Low-level heavy metals exposure may contribute much more toward the causation of chronic disease and impaired functioning than previously thought. Among the suggested preventive and intervention measures for the control of renal diseases are the reduction in the exposure to heavy metals. Although these indicate knowledge and awareness of possible role of some heavy metals in the etiogenesis of some chronic diseases by Nigerian Physicians, heavy metal assay as diagnostic guide in patient management is often omitted in most healthcare settings. This is a synoptic capture of the increased incidence and prevalence of some metabolic disorders where heavy metals may be implicated. A search of the terms heavy metal exposure, source, toxicity, metabolic disorders, poisoning in Nigeria, in bibliographical databases (in English language) such as PubMed, Scopus, Google Scholar, and Africa Journal Online (AJOL) digital library was conducted. Leaded gasoline, refuse dumping, absence of poison information centers, and poor record keeping characterize environmental health in Nigeria. Lead and cadmium are of most significant public health importance in Nigeria. The recognition and inclusion of heavy metals assays in the diagnosis of metabolic disorders may ensure early diagnosis and improve management.

Antenatal corticosteroids (ACS) are recommended for use in antenatal mothers at risk of preterm delivery before 34 weeks. One common side-effect of these drugs is their propensity to cause hyperglycemia. A PubMed search was made using terms 'steroid,' 'dexamethasone,' 'betamethasone' with diabetes/glucose. Relevant articles were extracted. In addition, important cross-reference articles were reviewed. This review, based upon this literature search, discusses the available evidence on effects on glycemic status as well as management strategies in women with pre-existing diabetes, gestational diabetes mellitus, as well as normoglycemic women after ACS use in pregnancy.

Background: Voluntary counseling and testing (VCT) is a cost-effective tool to prevent and control human immunodeficiency virus (HIV)/acquired immodeficiency syndrome. Community conversation (CC) is a community-based strategy meant to enhance the community utilization of VCT. However, the role of CC in VCT service uptake has not yet been evaluated. Aims: This study was conducted to compare VCT service utilization between rural communities with well CC performance and rural communities with poor CC performance in Shebedino woreda. Materials and Methods: A cross-sectional comparative community-based study was conducted in 2010 among 462 selected adults in the age bracket of 15-59 years. VCT service uptake was compared between well CC performing communities and poor CC performing communities using two sample test of proportion. Predictors of VCT service uptake were determined using logistic regression model. Results: Uptake of VCT service and the related VCT knowledge were statistically higher in well CC performing communities than poor CC performing communities; [73.0% vs. 54.1%, P < 0.001) vs. 97.8% vs. 93.8%, P = 0.034]. CC, VCT knowledge, and knowledge on HIV transmission were independent predictors of VCT service utilization. Conclusion: Uptake of VCT service is higher in well CC performing communities. Emphasis should be given to strengthen CC performance.

Background: Geohelminth infections are predominant in Nigeria and communities at greatest risks are those with poor environmental/sanitary conditions and unhygienic habits. Chemokine ligands (CXCL) a class under chemokine group play important roles in the immune system by either mediating susceptible or protective immune responses to parasitic infections. Aim: This study was to assess the impact of Ascaris lumbricoides sole infection and co-infection on some serum chemokines (CXCL5, CXCL9, and CXCL11) in infected Nigerians. Materials and Methods: A total of 194 individuals attending Agbor general hospital were examined for A. lumbricoides and hookworm infections. Thereafter, sera were obtained from positive volunteers and control group using enzyme-linked immunosorbent assay to examine the impact of these helminth infections on the serum concentration of some chemokines (CXCL5, CXCL9, and CXCL11). Results: The mean sera levels of CXCL5 and CXCL9 in infected volunteers were higher than the control subjects. Also, positive correlation was recorded for CXCL9 (P > 0.05), while negative responses were seen for CXCL5 and CXCL11 (P > 0.05) in relation to increase in the intensities of infections. CXCL9 was more expressed in A. lumbricoides + hookworm co-infections than single. Furthermore, the mean concentration of CXCL5 was higher in infected females than males (P < 0.05). Conclusion: The proinflammatory responses of CXCL5 and CXCL9 to A. lumbricoides and hookworm infections could be an indication of the meditating roles of these chemokines in the immune system to either confer some form of host/parasite immunity or susceptibility.

Background: The blood pressure and anthropometric measurements are important for evaluating the health of children, adolescents as well as adults. Aim: The aim is to study the blood pressure and body dimensions and to find out the prevalence of overweight/obesity and hypertension among adults. Materials and Methods: A cross-sectional study was conducted of all the people belonging to the Punjabi community, residing in Roshanara area and Jaina building in Delhi, for the past 20 years and aged 18-50 years. The men were engaged in transport business and women were mainly housewives. Results: Mean values of all the measurements, that is, height, weight, upper arm circumference, pulse rate, systolic blood pressure (SBP), and diastolic blood pressure (DBP) were higher among males as compared with females, except skinfold thicknesses. Body mass index (BMI) and fat percentage was found to be higher among females as compared with males. There was a significant positive correlation between BMI, fat percentage, and blood pressure both SBP as well as DBP. Odds ratio showed that overweight/obese subjects were more likely to have hypertension than those with normal BMI. Conclusion: Prevalence of prehypertension among overweight/obese suggested an early clinical detection of prehypertension and intervention including life style modification, particularly weight management.

Background: Quality of life is an important aspect in diabetes because poor quality of life leads to diminished self-care, which in turn leads to worsened glycemic control, increased risks for complications, and exacerbation of diabetes overwhelming in both the short run and the long run. Aims: The aim of our study is to examine the health-related quality of life of diabetic patients in rural India. Materials and Methods: This case-control study was done among type 2 diabetes mellitus patients attending Medicine Outpatient department of a 780-bedded rural medical college located in central India. We used the World Health Organization Quality of Life Questionnaire - short version (WHOQOL-BREF) to assess quality of life. Results: The HRQOL among diabetics and non-diabetic controls is comparable to each other with bad physical health, bad psychological health, deteriorating social relationships, and bad environmental conditions affecting the HRQOL of both the groups equally. The overall HRQOL of the total study population (cases and controls) was poor. Conclusion: The finding of this study will help in health promotion in rural medical practice in India. It would beckon the much awaited avenue of holistic care of a diabetic patient with equal importance to the mental wellbeing and quality of life, as compared to physical well being.

Context: A cervicofacial pain and foreign body sensation in pharynx associated with styloid process elongation is called Eagle syndrome. Typically, this syndrome is provoked by tonsillectomy or trauma. We report the first case of acute parotitis-induced Eagle syndrome. Case Report: A 65-year-old woman presented with right facial pain. CT scan of neck revealed asymmetric enhancement of the right parotid gland compatible with acute parotitis. All inflammation was resolved with antibiotics. However, the patient complained of pain in right mandibular region out of proportion to inflammation. Review CT found to have an asymmetrically long right styloid process measures. The diagnosis of acute parotitis-induced Eagle syndrome was established. Conclusion: Physicians should have a high index of suspicion for Eagle syndrome in patients with atypical neck pain and elongated styloid process since another significant manifestation of Eagle syndrome is carotid artery compression leading to recurrent syncope or stroke.

Context: Xeroderma pigmentosum is a rare autosomal-recessive disorder that appears in early childhood. Squamous cell carcinoma is not uncommon in patients with xeroderma pigmentosum and mostly involving the face, head, neck, and scalp. However, squamous cell carcinoma of the scalp may exhibit an aggressive course. Case Report: Here, we present a huge squamous cell carcinoma of the scalp in a three-years-old child with xeroderma pigmentosum. In addition, we illustrate the challenges of a child with xeroderma pigmentosum who grows up in a sunny environment where the possibility of early onset of squamous cell carcinoma is extremely high in any suspected skin lesion. Conclusion: In xeroderma pigmentosum patients, squamous cell carcinoma of the scalp can present early and tends to be unusually aggressive. In sunny areas, proper education to the patient and their parents about ultra-violet light protection and early recognition of any suspicious lesion could be life-saving.