This paper highlights the tenets of globalization and how its elements have spread to sub-Saharan Africa, and Nigeria in particular. It assesses the growing burden of non-communicable diseases (NCDs) in Nigeria and its relationship with globalization. It further describes the conceptual framework on which to view the impact of globalization on NCDs in Nigeria. It assesses the Nigerian dimension of the relationship between the risk factors of NCDs and globalization. Appropriate recommendations on tackling the burden of NCDs in Nigeria based on cost-effective, culturally sensitive, and evidence-based interventions are highlighted.

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Background: Diabetes mellitus (DM) is known to induce oxidative stress along with deranging various metabolisms; one of the late complications of diabetes mellitus is diabetic retinopathy, which is a leading cause of acquired blindness. Poor glycemic control and oxidative stress have been attributed to the development of complications like diabetic retinopathy. The aim of this study was to analyze and correlate oxidative stress marker, Malondialdehyde (MDA), and antioxidants (erythrocyte glutathione, vitamin C) along with glycosylated hemoglobin (HbA _1c ) and fasting blood sugar (FBS) in diabetic patients with and without retinopathy. Materials and Methods: The study population comprised of 50 type 2 diabetics with retinopathy as Group 1 (G1) and 50 type 2 diabetics without retinopathy as Group 2 (G2) in the age group 40-70 years as patients, and 50 age- and gender-matched healthy individuals as controls, Group 3 (G3). FBS, HbA _1c MDA, glutathione in erythrocytes, and vitamin C were assayed. Results were analyzed using SPSS 11.0, Mann-Whitney U-test, and Pearson correlation coefficient. Results: Mean FBS (mg/dl) were 194.04 ± 48.52 (G1), 181.24 ± 50.05 (G2), and 92.20 ± 9.19 (G3) (P < 0.001). Mean values of MDA were 6.65 ± 0.30 (G1), 4.63 ± 0.56 (G2), and 3.90 ± 0.34 (G3) (P < 0.001). The mean reduced glutathione (GSH) levels were (mg/g of Hb) 6.10 ± 1.41 (G1), 6.44 ± 1.53 (G2), and 13.09 ± 2.49 (G3) (P < 0.001). The mean vitamin C levels (mg/dl) were 0.70 ± 0.24 (G1), 0.87 ± 0.29 (G2), and 1.25 ± 0.27 (G3) (P < 0.001). Conclusion: Estimation of HbA _1c , MDA, GSH in erythrocytes, and vitamin C levels can contribute to determine the extent of oxidative stress in diabetes and help in effective control and prevention of the onset and progression of diabetic retinopathy.

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Aim: To describe the basic clinico-demographic profile and outcome of Early Post-Acute Stroke Seizures (EPASS). Materials and Methods: Two-hundred and fifty one patients admitted within 24 h of onset of stroke symptoms into the stroke unit of a tertiary care hospital were followed up for convulsive seizure(s) within 7 days of admission and for disease outcome in 42 days. Stroke subtype was defined by cranial computed tomography and ictal phenomenon was as described by the stroke unit doctors. Stroke severity was by the Canadian Neurological Scale (CNS) and Glasgow Coma Scale (GCS). Seizures were characterized as partial, generalized, or status. Stroke outcome was defined as discharge from inpatient care to follow-up or still in care and all cause in-hospital death. Data was compared between the group with and without seizures. The effect of age, sex, blood sugar, GCS, CNS, and seizure type on stroke outcome and time to in-hospital death in EPASS was tested on logistic regression and Cox proportional hazard regression. Result: EPASS occurred in 9.96% of subjects and intracerebral infarct was more associated with EPASS, a finding different from what is dominant in western literature. Conclusion: Profile of EPASS may appear different in terms of stroke subtype in Sub-Saharan African populations. Larger prospective studies may clarify the position better.

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Falciparum malaria is known to cause alterations in the coagulation cascade, including disseminated intravascular coagulation. Microthrombotic complications are the best described; however, a number of cases of thrombosis involving larger vessels have been published in the literature. Herein, we describe the case of a woman with malaria associated with massive pulmonary embolism.

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Background: The study is a retrospective review of the pattern of refractive errors in presbyopic patients seen in the eye clinic from January to December, 2009. Patients and Methods: The clinic refraction register was used to retrieve the case folders of all patients refracted during the review period. Information extracted includes patient's age, sex, and types of refractive error. Unaided and pin hole visual acuity was done with Snellen's or "E" Charts and near vision with Jaeger's chart in English or Hausa. All patients had basic eye examination and streak retinoscopy at two third meter working distance. The final subjective refractive correction given to the patients was used to categorize the type of refractive error. Results: There were 5893 patients, 1584 had refractive error and 644 were presbyopic. There were 289 males and 355 females (M:F= 1:1.2). Presbyopia accounted for 10.9% of clinic attendance and 40% of patients with refractive error. Presbyopia was seen in 17%, the remaining 83% required distance correction; astigmatism was seen in 41%, hypermetropia 29%, myopia 9% and aphakia 4%. Refractive error was commoner in females than males and the relationship was statistically significant (P-value = 0.017; P < 0.05 considered significant). Conclusion: Presbyopia is common and most of the patients had other refractive errors. Full refraction is advised for all patients.

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Aim: To evaluate the visual outcome of all patients who had cataract surgery with intraocular lens implant in five Local Government Areas (LGAs) of Kaduna State and to identify reasons for poor outcome and to proffer suggestions to improve outcome. Materials and Methods: A prospective study using the WHO cataract surgery record form to collect data from consecutively screened and operated cataract patients over a period of 18 months (January 2006-June 2007). Data was analysed using Monitoring Catarct Surgery Outcome V2.3 software by the WHO. Results: A total of 690 eyes of 644 patients were operated, ECCE+PCIOL implantation was achieved in 664 (96.2%) while 26(3.8%) had anterior chamber lens implant. The age range was 40 - 99 years and male to female ratio was 1: 0.9. Good outcome was obtained in 239 (34.6%) and 370(53.6%) of patients at 2 and 8 weeks respectively in the postoperative period. Surgical complications like striate keratopathy/corneal oedema (18.3%), cortical reminant (4.2%) and posterior capsular rupture (2.9%), and uncorrected refractive error were identified as reasons for poor outcome. Conclusion: A good outcome of greater than 80% at 8 weeks postoperative period was not achieved. Provision of postoperative correction of residual ametropia in the rural community, as well as improved surgical techniques of surgeons, will go a long way to improve the visual outcome and cataract surgery uptake.

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Background/Objective: Spinal fusion is a rapidly developing area of spine surgery. Many of the implants often used are not within the reach of the patients in the developing world. In this study, we describe the outcome of a novel technique of posterior spinal fusion using the rush nail and spinous process wire. Materials and Methods: We prospectively evaluated patients who underwent the technique since October 2006. We reviewed the patients' biodata, clinical diagnosis, imaging studies, indications for surgery, type of operations, and complications related to the implants and the technique. Clinical test of instability was also determined. Results: The technique was used in 11 female and 19 male patients. The age range was 11-82 years. The indication for surgery was trauma in 15 patients, degenerative disease in seven patients, tuberculosis of the spine in four patients, and four patients had neoplasms. Occipitocervical fusion was performed in three patients, cervical fusion in six patients, thoracic fusion in 10 patients, thoracolumbar fusion in seven patients, lumbar fusion in three patients, and lumbosacral fusion in one patient. The distal segment of the implant backed out in one patient following fracture of the spinal process. The implant was eventually removed. Clinical evidence of instability necessitating external orthotics was also seen in one patient. Two patients had wound infection. These were managed without removing the implants. We did not observe significant complications in other patients. Conclusion: The technique appears safe and effective in carefully selected cases. The technique needs further evaluation in a larger patient population and with a longer duration of follow-up.

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Background: Nulliparity is an obstetric high-risk group whose labor, compared with multiparae, are more likely to develop labor abnormalities that requires intervention. The aim of this report is todetermine factors that influence vaginal delivery in nulliparae. Materials and Methods: A prospective cross-sectional study was done on 286 eligible booked nulliparae in labor, to determine factors associated with vaginal delivery. Information about each patient's social demographic factors, and physical characteristics such as height and weight, events in labor and mode of delivery were recorded in the data sheet. Bivariate analysis was done using Chi square, while multivariate analysis was done using logistic regression. Level of significance was put at P < 0.05. Results: Of a total of 944 primigravidae delivered in the unit during the study period, 286 (30.3%) were eligible for the study. Vaginal delivery was achieved in 214 (74.8%) of the eligible parturient, while 72 (25.2%) had emergency caesarean delivery. Indications for the caesarean delivery were: failure to progress (46; 63.9%), fetal distress (20; 27.8%), maternal distress (5; 8.0%), and rapidly developing pre-eclampsia in labor (1, 0.3%). The birth weight of the baby ranged between 2.0 and 4.5 kg with mean weight of 3.1 ΁ 0.4 kg. Birth weight (odd ratio [OR] = 0.40, 95% confidence interval [CI] = 0.21-0.78), fetal head engagement in early labor (OR = 10.30, 95% CI = 1.35-78.69), and maternal body mass index (BMI) (odd ratio [OR] = 2.08, 95% confidence interval [CI] = 1.03-4.20) were found to be predictors of vaginal delivery. Conclusion: Normal range of maternal BMI, fetal head engagement and normal range of fetal birth weight were found to be the factors associated with vaginal delivery in nulliparae. Variations in these three factors may be the underlying reason for failure to progress, which is the most common indication for caesarean section among this population of parturient.

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Neurofibrolipoma is a very rare benign oral tumor with other synonyms such as neural fibrolipoma, perineural lipoma and intraneural lipoma. A 50 years old female presented with a massive swelling of the tongue of 6 years duration. The tumor was attached to the mucosa of the tip of the tongue, disturbing mastication and speech. On excision, histopathology revealed neurofibrolipoma. This case report shows the atypical presentation of neurofibrolipoma and the challenges of its management.

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Occurrence of solitary intramuscular cysticercosis without involvement of the central nervous system is rare. We report a case of solitary cysticercosis of the brachioradialis muscle in a 35-year-old woman who presented with discomfort and pain in the right elbow and arm after trivial trauma. There were no systemic or neurological features.

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Background: The causes of Blindness vary from place to place with about 80% of it been avoidable. Furthermore Blind people face a lot of challenges in career choice thus limiting their economic potential and full integration into the society. This study aims at identifying the causes of blindness and career choice among pupils in a school for the blind in South -Western Nigeria. Materials and Methods: This is a descriptive study of causes of blindness and career choice among 38 pupils residing in a school for the blind at Ikere -Ekiti, South Western Nigeria. Results: Thirty eight pupils comprising of 25 males (65.8%) and 13 females (34.2%) with age range from 6-39 years were seen for the study, The commonest cause of blindness was cataract with 14 cases (36.84%) while congenital glaucoma and infection had an equal proportion of 5 cases each (13.16%). Avoidable causes constituted the greatest proportion of the causes 27 (71.05%) while unavoidable causes accounted for 11 (28.9%). The law career was the most desired profession by the pupils 11 (33.3%) followed by Teaching 9 (27.3%), other desired profession includes engineering, journalism and farming. Conclusion: The greatest proportion of causes of blindness identified in this study is avoidable. There is the need to create public awareness on some of the notable causes particularly cataract and motivate the community to utilize available eye care services Furthermore there is need for career talk in schools for the blind to enable them choose career where their potential can be fully maximized.

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