ABSTRACT
Speedboat drivers are known to operate daily under challenging conditions, including prolonged engine vibration, exposure to fuel fumes, amongst others; thus, making it necessary to assess the likely adjustments in the cardiopulmonary profile possibly exerted by these occupational exposures. This cross-sectional observational study was conducted amongst speed boat drivers operating in Port Harcourt, Rivers State, Nigeria. The study used the purposive/snowball sample size techniques to recruit the participants. Precisely 60 consenting subjects were engaged in the study, making up 30 speedboat drivers and 30 non- speedboat drivers. Quantitative data obtained from the study participants were statistically analysed using version 25.0 of the IBM Statistical Product and Service Solutions (SPSS) software. The study found that, the boat drivers were within their productive age (44.60 years) with healthy mean BMI (26.00 ± 9.28 Kg.m2). On changes in cardiovascular indices, the study found significantly (p<0.05) raised systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure levels in the speed boat drivers with higher risks of hypertension. Considering the outcome on electrocardiographic (ECG) changes in the speedboat drivers, it was found that there was a comparatively lower incidences of sinus rhythm with normal ECG features but raised abnormal ECG features. The speed boat drivers also manifested sinus arrhythmia, septal infarct, sinus bradycardia, and many cases of sinus rhythm with abnormal findings. It is thus suggested that, the subjects should be educated or motivated to have good health-seeking attitude in order to avert possible risks of cardiovascular accidents.

ABSTRACT
Hearing is one of the greatest form of communication among living being. Other different form of communications are signs and writing. In the developed world hearing loss has been on the rise due to modernization of the communities all over the planet. This involves heavy industries, airplanes and occupations that produces a lot of noise. This study has shown the magnitude of hearing problems in adult and also associated factors in a particular group. The study has been conducted at referral consultant hospital serving about 8regions of the country. This is analytical cross-sectional study; conducted from Sept 2024 to December 2024. The total number of the study participants was 118 whereby the leading age group to be affected with hearing loss among adults is the age between 50yrs to 59yrs by 23.7% followed by age 30yrs to 39yrs and above 60years by 21.2%.Widowed were leading by 29.7% among the marital status that had highest problem with hearing loss followed by singles 27.1% .Also employees and fishing participants were found to have marked hearing loss compared to other cadres by 22%.The prevalence of hearing loss in adult is found to be 26.3%.Among those diagnosed, mixed hearing loss was the most common type, affecting 14.4% of participants, followed by sensorineural hearing loss at 6.8% and conductive hearing loss at 5.1%. In terms of severity, 10.2% of participants were found to have profound hearing loss, representing the most severe cases. Mild hearing loss was reported in 5.1%, while moderate and severe cases were 4.2% and 6.8%, respectively. These findings indicate delayed detection of the adult hearing loss and highlight the need for early screening, occupational noise control and ototoxic medication monitoring.

ABSTRACT
Background: Sleep is a complex phenomenon that plays a pivotal role in ensuring the optimal functioning of the body, especially in adolescence. Poor-quality sleep among adolescents is a major public health problem and the subject of numerous studies in other parts of the world; however, it remains relatively underexplored in our context. This study aimed to assess sleep quality among adolescents attending schools in urban and semi-urban areas. Methods: This descriptive and analytical cross-sectional study was conducted over seven months. We included all voluntary adolescents aged 10–19 years who had given their written informed consent or that of their legal guardian(s). Our sampling was convenient and consecutive. Data on socio-demographic features and lifestyle were collected, and we used the Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and Hospital Anxiety and Depression Scale to assess each participant. Univariate and multivariate analyses were performed to identify factors associated with sleep quality. P < 0.05 was considered statistically significant. Results: A total of 952 were selected, including 309 in semi-urban areas and 643 in urban areas. The mean age of the population was 16.33 ± 1.70 years, with 52.0% female participation. Drug consumption was found in 25.3% of participants, and psychoactive substance consumption in 49.9% of participants, with the rates of consumption of these substances being significantly higher in urban areas than in semi-urban areas. Sleep quality was poor in 41.0% of students, 46.3% in urban areas, and 29.3% in semi-urban areas, the prevalence of sleep quality being significantly higher in urban areas (p < 0.001). Insomnia, which was identified in 19.4% of study participants, was the most common sleep disorder in our study population. Independent risk factors for poor sleep quality among students included living in urban areas, age between 17 and 19 years, the female sex, being in the first or last year of school,

ABSTRACT
Background: Persons living with epilepsy (PWE) may present with poorer oral health outcomes compared to the general population, partly due to the effects of anti-seizure medications (ASM) and challenges related to oral hygiene practices. Gingival enlargement resulting from medication poses a clinically significant threat to oral health and treatment adherence. This study aims; to determine the prevalence of gingival enlargement among PWE compared with healthy controls, to evaluate periodontal status and oral hygiene practices, and to identify factors associated with gingival enlargement. Materials and Methods: We conducted a hospital-based case-control study at Yaoundé Central Hospital and Yaoundé General Hospital, Cameroon. Thirty-five PWE receiving ASM were enrolled and matched by age and sex with 35 healthy controls. Gingival enlargement (MB index), calculus index, plaque index, and gingival bleeding index were tools utilized in oral hygiene status assessment. A structured questionnaire was developed to aid in the collection of data on oral hygiene practices and ASM regimens. Bivariate and multivariate analyses permitted the identification of associations between gingival enlargement and clinical variables. Results: Seventy participants were included in the study (mean age 32.44±11.43 years; 64% male). Out of the 70 participants, 10.0% of participants had gingival enlargement, with an increased frequency among PWE compared with controls (17.1% vs 2.9%, p=0.046). All cases were classified as grade 1 enlargement. PWE had a significantly worse periodontal status, as evidenced by a higher plaque index (p=0.009), gingival bleeding index (p=0.003), calculus index (p=0.027), as well as a worse overall oral hygiene status (p=0.012). Gingival enlargement occurred exclusively among participants with the highest plaque index scores and was significantly associated with periodontal indices (p<0.001). No statistically significant associations were observed between gingival en

ABSTRACT
Introduction: Acute appendicitis during pregnancy is challenging to diagnose due to anatomical and physiological changes. Delay in diagnosis can increase maternal morbidity and foetal loss. Surgical management is necessary however the use of laparoscopy in pregnancy remains limited despite evidence of safety and advantages. Case Presentation: A 20-year-old primigravida at 19 weeks gestation presented with right-sided abdominal pain and nausea. Clinical examination was equivocal and ultrasound was inconclusive. Had persistence of symptoms despite bowel rest and antibiotics with worsening abdominal pain thus underwent diagnostic laparoscopic which revealed appendicitis thus appendectomy done with appropriate intraoperative precautions. Recovery was uneventful, with no maternal or foetal complications. Discussion: Diagnosis of appendicitis in pregnancy is hampered by altered pain localization, physiological leucocytosis, and limited ultrasound accuracy. Magnetic Resonance Imaging may improve diagnostic accuracy. Persistence of symptoms with clinical suspicion for appendicitis warrants laparoscopic evaluation and laparoscopic appendectomy offers advantages of faster recovery, lower infection risk, and better visualization of displaced anatomy. Despite guideline endorsements, concerns about foetal safety continue to limit its use. Conclusion: This case emphasizes the role of clinical suspicion of appendicitis during pregnancy and supports wider adoption of laparoscopy as a safe and effective surgical option when performed by an experienced team. This case highlights diagnostic complexities however illustrates successful laparoscopic approach in Tanzania.

ABSTRACT
Background: Dolutegravir (DTG) is recommended by the WHO as a first‑line antiretroviral. While its efficacy and tolerability are well established, hepatotoxicity concerns persist due to inconsistent findings, underscoring the need for a comprehensive synthesis of global data. Methods: We performed a systematic narrative review analyzing 19 eligible studies (2015-2025) from PubMed, Mendeley, Cochrane, and Google Scholar using keywords related to dolutegravir and hepatotoxicity alongside comparator antiretroviral agents. Inclusion criteria encompassed adult and pregnant populations with reported hepatic outcomes, while exclusions applied to low‑quality studies, non‑English publications, and participants under 15 years. Bias was assessed using the Newcastle‑Ottawa scale, with one randomized trial showing low bias and most observational studies demonstrating moderate bias. Results: Across cohorts, DTG therapy was associated with hepatotoxicity in 20–30% of patients. Comparative analyses often favored DTG, with lower rates of liver enzyme abnormalities than efavirenz and reduced bilirubin compared to protease inhibitors. Predictors of hepatotoxicity included prior ART exposure and elevated baseline liver enzymes. Conclusion: Dolutegravir demonstrates an acceptable hepatic safety profile, comparing favorably with other antiretroviral regimens. These findings support its continued role as a WHO‑endorsed first‑line therapy. Further randomized studies are warranted to refine risk estimates and guide monitoring strategies.

ABSTRACT
Introduction: The objective was to identify certain factors contributing to the poor prognosis of malignant tumours of the limbs. Materials and Methods: This is a descriptive cross-sectional study with retrospective data collection spanning eight years, conducted in the paediatric surgery department of Donka National Hospital. The parameters studied were epidemiological, diagnostic, therapeutic and evolutionary. Results: We collected 14 patient files of patients admitted, hospitalised, treated and followed up for malignant bone tumours of the limbs, including 12 cases of osteosarcoma and 2 cases of Ewing's tumour. The frequency of bone tumours compared to other tumours was 4.75%, with a clear predominance of osteosarcoma (85.71%). The average age was 12.5 years (7 to 17 years), with a sex ratio of 1.8. The average time between onset and consultation was 5.6 months (1 to 24 months). The reasons for consultation were dominated by pain and swelling of the limb in all patients. The mode of detection was traumatic fracture in 6 cases (42.86%). The tumour site was the distal femur in 8 cases (57.14%). The left pelvic limb was affected in 8 cases (42.86%). CT scans were performed in 11 cases (78.57%). Biopsies were performed in all patients. Amputation was performed in 8 patients. The 1-year Survival rate was 2 patients (14.28%). Conclusion: Malignant bone tumours of the limbs are a cause for concern due to delays in diagnosis and treatment. Multidisciplinary consultation involving the authorities and partners could improve treatment.