Abubakar Tafawa Balewa University

Background Haematological malignancies (HMs) are primary cancers of the blood and blood-forming organs. They are heterogeneous and of diverse clinical features, treatment protocols and prognoses. They constitute a significant source of cancer-related morbidity and mortality. Northeastern Nigeria, being the region in the country with the worst literacy rate and poverty indices, is also battling with the burden of these diseases with the limited health facilities to adequately diagnose and treat these ailments. There is paucity of a comprehensive data on HMs in the region, so this study aims to report on the multi-centre burden of the common HMs in the region and to discuss their patterns of distribution and management challenges. Materials and methods This was a 5-year retrospective study where records of cases of HMs diagnosed in the four health facilities [viz., Abubakar Tafawa Balewa University Teaching Hospital (ATBUTH), Bauchi; Federal Teaching Hospital (FTH), Gombe; Modibbo Adama University Teaching Hospital (MAUTH), Yola; and Federal Medical Centre (FMC), Azare] were collected from 1 January 2018 to 31 December 2022. Data on the age, gender, diagnosis and subtypes of some malignancies were also obtained and analysed using the SPSS Version 23.0 statistical software. Results A total of 493 cases of HMs, which constituted 8.2% of all cancers, were diagnosed during the period under review. Paediatric HMs constituted 42.0% (207/493) of the HMs. Non-Hodgkin lymphoma (NHL) constituted the majority of the HMs at 115/490 (23.5%), while multiple myeloma (MM) was the least at 38/493 (7.7%). An average cost of 5,000 to 10,000 United States dollars is required to manage an HM in Nigeria. Late presentation of patients, non-availability and inadequate number of personnel, inability to pay for investigations and/or treatments due to financial constraints, and limited facilities for tests such as flow cytometry, immunohistochemistry, cytogenetic and molecular genetic analyses were the challenges identified in the institutions in Northeastern Nigeria that manage cancer patients. Conclusion Haematological malignancies are common in our environment, and there are limited facilities and expertise to accurately diagnose and treat them in the region and Nigeria in general.

The resistance of ESBLs-producing Kp to various groups of antibiotics commonly used against infections they caused had become a global threat and required urgent attention. This study assessed the extended spectrum beta-lactamases (ESBLs)-producing Klebsiella pneumoniae isolates in terms of their genomic resistance. An analytical profile index (API) 20E kit was used to confirm a total of 100 clinical isolates of ESBL Klebsiella pneumoniae. The disc diffusion method was used to perform the antimicrobial susceptibility testing (AST), which was followed by the phenotypic detection of ESBLs. Six profiled representative ESBL positive strains were subjected to whole genome sequencing (WGS), multilocus sequence typing (MLST), and phylogenetic tree construction using the sequence data. The study showed that 46(46%) of the 100 isolates were positive for ESBL production and antibiotic susceptibility testing revealed significant resistance to β-lactam antibiotics including monobactam especially ampicillin/sulbactam (40%), cephalosporin groups (cefuroxime, cefotaxime, and ceftriaxone) stood at 51%, 49% and 48% respectively and aztreonam with 49%. The WGS analysis of the representative strains revealed genes encoding resistance to aminoglycoside (StrA4, StrB1, aac(3’)-IIa, aac(6’)-1b, aac(6’)1b-cr-1, aadA16, aph(3’)-VIa and aadA15), trimethoprim (dfrA14 and dfrA27), sulphonamide (sul1_11, sul2_2 and sul2_3), quinolone (QnrB40-1, QnrB10, QnrS2, OqxA and OqxB), tetracycline (tet(A)_4), fosfomycin (fosA3, floR2 and fosA7), macrolid (mph(A)_1), rifampicin (ARR-3), β-lactam (blaCTX-M-15_23, blaCTX-M-55, blaSHV-1_22, blaSHV11_18, blaSHV-11, blaSHV-1_1.1, blaSHV-11_3, blaSHV-11_19, blaTEM-1_1, blaTEM-1_5, blaOXA-51_10, blaOXA-30_1, blaNDM-1, blaLEN6, blaLEN8 and blaLEN21 were detected. The MLST analysis revealed two novel sequence types of representative strains (2 with ST NF* and 12 with ST NF) and four other heterogeneous STs which include ST394, ST985, ST17 and ST11 while the phylogenetic tree of the strains showed closed clonal relationship and lineages with other reference isolates. In conclusion, the study’s results showed a high prevalence of ESBL-producing Kp in the study area, and the representative strains’ genomic contents demonstrated that ESBL-producing Kp in a clinical setting could serve as a reservoir for resistance genes and be the source of genetic transfer to other bacterial species. As a result, ongoing surveillance is required to monitor this endemic situation to prevent an epidemiological outbreak of K. pneumoniae- carrying ESBL.

This article explores the participation of children living with disabilities in physical activities, highlighting the benefits, barriers, and facilitators of their inclusion. Disability is defined as a result of the interaction between impairments, activity limitations, and participation restrictions, which can vary across individuals and contexts. The article delves into several models of disability, including the medical, social, and human rights models and their implications for policy and practice. Epidemiological data suggest that 15% of the global population lives with some form of disability, with a higher prevalence in developing countries. Engaging in physical activity (PA) has been shown to offer numerous health benefits for children with disabilities, such as improved physical health, reduced social isolation, and enhanced mental well-being. However, these children face various barriers, including personal, social, environmental, and policy-related factors. The article concludes by emphasizing the importance of addressing these barriers and promoting facilitators such as inclusive programs, family support, and accessible facilities to ensure equitable participation in PA. This review is essential as it sheds light on the critical role that PA plays in the health and well-being of children living with disabilities. PA offers a wealth of benefits, including improved physical health, cognitive function, and mental well-being. Despite these advantages, children with disabilities often encounter significant barriers that limit their participation, including personal, social, environmental, and policy-related challenges. By exploring these barriers and the factors that facilitate participation, this article underscores the need for inclusive programs, accessible facilities, and supportive policies. The review calls attention to the broader social and human rights implications of ensuring equitable access to physical activities for all children, advocating for a more inclusive society where children with disabilities can thrive.

Groundwater occurrence in basement areas is very erratic, and mapping out suitable zones for groundwater exploitation in such terrain largely depends on the choice of the geophysical technique adopted. Groundwater potential zones (GWPZ) within the Jericho area of Ibadan, Southwestern Nigeria, were investigated using an integrated geophysical (electromagnetic profiling and electrical resistivity) approach. Vertical dipole (VD) and horizontal dipole (HD) surveys for the electromagnetic profiling (EMP) were executed along eleven (11) E-W profile lines 250-400 m long. The electrical resistivity methods included horizontal electrical resistivity profiling (HRP) using a current electrode (AB) spacing of 45 m at a 15 m measurement distance and 2D-multichannel resistivity tomography (MRT) with a minimum 5-7 m dipole length depending on the extent of each traverse line. Sixty-two (62) vertical electrical sounding (VES) were carried out at selected ground points with maximum AB/2 = 100 m. The EMP results reveal conductivity values for VD ranging between − 214 and 336 mS/m (average = 21 mS/m) and HD between − 24 and 56 mS/m (average = 14 mS/m). Furthermore, apparent resistivity values for HRP range between 575 and 14 Ωm (average = 134 Ωm), reflecting a moderately conductive subsurface lithology. The 2D MRT section revealed three to five subsurface layers, with aquifer thickness of 1-30 m. VES results reveal H, AK, HK, HA, QH, and HKH curve types revealing multiple layering systems (3-5 geoelectric subsurface layers) with varying resistivities and thicknesses (topsoil = 14-599 Ωm, 1-2 m; lateritic clay = 13-72 Ωm, 0.44-19 m; quartzitic/pegmatite unit = 288-1070 Ωm, 1-37 m; weathered saprolite = 10-2950 Ωm, 4-18 m; and fractured/fresh basement rock = 472-16,908 Ωm, 1-43 m). About 66.2% of investigated VES points represent potential drill points with apparently thick weathered overburden units and fractured underlying bedrocks. Conclusively, the eastern, western, and northeastern parts of the study area are classified as good GWPZs. This study has revealed the effectiveness of the combination of geophysical techniques for groundwater investigation in difficult geological terrains.

Background The burden of female genital tract cancers in low—and middle-income countries (LIMC) is not yet well investigated. Although available studies are few, they are mainly based on single institutions. Here, four-year multi-institutional data on gynecologic cancers in northeastern Nigeria were examined to determine their distribution by age and subtype. Patient and Methods This is a cross-sectional descriptive study using available data on histologically diagnosed gynecologic cancers archived in the pathology departments and/or cancer registries of six tertiary hospitals in northeastern Nigeria over four years. Alongside tumor type (according to site), patient age and presenting complaints were also documented. Descriptive statistics were used to present categorical variables as proportions, while quantitative variables of age were presented as medians. Results A total of 863 gynecologic cancers were included in this study. The median age was 50 years (3 – 95 years) with a peak at 40 – 49 years. The uterine cervix was the most common site of cancer (66.6%, 575/863), while uterine corpus (15.5%, 134/863) and ovarian cancers (14.8%; 128/863) were nearly equal in proportion. Squamous cell cancer was the commonest histotype overall, while ovarian cancers had a preponderance of epithelial tumors in 67.9% (87/128) over sex cord stromal (12.5%; 16/128) and germ cell (9.4%, 12/128) tumors. The most common symptom was abnormal vaginal bleeding (38%) followed by abdominal swelling (21.1%) and foul-smelling vaginal discharge (14.1%). Population-based data also showed high parity among women in the region, ranging from 4 births to 7 births per woman in a reproductive lifetime (total fertility rate, TFR). Conclusion The spectrum of cancers of the female genital tract in this study mirrors the population demographics characterized by a high proportion of young women in their reproductive age. Efforts to reduce the burden of this disease are urgently warranted.

The plant Eichhornia crassipes (commonly known as water hyacinth) was obtained from Lake Geriyo, Yola, Adamawa State, Nigeria. The sampled leaves were gently washed with deionized (DI) water and air-dried at room temperature (25–30 °C). Iron nanoparticles were synthesized using Eichhornia crassipes (water hyacinth extract) and characterized using XRD, SEM, TEM, SEM-EDX, and FTIR. The antioxidant activity of the iron nanoparticles was analyzed using DPPH scavenging activity. The plant extracts and iron nanoparticles were tested for antibacterial efficiency against Escherichia coli, Staphylococcus aureus, Streptococcus pneumoniae, Salmonella typhi, and Klebsiella pneumoniae. The results revealed the proximate composition of the water hyacinth plant, including moisture content, ash content, fiber, fat content, protein, and carbohydrates. The proximate composition followed the order: carbohydrates > lipids > fiber > moisture > protein > ash content. Qualitative phytochemical screening of the leaf revealed the presence of carbohydrates, terpenoids, phenolics, and saponins, while amino acids, terpenes, alkaloids, steroids, and flavonoids were absent. SEM-EDX, TEM, XRD, and FTIR confirmed the formation of iron nanoparticles. The iron nanoparticles exhibited higher percentage inhibition with varied concentrations of 25% FeNPs, 50/50 FeNPs, and 25/75 FeNPs, with 25/75 FeNPs showing significant scavenging activity of 24%, 39%, 47%, 55%, and 73% at 10, 20, 30, 40, and 50 µl/ml, respectively. The minimum inhibitory concentration (MIC) of 25% FeNPs for Klebsiella pneumoniae and Staphylococcus aureus showed that the extract had a higher inhibitory effect on Klebsiella pneumoniae compared to Staphylococcus aureus. The inhibition sequence showed similar inhibition for all pathogens except Salmonella typhi and Klebsiella pneumoniae, which exhibited the least inhibition among all FeNP concentrations. An increase in material concentration resulted in higher inhibition for four organisms, while Klebsiella pneumoniae showed a different trend, with the highest inhibition observed at a 200 µg/L concentration

Acetylsalicylic acid (ASA), commonly known as aspirin, is an organic compound with the formula C9H8O4 obtained from the natural compound salicylic acid, recognized for its analgesic, anti-inflammatory, antipyretic, and anticancer properties. Its role in medicine and plant biology is well-established, but its emerging potential in cancer treatment has garnered increased attention. This review aims to provide a comprehensive overview of the therapeutic applications of ASA as an anticancer agent, focusing on its mechanisms, effectiveness, and role as an adjuvant therapy, preventive compound, and radioprotective agent. Recent research papers, including mechanistic studies, preclinical investigations, and clinical trials related to the effects of ASA on various cancer types, were reviewed. The review places particular emphasis on the enhancement of traditional chemotherapy drugs by ASA and considers toxicological aspects. The analysis of recent studies highlights the potential of ASA to improve the effectiveness of chemotherapy and its role in cancer inhibition through specific molecular pathways. Mechanistic insights suggest that ASA may influence cellular processes that contribute to cancer growth suppression and increased sensitivity to conventional treatments. ASA exhibits promising potential as an adjunct therapy in cancer treatment, with evidence supporting its benefits in improving therapeutic outcomes when used alongside conventional chemotherapy. Further studies are needed to clarify its mechanisms and ensure its safe and effective application in clinical settings.

The nutritional and bioactive value of plants remains key for sustainable agriculture. However, whether pesticides affect the nutritional and bioactive compounds of leafy vegetables, spinach and lettuce, has not been thoroughly investigated. This research involved three experiments: spinach and lettuce grown in pesticide-untreated soil (SFP/LFP), pesticide-treated soil (SCP/LCP), and pesticide-untreated soil but sprayed with pesticide preharvest (SSP/LSP). Finally, various metabolites—protein, sugar, proline, chlorophylls, carotenoids, vitamins, polyphenols, and oxidative indicators—were assayed via spectrophotometry. Pesticide-treated vegetables presented altered levels of their metabolites. Chlorophyll a (mg/g D.W.) decreased in lettuce from 16.80 ± 0.29 (LFP) to 10.25 ± 0.04 (LSP) and 7.29 ± 0.12 (LCP). In spinach, a similar statistically significant difference (P ≤ 0.05) was observed: 7.94 ± 0.47 (SFP), 7.09 ± 0.38 (SSP), and 6.97 ± 0.29 (SCP). The statistically significant decrease in the carotenoid and chlorophyll b contents followed the same pattern as that reported for chlorophyll a. Pesticide treatment also led to a decrease in the total phenolic content: 16.23% (LSP), 18.92% (LCP), 1.00% (SSP), and 64.00% (SCP). However, the total soluble protein content increased by 28.79% (LSP), 32.86% (LCP), 19.09% (SSP), and 11.34% (SCP). The increase in vitamins A and C was significant across all the experimental groups; the vitamin A content (mg/100 g) increased in the LSP at10.92 ± 0.64, the LCP content was 16.61 ± 0.08, the SSP content was 8.08 ± 0.11 and the SCP content at 8.45 ± 1.15 compared with 3.96 ± 0.19 (LFP) and 2.50 ± 0.05 (SFP) of the normal controls. The vitamin C content (mg/100 g) in the LSP content was 14.31 ± 0.25, the LCP content increased to 12.15 ± 0.32, the SSP content was 13.51 ± 0.25 and the SCP content gave 18.35 ± 0.39 in comparison with 8.87 ± 0.40 (LFP) and 6.38 ± 0.08 (SFP) of the normal controls. Additionally, significant differences (P ≤ 0.05) in malondialdehyde levels (nmol/g FW) were detected between non-pesticide-treated vegetables, LFP (0.21 ± 0.00) and SFP (0.26 ± 0.00), and pesticide-treated vegetables, LSP (0.30 ± 0.01), LCP (0.40 ± 0.01), SSP (0.54 ± 0.03), and SCP (0.30 ± 0.01).The activities of antioxidant enzymes, such as superoxide dismutase (U/mg protein), significantly increased (P ≤ 0.05) in the pesticide-treated vegetables, including LSP (189.68 ± 2.42), LCP (190.79 ± 2.21), SSP (242.96 ± 1.28) and SCP (185.22 ± 1.28), compared with the nonpesticide-treated vegetables, LFP (171.83 ± 2.56) and SFP (179.92 ± 3.02). A similar significant difference in activities was also recorded for catalase and peroxidase antioxidant enzymes. Pesticide treatment significantly impacts spinach and lettuce vegetables, leading to alterations in their nutritional and bioactive compounds, hence distorting their nutritional quality and health benefits.

Globally, the need of future refrigerant is becoming important to save the environment owing to the increase of urbanization and industrialization. The rate of accumulation of greenhouse gasses (GHG) from refrigerants depends on the rate of increase in urbanization and industrialization. However, the candidature of different classes of refrigerants to the stage of future refrigerants has been hindered by different challenges. Hence, the developments achieved in eliminating the various challenges has been studied through literature and the viability status of those classes of refrigerants has been improvised on the basis of green refrigeration, thermodynamic properties, performances and system design approaches. This paper reviews viability of most recently proposed refrigerants as future refrigerants. Hydrofluoroolefin (HFO) is the most viable class of refrigerants because of improvements noted in the challenges that hinder its future scope. Carbon dioxide (R‐744) has also a viable scope of future refrigerants under controlled operating condition. In addition to that for ultra low temperature (ULT) refrigeration system, R‐170, R‐1132a, and R41 have been considered as most viable refrigerants.

Punica granatum, commonly known as pomegranate, is a traditional medicinal agent owing to its antiquity. The scientific literature has shown that pomegranate extracts exhibit favorable modulation of diverse signaling pathways. These pathways encompass those implicated in inflammation, angiogenesis, hyperproliferation, cellular transformation, tumorigenesis initiation, and ultimately, a reduction in advanced metastasis and tumorigenesis. Pomegranate extracts in this context can be attributed to their high polyphenol content, which has been observed to possess inhibitory properties toward specific signaling pathways associated with cancer. As a formidable pathology, cancer is the most significant cause of death worldwide after cardiovascular disease. The annual incidence of cancer‐related mortality has increased progressively. Modifying one's dietary patterns, engaging in regular physical exercise, and maintaining an optimal body mass index are three straightforward measures that an individual may undertake to mitigate their susceptibility to cancer. Incorporating diverse vegetables and fruits into one's dietary regimen exhibits promising potential for preventing a minimum of 20% cancer incidence and approximately 200,000 cancer‐related mortalities annually. Vegetables and fruits contain high levels of minerals and phytochemicals, which help alleviate and prevent the harmful effects of cancer. These substances are safe and exhibit minimal toxicity in biological systems. Furthermore, they exhibit antioxidant properties and have garnered extensive approval for their use as nutritional supplements. Pomegranates are used in ancient cultures to prevent and treat various diseases. Extensive research on pomegranate extract, fruit, oil, and juice has revealed promising findings regarding their potential anti‐proliferative, anti‐tumorigenic, and anti‐inflammatory properties through the modification of various signaling pathways related to cancer, thus demonstrating their potential as drugs to prevent and treat cancer. Emerging research indicates that pomegranate can potentially prevent and treat different cancers, including prostate, bladder, breast, skin, lung, and colon cancer.

A 35-year-old female journalist is planning to get married for the first time. She has come to the preconception clinic to receive care. How would you counsel her during this first visit to the clinic?

I am a 16-year-old class 2 senior secondary school student who was raped by my uncle last month. My parents were advised to bring me to the hospital 5 days after the incident. I was examined and given postinor 2 for emergency contraception while blood samples and vaginal swabs were taken for analysis. The case is already with the police, and I am supposed to appear in court next week for hearing. However, it is 6 weeks now since I last saw my menses and I think I might be pregnant. I have come to see the gynaecologist who saw me after the rape incident to discuss what next to do concerning my situation.

The Objective Structured Clinical Examination (OSCE) is a way of making valid assessment of the clinical performance of medical students and resident doctors. Since its introduction by Dr. Harden and colleagues in 1975, it has gained widespread acceptance across the globe [1]. When one reviews the wide spectrum of clinical tests that can be incorporated into the OSCE, its advantages are apparent. Its major drawbacks are that it is cumbersome and expensive to set and requires a great deal of personnel for its implementation [2].

I have come to book for antenatal care.

Mrs. JJ is a 24-year-old P1 + 0 A1 whose last confinement was about 6 weeks ago. She had group counselling on family planning in the postnatal clinic, and she wants to use the combined oral contraceptive pills. Using the medical eligibility criteria wheel and samples of the combined oral contraceptive pill sachets, counsel her to favourably use the combined oral contraceptive pills (Fig. 7.1).

Provided is a transvaginal ultrasound probe. Using the mannequin provided, demonstrate step by step how you would perform a transvaginal ultrasound to date a pregnant woman who present at about 10 weeks of gestation. Comment on the procedure to the hearing of the examiners, as you proceed.

You are provided with a model of the female pelvis and a baby doll. Demonstrate using the mannequin, and running commentary, the mechanism of normal labour.

Viva voce which means “by word of mouth” in Latin was the earliest form of formal assessment in medical training dating back to the Middle Ages. Although the invention of the printing press and consequent increase in popularity of mass-produced textbooks have since reduced the dependence on the spoken word, oral examination method (viva voce) remains an important method of assessment in many fields of medical training to date. While oral examinations are almost a continuous and an on-going exercise during lectures and ward rounds, they usually take the form of supplementary tests during the final or exit examinations. The oral examination is usually the last paper, supplementing the written and clinical aspects of the examination. These probing questions, and some situations cross-questioning, dig out the degree of real assimilation of learning where a student cannot easily dodge.