Overcoming the Potential Drawbacks of Artificial Intelligence in Psychotherapy: Literature Updates

Artificial Intelligence (AI) has progressively impacted healthcare around the world. The increasing need for readily available mental health services, coupled with the swift advancement of novel technologies, prompts conversations over the viability of psychotherapy approaches using engagements with AI. Despite the positive impacts, there are recognizable drawbacks associated with the application of AI in psychotherapy. Establishing a therapeutic alliance is difficult for non-human entities. Psychotherapy is a task too complex for limited artificial intelligence. AI appears capable of handling jobs that are clearly defined and relatively straightforward. Besides, AI malfunctions, data confidentiality, informed consent, and risk of bias are potential concerns. We present a literature update of possible solutions to overcome these concerns.

Burden of diabetic foot ulcer in Nigeria: Current evidence from the multicenter evaluation of diabetic foot ulcer in Nigeria

BACKGROUND Nigeria bears the greatest burden of diabetes prevalence in Sub-Saharan Africa. Diabetic foot ulcer (DFU) is a serious and potentially life-threatening complication of diabetes. Significant improvements in diabetic foot incidence and outcomes have been recorded in many Western countries in the past decade. However, the current burden of DFU in Nigeria is largely unknown. AIM To evaluate the patients’ profile, ulcer characteristics, associated co-morbidities and outcome of patients with DFU in Nigeria. METHODS Multicenter evaluation of diabetic foot ulcer in Nigeria was a one year multicenter observational study of patients hospitalized for DFU in six tertiary health institutions in Nigeria from March 2016 to March 2017. Demographic and diabetes information, ulcer characteristics and associated co-morbidities were assessed. Relevant laboratory and imaging studies were performed. All patients received appropriate multi-disciplinary care and were followed up until discharge or death. Outcome variables of interest were ulcer healing, lower extremity amputation (LEA), duration of hospitalization and mortality. RESULTS A total of 336 patients (55.1% male) with mean age of 55.9 ± 12.5 years were enrolled into this study. Majority (96.1%) had type 2 diabetes. Only 25.9% of the subjects had prior foot care knowledge. Most of the subjects presented late to the hospital and median (IQR) duration of ulcer at presentation was 39 (28-54) d. Ulcers were already advanced (Wagner grades ≥ 3) in 79.2% of the subjects while 76.8% of the ulcers were infected at the time of admission. The commonest comorbidities were systemic hypertension, anemia and hyperglycemic emergencies. One hundred and nineteen subjects (35.4%) suffered LEA while 10.4% left against medical advice. The median (IQR) duration of hospitalization was 52.0 (29-66) d with case fatality rate of 20.5%. CONCLUSION The burden of DFU in Nigeria is very high. The major gaps include low level of foot care knowledge among diabetic patients, overdependence on self-medication and unorthodox medicine following development of foot ulceration, late hospital presentation, and high amputation and mortality rates. Extensive foot care education within the framework of a multi-disciplinary foot care team is highly desirable.

Ponseti method treatment of neglected idiopathic clubfoot:Preliminary results of a multi-center study in Nigeria

AIM To evaluate the effectiveness of the Ponseti method for initial correction of neglected clubfoot cases in multiple centers throughout Nigeria.METHODS Patient charts were reviewed through the International Clubfoot Registry for 12 different Ponseti clubfoot treatment centers and 328 clubfeet(225 patients) met inclusion criteria. All patients were treated by the method described by Ponseti including manipulation and casting with percutaneous Achilles tenotomy as needed.RESULTS A painless plantigrade foot was obtained in 255 feet(78%) without the need for extensive soft tissue release and/or bony procedures.CONCLUSION We conclude that the Ponseti method is a safe, effective and low-cost treatment for initial correction of neglected idiopathic clubfoot presenting after walking age. Longterm follow-up will be required to assess outcomes.

Management of Non-Traumatic Urological Emergencies at Souro Sanou University Teaching Hospital of Bobo-Dioulasso (Burkina Faso)

Background: Generally, urological emergencies are assumed not to be very common, however, recent reports showed that they constitute an important aspect of the day-to-day urological practice. If not well and promptly managed, they may lead to serious morbidity or mortality. Objectives: To study the pattern of presentation, diagnosis and outcome of management of non-traumatic urological emergencies seen at the Emergency Department of Souro Sanou University Hospital in Bobo-Dioulasso. Patients and Methods: This was a retrospective and descriptive study over four years. It included patients of all ages and both sexes, admitted for non-traumatic urological emergencies in the surgical emergency department of Souro Sanou University Hospital. It took place from January 1, 2017 to December 31, 2020. Results: A total of 584 patients were reviewed in our study. Non-traumatic urological emergencies account for 6.3% of all surgical emergencies seen during the study period. The male-to-female ratio was 9.2 to 1. The mean age of the patients was 51.9 ± 23.9 years. Forty-five per cent of the patients presented within 48 hours of symptoms. The vast majority of the patients presented with difficulties with passing urine (41.6%), followed by cases of hematuria (18.4%). On admission, 154 patients (26.4%) presented with severe conditions such as anemia as seen in 40.9% of the cases and deterioration in the general health condition as seen in 34.4% of the patients. Leukocytosis was noted in 18.7% of the patients and anemia in 17.9%. Urine culture was positive in 15.4% of the patients and Escherichia coli was the most common pathogen found (40.6%). Ultrasound was the most requested examination (81.2%), followed by a computerized tomography (CT) scan (22%). The most frequent diagnoses were urine retention (42.9%), hematuria (16.9%) and renal colic (10.1%). Emergency interventions were carried out in 525 patients (89.9%) who include bladder catheterization (46.1%), bladder lavage and/or bladder irrigation (20.9%) and suprapubic cystocatheterization (10.1%). Most of the patients (61.3%) were discharged after a mean stay in the hospital of about 5.1 ± 7.5 days. A mortality rate of 3.8% was also recorded among the patients studied. Conclusion: Non-traumatic urological emergencies are common and are an important aspect of daily urological practice. The majority of the patient presents late with usually a severe form of the disease, which adversely affects the outcome even after treatment.

Symptomatic Urinary Lithiasis: Epidemiology and Management at Urology Department of University Hospital of Cotonou

Purpose: To study the epidemiology and treatment modalities of urolithiasis at Urology Department of University Hospital of Cotonou. Materials and Methods: It was a retrospective and descriptive study over a 10 years period ranging from January 1st, 2004 to December 31st, 2013. One hundred and two patients who were hospitalized for symptomatic urolithiasis at the Urology Department of University Hospital of Cotonou were enrolled. Results: Hospital incidence of urolithiasis was 3.7%. Patients mean age was 39.6 years (extremes: 10 years to 73 years). Male to female ratio was 2.2. The main reason for consultation was renal colic for 81 patients (79.4%). Average duration of symptoms at presentation was 5 months (range: 1 day to 10 years). A total of 173 stones were identified with an average size of 12 mm (range: 1 mm to 95 mm). Calyceal stones were seen in 32.9% of cases, renal pelvis stones in 21.4% of cases, ureteral stones in 34.1% and bladder stones in 11.5% of cases. Open surgery was the main treatment for stones that could not be managed medically. 50.8% of patients underwent surgery with extraction of 116 stones. This represented 67.1% of all stones. 9 patients (8.8%) had expelled their stone during urination. The postoperative course was uneventful in 77.5% of cases. Conclusion: Modern treatment options for urolithiasis remain rudimentary in our health facilities. Open surgery is still the main stay of treatment in our countries with limited resources.

Relationship between Serum Anion Gap and Diabetes Mellitus

Diabetes mellitus is the most common metabolic disorder occasioned by derangement in glucose equilibration between the ECF and ICF. The derangement is known to affect the appropriate balance of electrolytes that serves as a buffer in the body. In this study anion gap was evaluated among outpatient diabetics as compared to non-diabetics control group. The categorization into the study or control groups was done by serum glucose estimation using glucose oxidase method. The study group mean age was 51 ±14 as against control group of 47 ± 10. One hundred and fifty subjects were divided in two groups based on serum glucose concentration. Group A (control group) consisted of 50 subjects with mean serum glucose concentration 4.3 ±1.7 mmol/l and anion gap 13.8 ± 2.6, group B (diabetics) consisted of 100 subjects that had serum glucose concentration 15.0 ± 3.9 and anion gap 18.4 ± 2.5. The glucose was estimation by glucose oxidase method, whereas the anion gap was calculated by subtracting the concentrations of sodium and potassium from the concentrations of chloride and bicarbonate. The concentrations of the electrolytes where assayed using ion selective electrodes (ISE). A statistical significant difference P was observed between group A and B glucose concentrations and the anion gap. The abnormal anion gap was created by the insufficiency of bicarbonate used for the buffering of the electrolytes variability occasioned by derangement in glucose metabolism and distorted hormonal secretion. Hence metabolic acidosis is strongly linked with diabetics as a result of distorted anion gap. Healthcare providers and takers should ensure that anion gap estimation is factored into investigations for the management of diabetics. Also, patients with deranged anion gap should be placed as an emergency case for proper management. Clinicians should ensure that patient’s anion gap is within the reference anion gap range so as to prevent development into metabolic acidosis and subsequent ketoacidosis.

Functional Expansion of Music Education Technologies(through the example of music rehabilitation therapy of neurology ward patients)

This article presents a research of the possibility to apply music education activities for rehabilitation of patients with neurodegenerative disease.The purpose of this work was development of a music psychotherapy program for rehabilitation of patients with Parkinson’s neurodegenerative disease.We suggested“target objects”for music rehabilitation therapy at all levels of manifestation of symptoms of illness:1)physical restriction and rigidness which includes well-aimed work with breathing and movement symptoms,loss of control,lack of coordination,inflexibility,tremor;2)emotional deprivation(realization and expression of emotions and feelings)through plastics of movements to music and singing-seeking catharsis through vivified contact with oneself and intensification of feelings;3)social deprivation:well-aimed work on resocialization of the patient.Сonclusions:Results we obtained contribute to further understanding and wider application of music education methods,technologies and approaches that may add to rehabilitation practices.

The Predictive Potential of the Kinetic Model of Aging of Living Systems in Demography

An original mathematical model,previously tested by the authors on other non-demographic objects,is proposed for describing and forecasting demographic systems—the population of the countries of the World using the examples of the USA,China and Russia,as well as the number of mice in the“mouse paradise”experiment of the American scientist John Calhoun.The proposed approach allows us to describe the stages and features of this dynamics:population growth in the USA,growth and possible decrease in the population in China,loss of a part of the population of the Russian Empire and the USSR due to two world wars and the collapse of the USSR,biological degradation of the“mouse paradise”up to its complete extinction.The use of the kinetic model of aging of various types of living systems to predict the development of the number of demographic systems is based on the assumptions that the aging and development processes are related to each other and have the same statistical regularity,reflecting the fractal principle of Nature-the unity of structure and function.The results obtained suggest that a person,a population of the World,humanity and other biological species develop and simultaneously age like each other under the conditions of the always existing syndrome of general adaptation(stress)and according to the same pattern corresponding to the mathematical model proposed here.

Wound healing effect of methanolic leaf extract of Napoleona vogelii(Family:Lecythidaceae) in rats

Objective:To investigate the wound healing properly of Napoleona vogelii leaf extract in folkloric medicine.Methods:Roth sexes of adult albino rats(n=25) were used in this study and another group(n=30) were subjected to acute toxicity test(LD_(50)) of the plant extract.For the LD_(50),three randomized groups of 5 rats were first treated with 10,100,1 000 mg/kg body weight(bw),orally.This w as followed by a second treatment of 1500,3000,and 5 000 mg/kg bw of the leaf extract with continual monitoring of the animals for mortality or non-mortality.Incision wounds(1.3cm) were created on the skin of five groups of 5 rals using surgical blade under anesthesia.The first group was topically treated with petroleum jelly alone,group 2 was topically applied 400 mg/mL w/v of the reference drug,Neobaein,while group 3-5 were topically treated with 5-50 mg/mL w/v of the plant extract,respectively.Results:The percentage yield of the extract was 49.80%w/w dry matter.The phytochemical analysis revealed several bioactive constituents including glycosides,tannins,alkaloids,perpenoids.saponins,steroids,proteins,and carbohydrates.The LD_(50) was beyond our experimental limit and was not determined.Increased concentrations(5,20,and 50mg/mL w/v) of the extract had significant(ANOVA,P<0.05) healing effect on the incision wounds giving rise to 125%-140% while treatmentawith Neobacin resulted in 150% healing effect on the third treatment regimen compared to the control(100%).Conclusions:These data indicate that Napoleona vogelii leaf extract contains potent bioactive compounds containing wound healing activity,substantiating its use as a wound healer in folkloric medicine.

Educational Status and Risks of Cardiovascular Disease in Awka, Southeast Nigeria

Background and Objectives: All over the world, cardiovascular risks constitute a heavy healthcare burden, affecting people with different levels of education, across economies in both the developed and the developing ones. Differences in educational levels in cardiovascular risks have not been completely defined. This study was set out to evaluate the influence of levels of education on the risks of cardiovascular disease in an urban community in Awka, southeast Nigeria. Methodology: In this cross sectional study of 294 subjects conducted in Awka in 2017, biodata, anthropometric and demographic data were obtained. A questionnaire was used to extract information on smoking, alcohol use, tobacco snuff use, diabetes mellitus status, time spent at work > 10 hours daily and night sleep duration < 4 hours. Blood pressure and body mass index were measured. Data were analyzed and the association between levels of education and the potential cardiovascular risks determined. Results: The prevalence of smoking was 5.4%, tobacco snuff use 5.4%, alcohol 42.2%, thickened arterial wall 27.2%, meat protein 91.8%, diabetes mellitus 9.5%, time spent at work > 10 hours daily 29.3%, obesity 33.3%, hypertension 58.5%, night sleep < 4 hours 5.4%. Levels of education has association with tobacco use (p = 0.009), alcohol use (p = 0.013), thickened arterial wall (p < 0.001), diabetes mellitus (p < 0.001), time spent at work > 10 hours daily (p < 0.001), obesity (p = 0.020), hypertension (p < 0.001), meat consumption (p = 0.047). However, smoking and night sleep < 4 hours have no significant association with levels of education, p = 0.415, and p = 0.132. Conclusion: There was variability in the prevalence of cardiovascular risks at different levels of education. The prevalence of smoking and night sleep duration < 4 hours did not vary with levels of education. The prevalence of tobacco snuff and thickened arterial wall was high in primary education holders and meat consumption in secondary education. Alcohol prevalence increased with increasing levels of education. Diabetes mellitus, time spent oat work > 10 hours daily, hypertension and obesity increased in prevalence with increasing levels of education but declined with tertiary education.

Evaluation of Malaria Parasitaemia and Assessing the Knowledge, Attitude and Practice of Pregnant Women Attending Health Facilities in Owerri Metropolis towards Malaria Prevention and Control

There are a few investigations on malaria in pregnancy;however, examinations zeroing in on the discernment and current acts of malaria counteraction and treatment among pregnant women are scanty. This examination was pointed toward evaluating the information, recognitions about malaria anticipation with accentuation on information about placental malaria too consistence to utilization of LLIN and IPTP among pregnant women in Owerri, South Eastern Nigeria. A cross-sectional descriptive study was conducted at an emergency department, Federal Medical Centre, Owerri using a pretested questionnaire from 200 randomly selected consenting pregnant women. Acknowledgment of malaria manifestations during pregnancy, information about IPTP and placenta malaria were things used to survey the degree of information about malaria in pregnancy. Their blood tests were additionally diagnosed for malaria parasitaemia. Malaria prevalence in the examination populace by microscopy was 13.5%. Additionally 62% of the respondents were learned about the conceivable impeding impacts of the existences of malaria during pregnancy. About 79.5% of the respondent decidedly related mosquitoes to malaria contamination while 31% and 14% related reason for malaria disease to messy encompassing and stale water individually. Malaria Prevention Mentality and Practice in this examination was acceptable (60%) while 18.5% had reasonable practice. All the more so and 15.5% of the respondents had been associated with helpless practice. About 34% of the pregnant ladies rested under a mosquito net frequently study watched factual criticalness between age, occupation and malaria counteraction rehearses (p = 0.014, 0.0089). There was likewise measurably huge relationship between respondent’s training and respondent mentality (p = 0.0034). Information with respect to the utilization of Sulphodaxine primethamine (SP) as medication of decision during pregnancy was restricted (12.0%) as utilization of chloroquine was positioned most elevated (48%). The study showed low peripheral malaria prevalence and furthermore exhibited that pregnant women’s knowledge, mentality and practice towards malaria avoidance was impressively all things considered. Be that as it may, there was helpless information about discontinuous preventive treatment of malaria (IPTP) or suggested antimalarial during pregnancy.

Covid-19 Diagnosis by Artificial Intelligence Based on Vibraimage Measurement of Behavioral Parameters

The hypothesis of behavioral parameters dependence measured from person’s head movements in quasi-stationary state on COVID-19 disease is discussed. Method for determining the dependence of vestibular-emotional reflex parameters on COVID-19, various diseases and pathologies are proposed. Micro-movements of a head for representatives of the control group (with a confirmed absence of COVID-19 disease) and a group of patients with a confirmed diagnosis of COVID-19 were studied using vibraimage technology. Parameters and criteria for the diagnosis of COVID-19 for training artificial intelligence (AI) on the control group and the patient group are proposed. 3-layer (one hidden layer) feedforward neural network (40 + 20 + 1 sigmoid neurons) was developed for AI training. AI was firstly trained on the primary sample of patients and a control group. Study of a random sample of people with trained AI was carried out and the possibility of detecting COVID-19 using the proposed method was proved a week before the onset of clinical symptoms of the disease. Number of COVID-19 diagnostic parameters was increased to 26 and AI was trained on a sample of 536 measurements, 268 patient measurement results and 268 measurement results in the control group. The achieved diagnostic accuracy was more than 99%, 4 errors per 536 measurements (2 false positive and 2 false negative), specificity 99.25% and sensitivity 99.25%. The issues of improving the accuracy and reliability of the proposed method for diagnosing COVID-19 are discussed. Further ways to improve the characteristics and applicability of the proposed method of diagnosis and self-diagnosis of COVID-19 are outlined.

The Prevalence of Stroke Survivors in Urban Slums in Enugu, Nigeria

Background: Stroke is one of the commonest non-communicable diseases and the commonest cause of death in adult neurology wards. Stroke preva-lence in sub Saharan Africa has dramatically increased over the past decades possibly due to changing life styles, poverty, poor health infrastructures which had led to increased risk factors for stroke. Poor nutrition and lack of access to standard medical care, predispose to high rates of stroke morbidity and mor-tality hence possible low prevalence. Little is known about the prevalence of stroke in people with low socio-economic status in Nigeria. Objectives: The main objective of this study was to determine the prevalence of stroke in two urban slums in south east Nigeria. Materials and Methods: This was a cross sectional descriptive study carried out in two slums in Enugu, South East Nige-ria. Participants were screened using a stroke specific questionnaire and further examined by two independent neurologists for evidence of focal neurological deficits. Analysis was done by SPSS version 22. Results: A total of 1440 par-ticipants were surveyed in the study;769 (53.4) females and 671 (46.6%) males. About 22.3% (321) screened positive for various neurological diseases out of which 17 (5.3%) had evidence for stroke giving an overall prevalence of 1.2% (males 9 (1.3%) vs females 8 (1%) p = 0.6). The mean age of stroke sur-vivors was 60.1 years, similar in males and females (p = 0.6). The odds ratio for stroke from 40 years showed progress increment doubling between 60 and 70 years and tripled between 40 and 70 years. Age, lower level of education, positive history of hypertension, sickle cell disease, leg swelling and use of snuff positively are correlated with clinical diagnosis of stroke. Conclusion: The prevalence of stroke in two urban slums in Enugu metropolis was 12/1000. Hypertension, diabetes, use of snuff, and low levels of education were signifi-cant risk factors for stroke. Public health educational measures, promoting prevention and early detection of diabetes should be encouraged.

Cervical Ripening for Induction of Labor: A Randomized Comparison between Vaginal Misoprostol versus Foley’s Catheter Placement in a Nigeria Tertiary Hospital

Background: Cervical ripening is prerequisite of successful induction of labor. Vaginal misoprostol and Foley’s catheter placement have been widely used for this purpose but the data are not always sufficient. We attempted to determine which (misoprostol versus Foley’s catheter) is more effective/safer in Nigerian setting. Methods: A randomized controlled trial was performed at Federal Teaching Hospital Abakaliki, Nigeria, involving 135 term pregnant women requiring cervical ripening and labor induction. Participants were randomly allocated to misoprostol versus catheter group. The following were recorded/measured/analyzed: Bishop’s score, age, parity, body mass index, gestational age, labor duration, indication, oxytocin use, mode of delivery, and Apgar score. Chi square test and t test were used where appropriate. Results: At 24 hours, all of misoprostol group were either in labor, had ripe cervix, or had delivered, whereas 35.4% of catheter group had still unripe cervix (x2 = 29.856, P = 0.0001). Misoprostol group was less likely to require oxytocin infusion (x2 = 52.600, P = 0.0001) and less likely to require cesarean delivery (cesarean: misoprostol versus catheter: 11% versus 34% (x2 = 9.800, P = 0.001)). Total medical cost for misoprostol was less than that of catheter (x2 = 14.703, P = 0.0001). Conclusion: 50 μg vaginal misoprostol, compared with catheter placement, was more effective, cheaper, and safe as a procedure of cervical ripening before induction of labor.

Determinants of Risky Sexual Behaviour among Inmates in Katsina Correctional Service: A Mixed Methods Study

Background: Incarceration does not vitiate sexual desire. Therefore, sexual activities occur behind bars, regardless of the stringent rules in correctional institutions. However, little has been documented about risky sexual behaviors, determinants, and experiences among inmates of correctional institutions in Katsina State, Nigeria. The study determined the sexual practices, prevalence, and determinants of risky sexual behaviors among prison inmates in Katsina. Methodology: A descriptive cross-sectional design with concurrent mixed methods of data collection was used to interview 216 inmates using a semi-structured questionnaire supplemented with 22 in-depth interviews. Result: Most (94%) respondents were male, almost half (44.4%) had secondary education, more than half (55.1%) were engaged in business or trading before incarceration, and the majority (75.9%) were awaiting trial. Nearly all inmates (98.6%) reported having sexual desire. Drug use (80.1%) and unprotected sex (79.2%) were quite common but sexual violence was low (7.4%). The number of sexual partners of respondents remained a significant predictor of sexual activity. Inmates who had one (1) or no sexual partner were 64% less likely to engage in risky sexual activity within the confines of the prison (AOR = 0.36, 95% CI = 0.20 - 0.63, p = 0.01). Qualitative interviews revealed the denial of occurrence of sexual activity in prison despite sexual desire felt by inmates;loneliness, poverty, and curiosity as motives for sexual relations;denial of occurrence of sexual violence in prison;and drug use and use of unsterilized sharps as risky sexual behaviors. Conclusion: Despite the disciplinary action meted out on inmates, prisoners still engaged in a range of risky sexual behaviors. Conjugal visitations for married inmates could be considered to reduce sexually deviant and risky alternatives of relieving sexual desire among prisoners.

Disease modifying treatment of spinal cord injury with directly reprogrammed neural precursor cells in non-human primates

BACKGROUND The development of regenerative therapy for human spinal cord injury(SCI)is dramatically restricted by two main challenges:the need for a safe source of functionally active and reproducible neural stem cells and the need of adequate animal models for preclinical testing.Direct reprogramming of somatic cells into neuronal and glial precursors might be a promising solution to the first challenge.The use of non-human primates for preclinical studies exploring new treatment paradigms in SCI results in data with more translational relevance to human SCI.AIM To investigate the safety and efficacy of intraspinal transplantation of directly reprogrammed neural precursor cells(drNPCs).METHODS Seven non-human primates with verified complete thoracic SCI were divided into two groups:drNPC group(n=4)was subjected to intraspinal transplantation of 5 million drNPCs rostral and caudal to the lesion site 2 wk post injury,and lesion control(n=3)was injected identically with the equivalent volume of vehicle.RESULTS Follow-up for 12 wk revealed that animals in the drNPC group demonstrated a significant recovery of the paralyzed hindlimb as well as recovery of somatosensory evoked potential and motor evoked potential of injured pathways.Magnetic resonance diffusion tensor imaging data confirmed the intraspinal transplantation of drNPCs did not adversely affect the morphology of the central nervous system or cerebrospinal fluid circulation.Subsequent immunohistochemical analysis showed that drNPCs maintained SOX2 expression characteristic of multipotency in the transplanted spinal cord for at least 12 wk,migrating to areas of axon growth cones.CONCLUSION Our data demonstrated that drNPC transplantation was safe and contributed to improvement of spinal cord function after acute SCI,based on neurological status assessment and neurophysiological recovery within 12 wk after transplantation.The functional improvement described was not associated with neuronal differentiation of the allogeneic drNPCs.Instead,directed drNPCs migration to the areas of active growth cone formation may provide exosome and paracrine trophic support,thereby further supporting the regeneration processes.

Blood Pressure Profile of Apparently Healthy Primary School Children in Delta State, Nigeria: Impact of Social Factors and Anthropometric Variables

Background: Systemic hypertension in children is one of the rising public health problems because of its attendant significant morbidity and mortality. Despite the rising prevalence of this problem, it is often under-reported as most of the attention has been focused on hypertension in adults with not much concerted effort made in tackling this problem in children. Aim: This study is aimed at determining the prevalence of hypertension and possible risk factors for its development and their relationship to hypertension among healthy primary school children in Asaba, Delta State. Subjects and Methods: This was a cross-sectional descriptive study involving 400 primary school students in Asaba. Variables such as weight, height, Body Mass Index (BMI), and blood pressure were measured using standard methods and the children categorized for hypertension and obesity using the Fourth Task Force Report and WHO BMI chart respectively. Result: The overall prevalence of hypertension was 3.5% and pre-hypertension 12.5%. The prevalence of hypertension increased from 2.4% in childhood to 12.5% in mid adolescents. Of the 14 subjects with hypertension, 12.5% were obese while 14.3% were overweight. The mean systolic and diastolic blood pressure of subjects in public schools was higher than their counterparts in private schools. Prevalence of hypertension in children was independent of the socioeconomic status and the type of school attended by the children unlike obesity and presence of proteinuria which appeared to be influenced by these variables. Conclusion: Hypertension was observed to be common in the study subjects. It appeared to be more among obese children and those in their mid adolescent period.

Occurrence of Extended-Spectrum β-1actamase Producing Enterobacteriaceae （ESBLPE） among Primary School Pupil in Obafemi-Owode, Nigeria

Occurrence of extended-β-1actamase producing enterobacteriaceae （ESBLPE）, which has reduced the antibacterial efficacy and potency of many 3rd generation cephalosporins, was investigated among the primary school pupils. 88 primary school pupils in Obafemi-Owode Local Government, Southwestern Nigeria, including 49 males （55.7%） and 39 females （44,3%） （mean age 12 ± 3） were screened for ESBLPE isolates with exclusion criterion of antimicrobial use in the preceding 2 weeks either as therapy for gastro-intestinal complication or prophylaxis. ESBLPE detected include 4.5% of Eschericia coli, 2.3% of Enterobacter cloaca, 0% Proteus mirabilis, 2.3% Pseudomonas aeruginosa, 1.1% Staphylococcus aureus and 4.5% of Klebsiella oxytoca. 10 （76.9%） of ESBLPE isolates were resistant to disc of cefuroxime （30 μg）, 8 （61.5%） susceptible to amoxicillin/clavulanic （20/10 lag） and low susceptibility of 7 （53.8%） was recorded for ceftazidime （30 lag）. 0% susceptibility was recorded for the ESBLPE isolates to cefuroxime MIC 〉 8 gg/mL and ampicillin MIC 〉 8 lag/mL while E, coli and E. cloca each show 50.0% and P. aeruginosa and K. oxytoca show 100.0% and 75.0% susceptibility to augmentin （MIC 〈 8）. This study has shown a 14.7% proportion of the pupil to harbour ESBLPE from enteric source with increased resistant to most new generation cefuroximes. Therefore, transfer of virulent and antibiotic resistant ESBLPE could be aided by sharing feeding materials while fecal-oral route of transmission cannot be ruled out as hygiene level is very low thereby increasing emergence of virulent resistant enteric strains leading to treatment failure.

Emergency medicine providers＇ opioid prescribing practices stratified by gender, age, and years in practice

BACKGROUND: Emergency medicine providers(EMPs) prescribe about 25% of opioids, but the effect of EMP risk perception on decisions to prescribe opioids is unknown. This study was undertaken to identify factors that infl uence EMP risk and opioid prescribing practices.METHODS: We distributed an anonymous questionnaire to EMPs at a military trauma and referral center. Response frequencies and distributions were assessed for independence using the Chi-square test.RESULTS: Eighty-nine EMPs completed the questionnaire(100% response). Respondents were primarily younger male physicians(80%) in practice under fi ve years(55%). Male EMPs were more likely to prescribe more opioid tablets than female ones both when and when not concerned for opioid misuse(P<0.001, P<0.007, respectively). Of the providers, 70% stated that patient age would inf luence their prescribing decisions. Hydrocodone and oxycodone were the opioids prescribed most frequently. About 60% of the providers reported changing their prescribing behavior would not prevent opioid misuse. Additionally, 40% of the providers believed at least 10% of patients seen at this military ED misused opioids.CONCLUSION: Female EM providers reported prescribing fewer opioid tablets. Patient age infl uenced prescribing behavior, but the effect is unknown. Finally, EM providers reported that altering their prescribing behavior would not prevent prescription opioid misuse.

Fractality of Aging of Living Systems

On the basis of the basic model of the kinetic theory of aging of living systems,mathematical modeling of various characteristics of aging of mankind,state,generation,human body,organs and cells has been carried out.These results are compared with experimental and calculated data of other authors.The analysis of the works presented here and those carried out earlier gave reason to believe that the basic mathematical model of the evolution of aging of living dynamic systems of various hierarchical levels and nature is the invariant differential equation of the kinetic theory of aging,as a manifestation of the fractality property of living systems.