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/Purpose: Low back pain (LBP) is an important public health problem. It is one of the most expensive conditions in musculoskeletal health care; hence the need for a safe, efficacious and cost effective management. The aim of the study was to determine the efficacy of interferential therapy and exercise therapy in the treatment of LBP. Materials and Methods: Sixty-five subjects diagnosed with low back pain participated in the study. The subjects (29 males and 36 females) were aged between 20-66 years (mean age 46.45 ± 11.90 years). Each subject was treated with interferential therapy (IFT) and some specific spinal-based therapeutic exercises thrice weekly. Assessment of pain intensity and spinal range of movements were carried out with Visual Analogue Scale (VAS) and Modified Schober Technique (MST) respectively. Measurements were carried out before and after eight weeks of treatment. Results: There was a statistically significant decrease in pain from 6.29 ± 2.16 before treatment to 2.54 ± 1.86 after treatment (P < 0.001). Spinal flexion increased from 3.44 ± 1.7 cm pretreatment to 5.22 ± 1.59 cm after 8 weeks of treatment (P < 0.01). Also, spinal extension increased from 1.2 ± 0.62 cm pretreatment to 2.29 ± 0.63 cm after 8 weeks of treatment (P < 0.001). Subjects with pain localized to the lower back and those with pain radiating to lower limbs had significant improvements from the treatment. Conclusion: The results of this study showed that interferential therapy combined with exercise therapy could help to reduce pain intensity and increase spinal range of motion in patients with low back pain.

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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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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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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: Human identification has recently been optimized following the completion of human genome sequence, by using DNA markers that exhibit the highest possible variation. However, in developing countries such as Nigeria, the application of DNA typing for identification of human subjects either for forensic or medical purposes is inadequate due to the absence of national forensic DNA laboratories and lack of the legislative framework. Materials and Methods: In this study, two male subjects of Igbo origin provided their blood, hair and buccal samples for DNA analysis. DNA was extracted, purified, quantified with human quantifiler™ polymerase chain reaction reaction mix. Hyper-variable segment 1 of the D-loop mitochondrial DNA (mtDNA HVS-1) was amplified, purified and fragments sequenced and analyzed with ABI Genetic Analyzer. A multiplex AmpFlSTR Identifiler kit amplified 15 STR plus amelogenin loci of the nuclear DNA and 16 STR of the Y-chromosome. GeneMapper ID software version 3.2 was used for the analysis of autosomal and Y-chromosome AmpFlSTR. Results: Result show that the mtDNA lineage of UMBACK subject belongs to L3e2b while ELAMBIA is assigned to L3f1b1 haplogroup. Based on the allelic frequency database, both subjects displayed uniqueness in random match probability for the autosomal allelic short-tandem repeat (STR). Based upon a mutation rate of 0.003 for Y-DNA STR markers, the two individuals most likely shared a common paternal ancestor 96 generations ago. Both subjects were assigned to E1b1a haplogroup with a 100% probability, which is consistent with the haplogroup associated with Igbo people in Nigeria. Conclusion: As expected, well-established forensic genetic tools comprising of mtDNA, autosomal and Y-chromsomomal STR typing methods were all found to distinguish two selected Nigerian Igbo individuals with a very high power of discrimination.

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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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Aim: The aim of this paper is to conduct a literature review on the clinical anatomy of the frontal sinus as it relates to its implication in frontal sinus fractures (FSFs), as well as review the contemporary opinions on the management of these fractures. Materials and Methods: A computerized literature search of PubMed and Medline was conducted for publications on the clinical anatomy and management of FSFs. Search phrases were "frontal sinus" combined with "management", "treatment", and "anatomy". The Boolean operator 'AND' was used to narrow the searches. Result: FSFs account for 5-15% of all maxillofacial injuries and are associated with 32% of panfacial and maxillary injuries. The FSFs may result from high-velocity impacts, such as motor vehicle accidents and assaults; blunt or penetrating force. The potential for intracranial injuries, esthetic deformities, and late mucocele formation is high. The treatment goals of FSFs are an accurate diagnosis, avoidance of short- and long-term complications, return of normal sinus function, and re-establishment of the premorbid facial contour. Recently, several treatment protocol with greater emphasis on the nasofrontal outflow tract (NFOT) injury are described in the literature, however, controversies still abound on effectiveness of these protocols in reducing the attending complications. Conclusion: The management of FSFs presents a unique and challenging problem for the contemporary surgeons. A clear understanding of corrective techniques is essential when approaching these challenging injuries. Each treatment method has its advocates, and controversies still abound regarding indications, applications, and ultimate success in given situations.

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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: Transcutaneous electrical nerve stimulation (TENS) is one of the most widely used physical modalities for the management of osteoarthritis (OA) knee and various stimulation parameters have been adopted with varying stimulation frequencies. However, the optimal stimulation frequency of TENS in the management of OA knee pain appeared not to have been well studied. Aim: The purpose of this study is to find out, which among conventional TENS (ConTENS) and acupuncture-like TENS (AcuTENS) is more effective for treating knee OA. Materials and Methods: Twenty-four patients with knee OA were randomly allocated to three groups. ConTENS AcuTENS and Placebo TENS (PlaTENS). Participants in the ConTENS and AcuTENS group received TENS treatment with current intensity and frequency based on their group allocation at selected acupuncture points (acupoints) for knee pain; the Pla-TENS participants received intervention, which was identical to the ConTENS treatment group, but the circuit was disconnected. Participants in the three groups were also treated with soft tissue manipulation around the knee joint. Each group received treatment 3 times a week for 3 weeks during the study. Outcome measures were pain intensity measured with numeric pain rating scale (NPRS), goniometric assessment of knee active range of motion and knee functional mobility measured with timed up and go test. Data were collected prior to intervention, at weekly basis during intervention and at 4 weeks follow-up assessment. Results: The ConTENS and AcuTENS reported lower pain intensity scores and increase in the knee active range of flexion than the PlaTENS group at the end of 3 weeks of treatment and at follow-up assessments. However, only the AcuTENS group recorded statistically significant lower pain intensity and improvement in knee flexion than other groups (P < 0.005). Conclusion: AcuTENS treatment was more effective than ConTENS in pain relief and increasing active range of knee flexion for patients with OA of the knee

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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: 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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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: 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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Background: Hydantoin racemase from Lactobacillus species of human origin has not been reported and characterized. The genome of Lactobacillus pentosus KCA1 has been sequenced and found to possess gene cassettes and open reading frames encoding the hydantoinase machinery, including a putative hydantoin racemase. Aims: To use bioinformatic tools to characterize the new hydantoin racemase predicted in the genome sequence of L. pentosus KCA1. Materials and Methods: Bioinformatic tools such as ClustalW algorithm was used to align hydantoin racemase from L. pentosus KCA1 with other hydantoin racemases extracted from the uniprot΢ database. I-TASSER was used for the prediction of secondary structure, 3-D model, similarity structure in PDB, and functional active binding site residues. Results: L. pentosus KCA1 hydantoin racemase showed significant amino acid sequence identity with hydantoin racemase from the selected bacterial organisms in the protein databank (PDB). The predicted secondary structure revealed 9 alpha-helices and 8 beta-strands. Functional prediction using enzyme partners predicted EC number 5.1.1.13 as the corresponding enzyme homolog (3eq5A) showing Cys83 and Cys187 as the potential active residues in KCA1 hydantoin racemase. The 3-D structure of KCA1 hydantoin racemase has a confidence score (C-score) of 1.2 that reflects a model of better quality, based on 3qvjA from PDB. Conclusion: The in silico data presented provides new insights into the potential activity and substrate specificity of hydantoin racemase from L. pentosus KCA1 and has proposed a mechanism for racemization of hydantoin derivatives that is consistent with the two-base process observed in other members of the Aspartate/Glutamate superfamily.

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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: Despite being identified as a serious health concern, effective means of managing chronic LBP with SIJ disorders based on sound evidence still remains controversial. Aims: The purpose of this study is to compare the effects of combined treatment (acupuncture, manipulative therapy, AMG) with manipulative therapy (MTG) and standard physiotherapy (STG) alone based on Flyn et al.'s clinical prediction rule (CPR). Methods: Eighty-one participants with disorders of lower back pain and Sacroiliac joint (SIJ) were randomised into the 3 treatment groups. Outcome measures of pain intensity, functional disability and quality of life were carried out at baseline, after 6 weeks of treatment and at 3-month follow up. Participants were treated according to the treatment in the group to which they are randomised. Results: Participants in the AMG showed grater improvement than the others after six weeks of treatment. Paired t – test showed significant difference (t = 3.142, P = 0.004) in the mean percentage improvement between those who met the CPR (64.39 (13.0)) and those who did not (49.44 (7.89)). In the AMG, 21 (77.8%) participants recorded treatment success while 6 (22.2%) recorded treatment failure. One of the hip having more than 350 of internal rotation showed significant predictive value in association with treatment success (Wald test score = 37.887, P = 0.035 with an odd ratio value of 0.857). Conclusion: A combined treatment consisting of acupuncture, manipulative therapy and exercises will offer greater benefits to patients with lower back pain and SIJ disorders. The presence of at least 35 degrees of internal rotation in one of the hip joint is predictive factor of treatment success with manipulative therapy and acupuncture in patient with lower back and SIJ disorders.

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Tooth transposition is a relatively rare developmental anomaly of the teeth characterized by a positional interchange of a permanent tooth leading to distortion in the alignment of the affected segment, a midline shift, and malocclusion of the teeth. In the general population, the prevalence of this anomaly has been reported to be below 1% in most investigations. This condition is frequently observed in the maxillary arch and most commonly involves the canine tooth. Investigations in three Indian patients revealed different variants of tooth transpositions all occurring in the maxilla. The present article reports these different cases of transpositions associated with other dental anomalies.

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Background: Absence of surgical stress and the limitations associated with maxillo-mandibular fixation have been identified as advantages with non-surgical management of mandibular fractures where indicated. This treatment modality entails close observation, feeding on soft diet, use of analgesics and antibiotics alongside warm saline mouth rinses. This study serves as a pilot to evaluate oral health-related quality of life (QoL) for patients with mandibular fractures who were managed non-surgically in a Nigerian teaching hospital. Patients and Methods: A total of 153 patients were evaluated prospectively over the space of 1 year from which 10 patients met the selection criteria for non-surgical treatment of mandibular fractures. Evaluation at presentation was done using General Oral Health Assessment Index questionnaire. The questionnaire was subsequently completed during reviews at day 1, 6 weeks, and 8 weeks, respectively. Results: There was acceptable healing of all the fractures with a significantly improved mean QoL outcome from 41.42 ± 1.14 at presentation to 59.90 ± 2.00 at 8 weeks review. Conclusion: Although very few patients meet the criteria for non-surgical treatment of mandibular fractures, it is an acceptable treatment option in patients with fractures of the mandible. This form of treatment in such selected cases results in satisfactory fracture healing and acceptable QoL to the patient.

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Background: The use of herbs such as Irvingia gabonensis (Aubry-Lecomte et O'Rorke Baill) for nutrition and to treat diseases is almost universal among nonindustrialized societies, as it is often more affordable than modern pharmaceuticals. Therefore, the objective of this study was to screen the coagulation potentials of the crude methanolic leaf extract of I. gabonensis in albino wistar rats. Materials and Methods: Thirty albino wistar rats were used for the study. They were grouped into: A, B, C, D and E, with Group A as the control. The test Groups (B-E) were orally administered with graded concentrations (50, 100, 150 and 200 mg/kg body weight) respectively once daily for 9 days. Four ml of venous blood was collected from the ocular plexus on days 3, 6 and 9. Two ml was delivered into a test tube containing 0.25 ml of trisodium citrate anticoagulant for the determination of prothrombin time (PT) and activated partial thromboplastin time (APTT). The remaining 2 ml was emptied into tripotassium ethylene diamine tetra-acetic acid anticoagulant bottle for the determination of platelet count. Results: All investigations were analyzed using standard hematological methods. There was no statistically significant difference (P > 0.05) when all the parameters evaluated in the test groups were compared with the control group on day 3. However, there was a statistically significant decrease in Groups B and C (P < 0.05 each) in APTT when compared with the control group on day 6. In addition, there was no statistically significant difference (P > 0.05) recorded in all the parameters investigated in all the test groups when compared with the control group on day 9. There was neither duration of exposure nor dose-related statistically significant difference (P > 0.05) in all the parameters evaluated in all the test groups when days 3, 6 and 9 were compared. Conclusion: From the result of the present study, it can be concluded that I. gabonensis crude methanolic leaf extract has no adverse effects on PT, APTT and Platelet mean values at low dose and short duration.

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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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Background: The therapeutic and culinary applications of Ocimum gratissimum leaf have been practiced in Central and West Africa for decades. This study was designed and conducted to investigate the haematinic and haemopoietic activities of phenylhydrazine-induced anaemia in Albino wistar rats. Materials and Methods: Twenty-four (24) Albino wistar rats were grouped into four (A, B, C and D) with six rats per cage. Groups B, C and D served as the test groups, while group A was the control. The test groups were gavaged with graded doses (4, 8 and 12mg/kg body weight respectively) of Ocimum gratissimum methanolic crude leaf extract once daily for 9 days. Two (2) mls of venous blood was collected from the ocular plexus from each animal into tripotassium ethylene diamine tetra-acetic acid anticoagulant bottle. This was used to determine complete blood count using automated haematology autoanalyzer (Sysmex KX-21N). Results: Red blood cell (RBC) mean value recorded a dose and duration-related statistically significant decrease (P < 0.05) in group D on day 3. However, there was statistically significant increase (P < 0.05) in the RBC indices. In addition, total white blood cell (WBC) recorded a marginal increase in the mean values throughout the study period though not statistically significant (P > 0.05). Furthermore, lymphocyte recorded both dose and duration-related statistically significant increase (P < 0.01). Conclusion: From the result of this study, it can be concluded that the methanolic crude leaf extract of Ocimum gratissimum possesses both haemopoetic and haematinic potentials which are dose and duration-related.

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Objective: The aim of this in vivo study was to determine the accuracy of 3 ^rd generation apex locator (Root ZX) in determining the canal length in primary teeth with normal saline and 0.12% chlorhexidine as root canal irrigants. Study Design: A total of 36 primary anterior teeth with minimum of 2/3 ^rd root lengths (indicated for extraction) were selected for this study. Working length (WL) was measured in dry, saline and chlorhexidine mode respectively and the standardized WL was measured using stereomicroscope under ×30. The data were evaluated using one-way ANOVA and Tukey's post-hoc test using SPSS software version 19 (IBM Company). The critical value for statistical significance was 5%. Results : For teeth without root resorption, the accuracy of Root ZX was 83% in dry mode and 92% in saline and chlorhexidine mode. For root canals with resorption the accuracy of Root ZX was 67% in dry mode and 83% in saline and chlorhexidine mode within ± 1 mm. However these figures decreased to 17%, 58% and 75% without resorption and 0%, 17% and 50% with resorption respectively for within ± 0.5. No significant differences were detected between the three different modes with the tolerance ± 1 mm under without resorption. However, significant difference was found without resorption as well as with resorption under tolerance ± 0.5 mm. Conclusion: The study concluded that Root ZX electronic Root apex locator is accurate with tolerance ± 1 mm in determining the root canal length in primary teeth without root resorption under different root canal irrigants that is, saline and chlorhexidine.

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Background: Community health workers, nurses, and doctors have misconception on teething, resulting in inappropriate medical advice and unnecessary prescriptions. Hence, sound knowledge of the teething process is imperative for proper parental education. This study aims to determine the knowledge and attitude of nurses in north-west Nigeria toward teething. Materials and Methods: It was a cross-sectional study of nurses conveniently sampled in two health facilities in Nigeria. Results: Three hundred and twenty-four nurses were involved comprising 230 (71%) females and 94 (29%) males. Two hundred and eighty-five (88.0%) of the respondents believed teething was associated with systemic symptoms; however, most of the respondents would advice for further medical care for symptoms they attributed to teething. Fever was the most prevalent symptom believed to be associated with teething, followed by loss of appetite and loose stools. However, their gender (X ² = 0.956, df = 2, P = 0.62), age (X ² = 0.551, df = 6, P = 0.99), number of years post qualification (X ² = 6.258, df = 4, P = 0.181), and number of children (X ² = 6.406, df = 4, P = 0.17) had no relationship with their perception toward teething symptoms. Two hundred and eighty (86.4%) of the respondents will give prescription for teething symptoms and teething powder was the most common teething drug prescribed. Eighty percent of the respondents believed teething remedies are effective. Conclusion: Teething myths are common among nurses in north-western Nigeria; therefore, efforts should be made to eradicate these through effective continuous medical education programs.

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