The situation whereby there is appearance of HBV DNA in the absence of observable hepatitis B surface antigen (HBsAg) has been described as occult hepatitis B virus infection. The above situation was first mentioned in late 1970s and its prevalence depends on the differences in the distribution of HBV in each region or community, the study population, sensitivity and specificity of the adopted screening method. The sero-prevalence of HBsAg in Nigeria is estimated to range from 10-40% and this qualifies Nigeria as hyper- endemic area (Odemuyiwa et al., 2001; Fasola et al., 2008). There is also observable increase in detected HBV DNA among patients who were previously screened as negative for HBsAg (Adeniyi et al., 2022). Furthermore, high prevalence of HBsAg has been reported in the population of screened blood donors (Ejele and Ojule, 2004) and also in patients attending clinics (Nwokedi et al, 2011; Adeniyi et al., 2022).

Occult HBV is clinically important as it can be contacted by means of blood transfusion and organ transplant among others (Kwak et al., 2014). In Nigeria, there has being increase in prevalence of occult HBV despite ongoing immunization program (Opaleye et al., 2015; Adeniyi et al., 2002). When compared to similar viruses that could be transmitted during transfusion, occult HBV is more common (Comanor et al., 2006).

Lymphatic filariasis is a systemic disease arising from infestation with filarial worms. The species that commonly infest the lymphatic vessels include Wuchereria bancrofti and Brugia malayi. The larval stages of the worms are transmitted by biting mosquitoes or flies. Wuchereria bancrofti is transmitted by night biting anopheline mosquitoes. The infection is common in tropical Africa. The adult worms infiltrate the lymphatics and produce large numbers of microfilaria into the circulation. The species B. malayi is inoculated by Mansonia or Anopheles mosquitoes and is known to cause less severe disease. Infection with W. bancrofti may present diversely from subclinical infection to overt manifestation such as elephantiasis. Acute infection may present with febrile illness, pain or tenderness in the area of the inflammed lymphatics. The chronic phase is usually characterized by presence of lymphadenopathy in lower limbs, retroperitoneal tissues, lymphedema, hydrocele and elephantiasis. The clinical presentation of lymphatic filariasis can mimic that of Kaposi Sarcoma, a malignancy common in advanced HIV disease and may present a diagnostic dilemma especially in the absence of histopathologic findings. We report a case of a 73 year old known HIV disease patient presenting with chronic indurating leg swelling. Histopathology report revealed papillomatus and hyperkeratotic skin lesions with no evidence of malignancy and no presence of microfilaria on a blood smear.

There has been a rise in the number of health training facilities offering training in Pediatrics in Zambia in recent years. For nearly four decades, there was only one medical school offering medical training in Zambia, with very low annual enrolment numbers. In the past one decade, the number of students being admitted to medical school have increased dramatically, more so with the introduction of new medical schools both public and private. However, the number of trainers has not increased proportionately, hospital infrastructure has remained relatively static, and the number of trainees per patient has greatly increased. This would thus entail the need to introduce new and additional methods of teaching, such as the simulation based approach as a safe supplementary mode of training to be considered for our setting. This paper will therefore seek to examine the role of simulation based training in medical education in the field of Pediatrics and Child Health.

Introduction: The comprehensive research on the chemical composition of citronella grass led to various advantages, including the development of analytical tools for quality evaluation, which is the primary reason the plant is cultivated. Attacks by pests such as stink bugs, brown planthoppers, grasshoppers, ladybugs, and aphids are the most significant threat to crop productivity. Other problems include grasshoppers. This assault slows the development of the rice plants, resulting in a decrease in productivity or possibly preventing harvesting altogether. Applying chemical pesticides may help minimize the number of illnesses and pests. Using chemical pesticides over an extended period, on the other hand, may wreak havoc on the environment.

Objective: This review aims to examine the biological & insecticidal effectiveness of citronella oil, which can help to understand to use of this oil to control insects and mosquitos.

Method: Multiple computerized databases, such as PubMed, Google Scholar, ScienceDirect, etc., were used to write the paper. Result. The medicinal benefits of Citronella oil have been extensively documented, and the oil's components have been well studied. Citronella oil has been used as an antifungal, antiparasitic, effective insect repellent, and antibacterial, thanks to extensive research into its medicinal potential.

Conclusion: Oil of citronella contains citronellol, citronellal, and geraniol. If they enter the environment, some will vaporize. In water, they evaporate slowly. Once vapours are airborne, their half-lives range from 38 minutes to 3.2 hours. Instead, microbes degrade citronellol and geraniol.

The objective of this study is to evaluate the histological effect of Annona muricata aqueous leaf extract on the liver of adult wistar rats. Twenty four adult wistar rats weighing 180-205g were used for the study. They were divided into four groups (A, B, C and D) of six animals each. Group A served as the control and received distilled water; the experimental group B, C and D were orally administered 0.2ml, 0.4ml and 0.6ml of Annona muricata aqueous leaf extract respectively for twenty one days. Both the control and experimental groups were weighed, and sacrificed under chloroform anaesthesia at the end of the period of administration. liver tissues were removed and fixed in 10% formaline for histological studies. The body weight result showed reduction in the groups C and D animals treated with 0.4ml and 0.6ml of Annona muricata ethanolic leaf extract when compared with the control while group B increased significantly relative with the control. Histopathological results showed that group B presented mild cellular infiltration and vascular congestion, Groups C was observed to have vascular congestion and pyknotic nuclei while Group D showed area of aggregates of cellular infilteration, vascular congestion and vacuolated nuclei. This study suggests that high doses of administration of Annona muricata aqueous leaf extract may cause adverse effects on the liver cells.

Objective: Comparison of pin site infection rate between schanz screws and k-wires in ilizarov fixator for tibial fracture

Methodology: It was a randomized control trial, conducted at department of Orthopedics, Khyber Teaching Hospital, MTI, and Peshawar from July 2021 to June 2022. Sampling Technique was Non-probability consecutive sampling. Patients were divided into two groups using computer generated random sequence number. Patients in group A were stabilized using K-wires and patients in group B were stabilized using k-wire and schanz screws. Data were entered in specially designed proforma.

Result: Mean age in group A patients was 35±2.77 years, while in group B it was 38±3.12 years. Gender distribution between two groups was analyzed. In Group A 72.3% were males and 27.7 % females while in Group B patients, 70% were males and 30% were females. Mean duration from injury to surgery was 5 days with SD±2.12 in group A, while 5.5±2.37 days in Group B. Analysis of PSI among both groups shows that Group B, in whom Schanz pins technique was used, had significantly high rates of pin site infection (24.1%) compared to group A (9.6%) in whom K-wires technique was used (p 0.012).

Conclusion: Our study concludes that the frequency of pin site infection is significantly less in Ilizarov fixator using K-wires (9.6%) as compared to Ilizarov fixator using Schanz pins(24.1%).

The therapeutic effect is brought about by the drug delivery system dispensing the active medicinal ingredient. Due to fluctuations in plasma drug levels, traditional drug delivery devices have poor bioavailability and cannot generate a continuous release. The drug must also be supplied at a tightly regulated rate and to the correct location for it to be most effective and safe. To solve the problems inherent in the current methods of administering medication, scientists are working on perfecting controlled drug delivery systems. Controlled pharmaceutical delivery systems have come a long way in the last twenty years, from bulk distribution to nanoscale precision to smart, patient-specific dosing. The paper's initial portion provides background knowledge on drug delivery methods, emphasizing pharmacokinetics. The article also discusses the pros and cons of more conventional drug delivery methods. Controlled drug delivery systems' design factors, categorizations, and schematics are also discussed in length. In addition, recent advances in nano-drug delivery, targeted, and innovative drug delivery utilizing stimuli-responsive, intelligent biomaterials are discussed. The limitations of regulated medicine distribution and some possible solutions are discussed at the end of the study.

This study evaluated the serum calcitonin, creatinine and uric acid levels in chronic kidney diseases (CKD) complicated by dysthyroidism. A total of 119 participants were recruited in this study, majority of who were males. This may likely be as a result of the bread winning role of men and hence are often economically empowered to seek health care. The higher proportion of males in this study could reflect a positive change in health seeking behavior of the male gender. Majority of the participants in this study were between the ages of 30 to 68 years with a median of 49 years. The high prevalence of CKD among this age group can be attributed to underlying pathologies such as hypertension, diabetes or both. Result from this study showed a significant increase (p ≤ 0.05) in serum calcitonin,TSH, creatinine and uric acid levels of CKD subjects when compared to the control and a significant decrease (p ≤ 0.05) was observed in serum T₃ and T₄ levels of CKD subjects were observed.T₃ value showed significant decrease when the value of T₃ gotten from stage 3,4 and 5 of CKD subjects were compared.

Introduction: Lutembacher’s syndrome is a rare clinical entity. In 1916, French physician Rene Lutembacher described his first case of 61 years old woman with a combination of congenital ASD with acquired MS. But he attributed this mitral lesion to congenital mitral stenosis. The definition of this syndrome named after him has undergone many changes since then. The current consensus defines Lutembacher Syndrome (LS) as any combination of ASD (congenital or iatrogenic) and MS (congenital or acquired). The clinical presentation of LS is a result of the interplay between the size of ASD, the severity of MS, pulmonary vascular resistance and RV compliance. Financial constraints also add to the delayed diagnosis and adequate treatment in our part of the world. Here we have discussed a case of LS with severe TR and moderate PAH in congestive cardiac failure which was successfully treated by surgery thereby demonstrating cost-effective and successful surgical management of a rare cardiac disease where vascular resistance, compliance, size and severity of lesions interplay causing cardiac failure.

Case report: A 42 years old thin built, poorly nourished housewife presented with chest discomfort and fatigue for the last 4 years. She was diagnosed with an atrial septal defect four years back but could not receive appropriate treatment due to financial constraints. For the last 15 days, she had breathlessness even at rest and paroxysmal episodes that interrupted her sleep. Icterus and pedal edema was also present. As we evaluated the patient, her clinical examination could not be entirely explained by ASD alone. Soon, our suspicion of LS was confirmed by TTE and the diagnosis of Lutembacher Syndrome with Severe Tricuspid Regurgitation with Moderate PAH was made. As the patient presented to us with atrial fibrillation & heart failure, she was admitted for optimization. The patient was then successfully managed by MVR [#27 SJM, metallic] with pericardial patch closure of ASD with Devaga’s Tricuspid Valve annuloplasty and discharged on a postop day 11.

Conclusions: Early diagnosis and surgical treatment bear a good prognosis and prolong survival. If a patient is diagnosed late, pulmonary hypertension and heart failure set in and the outcome becomes poor. The higher cost of surgical intervention and low socio-economic distribution of the disease in developing countries like India should not challenge the patient’s right to receive the standard treatment.

Introduction: Subarachnoid haemorrhage (SAH) refers to the bleeding in the space surrounding the brain and its membrane and occurs usually due to the bulging or ruptures in the blood vessels of the brain. Following SAH, cerebral vasospasm can occur which can lead to sudden death or brain damage if not treated correctly and immediately. This paper presents a case of a 35 years old male patient with SAH & cerebral vasospasm, who completely recovered after a successful surgery, and using Yoga Prana Vidya Healing techniques as complementary therapy.

Method: This paper uses case study method going through patient medical records, YPV healers’ records and patient feedback. 

Results: The patient recovered within 4 hours from a complicated 7⁺ hours of SAH surgery, was able to recognize people and respond to body movements and also use the washroom comfort ability by himself. Within 14 days of YPV healing, the patient was discharged from the hospital and within 2 months of the surgery the patient resumed office and started leading normal life.

Conclusion: It is observed that with Yoga Prana Vidya, which is a no-touch no-drug and distant healing modality, faster and complete recovery of patients takes place when used complementarily to medical and surgical treatments such as this case. YPV Healing techniques have been known to increase the life energy or prana in the energy body of a person thereby helping them with a speedy recovery. There is a great scope for further research on this topic using appropriate methodology and sample size.

As obesity is the epidemic of the 21st century and has become a major public health problem worldwide, being responsible for the vast majority of chronic diseases, a prospective convenience study was carried out on the effect of low-carb and low-calorie diets in people with overweight and/or obesity, at the Centro Hospitalar Universitário do Algarve (CHUA), Portimão unit, at the external nutrition appointment. The study lasted three months. As a result, there is a decrease in weight, Body mass index, fat mass (FM), and visceral fat (VF) in users who had nutritional intervention, with statistical significance (weight (p=0.012), BMI (p=0.012), FM (p<0.001), and VF (p=0.003). In short, concludes that, throughout the appointments, there were statistically significant reductions in weight, BMI, fat mass and visceral fat.

The Brazilian Cardioprotective Diet is a diet for patients with heart disease, but it provides health benefits when used as an adjuvant in the prevention and treatment of diseases that have food as one of the factors for their development. It was developed by Hcor in partnership with the Ministry of Health in 2018. It classifies and recommends the consumption of foods by groups: green, yellow, and blue, using the Food Guide for the Brazilian Population as a referência. The objective of this study was, through a literature review, to find scientific data on the cardioprotective diet. This diet indicates the inclusion or exclusion of food from the values of food density (kcal, saturated fat, cholesterol, and sodium).Studies have pointed out that the excessive intake of ultra-processed foods is associated with practicality of eating, afforda prices, and easy availability of products, and therefore these foods have become cheaper compared to fresh, minimally processed foods, and the ultra-processed foods are the main responsible for the increase in non-transmissible chronic diseases. The cardioprotective diet shows the significant effect on the modulation of inflammatory response, through the intake of several nutrients and bioactive compounds from food, which act by activating the signaling pathways involved in the synthesis of inflammatory biomarkers. Therefore, although there are few published studies on cardioprotective food and being it effective in the secondary treatment of chronic noncommunicable diseases, it is necessary to conduct research among nutritionists to know the difficulties of assistance within the Public Health System.

The Coronavirus disease 2019 (COVID-19) pandemic has put the world on its toes for more than 2 years. It is caused by a novel virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Initial symptoms associated with the virus were mainly respiratory in nature but over time, varied presentations have been noted in persons infected with the disease. Research has shown that COVID-19 can cause both pulmonary and systemic inflammation, which may result in multi-organ dysfunction. The effects of COVID-19 on metabolism including glucose regulation and diabetes mellitus have been highlighted in literature and it is now known that persons with poorly controlled diabetes will most likely have a poor clinical outcome when infected with SARS-CoV-2. Biochemical abnormalities of the thyroid hormones during and post-COVID infection have been noted by some authors, however, there is scanty information available in sub-Saharan Africa. The essence of this case series is to document the experience of an endocrine facility as regards thyroid abnormalities observed in persons who presented with confirmed COVID-19 infection and COVID-19 related symptoms without confirmation by PCR.