Articles

We present a case of a 54-year-old White man who was admitted to our clinic for evaluation of gastroparesis. His gastroparesis was severe and unresponsive to previous treatments. Darkfield microscopy revealed the presence of spirochetes and corkscrew-shaped bacteria; although Lyme immunoglobulin M (IgM) and immunoglobulin G (IgG) Western Blot testings were negative. The patient was diagnosed with Chronic Lyme disease and recovered with antibiotherapy. We outline a rare case of dysmotility syndrome; a unique presentation of cChronic Lyme disease and emphasize the limitation of tools necessary in diagnosing Lyme disease

Alcohol drinking habit is a serious epidemic that afflicts people worldwide regardless of socioeconomic class and the country’s development or civilization. The purpose of this systematic review was to summarize research findings on drinking and driving, its implications for Nigerian society, and the role forensic science can play in drunk driving. Nigeria, in particular has seen a lot of fatal accidents attributed to alcohol but due to a lack of forensic sobriety and toxicology drug tests at the crash scene that is not yet in place in the country, the offenders are not punished for this crime. The only two African countries that have legislation on Blood Alcohol Concentration (BAC) are South Africa and Zimbabwe. Nigeria has no such legislation and does not conduct such tests in injury and fatal accident cases. The prevalence of drinking habits among Nigerians and in particular the drivers cannot be ignored. This study examined global drinking habits including its prevalence in Nigeria and more importantly understudied the need for forensic science interplay in a criminal investigation against drunk driving in the country. Drunk driving in Nigeria is a serious problem. Establishing and enforcing drunken driving laws as a criminal offense would assist the country in the reduction of road accidents, injuries, and fatalities relating to road accidents. Forensic science is a unique field that is equipped with skills and knowledge that could be useful for criminal investigation in the country including accident cases. Forensic scientists have outstanding technical skills to identify, detect, and even assist the country’s prosecutors in the administration of justice in crime investigations. Nigeria as a country will be well served if forensic scientists work in partnership with the government. Drinking and driving in addition to other crimes has become a matter of concern. The country’s police force and courts still rely mostly on eyewitness circumstantial evidence, testimonies, and suspects’ confessions. Based on this, I personally believe that the advent of Forensic science in the country’s system will assist a great deal in solving crimes and reducing fatal accidents due to drunk driving.

Although the beneficial effect of physical activity in the general population is well established, in elite athletes under vigorous physical activity, the effect on the electrical system of the heart is controversial. Indeed, several studies have shown an increased rate of atrial fibrillation among athletes, whereas others suggest that improved exercise capacity with training reduces atrial fibrillation recurrence. The pathophysiologic explanation of that discrepancy is missing, although several underlying mechanisms have been proposed. Taking into account the current knowledge, it seems that, although the beneficial effects of exercise are well recognized, there are conflicting data regarding the relation of the occurrence - the rate of atrial fibrillation to high-volume exercise and too long-term training. Its significance on the quality of life especially in highly trained athletes remains to be elucidated. Therefore, this short review will try to discuss this discrepancy and hopefully underlie the arising arguments. 

Studies in children with eosinophilic esophagitis (EoE) have reported esophageal strictures but none have examined risk factors associated with strictures. Aim: To assess risk factors associated with strictures in children with EoE. Methods: In this retrospective study, children with EoE seen over 20 years were separated into two groups; with and without strictures. Physical features, CBC, endoscopic findings, and biopsy of the distal and mid-esophagus were captured. Statistical significance with p - value and multivariate logistic regression was done. Results: Total patients 222 and 20 (9.1%) had strictures. Mean age of stricture patients 12.7 years (range 7-18) and non-stricture 9.3 years (range 1-17) (p = 0.006). Among stricture patients following were prevalent and significant; dysphagia (stricture 100% vs. non-stricture 41.6%, p = 0.0005) and food impaction (70.04% vs. 4%, p = 0.0005); EGD: rings and exudates were strongly associated with stricture, 45.0% vs. 4.5%, p = 0.0005 and 60% vs. 30.7%, p = 0.008, respectively. Abdominal pain was lower in the stricture group (5% vs. 31.2%, p = 0.017). Eosinophil counts were numerically more in the stricture group but not significant. Multivariate logistic regression confirmed that strictures are likely to occur among patients with dysphagia (p = 0.02, OR = 11.7, 95% LCL 2.0) and food impaction (p = 0.0001, OR = 80.9, 95% LCL 15.4), respectively, adjusted for age and gender. Conclusion: EoE children with dysphagia or food impaction have a higher chance of having an esophageal stricture. These EoE children 12 years or over with exudates or rings on endoscopy, should be treated and carefully monitored, to reduce the risk of stricture formation.

Kinesiophobia is described as pain-related fear of movement and plays a role in the development of chronic musculoskeletal pain. Several approaches have been described in the literature, but there does not seem to be a consensus on the most appropriate way to evaluate and treat patients with kinesiophobia. The aim of this study was to identify clinically relevant assessments and treatments recommended by a consensus of experts. Fourteen experts were identified to participate in a three-round internet-based Delphi study. Participants were asked to propose assessments and treatments (round 1), to grade each proposal on a Likert scale of 9 (round 2), and to reassess their level of agreement (round 3). The consensus was defined with 75% agreement. Five methods of assessment and six treatment approaches reached a consensus. The TAMPA scale reached the top position as an assessment of kinesiophobia. Graded exposure to movement, cognitive and behavioral therapy, and pain neuroscience education were the highest-rated interventions. These results provide the first expert consensus on preferred assessments and treatments for patients with kinesiophobia and correspond with the evidence base in the literature.

Numerous studies of bullying in schools have identified aspects of the environment (E) and aspects of the person (P) as contributing to the prevalence of bullying in schools. It is proposed that the concept of desire can play a central role in explaining how bullying in schools arises and how it can be effectively addressed by schools by promoting social and emotional learning, mindfulness, and problem-solving techniques such as the Method of Shared Concern. The article identifies a need for further research to confirm the hypothesized relationships and assess the utility of the concept of desire as a variable in research and the practice of bullying prevention in schools.

Diabetes Mellitus (DM) is a frequent comorbidity in hospitalized patients, with prevalence ranging from 15% - 35%. However, in almost half of the cases, this antecedent is omitted in the medical records or even unknown by the patient. Furthermore, about 10% of hospitalized individuals may have hyperglycemia of stress, a condition characterized by transient and reversible elevation of blood glucose, in the presence of acute circumstances, such as trauma, surgery, medications, shock, or infections [1].

We demonstrated intrinsic connections between left ventricular hypertrophy (LVH) and arterial hypertension (AHT) through the recently announced centralized aerobic-anaerobic energy balance compensation (CAAEBC) theory. CAAEBC has already demonstrated achievements in the treatment of AHT, diabetes myelitis (DM), and osteochondrosis. Such demonstration lifts the necessity to check the applicability of this theory to other non-communicable diseases (NCDs) and develop the proper way to model the main idea of CAAEBC.

Concussion diagnosis is a clinical categorization that often rests primarily on symptom reporting. However, diagnostic criteria require certain signs and symptoms to be either ruled in or ruled out. 

Bacterial blight (BB), is a disease caused by Xanthomonas oryzae PV. oryzae (Xoo), was first reported in Senegal by Trinh in 1980. BB represents a severe threat to rice cultivation in West Africa. Characterizing the pathotypic diversity of bacterial populations is a key to the management of pathogen-resistant varieties. Pathogenicity tests show that all strains are virulent on the susceptible rice variety Azucena, and interact differentially with twelve near-isogenic rice lines, each carrying a single resistance gene. On this rice panel, six races were identified, two of which were previously reported in Mali (A3) and Burkina Faso (A1). Four races (S2, S4, S5, and S6) are described for the first time in Africa. Races A1, isolated in Ndiaye and Ndioum areas is the most prevalent in Senegal. The Xa1 gene controls 100% of the isolates tested and xa5 controls all isolates except S4 strains. The geographical distribution of Xoo races is contrasted. Four races are detected in the North and two in the South East of the country. Race S4 can be a major risk to rice cultivation because strains from this race are the most virulent and can only be controlled by Xa1. To identify local sources of resistance, we screened Xoo strains representative of the various races on twenty-three rice varieties grown by farmers in Senegal. Four rice varieties namely Sahel210, Sangangbye, Dansna2, and Sahel305 effectively control all the isolates tested. Our characterization of the first collection of Senegalese Xoo strains provided insight into the races present in the country and identified sources of resistance in local rice varieties. This information will help design effective breeding programs for resistance to bacterial leaf blight in Senegal.