Multi-organ Failure in a Patient With Chronic Ketamine Use: A Case Report.

Ketamine is increasingly used as a recreational drug. The report outlines the various multi-organ dysfunctions identified following chronic abuse in a 24-year-old patient with no significant past medical history and the subsequent patient management. Besides ketamine cessation, other treatments only provide suboptimal relief to the damage inflicted by the toxic ketamine metabolites.

A Review of Peripheral Artery Disease in Diabetic Patients in Sub-Saharan Africa.

Peripheral artery disease (PAD) is an atherosclerotic occlusive disease of the lower extremities and is associated with an increased risk of amputation and cardiovascular events. The interplay between diabetes and PAD is complex, influenced by shared risk factors such as hypertension, dyslipidemia, and smoking. High rates of undiagnosed diabetes, coupled with barriers to accessing care, contribute to the complexity of managing PAD.

Catastrophic Antiphospholipid Syndrome: A Review of Current Evidence and Future Management Practices.

Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by blood clots and pregnancy complications due to antiphospholipid antibodies. Catastrophic APS (CAPS), a severe variant, leads to multiorgan failure and is often fatal. Pathogenesis involves antiphospholipid antibodies, particularly anti-beta-2-glycoprotein I (aβ2GPI), which trigger endothelial cell (EC) activation, cytokine release, and a prothrombotic state.

Safety and Efficacy of Gamma Knife Radiosurgery for the Management of Trigeminal Neuralgia: A Retrospective and Cross-Sectional Study.

Background: Medical management is the first line of care for patients with trigeminal neuralgia (TN), and carbamazepine is the drug of choice used alone or in combination with other drugs. Gamma knife radiosurgery (GKRS) has been an established option in the management of refractory TN based on its noninvasiveness and robust safety profile. Our study aims to confirm the safety and assess the efficacy of GKRS in the management of TN.

Awake Craniotomy in Africa: A Scoping Review of Literature and Proposed Solutions to Tackle Challenges.

Background: Awake craniotomy (AC) is a common neurosurgical procedure for the resection of lesions in eloquent brain areas, which has the advantage of avoiding general anesthesia to reduce associated complications and costs. A significant resource limitation in low- and middle-income countries constrains the usage of AC.

Objective: To review the published literature on AC in African countries, identify challenges, and propose pragmatic solutions by practicing neurosurgeons in Africa.

A Review of Insect Pest Management in Vegetable Crop Production in Nigeria.

Insect pest infestations and damage can limit the production of vegetables in the farming systems in Nigeria. This review looks at integrated insect pest management as a possible panacea for resolving insect pest issues in vegetable crops. The main vegetable crops which include okra, tomatoes, chilli peppers, cucumbers, green amaranth, carrots and onions are highlighted.

Incidental blast injuries to the hands of hunters in suburban Africa.

Background: Civilian blast injuries are common during celebrations and festivities. In the intervening times, civilian nonterrorist blast events are rare. The aim of this report is to highlight the increasing occurrence of blast injuries to the dominant right hand of hunters and the ensuing crippling consequences.

A delayed diagnosis of congenital midline cervical cleft.

Congenital midline cervical cleft (CMCC) is an extremely rare anomaly of the neck that typically presents in the neonatal period as a thin suprasternal vertical band of erythematous skin with a nipple-like projection. We present the management of this uncommon and rarely described entity in a 9-year-old girl.

Thumb talc granuloma mimicking squamous cell carcinoma: A case report.

Application of topical powdery substances to the wound is an age old practice. Talc containing powdery substances are however commonplace and predominant in our environment. This insoluble mineral has been linked to chronic granulomatous reaction particularly in the lungs.

Cervical spine computed tomography motion artifact mimicking spine injury in a patient with severe head injury.

Background: Craniocervical CT scan is an essential part of the routine evaluation of patient with moderate and severe head injury to rule out associated cervical spine injury. Computed tomography motion artifacts can affect clinical decision making. The aim of this report is to emphasize that motion artifact still exists despite advance in technology and this can pose clinical challenge.

Paratesticular fibrous pseudotumour in a 26-year-old Nigerian man: A case report.

Introduction And Importance: Benign fibroblastic proliferation located within the scrotum are uncommon. They are also identified as fibrous pseudotumour and usually arise from the paratesticular region. Their pathogenesis is unknown.

Parasagittal cystic meningioma mimicking hemangioblastoma: A case report.

Background: Cystic meningioma is a rare variety with similar histological profiles like the solid tumors. It has been documented in both supratentorial and infratentorial compartments presenting radiologically as a large cyst with mural nodule mimicking hemangioblastoma.

Case Description: We managed a middle-aged woman who presented with recurrent seizures and brain MRI revealed left frontal cystic parasagittal tumor with mural nodule.

Awake craniotomy in a Covid-19 positive patient: The challenges and outcome.

Background: The SARS-COV-2 is a novel coronavirus which is the etiological agent of the COVID-19 infection. The neurosurgical practice is not exempted from the impact of the COVID-19 pandemic. Awake craniotomy in a COVID-19 positive patient pose a significant risk for theatre staff but intubation of a COVID-19 positive patient for surgery under general anesthesia also pose similar risk.

Epidural lipomatosis in elderly patient: A rare cause of cauda equina compression.

Background: The most common cause of cauda equina compression in the elderly is lumbar spinal stenosis. Epidural lipomatosis is an additional known but rare cause of cauda equina compression readily diagnosed on MR studies. Notably, spinal canal decompression and direct excision of the epidural fat effectively manage this combined pathology.

Serum cartilage oligomeric matrix protein as a biomarker for predicting development and progression of knee osteoarthritis.

Purpose: Current modes of diagnosing and monitoring knee osteoarthritis (OA) are based on weight bearing radiographs usually made by the time joint destruction is already established. Cartilage oligomeric matrix protein (COMP) is a breakdown product of cartilage and its serum levels may be a potential indicator of early destruction in OA. This study aimed to ascertain the usefulness of serum COMP (sCOMP) in diagnosis and monitoring of knee joint OA within the study environment.

WHO classification of meningiomas-A single institutional experience.

Introduction: Meningiomas are among the most common intracranial neoplasms worldwide. The World Health Organization (WHO) has classified the neoplasm into three grades with each grade having several histological variants. Several studies done in blacks have shown differences with Caucasian populations regarding the occurrence of histological variants.

Intra-operative wound irrigation with ceftriaxone does not reduce surgical site infection in clean neurosurgical procedures.

Background: The spectrum of post-operative infections in neurosurgical practice includes scalp infection, bone flap osteomyelitis, meningitis and intracranial abscesses and is associated with significant morbidity and mortality. There is a wide variation across neurosurgical centres in the use of perioperative antibiotic prophylaxis. The aim of this study was to determine whether intraoperative wound irrigation with ceftriaxone provides additional prevention of surgical site infection (SSI) in patients already receiving the drug parenterally.

Microsphere formulations of ambroxol hydrochloride: influence of Okra (Abelmoschus esculentus) mucilage as a sustained release polymer.

Ambroxol hydrochloride (AH), a secretion-releasing expectorant, is a good candidate for sustained delivery. Mucilages are biodegradable, inexpensive carriers in microsphere formulations. The study aimed to prepare microspheres of AH using Okra mucilage obtained from pods of Abelmoschus esculentus combined with sodium alginate at various polymer/drug ratios.

Adult-Onset Seizure Disorder Secondary to Schizencephaly.

Schizencephaly is a very rare neurological disorder usually discovered during radiological evaluation of children and young adults with seizure disorders or neurodevelopmental anomalies. We present a 66-year-old patient with right-sided hemiatrophy and paresis presenting with an adult-onset seizure disorder. Her seizure was satisfactorily controlled with a single-therapy antiseizure drug.

Development of Theophylline Microbeads Using Pregelatinized Breadfruit Starch () as a Novel Co-polymer for Controlled Release.

The aim of this study was to prepare formulations of theophylline microbeads using pregelatinized breadfruit starch (Artocarpus altilis, family Moraceae) in combination with sodium alginate and chitosan at various polymer: drug ratios. Microbead formulations for controlled delivery of theophylline would be better alternatives to conventional dosage forms for optimized drug therapy. The native and pregelatinized starches were characterized for morphology (scanning electron microscope), crystallinity (Fourier transform intra-red spectroscopy, FTIR and X-ray diffractometer, XRD), thermal flow (differential scanning colorimeter), density and flow properties.

Chance Fracture in an Unbelted Rear Seat Passenger.

Chance fracture occurs from flexion-distraction injury in motor vehicle road crash usually when the patient is on a seat belt. It is often associated with intra-abdominal injuries. We managed a 22-year old female unbelted rear seat passenger of a bus which was involved in a lone accident.

Pediatric Meningiomas in Southwestern Nigeria: A Single-Institutional Experience.

Background: Meningiomas are the second commonest intracranial tumors in many places worldwide. They are rare in the pediatric age group, however, and most studies have been able to document only a few patients. Meningiomas in pediatric patients have also been shown to behave differently from those in the adult population.

UPPER LUMBAR DISC PROLAPSE.

Upper lumbar disc prolapse (ULDP) is a rare and a unique clinical entity which has a potentially devastating clinical outcome. It may manifest with low back or anterior thigh pain, polyradiculopathies (from spinal cord or cauda equina compression) and/or degenerative kyphoscoliosis. Its diagnosis is often difficult and may be missed because of the lack of specific root signs.

Development of repaglinide microspheres using novel acetylated starches of bitter and Chinese yams as polymers.

Tropical starches from Dioscorea dumetorum (bitter) and Dioscorea oppositifolia (Chinese) yams were acetylated with acetic anhydride in pyridine medium and utilized as polymers for the delivery of repaglinide in microsphere formulations in comparison to ethyl cellulose. Acetylated starches of bitter and Chinese yams with degrees of substitution of 2.56 and 2.

Design of cissus-alginate microbeads revealing mucoprotection properties in anti-inflammatory therapy.

Cissus gum has been employed as polymer with sodium alginate in the formulation of diclofenac microbeads and the in vivo mucoprotective properties of the polymer in anti-inflammatory therapy assessed in rats with carrageenan-induced paw edema in comparison to diclofenac powder and commercial diclofenac tablet. A full 2(3) factorial experimental design has been used to investigate the influence of concentration of cissus gum (X1); concentration of calcium acetate (X2) and stirring speed (X3) on properties of the microbeads. Optimized small discrete microbeads with size of 1.