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Case Record: Late-Onset Temporary Lobe Epilepsy Subsequent Subarachnoid Hemorrhage: An Interaction Involving Pre-existing Cortical Advancement Problem and Tissue Damage.
Cardiovascular diseases are recognised complications of pregnancy, however, pregnancy-associated acute myocardial infarction (PAMI) is uncommon. Pregnancy is known to increase risk of myocardial infarction even in the absence of traditional risk factors for atherosclerotic vascular disease. Our patient presented with acute chest pain two weeks after delivery and her electrocardiogram was in keeping with STelevation myocardial infarction (STEMI). Coronary angiography revealed coronary artery dissection and she was managed conservatively. Various pathophysiological mechanisms of PAMI have been described in literature including spontaneous coronary artery dissection (SCAD) found in our case. The diagnosis is often missed and earlier reported cases were diagnosed at autopsy. Therefore, we report this case as a learning tool. Also, there is a need for a high index of suspicion in pregnant patients presenting with features suggestive of aortic dissection, and its diagnosis should be thought of in peripartum women presenting with acute chest pain.Pneumococcus is a major cause of life-threatening invasive infections accounting for considerable morbidity and mortality among older adult population. The burden of pneumococcal infections (non-invasive) is mostly determined by Community Acquired Pneumonia. Globally and from public health perspective, vaccination has been recognised as a preventive measure of infectious diseases, thereby reducing health care cost, morbidity and mortality. Most high-income countries have included the pneumococcal vaccination in their mandatory and voluntary vaccination policies. However, many low and middleincome countries of the world have not adequately addressed the issue of adult pneumococcal vaccine. this website This overview describes the current status of pneumococcal vaccination and strategies to reduce the rate of pneumonia in this age group. Our aim is to stimulate the adoption of policies and production of national guidelines for the use of pneumococcal vaccines in Sub-Saharan Africa.
Benign prostatic hyperplasia is a common cause of lower urinary tract symptoms in men. The enlarging prostate gland resulting from proliferation of fibro-glandular tissue within the transitional zone is responsible for the associated lower urinary tract symptoms (LUTS). The International Prostate Symptom Score (IPSS) is a validated symptom scoring tool for assessing severity of LUTS, while the prostate volume is use in BPH treatment guidelines.

To determine the relationships between total prostate volume (TPV), intravesical prostatic protrusion (IPP) and the severity of LUTS measured with the IPSS in patients with BPE.

This was a prospective study carried out on patients who presented at the out-patient unit with LUTS from BPE. They all completed the IPSS form and had digital rectal examination (DRE). Total prostate volume was measured using ultrasound scan trans-rectal probe for TPV and transabdominal probe for IPP. The data was then analyzed using SPSS version 17.

145 patients between ages 49 to 93 years participated in the study. The 60-69year group had the highest frequency, 61(42.07%). Mean TPV and IPP were 82.33 ± 55.06ml and 9.80 ± 0.641mm respectively. Mean IPSS was 23.27 ± 7.18 and QoL score 4.76 ± 1.41. TPV had no linear correlation with IPSS (p=0.044; r=0.07), while IPP had a moderate linear correlation IPSS (p = 0.001, r = +0.576).

IPP in patients with BPE seems to be a better predictor of severity of LUTS assessed by IPSS than TPV.
IPP in patients with BPE seems to be a better predictor of severity of LUTS assessed by IPSS than TPV.
Human immunodeficiency virus (HIV) infected patients are at increased risk for myocardial infarction and cardiomyopathy. Low CD4 cell count and high viral load were identified as independent risk factors for cardiac disease. Asymptomatic cardiac dysfunction has also been reported in HIV-infected individuals.

This was a cross-sectional study conducted among consecutive HIV patients who are asymptomatic for cardiac disease receiving highly active antiretroviral therapy (HAART) at the ART clinic of Federal Medical Centre Nguru, Yobe State Northeastern Nigeria.

Statistical analysis was done using SPSS version 21.0 (SPSS IBM) Chicago Illinois. Data were presented as mean ± standard deviation (SD) for continuous variables, while categorical variables were expressed as frequencies and proportions. Correlation and regression analyses were done to determine the relationship between CD4 cell count, viral load and left ventricular function. A p-value of d"0.05 was considered significant.

Patients with high CD4 cells count (>500 cells/µL) were found to have preserved left ventricular systolic function while those with low CD4 cells count (500 cells/μL while those with low CD4 cell count (1500 copies/mL) were associated with reduced left ventricular systolic function and severe diastolic dysfunction. We therefore suggest that there is need for early evaluation of left ventricular function in HIV patients before developing symptoms of cardiac decompensation.
500 cells/µL) were found to have preserved left ventricular systolic function while those with low CD4 cells count (500 cells/μL while those with low CD4 cell count (1500 copies/mL) were associated with reduced left ventricular systolic function and severe diastolic dysfunction. We therefore suggest that there is need for early evaluation of left ventricular function in HIV patients before developing symptoms of cardiac decompensation.
The role of prophylactic antibiotics in mesh repair of inguinal hernia is controversial and often based on institutional policies. Surgical site infection rate from earlier studies in Nigeria justifies the continued use of prophylactic antibiotics during hernia repair. With increased use of antibiotics comes the challenge of antibiotic resistance and toxicity. The use of antimicrobial coated suture may help avoid these challenges but its efficacy needs to be tested.

To compare Triclosan coated suture with intravenous antibiotics for the repair of inguinal hernia with mesh.

Patients with uncomplicated inguinal hernia undergoing mesh repair were randomized to either have intravenous antibiotics administered for prophylaxis or to have wound closure with Triclosan coated Vicryl 2/0 suture. Post operatively, wound infection rates were compared between the two groups. Follow up was for 1 year.

We studied 49 patients with 59 hernias with a mean age of 53 years. Hernias were solitary in 75% of cases, the majority of which were right sided, while 25% were bilateral.
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