This paper aims at examining the theme “River Basin as a geomorphic units and Environmental Challenges associated with its development in Nigeria”. It also examined the environmental problems associated with harnessing their resource potentials in Nigeria. The paper also highlighted a brief history of river basins development in Nigeria, as well as their importance as a geomorphic planning unit. It also attempted a general overview of the problems associated with the development of this unique geomorphic unit. The paper thus advances some deliberate and aggressive environmental management strategies that can provide sustainable environmental management solutions. These strategies can mitigate and ameliorate the challenges associated with its development for the present generation and for posterity, with a view to ensuring a healthy environmental sustainability plan is achieved.

There are many dermatoses that can affect the genital area. These may be isolated genital conditions or signs of a general cutaneous disorder. Genital dermatoses can be classified as physiologic variants, and inflammatory, neoplastic, or infectious in etiology. Psoriasis is a chronic autoimmune disease, which has a prevalence of about 3% with genital involvement, reported in 29% a 40% of patients. Although the diagnosis of genital psoriasis can be aided by the presence of classic psoriatic plaques on the body, the penis may be the only affected region. In uncertain cases, a skin biopsy can lead to diagnosis. Initial management should consist of mild topical corticosteroids with increasing potency titrated to effect or topical calcineurin inhibitors. Systemic therapy with disease modifying small molecules or biologic drugs may be considered when disease is particularly bothersome, widespread, or unresponsive to conservative approache. This article provides a broad overview for dermatologists in addressing the Psoriasis wich is placed on. Recommendations for diagnostic evaluation, treatment, and appropriate follow-up are discussed.

Background: In the Niger Delta area of Nigeria, human medical biomonitoring, including that of maternal Carboxyhemoglobin (MCOHb) had never been performed irrespective of the devastating environmental pollution in the region. Aim: The goals of the study were to quantify the impact of maternal exposure to CO in the first trimester of pregnancy in the core Niger Delta by measuring MCOHb concentrations and to assess the effect of maternal demographic and obstetric characteristics on the impact. Material and methods: The study was of cross-sectional design carried out at the Rivers State University Teaching Hospital (RSUTH) in Nigeria. 490 consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Gestational age was estimated with the aid of an ultrasound scan. Demographic, social and obstetric characteristics were taken. MCOHb concentrations were measured with the aid of a smokerlyser. Data was analyzed, using SPSS version 25.0 (Armonk, NY) software. Ethical approval was obtained from the RSUTH Ethics Committee. Results: The mean value of MCOHb concentration was 1.15±0.40% Out of the 490 patients that were assessed, 461(94.08%) had mild impact from CO exposure (MCOHb= 0.78-1.5%), 18 (3.67%) – moderate impact (MCOHb = 1.75-2.23%) and 11 (2.24%) had severe impact (MCOHb = 2.39% and above). Moderate and severe impact were most prominent in women of 25-29 and 35-39 years of age respectively at which they occurred in 11 out of 145 (7.59%) and 7 out of 103 women (6.80%) respectively and the differences at various age groups were statistically significant [X2=23.119, p<0.010, 95%CI (0.038,0.046)]. The differences in the severity of maternal impact among women with different BMI classes were statistically significant [X2=56.707, p<0.001, 95%CI (0.001,0.001)] with those with class III BMI most likely to have severe impact [4(22.22%) out of 18 patients]. There was inverse relationship between parity and the severity of the impact of CO exposure but the differences at various parity groups were not statistically significant [X2=10.580, p<0.012, 95%CI (0.101,0.113)]. There was also a paradoxical finding of 3 smokers having only mild impact. Conclusion: The mean value of MCOHb was 1.15±0.40. Mild, moderate and severe impact from maternal CO exposure was established with the moderate and severe impacts more prominent at maternal ages of 25-39 years, at higher BMI and at lower parity.

The purpose of this study is to assess the effect of ethanolic stem bark extract of Persea americana on lipid profile and oxidative stress markers of male Wistar rats. The rats were randomly divided into three groups of five rats each. They were treated with ethanolic extract of Persea americana (except the control group) for a period of 21days. Group1 received distilled water. Group2 received 200mg/kg of the extract and Group3 received 400mg/kg of the extract. The administration was done for 21days. At the end, the rats were sacrificed and blood sample was collected and sent to the laboratory for analysis. The data obtained was statistically analysed using SPSS software version 21. The result showed that, there was no significant difference in serum total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein when test groups were compared to control. There was a significant decrease in serum very low density lipoprotein level in Group3 (400mg/kg) when compared to Group1 (Control). There was no significant alteration in glutathione reductase, catalase and superoxide dismutase enzyme activities. There was a significant difference in malondialdehyde level (a decrease). In conclusion, the ethanolic extract of Persea americana stem bark exhibited slight hypolipidemic effect because of the significant reduction in Very Low Density Lipoprotein. Also, the extract showed a significant decrease in Malondialdehyde at low dose, which shows that Persea americana may have an anti-oxidative property.

Background: Human fetal medical biomonitoring, including that of fetal carboxyhemoglobin (fCOHb) had never been performed in the Niger Delta area of Nigeria irrespective of the devastating environmental pollution in the region. Aim: The goals of the study were to establish the severity of fetal impact on maternal exposure to CO in the first trimester of pregnancy in the Niger Delta by quantifying the levels of fetal fCOHb and to assess the impact of maternal demographic, social and obstetric characteristics on it. Material and methods: A cross-sectional study which was carried out at the Rivers State University Teaching Hospital (RSUTH) in Nigeria. 490 consecutive pregnant women in the first trimester were recruited from the antenatal clinic from January 2021 to January 2022. Gestational age was estimated with the aid of an ultrasound scan. Demographic, social and obstetric characteristics were taken. fCOHb concentrations were measured with the aid of a smokerlyser. Data was analyzed, using SPSS version 25.0 (Armonk, NY) software. Ethical approval was obtained from the RSUTH Ethics Committee. Results: The mean value of fCOHb concentration ± SD was 0.93±0.72%. There were statistically significant differences in its values in different age categories (t=2.742, p<0.019), educational levels (t=2.328, p<0.020), BMI (t=5.545, p<0.0001), gravidity (t=6.447, p<0.0001) and parity (t=2.833, p<0.038). Paradoxically, the differences in its levels in the groups namely, smoking habits and drinking status, were not statistically significant. Out of the total 490 participants, 331(67.60%) had fetuses with mild impact from CO exposure (fCOHb= 0.28 to 0.85%), 125 (25.51%) – moderate impact (fCOHb = >0.85 to 1.70%) and 34 (6.90%) had severe impact (fCOHb = >1.70% and above). There were statistically significant differences in the severity of fetal impact in association with different maternal characteristics namely age groups (X2=26.687, p<0.003), maternal alcohol intake (X2=18.866, p<0.0001), gravidity (X2=37.819, p<0.0001), parity (X2=12.098, p< 0.047) and BMI (x2=19.409; p<0.013) but there was no pattern in the directions of the differences except for BMI which showed significant positive correlation (r=0.214, p=0.0001) due mainly to maternal weight (r=0.181, p<0.0001). There was a paradoxical finding of 3 smokers having only mild impact. Conclusion: The mean value of fCOHb concentration ± SD 0.93±0.72% and the 3 degrees of fetal impact on exposure to CO were significantly affected by demographic, social and obstetric characteristics but there was no pattern in their effect except for BMI where a positive correlation was established.

This study investigated the effects of hydromethanol leaf extract of Cnidoscolus aconitifolius on some male reproductive functions in Cadmium chloride (Cdcl2) toxicity-induced male Wistar rats. Twenty four adult male Wistar rats were used for this study. The animals were divided into four groups (6 rats each) as follows: Group 1 (negative control), Group 2 (positive control) which received 5mg/kg CdCl2, Groups 3 and 4 received 200 and 400 mg/kg BW of extract and 5mg/kg CdCl2 respectively. Duration of extract administration was 30 days, while males were co-habited with females in the last 10 days of the study to determine fertility index. Subsequently, the rats were sacrificed following light chloroform anaesthesia, while samples were collected for analysis. Phytochemical screening of the leaf extract revealed the presence of alkaloids, flavonoids, phlobatannins, saponins, triterpenoids and cardenolide; and the analysis of data was by SPSS version 23. The analysed result indicated that the extract caused a significant (p<0.05) increase in FSH and testosterone levels. The percentages of viable sperm cells, sperm cells with normal morphology and actively motile sperm cells as well as sperm count were significantly increased. In addition, the fertility index in the rats that received higher dose (400mg/kg) of the extract was significantly increased. Conclusively, extract of Cnidoscolus aconitifolius mitigated against Cdcl2 induced toxicity in some reproductive parameters of male Wistar rats.

Phenibut is an anxiolytic and nootropic drug, discovered in the Soviet Union used to treat several psychiatric disorders. Currently it is available online as supplement. The case report highlights the abuse potential of phenibut, with the associated clinical presentation of intoxication, withdrawal, and relapse, as well as the use of baclofen as a potential treatment of phenibut withdrawal.

Introduction: Several plants have been proven useful as antioxidant agents as a result of the abundance of bioactive substances embedded in the plant. Eugenia uniflora is a medicinal plant popular in the tropics where it is applied in traditional medicine practice for treatment of some illnesses but most of its acclaimed therapeutic effects have not been scientifically proven. Aim: The present study is aimed at assessing the testicular antioxidative and some biochemical effects of Eugenia uniflora in male Wistar rats. Methodology: A total of 30 male Wistar rats were divided into 5 groups of 6 animals each. Group I which served as the negative control received distilled water while group II (positive control) received 5 mg/kg Lead. Group III received 200 mg/kg BW of the extract and 5 mg/kg Lead, while Group IV received 400 mg/kg BW of the extract and 5 mg/kg Lead and the animals in Group V received 800 mg/kg BW of the extract and 5 mg/kg Lead. Administration was by oral gavage. At the end, the testes were harvested for analysis of testicular parameters. Result: The result showed a decrease in the level of Malondialdehyde (MDA) while Glutathione reductase (GSH) and Superoxide Dismutase (SOD) activities increased in some groups of animals treated with the extract and lead. The testicular total cholesterol level was significantly (P<0.05) decreased while the testicular protein level was not significantly affected in animals treated with the extract and lead when compared to the lead only group.

Case summary: A 19-year-old Saudi male morbidly obese patient (BMI 48 kg/m2). The patients underwent sleeve gastrectomy 5 months ago and cholecystitis 1 month ago. The patient presented to our emergency department (ER) with all limb numbness in the last 3 weeks, difficulty walking, blurred vision, headache, and nausea for the last week. The patient was diagnosed with Wernicke encephalopathy based on his symptoms, physical signs, and classical MRI brain findings. Conclusion: Bariatric surgery can complicate Wernicke encephalopathy, associated with thiamine deficiency. Prophylactic thiamine supplements can prevent the subsequent bariatric WE condition.

Background and objective: we conducted this study to find out the important relationship between time-management skills and physician career satisfaction and explore the importance of utilizing strategies that promote efficient time management. Methods: In this cross-section study, used a self-designed and validated questionnaire. The current study was conducted during a series of workshops, in CMH Lahore Medical College & IOD from August-October 2021. Participants were, no prerequisite knowledge, skills, or resources were required for the workshop. Results: A total of 157 participants were enrolled for a workshop and 155 participants fill the questionnaire completely so the response rate was 98.72%. Questionnaire, Cronbach’s Alpha value was 0.78 male participants were 60 (38%) and females 96 (61.4%). The age average was 25-39 years. Most participants are demonstrators/lecturers/registrars. About 77 (49%) of the physician’s sleep duration was normal hours and 78 (51%) complain to insomnia. Only 67 (43.9%) physicians give family time properly but 88 (56.4%) spend less than 4 hours with their families. Doctors spend less time on their smart devices 16 (10.3%) spend more than 2 hours/day. Very few physicians do their favorite hobby or any physical activity daily. Conclusion: Physicians are not good time managers, its means their patients are kept waiting, they get stressed, their work becomes less enjoyable, stress can build, they lose their sense of humor and they lose valuable time for family, exercise, and sleep, insignificantly different across gender, age, experience and entering qualification.

Vascular complications during an ulnar procedure are very rare. However, they must be identified quickly. We repport a case of a 68-year-old hypertensive patient who was admitted to the emergency department for unstable angina, where she underwent coronary angioplasty via the left ulnar route. she was referred to us for management of a pseudoaneurysm on the inside of the wrist facing the ulnar artery one month later.

The aim of the study was to find out the effect of six weeks pilates training on core muscles and BMI of obese children. Ten (10) male children aged 12 to 18 years from Bolpur, Birbhum, West Bengal, India have been selected and purposively divided into Pilates Training Group (PTG) (N=05) and Control Group (CG) (N=05) according to WHO BMI Index (Rush, 2004). Six weeks pilates training programme has been formulated to see the effectiveness of training programme on core muscles strength and BMI. The core muscles strength has been tested by ‘Bunkie Test’ through the performance of functional lines before the training starts and after completion of six weeks pilates training programme and BMI has been calculated by height and weight. Significant improvement in core muscles strength as well as on BMI has been found by analysing and comparing the pre-test and post-test score through descriptive analysis and ANCOVA among the obese children of PTG and CG. So it can be concluded that six weeks of pilates training programme is effective in the improvement of core muscles strength as well as in reduction of fatness and BMI among obese children.

Introduction: The CTS is one of the clinical syndromes, it was experienced by the patients from numbness, tingling, burning and or pain associated with localized compression of the median nerve at the wrist. Median nerve with the carpel tunnel (CTS) is localized and it was compressed in median nerve, resulting in mechanical compression and local ischemia has been associated with age and sex matched control. Objective: To assess The Relationship between Nerve Conduction Study and Clinical Grading of Carpal Tunnel Syndrome in Bangladesh Population. Methods: A prospective study was conducted at Department of Neurology, Uttara Adhunik Medical College Hospital (UAMCH), Uttara, and Dhaka, Bangladesh from January to December 2021. A total 100 case were prospectively observed for the period of six months 50 patients’ with symptoms consistent with CTS and 50 age and sex matched healthy control subjects were examined. Based on clinical assessment, the study patients were divided into 03 groups with mild CTS, moderate CTS and severe CTS respectively as per Mackinnsons classification. The relationship between the clinical severity grade and various nerve conduction study parameters were correlated. The study was correlated with age and gender matched control intervention and we extrapolate the any significant correlation between the clinical grades and various attributes of study traits. All the traits were carefully assessed by using logistic regression analysis and Fisher F- test statistics. Results: Out of 50 patients with symptoms consistent with CTS and 50 age and sex matched healthy control subjects were examined. The Left hand was involved in 11patients; right hand in 19 patients & 20 patients had involvement of both hands. Numbness and tingling of hand and first three fingers was the most common presenting symptom. Phalens test was positive 30 (60.0%) of our patients. 7(14.0%) pts had hypothyroidism, 10(20%) patients showed raised DM and 4(8.0%) patients showed lipid profile abnormalities. Both male and female sex ratio was 1:3. All cases were considered for the study. The distal motor latency was significantly correlated with different age group of the population and CMAP and conduction velocity not shows any significant relation with clinical severity of CTS. Since, the median sensory latency and nerve conduction velocity seen in study population and well apprehension with clinical different grading of CTS. Conclusion: Summing of the results concludes that, the sensory conduction appears to be more sensitive (95%) AUC 0.89 and significantly correlated when compared to motor conduction attributes, the correlation besides with clinical severity of CTS apart from gender and age matched cases.

Background: Documentation of the nursing method is crucial, however regularly ignored as a part of medical documentation. Paper-primarily based structures have been added to help the nursing documentation process. Objectives: The study aims to assess the effect of training program on knowledge and practice of nurses regarding nursing documentation. Methods: Quasi-experimental study was carried out in Omdurman military hospital extended from February 2019 to August 2019. A questionnaire and evaluation checklist was used to collect data from (203) nurses. They were selected by non-probability sampling technique (purposive sampling). The data were analyzed by computer software program (SPPS) version 20. Results: The study showed that more than half (60.6%) of nurses were female, (65%) had bachelor's degrees, (42.9%)had 1-2 years of experience and more than a third (34.0%) worked in general word. The nurse’s knowledge regarding the type of record system, pretest (51.7%) had unsatisfied knowledge. There was an increase in knowledge of nurses regarding documentation post-implementation of the program. Posttest (75.9%) with a highly significant relationship between nurses training courses and knowledge about the concept of quality in nursing (0.002) Study showed that the nurse's knowledge about nursing record forms was improved post educational program (48.3%) were satisfied knowledge compared with the pretest (69.05) were poor knowledge. Common nursing report errors were the change of shift and incidence report (73.4 %, 87.2%) in pretest which decrease to (50.2%, 44.3%) in the posttest, respectively. while the common nursing record error pretest Illegible record (69.3%), change in Patient condition (66.5%), Round book (73.9), Medication record error (60.1%). Conclusion & Recommendation: The teaching program had a positive effect on the quality of nursing care. The study recommended updating nurses’ knowledge and skills about documentation guidelines through continuous professional development.

This study develops a competency model for the HR Department of PT TCO and measures the competence of incumbents to determine employee competency profiles to identify competency gaps. The designing process of the competency model used the Behavioral Event Interview (BEI) technique to find out the critical of each job description. Competency measurement is carried out using behavioral indicators that have been compiled in the competency model. The rating scale method using a multi-rater was chosen to measure incumbents' competence. From the formulation of the competency model, four (4) core competencies, fifty-three (53) behavioral competencies, and 130 technical competencies were obtained. The competency level standards can apply to anyone holding the relevant position if the job description does not change. In addition, it is also obtained an overview of the same job cluster; different levels of positions tend to have the same competency model but different levels of competency standards. The results of the preparation of the competency model above; the company is recommended to implement the same process in other departments or divisions so that a comprehensive competency model can be arranged for all positions in PT TCO. The company is also expected to constantly update job descriptions linked to the entire series of competency models and explicitly carry out core competencies, especially by top management, so that they can be seen by all employees, even at the grassroots level.