Introduction: Many new inflammatory markers are being extensively used recently for assessing the severity and prognosis of chronic conditions. Neutrophil-Lymphocyte ratio (NLR) because of its simplicity and affordability stands out. Its applicability to psychiatric disorders specifically Depression is an eye-opener. Hamilton Rating Scale for Depression (HAM-D), a clinician-based scoring system is better among other self-scoring systems where the study population is semi-illiterate. Materials and Method: Total of 80 patients over a period of 1 year presenting to psychiatric OPD with depressive symptoms were evaluated for the severity of Major Depressive Disorder (MDD) using HAM-D scale. A score of 7-17, 18-24 and >25 was categorised under mild, moderate, and severe degrees respectively. NLR was calculated and was correlated with their severity. Statistical analysis was done using PSPP software and p value of <0.05 was considered significant. Results: Out of the 80 patients 45 were females and 35 were males. The average age was 35.41 years ± 10.13 SD. 23 patients categorised under mild depression had mean NLR of 1.56 ± 0.46 SD, 40 patients with moderate depression and 17 patients with severe depression had mean NLR of 2.70 ± 1.08 SD and 4.62 ± 1.31 SD respectively. The mean value of NLR for patients of severe depression lied in the Mild-Moderate Inflammation zone (3-7). P-value was <0.05 and was considered significant. Discussion: A novel and easy biomarker like NLR can be as useful as assessing Inflammatory Cytokines like IL-6, IL-1 and TNF-α for assessing the severity of MDD. Rise of cortisol in persistent stress favours an increase in neutrophils and a reduction in lymphocytes, and thus, increased NLR. Thus, a rise of NLR with increasing severity of Depression could become a robust tool in future for predicting mortality and severity in patients suffering from MDD.

Guiera senegalensis (“Senegal guiera” in English; “Sabara” in Hausa) (Combretaceae) is traditionally used for various purposes in Africa and other parts of the world with little or no scientific basis. It is thus the aim of this research to evaluate its biochemical and toxicity effects for its medicinal properties, safety, efficacy of treatment, and the optimum dose. The study qualitatively screened for phytochemicals, acute toxicity (LD50) and sub-chronic toxicity indices in the ethylacetate extract of the plant. The result of phytochemical screening revealed G. senegalensis ethylacetate leaf extract to contain some important phytochemical compounds that may attribute to the biochemical properties possessed by the plant. The result of acute toxicity study showed that the plant is practically non-toxic (oral LD50>5000mg/kg) when used for a short period of time and some signs of toxicity on heart in sub-chronic study (on long term of use). Also, the Haematological results indicated that the plant may have some effects on the immune system, might have caused an increase in RBC and haemoglobin production, and may also enhance O2 – transport capacity of the blood. Guiera senegalensis should therefore be used with care when used for a long period of time.

Malaria is one of the most serious infectious diseases found in the tropics and subtropics. P. falcifarum resistance to almost all anti-malarial drugs has necessitated the search for anti-malarial compounds. The aim of this study is to investigate the antiplasmodial effects of crude leaf and stem bark extracts of T. avicennioides, a plant utilized by traditional healers in Northern Nigeria to treat malaria and other ailments. Brine shrimp lethality (cytotoxicity) assay and acute toxicity were also evaluated, which are considered a useful tool for preliminary assessment of toxicity in plant extracts. The median lethal dosage (LD50) was calculated by administering different doses of the extract (100–4000 mg/kg) intraperitoneally to three groups of three mice each for 24 hours and observing the animals for physical sign of toxicity. Three models were employed to assess the extracts antiplasmodial effectiveness in vivo against the rodent malaria parasite Plasmodium berghei: suppressive, curative, and repository. The leaf and stem bark extracts were found to show significant toxicity to brine shrimp larvae of Artemia salina in the brine shrimp lethality test with LC50 values of >1000 and 29.6 respectively. Excitation, paw licking, and death were symptoms of acute toxicity of the extracts based on physical and behavioral observations. Death was recorded at 1000 mg/Kg of the stem bark extract and the LD50 is ≤100 mg/Kg body weight while for the leaf extract it was estimated to be ≤600 mg/Kg with no death record. In vivo evaluation revealed that the extracts significantly (P <0.05) reduced parasite count in all models (suppressive, curative and prophylactic), with high average percentage inhibition of parasitaemia (54.68, 58.67 and 65.61%) seen in both T. avicennioides leaf and stem bark extracts, which was comparable to that produced by chloroquine and artesunate, respectively (64.31&93.1; 70.08&80.67; 63.40&75.20%). Both extracts had moderate antiplasmodial activity and were non-toxic to mice and brine shrimps. This finding validates the plant's traditional use in malaria treatment.

The densities, ρ of pure 1-Hexanol, Benzene and their binary mixture covering the whole composition range have been measured at 303.15 K temperature. Excess molar volumes VmE, partial molar volumes, Vi have been calculated from the ρ data. To obtain correlation coefficients and standard deviations VmE was fitted to Redlich–Kister type function in terms of mole fraction. In the whole range of composition the values of VmE were found to be positive. The positive values of VmE were shown due to depolymerization of the network structures and disrupt their H-bonding and resulting into volume expansion.

Background: The successful implementation of an integrated curriculum in nursing education has been hindered by challenges, primarily faculty resistance due to a lack of familiarity and expertise in integrated module designing. To address this crucial issue, it is essential to empower nurse educators with the necessary knowledge and skills to embrace and implement an integrated curriculum effectively. This project aimed to enhance participants' knowledge of integrated module designing in nursing education through a training workshop. Methodology and Findings: A pre-experimental single-group pretest-posttest design was employed to assess the participants' knowledge before and after the training workshop. The study involved thirty nurse educators from various cities in Pakistan. The effectiveness of the training workshop regarding integrated module designing was evaluated using the paired t-test, revealing a significant difference with a p-value of 0.001. The results indicate that the participants' knowledge increased significantly after attending the workshop. Recommendation: To further reinforce the integration of different subject areas, it is suggested that nursing colleges organize follow-up workshops for facilitating the successful implementation of an integrated curriculum in nursing education.

Duodenal adenocarcinoma being the most common tumor of the small intestine: 33 to 48%, it remains very rare representing only 0.5% of malignant tumors of the digestive tract. Our retrospective study focused on four cases during the period 2017-2022 with an average age of 53.25 years and a sex ratio of 1M/3F. The clinical signs were varied with a predominance of cholestatic jaundice and a deterioration in general condition. The diagnosis was confirmed thanks to the endoscopy and the anatomopathological study of the biopsies carried out in all our patients. All our patients benefited from a surgical treatment, curative or palliative, which consisted of three cephalic pancreaticoduodenectomy and in one case a gastro-jejunal anastomosis. The post-operative follow-up was simple in two patients, one of our patients presented with gastroparesis which progressed well under medical treatment. In addition, we deplore a death which presented a hemoperitoneum related to a hemostasis disorder.

Ectopic spleen is a condition in which the spleen does not sit in the left hypochondrium but has an atypical, often pelvic, location. We report the case of a 35-year-old patient suffering from chronic abdominal pain for 11 years associated with an episode of hematemesis, pollakiuria and dysuria, with anemia and notion of multiple transfusions. Abdominal ultrasound found an ectopic spleen in the pelvic position, enlarged in size, with multiple collateral venous circulations and extensive partial thrombosis of the splenic vein. A total splenectomy by midline laparotomy was performed. Perioperative exploration found a bulky pelvic spleen with a long and tortuous splenic pedicle, involuted in 3 turns without splenic infarction. When the splenic artery is clamped, the colonic and gastric varicose veins lose half their diameter, so the decision is made to perform total splenectomy. Post-splenectomy antibiotic prophylaxis and vaccination was administered. The follow-up was favorable, with a follow-up of 4 years. The patient was then lost sight of.

Hepatic teratoma is an extremely rare tumour. Since 1898 only 28 cases of hepatic teratoma have been reported in the literature, including 21 in pediatrics. The diagnosis is often confirmed by the anatomopathological study and the therapeutic approach is multidisciplinary based essentially on surgery. We report the case of a 45-year-old woman with a history of ductal carcinoma of the right breast for which she underwent surgery. The patient presented with pain in the right hypochondrium, a diagnosis of hydatid cyst of the liver was made based on a cystic image of the right liver on ultrasound. It showed a heterogeneous thin-walled cystic image in the right liver suggesting a type IV hydatid cyst. The MRI was in favor of a fluid lesion of the hepatic dome evoking a remodeled hydatid cyst. During surgery, the liver was found of normal size and segment VIII is the seat of an oval formation 70/60 mm in diameter. A resection of the cystic formation with a closed cyst was performed. Histological analysis concluded with the diagnosis of mature teratoma with no signs of malignancy. After a follow-up of 12 years, the patient is in good health and without recurrence.

Background: The growing level of crimes committed by unscrupulous businessmen related to payments using blank checks or giro drafts makes it important to conduct research whether this includes criminal law in the realm of criminal law or only civil law. Object: The object of this research is a payment crime involving the use of blank checks and demand deposits in a banking environment. The purpose of this analysis is to ascertain whether this is a crime that belongs to the realm of crime or not. Method: The research method used is literature study and relevant data analysis. In this analysis, data were collected on payment crime cases using blank checks and demand deposits, as well as interviews. The data includes statistics, case studies, and reports from law enforcement and related financial institutions. Result: The results of the analysis show that payment traffic using blank checks and giro forms is a form of criminal offense in accordance with articles 378 and 379a of the Criminal Code in Indonesia. Payments using blank checks and demand deposits have a significant impact on banking and society. This crime is detrimental to the parties who become victims, such as traders, entrepreneurs, and individuals who receive payments with these financial instruments. Several factors that influence payment crimes include technological developments, lack of public awareness, ineffective banking supervision systems, and the increased ability of criminals to manipulate financial instruments. In an effort to deal with payment crimes using blank checks and demand deposits, effective preventive measures and law enforcement are needed. These efforts include increasing public awareness of the risks and signs of this crime, increasing the security of financial instruments, cooperation between banks and law enforcement agencies, and using more sophisticated security technology.

The primary dentition is essential in the maintenance of normal occlusion in the permanent dentition. Both dentitions enhance aesthetic, speech and are functional in nature. Early loss of the primary dentition necessitates the placement of space maintainers. This study determined the pattern of tooth extraction of patients attending the paediatric dental clinic in Lagos State University Teaching Hospital, Ikeja and the use of space maintainers. A retrospective study carried out using the dental records of patients who attended the Paediatric dental clinic, Lagos State University Teaching Hospital, Ikeja, Lagos. Data were analyzed using the Statistical Package for the Social Sciences (SPSS) software, version 20 (IBM, New York). The prevalence of tooth extraction was 49.8% among a population of 410 subjects with a total of 353 extracted teeth. The male to female ratio was 1:1.37. Majority (58.3%) of the subjects had only one tooth extracted. The commonest reason for extraction was retained primary teeth (35.8%). The commonest arch and segment of extraction was the mandible (56.1%) and the anterior teeth (51.0%). The commonest tooth extracted was upper right primary central incisor (7.6%). The most common space maintainer was band and loop. Retained teeth was the most common reason for tooth extraction followed by sequelae of dental caries, caries and trauma. This highlights the need for implementation of oral health prevention policies with regards to the use of fluoride, fissure sealants, silver diamine fluoride increased awareness of safety protocols to mitigate traumatic injuries and introduction of dental health education programs in schools and community.

Introduction: Oral diseases being a preventable oral condition and a non-communicable disease could be of little concern but about 3 billion people suffer from these conditions worldwide. This study seeks to evaluate the means and methods of oral hygiene and disease prevention in the city of Douala by adults. The population of Douala is chosen due to the fact Douala is a metropolitan city and most representative of the Cameroonian population in which similar studies have not been carried out. Methodology: A cross-sectional questionnaire study was carried out with random sampling of 498 participants. Data was collected using a questionnaire based on the objectives which included identifying the means and methods used, the behaviors of the population in relation to oral disease prevention, the reasons for the behaviors and the methods and used as well as determining their satisfaction in oral disease prevention using the latter means, methods and behaviors. The data inputted, organized and analyzed using Microsoft excel 2016 and SPSS version 26. In addition to percentages, chi square and regression analyses were carried out and represented for various variables in the questionnaire. Results: It was found out that the population of Douala generally had an above average satisfaction in oral disease prevention due to the use of more conventional means and methods like toothbrushes (94.78%) and bicarbonate mouthwash (27.4%) while the main traditional substance was the neem extract (18.75%), and green tea extracts (16.67%). Their main reasons for using these methods were effectiveness (38.55%), low cost (20.88) and availability (20.08%) with a significant relationship between traditional methods and low cost. Majority of the population used both conventional and traditional methods (55.16%). The studied population show better oral hygiene and disease prevention with a higher level of education and greater monthly allowance. Conclusion: After this evaluation, proper oral healthcare in disease prevention produces satisfaction with oral hygiene at least twice a day with toothbrush and bicarbonate mouthwash, carrying out routine dental visits, participating in sensitization which are directly related to education and finances. In the same light, traditional methods include chew stick, extracts like green tea and neem.

Small bowel lymphoma associated with celiac disease is rare. The annual incidence varies from 0.5 to 1 per million inhabitants. We report two cases of small bowel lymphoma associated with celiac disease. The first case is a 50-year-old patient, treated for celiac disease since 2010 and whose tumor was revealed on abdominal CT as part of the etiological assessment of abdominal pain with an anemic syndrome. In the other case, it was a 52-year-old patient presenting the same symptomatology, in whom endoscopy revealed total villous atrophy, indicating the diagnosis of celiac disease, and CT showed a small bowel tumor. Both patients underwent segmental resection with single-stage anastomosis. The anatomopathological study concluded to a small lymphoma. Adjuvant chemotherapy was administered in both cases, and their evolution was favorable.

Background: The occurrence of metastatic colon lesions in various organs has been documented extensively in the literature. The liver, lungs, and bones are the most frequently affected sites. Metastasis in the duodenum due to colon cancer is an infrequent occurrence. Case Presentation: We present a detailed case report of a 65-year-old female patient diagnosed with metastatic colon cancer to the duodenum. The patient initially underwent extended right hemicolectomy for stage III low-grade adenocarcinoma of the colon. Adjuvant chemotherapy was administered, resulting in a period of apparent remission. However, in 2020, the patient experienced elevated tumor marker levels, prompting further investigations. Endoscopy revealed an irregular mass infiltrating the muscle layer in the duodenum, confirming malignant involvement. The patient underwent curative distal gastric duodenectomy, with pathology results indicating a colonic origin of the tumor. The patient received first-line palliative chemotherapy with FOLFOX rechallenge and the addition of AVASTIN. Several cycles of chemotherapy were completed, with satisfactory tumor response observed in follow-up PET scans. Maintenance therapy was initiated after achieving disease-free status on CT scans. However, in October 2022, the patient exhibited increasing tumor marker levels and new findings on PET scan, leading to the initiation of second-line palliative therapy with FOLFIRI and ramucirumab. The patient has received multiple cycles of second-line therapy, with the most recent PET scan in February 2023 showing a favorable treatment response, including a decrease in the size of existing nodes and no identification of new lesions. Conclusion: In conclusion, this case exemplifies the journey of a patient with stage 3 colon cancer who initially responded well to surgery and adjuvant chemotherapy, but experienced subsequent relapse in the duodenum. Despite surgical intervention and palliative chemotherapy, the patient developed metastasis in the liver, lung, and multiple lymph nodes.

Background: Idiopathic Orbital Inflammatory Syndrome (OIS) ranks as the third most prevalent orbital disease, following thyroid eye disease and orbital lymphoma. In cases of localized inflammation, various structures within the orbit can be affected. This includes the Extraocular Muscles (orbital myositis), lacrimal gland (dacryoadenitis), sclera (scleritis), uvea (uveitis), as well as the superior orbital fissure and cavernous sinus (Tolosa-Hunt syndrome). Case Presentation: In this report, we discuss the case of a 35-year-old man who went to the Emergency Department due to intense, throbbing pain in his eye orbit and half of his head on the right side. He had been experiencing this pain for two days. The pain was aggravated by eye movement and accompanied by ipsilateral redness, mild photophobia, and blurred vision. The patient had no significant medical history prior to this episode. Upon eye evaluation, findings included mild swelling of the right eyelids, painful eye movements, inferior corneal erosions, and conjunctival chemosis with superficial and deep vessel congestion. Visual acuity was reduced due to myopic refractive error. Magnetic Resonance Imaging (MRI) revealed a soft tissue lesion in the right orbital apex extending into the right cavernous sinus, suggesting an inflammatory etiology such as Tolosa-Hunt syndrome. To investigate further, the patient underwent various diagnostic tests, including laboratory investigations, chest X-rays, and serological tests. These tests revealed unremarkable findings, ruling out systemic pathology. The patient received intravenous Solumedrol (Methylprednisolone) followed by oral Prednisolone, resulting in a dramatic improvement in symptoms. Conclusion: This case highlights the importance of a comprehensive diagnostic approach in evaluating severe orbital and hemi cranial pain. Prompt initiation of corticosteroid therapy can lead to rapid symptom resolution and favorable outcomes in patients with Tolosa-Hunt syndrome.

The integration of Generative AI (GenAI) in Education presents immense potential for reshaping learning experiences and empowering students and educators. However, harnessing this potential requires collective action and responsible decision- making to ensure the effective and ethical use of AI technologies. This paper presents a series of recommendations and proposals aimed at effectively integrating GenAI in the higher education sector, catering to the perspectives of government, AI developers, students, educators, universities, schools, and researchers. By exploring diverse viewpoints about ChatGPT and future Google Gemini, this research aims to create a comprehensive recommendation guiding regulatory measures that address challenges, ethical considerations, and best practices of GenAI integration. Through a holistic approach, researchers believe that policymakers can foster a transformative and ethical environment, leveraging the full potential of generative AI while safeguarding students' well-being and academic integrity.