Flat Feet (also known as pes planus) describes a condition in which the longitudinal (lengthwise) and/or medial (crosswise) arches of the foot are dropped down or flat.

Definition

Flat Feet (also known as pes planus) describes a condition in which the longitudinal (lengthwise) and/or medial (crosswise) arches of the foot are dropped down or flat. The entire bottom of the barefoot is in contact with the floor or ground surface during standing, walking, and other weight-bearing activities.

Flat feet

The condition is often present at birth (congenital) in one or both feet. When only one foot is affected, the problem is referred to as unilateral pes planus or flatfoot. When both feet are involved, the condition is bilateral flatfeet.

Pathophysiology

The medial longitudinal arch is made up of the calcaneus, navicular, talus, first three cuneiforms, and first, second, and third metatarsals. It is supported by the soft tissues of the spring ligament (plantar calcanea navicular ligament), deltoid ligament, posterior tibial tendon, plantar aponeurosis, and flexor hallucis longus and brevis muscles.

Dysfunction of any portion of the medial longitudinal arch may result in acquired pes planus. The main factors that contribute to an acquired flat foot deformity are excessive tension in the triceps surae, obesity, posterior tibial tendon dysfunction, or ligamentous laxity in the spring ligament, plantar fascia, or other supporting plantar ligaments. It may also result from a tight Achilles tendon or calf muscle.

Rigid pes planus is rare. It usually develops during childhood, but it can occur at any point in life. It develops from the tarsal coalition, accessory navicular bone, congenital vertical talus, or other forms of congenital hindfoot pathology.

Types of Flat Feet

There are three types of flatfoot:

Flexible flatfoot: Most children with flatfoot have this type, and it affects both feet. It is not painful and does not need treatment.

Flexible flatfoot with a short Achilles tendon: This rarely happens to young children. It also affects both feet. It can cause pain and disability, eventually leading to arthritis.

Rigid flatfoot: This is the least common type of flatfoot. It affects people who have problems with the bones in their feet, and about one in four has pain and disability. It may affect one or both feet.

Risk factors

Flat feet problems are more common in women than in men.

Other major factors that may increase your risk for adult flat feet include:

  • Diabetes
  • High blood pressure (hypertension)
  • Obesity
  • Traumatic injury
  • Arthritis
  • Age

Causes of Flat Feet

It is more caused by loose joint connections and baby fat between the foot bones. These conditions make the arch fall when your child stands up. This is why you sometimes hear flat feet called “fallen arches.” The feet may look like they have arches when your child is sitting or when the big toe is bent backward. But the arch flattens when your child puts weight on the foot.

Rarely, it can be caused by foot bones that are joined together.

In adults, a number of things can cause flat feet. Adult-acquired causes include:

Your tendons: Tendons offer support to your arches. If you tear a tendon or even weaken it over time, it can cause flat feet.

Rheumatoid arthritis: This type of arthritis can progressively cause deformities in your joints. These deformities can cause flat feet.

Broken bones: Damaging bones in your midfoot can cause flat feet.

Ligament injuries: Ligaments support your bones. An injury to these can impact your joints, which can cause flat feet.

Injuries caused by flat feet

Whether you have flat feet naturally or fallen arches because of an injury or other condition, both can cause many of the same injuries and problems including tired feet, foot pain, ankle swelling, and overpronation. While many of these flat foot problems and injuries can be addressed easily with the right insoles, avoiding them altogether is the goal.

Flat feet can cause:

  • Tired feet– When your feet feel fatigued after you’ve been on them, and especially at the end of the day.
  • Foot pain– Pain can occur over the length of the foot or in isolated areas. Pain typically occurs inside the ankle, on the outer edge of the foot, in the heel (known as plantar fasciitis) or in the arch itself.
  • Swelling along the inside of your ankle can make footwear uncomfortable.
  • An altered placement of the foot on the ground that can cause pain in the calf, knee, thigh, hip, and lower back.
  • Overpronation, or the excessive rolling inward of the foot.

Flat Feet Symptoms

Depending on the cause of the flatfoot, a patient may experience one or more of the different symptoms below:

  • Pain along the course of the posterior tibial tendon which lies on the inside of the foot and ankle. This can be associated with swelling on the inside of the ankle.
  • Pain that is worse with activity. High intensity or impact activities, such as running, can be very difficult. Some patients can have difficulty walking or even standing for long periods of time.
  • When the foot collapses, the heel bone may shift position and put pressure on the outside ankle bone (fibula). This can cause pain on the outside of the ankle. Arthritis in the heel also causes this same type of pain.
  • Patients with an old injury or arthritis in the middle of the foot can have painful, bony bumps on the top and inside of the foot. These make shoewear very difficult. Occasionally, the bony spurs are so large that they pinch the nerves which can result in numbness and tingling on the top of the foot and into the toes.
  • Diabetics may only notice swelling or a large bump on the bottom of the foot. Because their sensation is affected, people with diabetes may not have any pain. The large bump can cause skin problems and an ulcer (a sore that does not heal) may develop if proper diabetic shoewear is not used.

Complications of Flat Feet

Some people with flat feet experience complications when there is a delay in the treatment. Individuals with foot and ankle problems may find that flat feet can worsen the symptoms. Flat feet can lead to complications, such as:

  • Flat feet can impose extra pressure on the muscles and joints of the foot.
  • Flat feet can cause shin splint, a condition that causes pain along the inner edge of the tibia (shin) bone. Athletes with flat feet are more like to develop tibial stress fractures.
  • People with flat feet who wear improperly fitted shoes develop a condition known as bunions. It is a condition that affects the joint at the base of the big toe.
  • Flat feet can increase the risk of tendinitis, which affects the Achilles tendon due to the increased stress on the heel and ankle.
  • Flat feet may cause a hammertoe, a condition where a deformity occurs due to a curl or bend in the toe. Hammertoe occurs due to an imbalance in the muscles or ligaments that hold the toe straight.

Diagnosis and test

While flat feet can usually be self-diagnosed, the underlying cause may require investigation by a foot specialist known as a podiatrist. This may involve a visual exam as well as imaging tests to evaluate the structure of the foot.

Flat feet

Visual Examination

A podiatrist can usually diagnose flat feet by looking at your feet while standing. Among some of the visual tests used:

  • The wet footprint test is performed by wetting the feet and standing on a smooth, level surface. The thicker the print between the heel and ball of the foot, the flatter the foot. By contrast, a high-arch foot would leave only a narrow print of the outer foot.
  • The shoe inspection test can provide evidence of faulty foot mechanics. If you have flat feet, there will be more wear on the inside of your sole, especially in the heel area. The shoes upper will also tend to lean inward over the sole.
  • The “too many toes” test is performed as the doctor stands behind you and counts the number of toes peeking out to the sides. While only the pinky toe would be seen in people with normal pronation, three or four may be seen in those who overpronate.
  • The tiptoe test is used to see if you have flexible or rigid flat feet. If a visible arch forms when you stand on your toes, you have flexible flat feet. If not, your doctor would likely recommend treatment for a rigid flat foot.

Imaging Tests

If you are experiencing a lot of foot pain, your doctor may order imaging tests to help pinpoint the underlying cause. Among the imaging tests used:

  • X-rays and computed tomography (CT) scans are ideal for diagnosing arthritis and evaluating irregularities in the angle and/or alignment of the foot bones.
  • Ultrasound can be used to produce detailed images of soft tissue damage, such as a ruptured tendon.
  • Magnetic resonance imaging (MRI) can provide detailed images of bone and soft tissue damage, ideal for people with rheumatoid arthritis, tendonitis, or an Achilles heel injury.

Treatment of Flat Feet

Treatment for flat feet may range from noninvasive options to surgical intervention to help relieve foot pain and improve function for patients.

If you suspect you have flat feet, doctors recommend an examination and treatment as soon as possible. Treatment in the early stages of flat feet can prevent progression to the later stages.

Nonsurgical Treatment

If you experience symptoms with flexible flatfoot, doctors may recommend nonsurgical treatment options, including:

Activity modifications: Cut down on activities that bring you pain and avoid prolonged walking and standing to give your arches a rest.

Weight loss: If you are overweight, try to lose weight, as putting too much weight on your arches may aggravate your symptoms.

Orthotic devices: Doctors can provide you with custom orthotic devices for your shoes to give more support to the arches.

Immobilization: In some cases, it may be necessary to use a walking cast or to avoid weight-bearing completely.

Medications: Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, help reduce pain and inflammation.

Physical therapy: Ultrasound therapy or other physical therapy modalities may be used to provide temporary relief.

Shoe modifications: Wearing shoes that support the arches is important for anyone who has flatfoot.

Orthotic insole arch support

Surgical procedures to correct flatfoot include:

  • Repairing a stretched or torn tendon.
  • Fusing one or more of the bones in the foot or ankle together.
  • Cutting and reshaping a bone to correct alignment.
  • Using a piece of one tendon to lengthen or replace another.

Flat Feet Prevention

  • You can wear comfortable and supportive shoes that are designed to completely support the arch and heel.
  • If you add insoles to your shoes, you are providing extra support and comfort for the arch of your foot.
  • There is also the option of investing in custom orthotics that helps distribute and minimize the pressure in your foot.
  • If these methods of treatment are not helping, then surgery can be an option to lessen your pain.

Insoles arch support in shoes

Stomach cancer develops when cells in the lining of the stomach grow and divide in an abnormal way.

Definition

Stomach cancer develops when cells in the lining of the stomach grow and divide in an abnormal way. Tumours can begin anywhere in the stomach, although most start in the glandular tissue found on the stomach’s inner surface (mucosa). This type of cancer is called adenocarcinoma of the stomach (also known as gastric cancer).

If it is not found and treated early, stomach cancer can spread through the lymphatic system to nearby lymph nodes or through the bloodstream to other parts of the body, such as the liver and lungs. It may also spread to the walls of the abdomen (peritoneum). Rarely, it can grow through the stomach wall into nearby organs such as the pancreas and bowel.

Epidemiology

Once the second most common cancer worldwide, stomach cancer has dropped to sixth place, after cancers of the lung, breast, prostate, colon and rectum, and skin (non-melanoma). Stomach cancer is the third most common cause of death from cancer. The World Health Organization estimates that in 2018, gastric cancer accounted for 783,000 deaths worldwide.

Types of Stomach Cancer

Different types of stomach cancer include:

Adenocarcinomas of the stomach develop in the cells of the innermost lining of the stomach. Most stomach cancers are classified as adenocarcinomas of the stomach.

Lymphoma is a cancer of the immune system tissue that may start anywhere lymph tissues are found, including the stomach. Lymphomas in the stomach are rather rare and only account for about 4 percent of all stomach cancers.

Gastrointestinal stromal tumors, or GISTs, are a rare type of stomach cancer that forms in a special cell found in the lining of the stomach called interstitial cells of Cajal (ICCs). Under a microscope, GIST cells look similar to muscle or nerve cells. These tumors may develop throughout the digestive tract, but about 60 to 70 percent occur in the stomach.

Carcinoid tumors typically start in the hormone-producing cells of the stomach. These tumors usually do not spread to different organs and account for only about 3 percent of stomach cancer incidence.

Gastric carcinoid tumors come in three types:

  • Type I and II ECL-cell carcinoids rarely spread to other parts of the body and may produce no symptoms. They are most often discovered during an endoscopy for another health issue, such as acid reflux.
  • Type III ECL-cell carcinoids are more aggressive. The excess hormone secretion of carcinoid tumors may lead to a condition called carcinoid syndrome, marked by flushing, abdominal pain, diarrhea, constriction of the bronchial tubes in the lungs and, in some cases, heart troubles like valve dysfunction. Carcinoid syndrome is a sign that more aggressive treatment may be required.

Stomach cancer risk factors

Some risk factors can be attributed to lifestyle and therefore can be changed. However, there are also risk factors that cannot be controlled. Having a risk factor(s) does not mean you will get the disease, but scientists have found several risk factors that make a person more likely to get stomach cancer. They are:

  • Gender–it is more common in men than women.
  • More common in those of Hispanic, African, Native American and Pacific Islander descent than Caucasians.
  • People with mucosa-associated lymphoid tissue (MALT) lymphoma have an increased risk.
  • Diets with high amounts of smoked foods, salted meat and fish, and pickled vegetables.
  • Smoking increases risk
  • Being overweight or obese is a possible cause of gastric cancers.

Causes of Stomach Cancer

Scientists don’t know exactly what makes cancer cells start growing in the stomach. But they do know a few things that can raise your risk for the disease. One of them is infection with common bacteria, H. pylori, which causes ulcers. Inflammation in your gut called gastritis, a certain type of long-lasting anemia called pernicious anemia, and growths in your stomach called polyps also can make you more likely to get cancer.

Other things that seem to play a role in raising the risk include:

  • Smoking
  • Being overweight or obese
  • A diet high in smoked, pickled, or salty foods
  • Stomach surgery for an ulcer
  • Type-A blood
  • Epstein-Barr virus infection
  • Certain genes
  • Working in coal, metal, timber, or rubber industries
  • Exposure to asbestos

Symptoms and Signs

People with stomach cancer may experience the following symptoms or signs. Sometimes, people with stomach cancer do not have any of these changes. Or, the cause may be a different medical condition that is not cancer.

Stomach cancer is usually not found at an early stage because it often does not cause specific symptoms. When symptoms do occur, they may be vague and can include those listed below. It is important to remember that these symptoms can also be caused by many other illnesses, such as a stomach virus or an ulcer.

  • Indigestion or heartburn
  • Pain or discomfort in the abdomen
  • Nausea and vomiting, particularly vomiting up solid food shortly after eating
  • Diarrhea or constipation
  • Bloating of the stomach after meals
  • Loss of appetite
  • Sensation of food getting stuck in the throat while eating

Symptoms of advanced stomach cancer may include:

  • Weakness and fatigue
  • Vomiting blood or having blood in the stool
  • Unexplained weight loss

Complications of Stomach Cancer

If stomach cancer progresses to advanced stages, then it may lead to many complications like:

  • Gastrointestinal bleeding
  • Gastric perforation
  • Small Bowel Obstruction

Stages of stomach cancer

The stages of adenocarcinoma of the stomach or esophagus include:

Stage I: At this stage, the tumor is limited to the top layer of tissue that lines the inside of the esophagus or stomach. Cancer cells also may have spread to a limited number of nearby lymph nodes.

Stage II: The cancer at this stage has spread deeper, growing into a deeper muscle layer of the esophagus or stomach wall. Cancer may also have spread to more of the lymph nodes.

Stage III: At this stage, the cancer may have grown through all the layers of the esophagus or stomach and spread to nearby structures. Or it may be a smaller cancer that has spread more extensively to the lymph nodes.

Stage IV: This stage indicates that the cancer has spread to distant areas of the body.

Diagnosis and test

If a doctor suspects stomach cancer, a thorough patient history will first be done. This includes asking about your lifestyle, such as tobacco or alcohol use and whether you have a family history of stomach cancer. A physical exam may follow, along with some of the following tests:

Blood tests

Stool tests called fecal occult blood test – to find blood in the stool that might not be visible to the naked eye

Barium swallow or upper gastrointestinal (GI) series – the patient swallows a barium solution and the doctor uses an X-ray to track the barium’s progress as it passes through the esophagus and stomach

Endoscopy – A small tube with a light on one end is slid down the throat and into the stomach so the doctor can look directly at the stomach lining

Biopsy – Using a gastroscopy instrument that’s fitted with a special cutter, a small piece of tissue can be taken and examined under a microscope

If cancer is diagnosed, the doctor needs to determine the stage the cancer has reached. This may involve more tests, such as:

  • Chest X-rays
  • Ultrasounds
  • Computed tomography (CT) scans
  • Magnetic resonance imaging (MRI) scans
  • PET scan
  • Diagnostic laparoscopy
  • Blood tests

In its early stages, stomach cancer is very treatable. Unfortunately, early stomach cancer causes few symptoms. Usually, a diagnosis is made when the cancer is more advanced. Because it can take some time to identify stomach cancer, only about 10% of people are diagnosed while it’s still in the early stages.

Stomach Cancer Treatment

Common treatments include:

Surgery

Surgery is often the primary treatment for this type of cancer.

Chemotherapy

Chemotherapy may be used in combination with surgery and radiation therapy.

Radiation therapy

Radiation approaches may be used to treat adenocarcinoma of the stomach or lymphoma of the stomach. It may help destroy cancer cells that remain after stomach cancer surgery, alleviate pain and stop bleeding or shrink tumors that may be blocking the digestive tract. Radiation therapies used to treat stomach cancer include:

Intensity modulated radiation therapy (IMRT) allows a radiation oncologist to use higher radiation doses than traditional therapies. IMRT may also help spare more of the surrounding healthy stomach tissue from harmful doses of radiation.

Trilogy® allows a radiation oncologist to deliver controlled doses of radiation to stomach tumors with increased accuracy. The technology’s real-time imaging allows a radiation therapist to monitor stomach tumor motion during treatment.

TomoTherapy® combines IMRT and CT scan technology and is designed to deliver precise radiation to match tumor shapes while avoiding sensitive healthy tissue. TomoTherapy targets hard-to-reach stomach tumors by sculpting small, powerful and more precise radiation beams at the tumors from a full 360 degrees.

Interventional radiology may be a treatment option for stomach cancer that has spread to the liver. These minimally invasive procedures allow doctors to deliver radiation or chemotherapy drugs in high doses directly into liver tumors.

Immunotherapy

Immunotherapy drugs called checkpoint inhibitors work by blocking signaling receptors that help cancer cells hide from immune cells. The U.S. Food and Drug Administration have approved a checkpoint inhibitor to treat some forms of advanced or metastatic adenocarcinomas in the stomach and the gastroesophageal junction, where the stomach meets the esophagus. Checkpoint inhibitors and other immunotherapy treatments may be used in combination with other treatments, such as surgery. Immunotherapy may not be recommended for all patients, and responses to the treatment vary widely.

Targeted therapy

Targeted therapy may be a treatment option for patients with advanced stomach cancer whose cancer cells test positive for human epidermal growth-factor receptor 2 (HER2). This means their stomach tumors have a type of gene that stimulates cells to grow and become cancerous. HER2-positive stomach cancers may be treated with a monoclonal antibody that targets the HER2 gene. This drug, often used to treat HER2-postive breast cancer, may be used in combination with chemotherapy for stomach cancer. In some cases, this form of targeted therapy may be used alone.

Gastroenterology

Gastroenterology procedures may be required to diagnose, stage or treat stomach cancer. These procedures include placing stents or inserting tubes and balloon dilation to relieve obstructions.

Prevention

Screening programs are successful in detecting disease in the early stages in parts of the world where the risk of stomach cancer is much higher than in the United States. The value of screening in the United States and other countries with much lower rates of stomach cancer is not clear.

The following may help reduce your risk of stomach cancer:

  • Do not smoke.
  • Keep a healthy diet rich in fruits and vegetables.
  • Take medicines to treat reflux disease (heartburn), if you have it.
  • Take antibiotics if you are diagnosed with H. pylori infection.

A branchial cleft cyst is a type of birth defect in which a lump develops on one or both sides of your child’s neck or below the collarbone.

What is a branchial cleft cyst?

A branchial cleft cyst is a type of birth defect in which a lump develops on one or both sides of your child’s neck or below the collarbone. This type of birth defect is also known as a branchial cleft remnant.

This birth defect occurs during embryonic development when tissues in the neck and collarbone, or branchial cleft, don’t develop normally. It may appear as an opening on one or both sides of your child’s neck. Fluid draining from these openings may form in a pocket, or a cyst. This can become infected or seep out of an opening in your child’s skin.

Types of Branchial Cleft Cyst

There are four main types of Branchial cleft abnormalities

  • First branchial cleft anomalies, in which cysts develop around the earlobe or under the jaw
  • Second branchial cleft sinuses, which open on the lower part of the neck
  • Third branchial cleft sinuses, which develop close to the thyroid gland in the front part of the muscle which attaches to the collarbone
  • Fourth branchial cleft sinuses, which affect the area below the neck.

The most common type of Branchial cleft abnormality is ‘Second branchial cleft sinuses,’ or the failure of fusion of the second and third branchial arches.

Pathophysiology

At the fourth week of embryonic life, the development of 4 branchial (or pharyngeal) clefts results in 5 ridges known as the branchial (or pharyngeal) arches, which contribute to the formation of various structures of the head, the neck, and the thorax. The second arch grows caudally and, ultimately, covers the third and fourth arches. The buried clefts become ectoderm-lined cavities, which normally involute around week 7 of development. If a portion of the cleft fails to involute completely, the entrapped remnant forms an epithelium-lined cyst with or without a sinus tract to the overlying skin.

What are the causes and risk factors of a branchial cleft cyst?

This is a congenital birth defect that occurs early in embryonic development. Major neck structures form during the fifth week of fetal development. During this time, five bands of tissue called pharyngeal arches form. These important structures contain tissues that’ll later become:

  • Cartilage
  • Bone
  • Blood vessels
  • Muscles

Several defects in the neck can occur when these arches fail to develop properly.

In branchial cleft cysts, the tissues that form the throat and neck don’t develop normally, creating open spaces called cleft sinuses on one or both sides of your child’s neck. A cyst may develop from fluids that are drained by these sinuses. In some cases, the cyst or sinus may become infected.

Symptoms of Branchial Cleft Cyst

Branchial cleft cyst mostly does not cause any pain, except in cases when it gets infected. Some of the symptoms of a branchial cleft cyst include:

  • Pain in the affected area.
  • Feeling of pressure in the affected area.
  • Draining of fluid from the neck of the child.
  • Formation of a small lump or mass on the side of the neck close to the front edge of the sternocleidomastoid muscle.
  • Formation of a lump, dimple or skin tag on the child’s upper shoulder, or slightly underneath their collar bone.
  • Swelling or tenderness in the child’s neck, generally occurring with an upper respiratory infection.

Branchial cleft cysts generally develop in late childhood or early adulthood as a solitary, painless mass which becomes infected, though it is not noticed earlier.

Complications of Branchial Cleft Cysts

  • If branchial cleft cysts are left untreated, they’re prone to abscess formation and recurrent infection with a potential compromise to local structures and resultant scar formation.
  • Although rare, there have been reports of malignancies in branchial cleft cysts, including papillary thyroid carcinoma and branchiogenic carcinoma.
  • The outcome of surgery is usually good. But, cysts can recur, particularly if the surgery occurred during an active infection. Experiencing a little pain following surgery is normal, but if it gets worse and doesn’t go away, it could indicate bleeding or infection.
  • The surgeon makes every effort to completely remove the cyst. Sometimes, it can have tracts that the surgeon doesn’t detect during surgery. Most patients have the cyst removed successfully with just one surgery and no additional problems. You may need another surgery if it does recur to completely remove it.

Diagnosis of Branchial Cleft Cysts

  • A correct diagnosis will lead to proper management. Complete history and physical exam is usually all that is necessary for diagnosis. The classic fistula/sinus opening in the usual location, with mucous drainage, is specific for a branchial anomaly.
  • Ultrasound confirms the diagnosis and can usually trace if there is an internal opening (fistula).
  • CT or MRI may be needed if there is more information needed or if the diagnosis is not definite.
  • Depending on how sure the doctors are of the diagnosis, other studies might be ordered.

Conditions that mimic this condition

  • Dermoid cysts: Growth from skin elements
  • Thyroid nodules: Growth in the thyroid gland
  • Lymph nodes: Small nodules in the neck that enlarge in response to infection.
  • Skin infections such as boils or abscesses

Treatment and Medication

Medicine

No medications are usually needed. If the cyst, sinus or fistula is infected, medicines (antibiotics) are given to control infection.

Surgery

Removal of the cyst, fistula or sinus is the treatment of choice.

  • If the structure is infected, the infection must be treated first with antibiotics. Sometimes, control of the infection needs draining the pus from underneath the skin.
  • Abnormalities on the face may connect to the ear canal. Therefore, children with these lesions on the face are usually referred to pediatric ear/nose and throat surgeons.
  • Abnormalities of the neck are studied to see the entire structure along with internal openings. The sinus/ fistula or cyst is completely removed. Sometimes, a second small incision made higher in the neck is needed for complete removal. Usually the wound is closed with dissolving sutures, and there are no sutures to remove.

Preoperative preparation

Patients are usually asked to shower or bathe on the night before surgery. Patients are asked to stop eating or drinking for a few hours before surgery.

  • Informed consent: A consent form is a legal document that states the tests, treatments or procedures that your child may need and the doctor or practitioner that will perform them. You give your permission when you sign the consent form.
  • Emotional support: Stay with your child for comfort and support as often as possible while he or she is in the hospital. Bring items from home that will comfort your child, such as a favorite blanket or toy.

Postoperative care

Depending on the extent of the surgery, the patient goes home on the same day of the operation or stays in the hospital overnight.

Risks/benefits

  • Benefits of surgery: Confirm the diagnosis, prevent infection, and decrease the risk that the lesion could become malignant.
  • Risks of surgery: Bleeding, damage to nerves or neck structures, post-operative scar, risk of anesthesia, rare swelling around the airway that may interfere with breathing. The patient may be observed in hospital overnight if this is a concern.

Home Care

  • Diet: Your child may eat a normal diet after surgery.
  • Activity:  Your child should avoid strenuous activity first 1-2 days.
  • Wound care:  Surgical incisions should be kept clean and dry for a few days after surgery. Most of the time, stitches used in children are absorbable and do not require removal. Your surgeon will give you specific guidance regarding wound care, including when your child can shower or bathe.
  • Medicines:  Medicines for pain such as acetaminophen (Tylenol) or ibuprofen (Motrin or Advil) or something stronger like a narcotic may be needed to help with pain for a few days after surgery. Stool softeners and laxatives are needed to help regular stooling after surgery, especially if narcotics are still needed for pain.
  • What to call the doctor for:  Neck swelling or shortness of breath are serious signs that there is bleeding or swelling that is affecting breathing. The patient should go to the emergency room. Fever, redness of the incision or fluid draining from the wound can be signs of post-operative infection.
  • Follow-up care:  Follow-up visit with the surgeon a few weeks after operation.

Prognosis

Patients and families should be educated that branchial cleft cysts are typically benign, and with treatment, patients generally recover without complications or recurrence.

Craniosynostosis is a birth defect in which the bones in a baby’s skull join together too early.

What is Craniosynostosis?

Craniosynostosis is a birth defect in which the bones in a baby’s skull join together too early. This happens before the baby’s brain is fully formed. As the baby’s brain grows, the skull can become more misshapen. The spaces between a typical baby’s skull bones are filled with flexible material and called sutures. These sutures allow the skull to grow as the baby’s brain grows. Around two years of age, a child’s skull bones begin to join together because the sutures become bone. When this occurs, the suture is said to “close.” In a baby with craniosynostosis, one or more of the sutures close too early. This can limit or slow the growth of the baby’s brain.

When a suture closes and the skull bones join together too soon, the baby’s head will stop growing in only that part of the skull. In the other parts of the skull where the sutures have not joined together, the baby’s head will continue to grow. When that happens, the skull will have an abnormal shape, although the brain inside the skull has grown to its usual size. Sometimes, though, more than one suture closes too early. In these instances, the brain might not have enough room to grow to its usual size. This can lead to a build-up of pressure inside the skull.

Types of craniosynostosis

There are several types of craniosynostosis. Most involve the fusion of a single cranial suture. Some complex forms of craniosynostosis involve the fusion of multiple sutures. Most cases of multiple suture craniosynostosis are linked to genetic syndromes and are called syndromic craniosynostosis.

The term given to each type of craniosynostosis depends on what sutures are affected. Types of craniosynostosis include:

Sagittal (scaphocephaly). Premature fusion of the sagittal suture that runs from the front to the back at the top of the skull forces the head to grow long and narrow. Sagittal craniosynostosis results in a head shape called scaphocephaly and are the most common type of craniosynostosis.

Coronal. Premature fusion of one of the coronal sutures (unicoronal) that runs from each ear to the top of the skull may cause the forehead to flatten on the affected side and bulge on the unaffected side. It also leads to the turning of the nose and a raised eye socket on the affected side. When both coronal sutures fuse prematurely (bicoronal), the head has a short and wide appearance, often with the forehead tilted forward.

Metopic. The metopic suture runs from the top of the bridge of the nose up through the midline of the forehead to the anterior fontanel and the sagittal suture. Premature fusion gives the forehead a triangular appearance and widens the back part of the head. This is also called trigonocephaly.

Lambdoid. Lambdoid synostosis is a rare type of craniosynostosis that involves the lambdoid suture, which runs along the back of the head. It may cause one side of your baby’s head to appear flat, one ear to be higher than the other ear and tilting of the top of the head to one side.

What causes craniosynostosis?

Craniosynostosis occurs in one out of 2,000 live births and affects males slightly more often than females.

Craniosynostosis is most often sporadic (occurs by chance). In some families, craniosynostosis is inherited in one of two ways:

Autosomal recessive. Autosomal recessive means that two copies of the gene are necessary to express the condition, one inherited from each parent, who are obligate carriers. Carrier parents have a one in four, or 25 percent, chance with each pregnancy, to have a child with craniosynostosis. Males and females are equally affected.

Autosomal dominant. Autosomal dominant means that one gene is necessary to express the condition and the gene is passed from parent to child with a 50/50 risk for each pregnancy. Males and females are equally affected.

Craniosynostosis is a feature of many different genetic syndromes that have a variety of inheritance patterns and chances for reoccurrence, depending on the specific syndrome present. It is important for the child as well as family members to be examined carefully for signs of a syndromic cause (an inherited genetic disorder) of craniosynostoses such as limb defects, ear abnormalities, or cardiovascular malformations.

Risk factor

Fetal Constraint is a Potential Risk Factor for Craniosynostosis

Craniosynostosis Symptoms

In infants with this condition, the most common signs are changes in the shape of the head and face. One side of your child’s face may look markedly different from the other side. Other, much less common signs may include:

  • A full or bulging fontanelle (soft spot located on the top of the head)
  • Sleepiness (or less alert than usual)
  • Very noticeable scalp veins
  • Increased irritability
  • High-pitched cry
  • Poor feeding
  • Projectile vomiting
  • Increasing head circumference
  • Developmental delays

The symptoms of craniosynostosis may resemble other conditions or medical problems, so always work with your child’s physician to clarify a diagnosis.

Complications

Without treatment, further complications can arise.

The skull will continue to grow in an unusual way, and this may affect other functions. There may be vision loss on the one side, for example.

If craniosynostosis is mild, people may not notice it until a later stage. This can cause pressure to build up on the brain — known as increased intracranial pressure — as late as the age of 8 years.

The symptoms of increased intracranial pressure include:

  • Blurry or double vision
  • Low quality of school work
  • A constant headache

These symptoms do not necessarily mean that there is intracranial pressure, but it is important to seek medical help if these symptoms occur.

Without treatment, increased intracranial pressure can lead to further complications, such as brain damage, blindness, and seizures.

How is craniosynostosis diagnosed?

Craniosynostosis may be congenital (present at birth) or maybe observed later, during a physical examination. The diagnosis is made after a thorough physical examination and after diagnostic testing. During the examination, your child’s doctor will obtain a complete prenatal and birth history of your child. He or she may ask if there is a family history of craniosynostosis or other head or face abnormalities. Your child’s doctor may also ask about developmental milestones since craniosynostosis can be associated with other developmental delays. Developmental delays may require further medical follow-up for underlying problems.

During the examination, a measurement of the circumference of your child’s head is taken and plotted on a graph to identify normal and abnormal ranges.

Diagnostic tests that may be performed to confirm the diagnosis of craniosynostosis include:

X-rays of the head. A diagnostic test that uses invisible electromagnetic energy beams to produce images of internal tissues and bones of the head onto film.

Computed tomography scan (also called a CT or CAT scan) of the head. A diagnostic imaging procedure that uses a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the head. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

How is Craniosynostosis Treated?

Treating craniosynostosis usually involves surgery to unlock and bones and reshape the skull.  Historically, craniosynostosis has been treated using surgical methods that involve an incision from ear to ear and the removal, reshaping, and reattachment of affected bones.  Sometimes this is still the best option.  However, at Nationwide Children’s, advances in technology are allowing us to conduct more of these procedures in a minimally invasive manner.

Traditional Open Surgery

With traditional surgery, the procedure lasts approximately four hours and is performed with a craniofacial plastic surgeon.  A blood transfusion is usually necessary. The child is typically observed overnight in the ICU and then an additional three days on the regular neurosurgical floor before discharge.  Typically, swelling develops around the eyes for the first 2-3 days, but that goes away before the patient is released from the hospital.

This procedure is performed around the age of six months.  Younger infants are very unlikely to experience increased pressure inside the skull before then.  Because the head is reshaped during the surgery itself, no further reshaping measures are required after the surgery.

Minimally Invasive Surgery

This involves one or two small incisions and the removal of only the closed suture to unlock the bones.  The surgery lasts approximately one hour and rarely requires a blood transfusion.  After the surgery, the child is observed overnight on the regular neurosurgical floor and is then discharged.  Usually, there is no swelling around the eyes.  Minimally invasive surgery produces the most successful outcomes when performed on children before the age of six months.

With minimally invasive techniques, reshaping of the head occurs after surgery with the assistance of either a cranial molding helmet or implanted custom springs.

The cranial molding helmet has a hard outer shell with moldable foam on the inside.  The helmet is worn 23 hours per day until the child’s first birthday.  It does not press the skull into shape, but rather directs the growth of the skull into a more normal shape.  Because the helmet relies on the high rate of skull growth in the first year of life, helmet-assisted surgery is usually done between 10 to 14 weeks of age. The helmet requires no additional surgery, however frequent visits to an orthotist are required.  An orthotist is a healthcare professional who works under the direction of a child’s doctor to regularly check the helmet and the progress of head reshaping.

Stainless steel cranial expander springs are implanted after the closed suture is opened.  The springs are then removed three months later. The level of the spring force is selected based on the patient’s age, bone thickness, and head shape severity.  Spring-assisted surgery is performed between the ages of three to six months.  The springs require a second surgery for removal but not the use of the helmet.

Cranial Distraction

In very rare cases, when most or all of the sutures are closed, cranial distraction can be used to create more space inside of the skull.  After the bones are unlocked, distractors are implanted across the bone cut.  At a rate of 1 mm (less than 1/16th of an inch) per day, the sides are separated by turning a small screw. After 30 days, 3 cm (almost 1 and 1/4 of an inch) of new bone is created.  Three months later, the distractors are removed at a second surgery.

How do you Prevent?

  • It is necessary to monitor the patient regularly for any changes in intracranial pressure and circumference of the head.
  • It is also essential to confirm that the sutures do not fuse again.

Bone spurs also called osteophytes, are outgrowths of bone that develop along the edges of bones, often where two or more bones meet.

Definition

Bone spurs also called osteophytes, are outgrowths of bone that develop along the edges of bones, often where two or more bones meet. They can form in the back, hip, sole, or heel of the foot, spine, neck, shoulder, or knee. Most bone spurs are caused by tissue damage brought on by osteoarthritis. Many are silent, meaning they cause no symptoms and only detected by an x-ray or other test for another condition. Others cause problems and require treatment.

If a spur breaks off from the bone, it can linger in the joint or get stuck in the lining of the joint. Such wandering bone spurs are called loose bodies. A loose body can make it feel like you can’t move a joint. This “locking” can come and go.

Types of bone spurs

Bone spurs are sometimes called by their medical names, osteophytes, and enthesophytes. Experts suggest both types of bone spurs are a reaction to skeletal stress.

  • Osteophytes are typically found at the edge of a bone at a joint. They are considered to be the result of friction and stress on the bone and are often associated with osteoarthritis.
  • Enthesophytes are bone spurs that develop where a ligament or tendon insert into a bone. (The site of attachment of soft tissue into bone is called an enthesis.) Enthesophytes may develop because of tight ligaments and tendons rubbing against bone, a soft tissue injury, or an inflammatory disease.

People do not always make the distinction between osteophytes and enthesophytes; Enthesophytes may sometimes be called osteophytes.

Bone spurs risk factors

Certain factors and conditions may contribute to the formation of osteophyte. These include:

  • Increased age
  • Disc degeneration
  • Joint degeneration
  • Sports injury or other joint injury
  • Poor posture
  • Genetics
  • Congenital skeletal abnormalities

Causes of bone spurs

The most common cause is osteoarthritis, also known as degenerative joint disease. This is an age-related condition in which the cartilage within the joints at the ends of each bone, gradually wears away. Common causes of osteoarthritis include:

  • Repetitive movements or frequent stress on the spine which causes tears in the cartilage between the discs and can damage the spinal vertebrae.
  • The cartilage between the vertebrae and disc wears down and affects the spine’s motion
  • Thickening calcification of ligaments

Other causes of bone spurs include spondylosis, trauma, infection (Osteomyelitis), thinning disc, spinal stenosis (foraminal and within the spinal canal), facet joint eburnation (degeneration), facet arthropathy (facet joint arthritis), degenerative discs disease, forestier’s disease (ligament hardening in the spine), or ankylosing spondylitis.

Bone spur in the spine

Symptoms

The most common symptoms of bone spurs include:

  • Neck or back pain (eg, frequency and intensity varies)
  • Pain and other symptoms may radiate (travel) from the neck (cervical radiculopathy) or low back (lumbar radiculopathy).
  • Other symptoms may include: numbness, burning, and pins and needle sensations that may affect the shoulders, arms, hands, buttocks, legs or feet
  • Pain that eases with rest and worsens with activity
  • Muscle spasms
  • Cramping
  • Weakness

In severe cases, bone spurs may lead to loss of bowel or bladder control. This is a rare symptom that warrants emergency medical care.

Bone spur in the heel

Complications of bone spur

Bone spurs in the spine can cause conditions such as stenosis, nerve compression, and radiculopathy. Over time, the thickened ligament material calcifies and bone spurs develop. On your vertebrae, bone spurs can narrow the space that contains your spinal cord – a condition called stenosis. Stenosis most often occurs in the neck and lower back and imaging tests may show cervical bone spurs (neck) or lumbar bone spurs (lower back).

As stenosis occurs, as well as bone spurs, space where nerve roots exit the spine may occur causing nerve compression. The bone spurs can compress the spinal cord or its nerve roots and can cause radiculopathy, which is tingling, weakness, or numbness that travels down your arms or legs. The spurs cause pain when they touch against the nerves traveling along your spinal cord.

Diagnosis and test

After taking the patient’s medical history and performing a physical examination, physicians can rule out conditions that may have similar symptoms but different causes.

Tests that a doctor may order include:

Electroconductive tests: These show the degree and seriousness of the spinal nerve injury.

Computed tomography (CT) scans: A CT scan is similar to an MRI in that it provides diagnostic information about the internal structures of the spine.

Magnetic resonance imaging (MRI) scans: MRIs are needed to visualize soft tissues like discs in the spine. This type of imaging is very safe and usually pain-free.

X-rays: It shows bones and the space between bones. They are of limited value, however, since they do not show muscles and ligaments.

Treatment and medications

If spinal bone spurs are determined to be the likely cause of back pain and other symptoms, there are a wide range of possible treatment options.

Nonsurgical Treatment for Bone Spurs

Most patients with mild or moderate nerve compression and irritation from bone spurs can manage their symptoms effectively without surgery. The goal of nonsurgical treatment is to stop the cycle of inflammation and pain.

Medications

Medication, such as nonsteroidal anti-inflammatory medications (NSAIDs) and muscle relaxants may be recommended. Because of the risk of side effects, long-term use of medications should be approached with caution.

Short periods of rest

Activity may flare up inflammation in the joints. Short periods of rest can give the inflammation time to recede.

Physical therapy and exercise

Physical therapy, exercise, and manipulation (performed by chiropractors [DC], osteopaths [DO], and physical therapists [PT]), may alleviate back pain associated with bone spurs. These rehabilitation therapies attempt to restore flexibility and strength to the spine, improve posture and decrease nerve root compression.

Spinal manipulation

If the pain and inflammation caused by bone spurs are related to abnormal alignment and movement patterns in the spine, a spinal adjustment may help relieve symptoms. Chiropractors, osteopaths, and physical therapists use their hands or small instruments to apply pressure over the skin of vertebrae and manipulate the spine. The goal is to increase range of motion, reduce nerve irritability, and improve function. Spinal manipulation is not appropriate for everyone. A careful medical history, physical examination, and discussion of the risks and benefits of manipulation should occur prior to this type of treatment.

Weight loss

Losing excess weight can take pressure off the spine, reducing friction between the vertebrae’s facet joints and decreasing the likelihood of pain. Achieving an appropriate weight is especially effective in taking pressure off the lower back.

Surgical treatment

If a bone spur is causing pain that cannot be treated conservatively, your doctor may perform surgery to remove the bone spur. If you have another condition that is contributing to your spinal problem, such as osteoarthritis, your doctor may choose to remove the bone spur at the same time surgery is being performed to address the other problem.

Prevention

There are no ways to prevent the development of bone spurs. However, you can take self-care steps at home to keep your bones and joints healthy and decrease your risk of injuries.

Exercise regularly: Regular exercise is the best thing you can do to maintain strong, healthy joints, muscles, and bones. Low-impact exercises like walking, swimming, bicycling, or yoga can help you stay active while reducing stress and pressure on your joints and soft tissues.

Maintain a healthy weight: Excess body weight places more stress and pressure on weight-bearing joints. Talk to your doctor about ways you can maintain a healthy, stable weight.

Wear supportive footwear: Reduce the risk of heel spurs by wearing shoes that fit correctly and provide good heel and arch support. Additionally, supportive shoes will reduce pressure on your knees, hips, and back.

Polyhydramnios is an excess accumulation of amniotic fluid the protective liquid that surrounds the unborn baby in the uterus during pregnancy.

Definition

Polyhydramnios is an excess accumulation of amniotic fluid – the protective liquid that surrounds the unborn baby in the uterus during pregnancy. The condition occurs in 1 percent to 2 percent of all pregnancies.

Polyhydramnios can be an isolated condition (which means no other birth defect or condition occurs with it), but it is also more common when the unborn baby has certain congenital anomalies (such as duodenal atresia) or a medical condition involving the heart or lungs (such as hydrops fetalis). Polyhydramnios is also associated with various genetic disorders, including Down syndrome (Trisomy 21) and Edward’s syndrome (Trisomy 18), but only when the baby also has duodenal atresia or other blockages in the gastrointestinal tract.

Severe polyhydramnios symptoms may cause a pregnant woman to experience shortness of breath or other discomforts due to the abdomen becoming overly distended. In addition, the condition raises the risk of problems during pregnancy and childbirth, including preterm labor, premature rupture of the amniotic sac (also known as “water breaking”), and placental abruption (the peeling away of the placenta from the inner wall of the uterus). Polyhydramnios is also sometimes associated with a condition known as intrauterine growth restriction (IUGR), which occurs when the unborn baby’s weight is significantly smaller than expected for its gestational age.

Epidemiology

There are few recent studies but polyhydramnios is said to affect 0.2-1.6% of all pregnancies. Rates are much higher in pregnancies for women with diabetes or gestational diabetes.

Where polyhydramnios is mild, an underlying abnormality is found in only 17%, whereas in moderate-to-severe polyhydramnios, this figure rises to 91%. There is also an association with increasing maternal age and with fetal macrosomia.

Types of Polyhydramnios

There are two clinical varieties of polyhydramnios.

  • Chronic polyhydramnios where excess amniotic fluid accumulates gradually.
  • Acute polyhydramnios where excess amniotic fluid collects rapidly.

Risk factors

Risk factors for developing polyhydramnios

  • Mothers who are carrying multiple babies. This is because of the size of the placenta and the amount of space it occupies in the uterus.
  • Mothers with gestational diabetes which is not being treated effectively.
  • When identical twins are present and they have developed twin-to-twin transfusion. This is a condition which can arise when one baby is receiving more blood flow than the other.
  • In many cases, the cause for polyhydramnios is unknown.

Pathophysiology of Polyhydramnios

The volume of amniotic fluid increases steadily until 33 weeks of gestation. It plateaus from 33-38 weeks, and then declines – with the volume of amniotic fluid at term approximately 500ml.

It is predominantly comprised of the fetal urine output, with small contributions from the placenta and some fetal secretions (e.g. respiratory, oral).

The fetus breathes and swallows the amniotic fluid. It gets processed, fills the bladder, and is voided, and the cycle repeats. Problems with any of the structures in this pathway can lead to either too much or too little fluid.

Causes of Polyhydramnios

In about half of cases, polyhydramnios has no known cause. In the other half, polyhydramnios may be caused by:

  • Birth defects that affect swallowing (which helps regulate amniotic fluid levels)
  • Uncontrolled maternal diabetes (high blood glucose levels can cause the baby to pee more often)
  • An abnormal fetal heart rate
  • An infection in the baby
  • Blood incompatibilities between mom and baby (like Rh and Kell diseases)
  • Twin-to-twin transfusion syndrome
  • Low red blood cell count in the baby (anemia)

Symptoms

For women experiencing a mild case of polyhydramnios, there may not be any symptoms. Women experiencing a more severe form of the condition could have these symptoms:

  • A sensation of tightness in the stomach
  • Indigestion
  • Difficulty with bowel movements (constipation)
  • Producing less urine
  • Enlargement of vulva
  • Breathing troubles
  • Swelling of leg, thigh, hip, ankle and/or foot

Larger abdomen with excessive stretch marks- A symptom of polyhydramnios

Polyhydramnios complications

The most significant complications associated with polyhydramnios include:

Prematurity: Excess amniotic fluid levels can trigger pre-term labor and increase the chances of a baby being born prematurely. This is a concern because prematurity greatly increases a baby’s risk of various health problems and complications including birth injuries.

Fetal Macrosomia: Polyhydramnios is commonly associated with excess fetal growth which can develop into fetal macrosomia. Macrosomic babies cannot be safely delivered via vaginal delivery.

Placental Abruption: This is a very dangerous complication in which the placenta prematurely separates from the wall of the uterus before the baby is ready for delivery. This creates an emergency event that must be quickly diagnosed and managed to avoid injury to the baby.

Fetal Malposition: When there is too much amniotic fluid in the womb it has a tendency to cause malposition of the fetus (e.g., breech, transverse, etc.) which can complicate a vaginal delivery.

Umbilical Cord Prolapse: This is one of the most dangerous delivery complications which occurs when the umbilical cord drops down into the birth canal in front of the baby during delivery, creating a major risk of oxygen deprivation.

Diagnosis and test

Your healthcare provider will examine you and ask about your symptoms. Tell your doctor if your baby is moving less than usual, or if any fluid leaking from your vagina. Tell him about all medicines you are taking. You may need any of the following:

Ultrasound pictures are used to find the amount of amniotic fluid in the womb. The pictures may also show the baby’s size. Baby kidneys and urinary tract will be checked. Moving ultrasound pictures are used to check blood flow through arteries in the baby’s kidneys and through the placenta.

Ultrasound

Amniocentesis is a procedure used to take a sample of amniotic fluid from the womb. The fluid contains cells that can be tested for birth defects and other problems.

Amniocentesis procedure

A glucose challenge test is used to find the amount of glucose (sugar) in your blood. An increased amount may be a sign of gestational diabetes (diabetes during pregnancy). You will fast overnight and then drink a sweet liquid. Your blood sugar level will be tested every hour for 3 hours in a row. A high level in at least 2 of the tests is a sign of gestational diabetes.

A fetal nonstress test is used to check how the baby’s heartbeat changes when he moves. You will wear a device on your abdomen. The device measures your baby’s heart rate. You may need to eat or drink something to make your baby more active.

A biophysical profile is a test that checks the baby’s breathing and movement. It also checks for the amount of amniotic fluid in the womb.

Treatment and medications

Mild cases of polyhydramnios may not require treatment, but doctors should have their patients come in for extra prenatal check-up’s to monitor the condition and make sure it does not become severe. Treatments for more severe forms of polyhydramnios sometimes focus on addressing the underlying causes.

Additional treatments/interventions include:

Amnioreduction: This involves using a long needle to drain excess amniotic fluid from the uterus. There are certain risks associated with this, which doctors must weigh when deciding whether it is an appropriate intervention.

Medications to reduce the amount of fetal urine: This can put the fetus’s heart health at risk, so again, doctors must be careful in determining whether this is the right path. They must also carefully monitor the baby for signs of fetal distress.

Early induction

Bed rest: This can help delay preterm labor in cases of moderate polyhydramnios

Prevention

This condition cannot always be prevented. Proper care before and during pregnancy may help lower the risk.

Nigeria flash news phase 3 Tuesday morning 11 Jan.

1, Report from Kebbi State, in Northwest Nigeria, indicated that 30 students that were kidnapped from a government school in Yauri and a teacher, have regained freedom from bandits who kept them in captivity since June last year.

2. The Niger State chapter of the Nigeria Union of Teachers has ordered its members to sit at home indefinitely until the State government addresses the payment of salaries on a percentage basis to teachers in the State. This was contained in a letter jointly signed by the branch Chairman, Muhammad Ibrahim Khaliel, and the branch Secretary, Comrade Jimada Abubakar Yusuf.

3. Hoodlums have abducted four people who were returning from a naming ceremony at Oko in Yagba West Local Government Area of Kogi State. It was gathered that the incident happened on Saturday around 8pm.

Oneworldvisionnews

Nigeria flash news phase 2 Tuesday morning 11 Jan.

1 At least three police officers lost their lives in an accident that occurred along Kubwa-Zuba expressway, opposite popular Gwarinpa Estate in Abuja. It was gathered that the incident involved men of the Special Tactical Squad (STS) of the Nigerian Police.

2. Alhaji Muhammadu Sanusi II, President-General of the Jam’iyyatu Ansariddeen of Nigeria (Attijaniyya), has asked those eligible to vote to get their Permanent Voters’ Card (PVC) ahead of the 2023 general elections. He gave the charge at the annual conference of the Nigeria World Maulid anniversary in Lokoja, Kogi State capital.

3. Benue State Government says it has concluded plans to give N6 million to families of more than 120 security personnel who were killed in their line of duty while defending the State. Governor Samuel Ortom disclosed this, Sunday, during a thanksgiving service to mark the 2022 Armed Forces Remembrance Day organized by the Christian Association of Nigeria, CAN

Oneworldvisionnews

Nigeria flash news Tuesday January 11.

Onewrold news channel learnt that.

Gunmen, on Sunday, abducted a traditional ruler at Y-Junction, Ubomiri in Orlu Local Government Area of Imo State. A source said the abduction occurred during a heavy downpour in the afternoon.

2. Gunmen have killed a member of Ebubeagu Security Network in Ebonyi State. The victim, Ifeanyi Orogbowhow, 32, was murdered and partially burnt by the attackers.

3. The Police Command in Ogun State, yesterday, said it has arrested a 38-year-old man for allegedly stabbing his mistress’s husband to death. The command’s Spokesman, DSP Abimbola Oyeyemi, who disclosed this in a statement issued on Sunday, said that the incident happened at Onipanu area of the State.

4. Cameroon came from behind to beat Burkina Faso 2-1 in an incident-packed opener at the Africa Cup of Nations. An acrobatic volley from Gustavo Sangare put the Burkinabe ahead midway through the first half in Yaounde.