materials and Methods: The present study was conducted in the Department of Microbiology of a teaching tertiary care hospital located in central India, from July 2013 to December 2013. All the uropathogenic isolates were identified up to species level by conventional and automated methods. The samples with mixed flora were picked up as significant based on patient's age, clinical conditions, hospitalization status, pyuria, and significant bacteriuria. Drug resistance mechanisms were detected in all the isolates. Results and Discussion: Urine samples from 1471 male and female, inpatients and outpatients were studied. Six hundred and eight (41.3%) samples were found to be positive with 59 (9.7%) confirmed with mixed flora (two pathogens). Among the 59 samples with mixed flora, 44 patients were grouped as catheterized (18 patients were elderly and catheterized both), one was elderly but not catheterized, eight patients had urological while six had gynaecological problems. Study revealed that Escherichia coli were frequently replaced by other organisms (other Gram negative bacilli, Gram positive cocci, and Candida) in urine samples from male patients. The isolates exhibited considerable ranges of antibiotic resistance. Conclusion: The pathogens present in the urine samples with mixed flora that are frequently dismissed as contaminants may constitute important drug resistant mechanisms. As a result, the patients with the mixed flora in their urine may be left untreated or inadequately treated. Therefore, there is an urgent need to modify the guidelines for urinary tract infection (UTI) diagnosis with respect to high risk patients.

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Background: Medroxyprogesterone acetate (MPA) is the most commonly used progestin component of hormone therapy (HT). In vitro, MPA negatively impacts markers of neuronal health and exacerbates experimentally induced neurotoxicity. There is in vitro evidence that these factors are driven by GABAergic and neurotrophic systems. Whether these effects translate to a negative impact on brain function has not been tested in vivo, clinically or preclinically. Aim: The goal of the present study was to determine whether MPA exerts detrimental effects on cognitive function in actively reproducing rats using Y-maze apparatus. Materials and Methods: Twenty-four female rats were randomly selected into three groups. Control group, Low dose (100 mg/1 ml MPA) group, and High dose (200 mg/1 ml MPA) group, respectively. Dose was delivered by intramuscular injection for the period of 3 weeks. Result: Intramuscular administration of MPA resulted in a dose-dependent decrease in memory and locomotion activities of the female wistar rats (P < 0.05). Discussion: These findings suggest that MPA, the most commonly used progestin in HT, is detrimental to learning and two types of memory, and possibly modulates the GABAergic system in cognitive brain regions, in actively reproducing rats. These findings, combined with in vitro evidence that MPA is detrimental to neuronal health, indicates that MPA has negative effects for brain health and function. Conclusion: Therefore, MPA despite being effective in modulating hormonal interaction to prevent conception in actively reproducing females, learning and memory depression could be one of its adverse effects.

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Background: Azadirachta indica (neem) is an ever green tropical plant with ethno-medicinal uses; it is a very potent anti-malaria plant. There is a paucity of the scientific literature on the impact of A. indica on the biliary flow rate and bile composition, considering that alterations in bile composition may lead to gall stone. Aim: This study therefore sought to elucidate the impact of A. indica leaves extract on biliary flow rate and bile composition in rats. Materials And Methods: Eighteen (18) albino Wistar rats were randomly assigned into three groups of six rats each and fed on normal rat chow and/or 150 mg/kg, 300 mg/kg body weight of A. indica extract for 21 days. Results: The rate of bile secretion is in the control, low dose (LD) and high dose (HD) A. indica extract treated rats was 3.0 ± 0.02 ml/h, 5.60 ± 0.46 ml/h and 5.38 ± 0.32 ml/h respectively, showing a significant (P < 0.001) increase in LD and HD compared with control. Na ⁺ concentration increased significantly (P < 0.05) in the HD extract recipients compared with control. LDs of the extract increased K + significantly (P < 0.001) compared with control and HD. HDs of the extract increased Cl− concentration significantly (P < 0.05) compared with LD. HCO3⁻ did not alter significantly among these groups. LDs of the extract significantly (P < 0.01) increased total cholesterol, total and unconjugated bilirubin concentrations, HDs reduced it. Conclusion: Hence, A. indica leaves extract increases bile flow rate, LDs of the extract increases cholesterol and bilirubin saturations while HDs reduces it.

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Gambling disorder(GD)is a behavioral addiction recognized by the Diagnostic and Statistical Manual for Mental Disorders 5^th version and the International Statistical Classification of Diseases 10^th version (ICD-10). GD according to the ICD-10 is characterized by maladaptive and recurrent pattern of gambling behavior that persists despite the negative consequences for the individual and his family. GD is a rising global health issue, and its consequences are family problems, substance abuse, suicide ideation, suicide attempts, suicide, and criminal behaviors such as theft and drug trafficking to raise money for gambling activities. Mood disorders such as major depressive disorder, anxiety, obsessions, and personality disorders are comorbid with GD. Papers were searched using key terms indicating addiction, exercise, physical activity, and GD on PubMed, Science Direct, Psych INFO, Medline, and Google Scholar database. Exercise is effective in the prevention and treatment of depression in addition to psychotherapy and antidepressant drug therapies. Pathological gamblers who are not physically active are expected to have poor cardiovascular and mental health, lack of physical fitness, and low quality of life compared to healthy controls who exercise regularly. There is a need to include a standard exercise program in support of psychotherapeutic and pharmacological treatment of GD because of the benefits of regular exercise in the improvement of cardiovascular and mental health, lifestyle modification, and in the primary and secondary prevention of chronic diseases. Exercise was found to be effective as an adjunctive therapy in the treatment of GD and co-occurring psychiatric disorders.

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Introduction: Lumbar disc herniation with radiculopathy (LDHR) has been one of the most difficult conditions to manage among low back disorders. Individuals with chronic or recurring lumbar radiculopathy experience difficulties returning to work due to poor lower limb neuromuscular control. Given the consequences of LDHR, there is the need for effective treatment approaches that will be helpful in the amelioration of the problem. Objectives: In this study the most recent physical therapy literature in the management of patients with LDHR was evaluated. Methods: A literature review was conducted from inception to January 2019 in the PubMed, PEDro, and OTseeker databases. Results: Fifteen studies relating to the physiotherapy managements of LDHR were identified and discussed. Out of these studies, 1 study was a cohort study and 14 studies were randomized controlled trials. 5 studies examined the effects of physical therapy modalities, 6 studes examined the effects of physical therapy/exercises and 4 studies examined the effects of spinal manipulation (SM) in the management of LDHR. Conclusion: The findings of this study concluded that extension-oriented treatment approach, SM and lumbar stabilization exercise in combination with low power laser therapy are better than any physiotherapy intervention in the management of LDHR.

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An awareness pertaining to the variations in root morphology in primary teeth is highly important among clinicians to render best treatment and in the maintenance of these teeth in the oral cavity. Primary mandibular second molars usually have two roots with three canals. Very rarely an additional supernumerary root occurs and when this extra root is situated mesiobuccally it is referred as radix paramolaris (RP) and when it is present distolingually to the main distal root it is called as radix entomolaris. Most of the times, this extra root remain undiagnosed due to its overlapping with the main mesial root on radiographic examination leading to endodontic failures. The aim of this paper is to present two cases of RP in primary mandibular second molars and to describe its clinical significance.

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Background: Central to the process of keeping current with clinical information in dentistry is the ability of a practitioner to evaluate the reliability and validity of current scientific evidence. Pertinent to this is a basic understanding of statistics. The level of understanding of biostatistics has not been reported among Dental resident doctors in Nigeria. Aim: The purpose of this study was to evaluate dental residents' understanding of biostatistics and the interpretation of research results. Materials and Methods: This was a study carried out among dental resident doctors who attended the revision course organized by the Faculty of Dental Surgery, National Postgraduate Medical College of Nigeria in March 2013. A cross-section of dental resident doctors at the Lagos University Teaching Hospital was also included in the study. Data collected through a self-administered questionnaire included demographic characteristics of the residents, their attitudes toward statistics, and their confidence about interpreting and assessing statistical concepts. Residents' knowledge of statistics was also tested by asking some basic statistical questions. Results: Eighty-one respondents completed the questionnaire. About two-third (66.7%) had taken a course in epidemiology; and 60.5% had taken a course in biostatistics. Only a quarter (25.9%) of respondents could correctly identify that "lower facial height in centimeters" as a continuous variable, and 23.5% thought that centimeters was a nominal measure of facial height. "Facial asymmetry classified as none, moderate, severe" was correctly identified as an ordinal variable by only a third (35.8%) of the respondents. Two keys to the highest level of evidence in a study are blinding and controls. Sixty-eight percent of the respondents correctly identified that this avoids observer and subject bias. However, only about one-fifth (22.2%) correctly identified that a P > 0.05 (not statistically significant) indicates at least a 1-in-20 chance occurrence. Overall, respondents' knowledge of biostatistics was low, with only 29% of the item answered correctly. Conclusion: Most residents in this study lack the knowledge in biostatistics needed to interpret many of the results in published clinical research. Because clinicians need to have such skills to engage in evidence-based practice, every effort needs to be made to include effective training in biostatistics during undergraduate and residency training programs.

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Background: Feeding sick children by mouth at times may be difficult. Therefore, alternative methods such as nasogastric tube feeding may come handy. Similarly, oxygen therapy is life saving; however, there are concerns of parental refusal of these treatments. Therefore, this study seeks to determine the level of acceptance of these treatments and factors responsible for treatment refusal if any. Materials and Methods: This study was cross-sectional and 202 mothers whose children were on or had nasogastric tube feeding and oxygen therapy were recruited. Results: Most of the respondents' accepted nasogastric tube feeding and oxygen administration on their children despite the fact that most were not counseled (66.8% and 61.4%, respectively). The most common reason for declining nasogastric tube feeding was the belief that it may occlude the airway while those who declined oxygen therapy was because they believed it may result in death. Most of those that accepted nasogastric tube feeding also accepted oxygen therapy (X ² = 32.031, df = 1, P = 0.00). The educational status of the respondents had no significant relationship with acceptance of nasogastric tube feeding (X ² = 3.245, df = 3, P = 0.36) and also oxygen therapy (X ² = 0.487, df = 3, P = 0.92). Furthermore, their age and number of children had no influence on their decision on acceptance of nasogastric tube feeding or oxygen therapy. Similarly, ethnicity and occupational status had no statistically significant relationship on acceptance of oxygen or nasogastric tube feeding. Conclusion: The acceptance of nasogastric tube feeding and oxygen therapy is very encouraging and was not affected by maternal age, ethnicity, or educational qualification.

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Background: Inherited disorders of hemoglobin are the most common gene disorders worldwide. The objective of this study is to determine the frequency distribution of hemoglobin variants among the Yorubas residing in Ibadan. Materials and Methods: Five hundred and thirty one subjects comprising 184 males and 347 females, of age 1-70 years, were enrolled in the study. Ethical approval was obtained from the Ethical Committee of the University College Hospital and a duly signed informed consent was obtained from each subject. Two milliliters of venous blood was aseptically collected from each participant for the determination of hemoglobin genotype, using the standard hematology method. Results: Hemoglobin HbAA recorded the highest frequency distribution (65.3%). This was followed by hemoglobin variant HbAS (24.1%), abnormal hemoglobin variant HbSS (5.5%), HbAC (4%), and HbSC (1.1%), (P > 0.05). The female subjects revealed higher frequency distributions of AA, AS, SS, and SC, while the male demonstrated higher frequencies in AC and SC only. Conclusion: It can be concluded that the Yoruba indigenes residing in Ibadan have a high frequency distribution of HbAA and a future reduction in the HbSS disease in the populace is possible.

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Background: Acalypha wilkesiana, commonly called Irish petticoat, is native to the South Pacific Islands and belongs to the family Euphorbiaceae. In traditional medicine practice, the leaves of A. wilkesiana are eaten as vegetables for the management of hypertension, being a diuretic plant. Aim: This study was conducted to evaluate the effects of extracts of A. wilkesiana leaves on activities of serum aminotransferases and bilirubin levels, which are indicators of liver function, in salt loaded rabbits. Materials and Methods: A total of 30 rabbits were randomly divided into five Groups (A to E) of six rabbits each and treated with salt loaded diet, aqueous extract (Group B) and ethanol extract (Group C) of A. wilkesiana leaves; continuous salt loading (Group A); salt loaded and nontreated (D); nonloaded (with salt) and nontreated (with extract) (E). Results: Salt loading resulted in a significantly (P < 0.05) higher serum alanine aminotransferases (ALT) and aspartate aminotransferases (AST), and a significantly (P < 0.05) lower serum direct bilirubin, when compared with the control. Treatment with A. wilkesiana leaf extracts, at a dose of 300 mg/kg body weight, resulted in a nonsignificantly (P > 0.05) lower serum total bilirubin and direct bilirubin, as compared with the control, in the salt loaded rabbits. Discussion and Conclusion: The use of A. wilkesiana leaf could be relatively safe considering its effects on serum ALT, AST, total and direct bilirubin of the experimental animals. Thus, it may be useful in the management of any possible deleterious effect of salt load to the liver.

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Objective: Rheumatoid arthritis is a chronic multi-system disease of unknown cause. It affects people in their prime of life, predominantly between the ages of 20 and 50 years with an unpredictable course. The present study was to evaluate the anti-arthritic activity of ethanolic extract of Commiphora caudata leaves in complete Freund's adjuvant (CFA)-induced arthritic rats. Materials and Methods: Arthritis was induced by sub-cutaneous injection of 0.1 ml of CFA in rats. Arthritic arts were divided into different groups and ethanolic extract of C. caudata leaves (EECCL) was administered at doses of 200 and 400 mg/kg, p.o for 28 days. The control group received Tween 20 for 28 days. Dexamethasone (1 mg/kg, i.p) was used as a standard drug. Paw volumes were recorded on 7, 14, 21 and 28 day using a plethysmometer. Blood samples were collected at the end of the experiment from all the groups to analyze the serological rheumatic factors: C-reactive protein (CRP), serum rheumatic factor (SRF) and hematological parameters. EECCL was also tested for protein denaturation and membrane stabilization activities. Statistical Analysis: All data were expressed as mean ± SEM. One-way ANOVA followed by Dunnett's test was used to compare the mean values of test groups and control. Results: The EECCL (200 and 400 mg/kg, p.o) showed significant (P < 0.01, P < 0.001) reduction in paw volume, change in body weight in CFA rats at 28 day when compared with arthritic control rats. In addition, EECCL with dose 400 mg/kg, p.o significantly (P < 0.05, P < 0.001) increase the red blood cells, hemoglobin and above the 400 mg/kg dose significantly (P < 0.001) decrease the white blood cells, erythrocyte sedimentation rate, SRF and CRP when compared with arthritic control rats. Conclusion : The results obtained from the present study revealed the potential anti-arthritic activity of ethanolic extract from the leaves of C. caudata.

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Introduction: In ancient times Cissus quadrangularis Linn. was used as a general chow item in China. The stout fleshy stem of C. quadrangularis is an edible plant found throughout the hotter parts of India, Malaya, West Africa, and Ceylon. The plant part contains a number of phytoconstituents like alkaloids, glycosides, polyphenols, flavonoids, sterols, etc. It has demonstrated antiulcer and cytoprotective properties. Aim: The present study was designed to evaluate immune-modulatory potential of C. quadrangularis. Materials and Methods: Plant material was powdered and extraction was done with ethanol phytochemical screening and estimations of phenolics and flavonoids were carried out. Acute toxicity studies were performed as per Organization for Economic Co-operation and Development (OECD) guidelines. The extract was further evaluated for immunomodulatory activity through carbon clearance test, effect on serum immunoglobulins, determination of delayed-type hypersensitivity (DTH) and phagocytosis of killed Candida albicans tests were done to determine immunoprophylactic potential. Result: Results of phytochemical and phytoanalytical tests demonstrated that C. quadrangularis is rich in polyphenolic and flavonoid content. C. quadrangularis also showed promising immunomodulatory potential on various models like DTH, carbon clearance test and effect on serum immunoglobulins. Discussion and Conclusion: These studies conclude that C. quadrangularis possess immunomodulatory activity which might be due to presence of phytochemicals like flavonoids and phenolic compounds.

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