Niger J Clin Pract
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Cryptococcal meningitis (CM) is underreported in the immunocompetent, the disease being more commonly associated with advanced human immunodeficiency virus (HIV) disease. We report the diagnosis, management, and eventual fatal outcome of CM in a non-HIV-infected man. Late presentation, delayed diagnosis, difficulties in accessing medications, and raised intracranial pressure (ICP) were contributory to his demise. Detailed history, a high index of suspicion, and laboratory workup coupled with prompt antifungal therapy and aggressive ICP management are essential for better outcomes.
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School Health Instruction (SHI) comprises of series of formal, well-planned, and organized learning whereby information concerning knowledge, habits, attitudes, practices, and conducts are given pertaining to the health of an individual or members of the school community. A well-structured and implemented SHI forms the basis for a healthy health promotion. ⋯ School health instruction was poorly implemented in the study location. There is a need to scale up SHI and monitor its implementation in the study location. These efforts should be supported by all stakeholders and backed with adequate oversight function by regulatory authorities, provision of in-service training, and teaching aids for teachers.
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Gravity impact has been mainly evaluated in mature teeth related to debris extrusion, even though it may affect the amount of apically extruded irrigant. In the literature the influence of gravity on the amount of apically extruded irrigant in immature teeth has been studied by a 45o inclined plate to mimic the position of the maxillary teeth and 90o for the mandibular teeth. However, patients are positioned horizontally in the dental chair while treatment. There is no study in the literature testing the horizontal position to mimic the clinical settings realistically. ⋯ The EndoVac macrocannula is a more reliable and safer irrigation system as it prevents irrigant extrusion independent of the position of the tooth.
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Case Reports
Diagnostic challenges in the management of septic arthritis of the neonatal hip: A case report.
Septic arthritis of the neonatal hip is a very rare pathology. The clinical features may be different from those associated with older children, resulting in diagnostic challenges. ⋯ The index patient is a 3-week-old neonate who had left hip arthrotomy on account of septic arthritis. The aim of this report is to highlight the challenges encountered in the diagnosis of septic arthritis of the hip in this patient.
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Studies evaluating immunization data quality and its determinants in low- and middle-income countries are scarce. ⋯ Routine immunization data are not always accurate in Enugu state. Continuous efforts to improve the data monitoring system, supervision, data audits, funding, and staffing are warranted.