Mitochondrial disease result from failures of the mitochondria.

Definition

Mitochondrial disease result from failures of the mitochondria, specialized compartments present in every cell of the body (except red blood cells). Mitochondria are responsible for creating more than 90% of the energy needed by the body to sustain life and support organ function. When they fail, less and less energy is generated within the cell. Cell injury and even cell death follow. If this process is repeated throughout the body, whole organ systems begin to fail.

Human mitochondrion

The parts of the body, such as the heart, brain, muscles, and lungs, requiring the greatest amounts of energy are the most affected.  Mitochondrial disease is difficult to diagnose because it affects each individual differently. Symptoms can include seizures, strokes, severe developmental delays, inability to walk, talk, see, and digest food combined with a host of other complications. If three or more organ systems are involved, mitochondrial disease should be suspected. Although mitochondrial disease primarily affects children, adult onset is becoming more common.

Epidemiology

Infants, children, and adults may develop mitochondrial disorders. Experts in mitochondrial medicine describe a spectrum of disease, ranging from mild to severe. 1 in 4,000 people are estimated to have a genetically confirmed primary mitochondrial disease, yet many remain undiagnosed.

In adults, many diseases of aging have been found to have defects of mitochondrial function, including, but not limited to, diabetes, Parkinson’s disease, Huntington’s disease, atherosclerotic heart disease, stroke, Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), autoimmune disorders, environmental toxicities, and cancer.

Who is at risk?

The more energy a cell needs, the more mitochondria they have. Because our brain, heart, liver, kidneys, digestive tract and muscles need the most energy, they are the most susceptible to mitochondrial disease.

Causes and it types

In most people, primary mitochondrial disease is a genetic condition that can be inherited (passed from parents to their children) in several ways.

To understand inheritance types, it’s helpful to learn more about genes and DNA. Genes are substances that give us our traits, such as brown eyes or blue eyes. Genes contain DNA, which is the “blueprint” that gives each person his or her unique makeup.

Under normal circumstances, a child inherits genes in pairs one gene from the mother and one from the father. A child with a mitochondrial disease does NOT receive a normal pair of genes from the parents. The gene has mutated – meaning it has become defective (changed). Learning the way a mitochondrial disease has been inherited helps predict the chance of passing on the disease(s) to future children.

Inheritance types are:

Autosomal recessive inheritance: This child receives one mutated copy of a gene from each parent. There is a 25% chance that each child in the family will inherit a mitochondrial disease.

Autosomal dominant inheritance: This child receives one mutated copy of a gene from either parent. There is a 50% chance that each child in the family will inherit a mitochondrial disease.

Mitochondrial inheritance: In this unique type of inheritance, the mitochondria contain their own DNA. Only mitochondrial disorders caused by mutations in the mitochondrial DNA are exclusively inherited from mothers. If this is the way a mitochondrial disease was inherited, there is a 100% chance that each child in the family will inherit a mitochondrial disease.

Random mutations: Sometimes genes develop a mutation of their own that is not inherited from a parent.

Symptoms of mitochondrial disease

The severity of mitochondrial disease symptoms is different from person to person. The most common symptoms are:

Poor growth and failure to thrive (in children)

Loss of muscle coordination, muscle weakness, and pain, low tone, exercise intolerance • Neurological problems, seizures

Autism, autistic spectrum, autism-like features

Visual and/or hearing problems

Developmental delays, learning disabilities

Movement disorders

Heart, liver or kidney disease

Gastrointestinal disorders, including severe constipation, diarrhea, swallowing difficulty, repeated vomiting, cramping, reflux

Diabetes

Increased risk of infection

Neurological issues, including difficult to treat seizures, migraines, and stroke or stroke like events

Thyroid and/or adrenal dysfunction

Autonomic dysfunction (may affect the functioning of the heart, bladder, intestines, sweat glands, pupils, and blood vessels

Respiratory issues

Lactic acidosis (the buildup of lactate in the body, which results in an excessively low pH in the bloodstream)

Neuropsychological changes characterized by confusion, disorientation, dementia, and memory loss

Diagnosis and test

Unfortunately, mitochondrial genetic disorders can be difficult to diagnose, and many affected people may never receive a specific diagnosis. They are often suspected in people who have a condition that effects multiple, unrelated systems of the body. In some cases, the pattern of symptoms may be suggestive of a specific mitochondrial condition. If the disease-causing gene(s) associated with the particular condition is known, the diagnosis can then be confirmed with genetic testing.

If a mitochondrial genetic disorder is suspected but the signs and symptoms do not suggest a specific diagnosis, a more extensive work-up may be required. In these cases, a physician may start by evaluating the levels of certain substances in a sample of blood or cerebrospinal fluid. Other tests that can support a diagnosis include:

Exercise testing

Magnetic resonance spectroscopy (detects abnormalities in the brain’s chemical makeup)

Imaging studies of the brain such as MRI or CT scan

Electroencephalography (EEG)

Tests that evaluate the heart including electrocardiography and echocardiography

Muscle biopsy

When possible, confirming a diagnosis with genetic testing can have important implications for family members. Identifying the disease-causing gene(s) will give the family information about the inheritance pattern and the risk to other family members. It will also allow other at-risk family members to undergo genetic testing.

Mitochondrial disease treatment

There are no cures for mitochondrial diseases, but treatment can help reduce symptoms or slow the decline in health.

Treatment varies from patient to patient and depends on the specific mitochondrial disease diagnosed and its severity. However, there is no way to predict a patient’s response to treatment or predict how the disease will affect that person in the long run. No two people will respond to the same treatment in the same way, even if they have the same disease.

Treatments for the mitochondrial disease may include:

Vitamins and supplements, including Coenzyme Q10; B complex vitamins, especially thiamine (B1) and riboflavin (B2); Alpha lipoic acid; L-carnitine (Carnitor); Creatine; and L-Arginine.

Exercises, including both endurance exercises and resistance/strength training. These are done to increase muscle size and strength. Endurance exercises include walking, running, swimming, dancing, cycling and others. Resistance/strength training include exercises such as sit-ups, arm curls, knee extensions, weight lifting and others.

Conserving energy: Don’t try to do too much in a short period of time. Pace yourself.

Other treatments: These may include speech therapy, physical therapy, respiratory therapy, and occupational therapy.

Avoid situations that can make your medical condition worse. These include: exposure to cold and/or heat; starvation; lack of sleep; stressful situations; and use of alcohol, cigarettes and monosodium glutamate (MSG, a flavor enhancer commonly added to Chinese food, canned vegetables, soups, and processed meats).

Prevention of Mitochondrial disease

The transmission of mitochondrial disease is dependent on the proportion of mutated mtDNA carried by the affected mother’s egg. Homoplasmic mutations will be transmitted to each child in a homoplasmic state.

However, in women with heteroplasmic mutation loads, the level transmitted to their children is more difficult to predict. The only methods to avoid transmission of mutated mtDNA are those dependent on egg donation, including mitochondrial donation where there remains a small risk of mutation carryover.

Other methods such as PGD are risk reduction procedures and are unlikely to completely prevent transmission of the mutated mtDNA. Preimplantation genetic diagnosis and/or prenatal diagnosis are offered to women who have heteroplasmic mtDNA mutations but are aiming to use their own eggs to have a baby and women having a mitochondrial disease due to a nuclear mutation.

A preimplantation genetic diagnosis may be offered as part of an in vitro fertilization (IVF) cycle prior to the pregnancy. Prenatal diagnosis will be carried out when the pregnancy has been established for some time (chorionic villus sampling at 11-12 weeks’ gestation or amniocentesis at 15-17 weeks).

However, none of these techniques can be offered to women with homoplasmic mutations. Mitochondrial donation is a new approach to prevent the transmission of mutated mtDNA from mother to child.

The pronuclei, containing the nDNA of both parents, are removed from the fertilized egg and placed into a donor egg containing healthy mtDNA and from which the pronuclei have been removed, a technique known as pronuclear transfer. Alternatively, this IVF technique can be performed before fertilization using maternal spindle transfer and this may be ethically more acceptable to some couples.

Orchitis is an inflammatory disorder occurring in one or both testicles of males.

Introduction

Orchitis is an inflammatory disorder occurring in one or both testicles of males, widely caused by various types of bacterial and viral infections. It is a type of infection may also be a progression of epididymitis, an infection with the tube that carries semen from the testicles. This condition is called epididymo-orchitis. It may also be caused by sexually transmitted infections such as chlamydia and gonorrhea. In children with this disorder is generally caused by the infection with mumps virus.

Types of orchitis

There are two types of orchitis as follows:

Acute orchitis

Acute orchitis always occurs as a secondary disease or complication of cystitis, urethritis, benign prostatic hyperplasia (BPH), prostatitis and other reproductive diseases. It is often caused by urinary infection commonly in young adults and kids.

The symptoms of Acute orchitis are sudden fever and chill, pain in the scrotum, swelling, redness, tense skin, frequent urinating, hydrocele in the testis, and pain of touch.

Chronic orchitis

A chronic orchitis is a severe form of acute orchitis which cannot be alleviated for a long time. The disease conditions that often lead to chronic orchitis is syphilis of the testis, and also the trauma of the testis.

Signs and symptoms include hard and enlarged testis, hard sperm duct and testis that do not stick to skin.

Epidemiology

The prevalence of those situations in isolation is uncommon, with epididymitis and orchitis commonly going on together. Approximately 20% of prepubertal sufferers (extra younger than 10 years) with mumps broaden orchitis. Unilateral testicular atrophy takes vicinity in 60% of patients with this disorder. Sterility has been hardly ever a final result of unilateral orchitis.

In the US, it is anticipated that there are 600,000 instances of this situation every year, taking vicinity most typically within the 19-35-one year-vintage age group. The perfect prevalence in Australia isn’t always identified.

History

The orchitis was first coined and described by Hippocrates in the 5th century. The term Orchitis literal meaning is ‘testicle inflammation’ which is a Greek word for ‘Testicle’.

What causes orchitis?

The major causes are bacteria and viruses.

The commonly available bacterial species include Escherichia coli, Staphylococcus, and Streptococcus. These bacteria initially cause epididymitis and finally lead to orchitis as well.

Sexually active men aged 19-35 years, can be infected with bacteria that are responsible for sexually transmitted diseases such as syphilis, gonorrhea, and chlamydia.

If the person is affected with mumps, they may have an infection of testis by the mumps virus. Mumps virus can also cause orchitis. This happens most commonly in young boy children.

The common viral organisms which cause orchitis are coxsackievirus, cytomegalovirus ( the causative agent of infectious mononucleosis), echovirus, and varicella.

The most cases of this disorder are caused by progression and spreading of the testis diseases such as epididymitis, prostate cancer, prostate gland/urinary tract infection.

Risk factors

A person may be at risk if they are not being immunized against mumps

If people older than 45 years get frequent urinary tract infections

If an individual beyond 50 years have placed Foley catheter into the bladder for prolonged time

Genitourinary surgery (A Surgery for urinary tract)

Congenital urinary tract disorders

Having multiple sex partners

Sex with a partner who had Sexually transmitted disease (STD)

An unprotected sex and promiscuous sexual life

If you have a history of STD’S

Anal intercourse is also a major risk of infection with pathogens

Untreated Urethritis and prostatitis may also pose a risk

Bladder obstruction due to enlarged prostate and urethral abnormality

Symptoms

Symptoms may range from mild to severe. Inflammation may occur in one or both the testicles. The common primary symptoms are pain and swelling or the symptoms may appear more gradually. Symptoms that may include such as follows

Body aches

Pain when urinating (dysuria)

Testicular swelling in one or both testicles

Testicular redness

Testicular pain and tenderness, which may last for weeks

Fever and chills

Headache

Nausea

Malaise and fatigue

Bleeding in semen

Abnormal discharge

Enlarged prostate

Symptoms of orchitis

Complications of Orchitis

Complication includes:

Testicular atrophy

Scrotal abscess (The infected tissue fills with pus)

Repeated epididymitis

Infertility

Diagnosis and test

Your doctor may start with a physical examination to check for enlarged lymph nodes in the groin area and enlarged testicles in the affected area. Your doctor may do a rectal examination to check tenderness or prostate enlargement.

Other laboratory tests and imaging tests are undertaken to evaluate other medical conditions which may present with similar symptoms:

Nuclear scan of testicles: the radioactive tracer is discharged into your blood. Then the scanner will scan the blood flow to the testicles which indicates torsion.

Ultrasound: Ultrasound imaging can rule out testicular torsions. Ultrasound with color Doppler can find the blood flow to the testicles. If the blood flow is lower than normal, then it indicates testicular torsion. If the blood flow is higher than normal then it will help to confirm the diagnosis.

Urine test: urine sample is taken and it is analyzed to find any abnormalities, appearance or content and to find which bacteria are the reason for infection.

STI (Sexually Transmitted Infection) screening: Discharge from the urethra is taken from the end of the penis. The sample is investigated in the laboratory for chlamydia and gonorrhea.

Treatment and medications

Treating bacterial orchitis

Antibiotics are required to treat bacterial orchitis. If it is caused by STI then your sexual partner also should go for diagnosis and treatment.

A patient should take the entire course of antibiotic which is prescribed by the doctor. It may take several weeks to get disappear from orchitis symptoms. Resting, supporting scrotum, ice packs and having pain medications may reduce the pain.

Antibiotics are prescribed based on the patient age and causes of the bacterial infection. Some of the common antibiotic which is used as follows:

Ceftriaxone (Rocephin)

Doxycycline (Vibramycin, Doryx)

Azithromycin (Zithromax)

Ciprofloxacin (Cipro)

Treating viral orchitis

If the orchitis is caused by a virus then it should not be treated with antibiotics. Treatment for relieving symptoms of viral orchitis, your doctor may advise

Nonsteroidal anti-inflammatory drugs, such as ibuprofen (Advil, Motrin IB, others) or naproxen (Aleve, others)

Bed rest and elevating your scrotum

Cold packs

Although viral orchitis takes several weeks for disappearing symptoms, most people with viral orchitis will feel better after 10 days of treatment.

Prevention of Orchitis

The most common cause of this disorder is a sexually transmitted infection. So practice safe sex by using condoms to reduce the extent of sexually transmitted diseases

Immunise against mumps is the most common cause of viral orchitis

Men’s above 50 years of age should be examined for prostate gland during their physical examination

Inflammation and prevention may also be prevented by reducing the use of urinary catheterization

Multiple sclerosis is a disease that involves an immune-mediated process that results in an abnormal response.

Definition

Multiple sclerosis is a disease that involves an immune-mediated process that results in an abnormal response in the body’s immune system that damages central nervous system (CNS) tissues in which the immune system attacks myelin, the substances that surrounds and insulate nerves fibers causing demyelination that leads to nerve damage or blocks the signals. The symptoms you feel depend on which nerves are affected.

History

The first description of what was probably MS dates back to August 4, 1421, when Jan Van Bieren, Count of Holland, described the “strange disease of the virgin Lidwina,” who in 1395, at the age of 15, developed severe facial pain and leg weakness after falling on the ice while skating. Within a few years her problems had increased: her legs were so weak that she could not walk, she had leg numbness and she was intermittently blind in one eye.

She died in 1433 at the age of 53. 4 The Facts You Need, Fifth Edition The first descriptions of the physical changes that MS produces in the brain and spinal cord came almost simultaneously, in 1835, from Jean Cruveilhier, professor of pathologic anatomy in the Sorbonne’s Faculty of Medicine in Paris, and Robert Carswell, a Scotsman who worked at the Hôpital de la Pitié in Paris for 3 years. However, the first scientific description of the signs and symptoms of MS came from Jean-Martin Charcot (1825–1893).

Charcot outlined a condition called la sclérose en plaques in effect, multiple sclerosis which he had first become familiar with while watching its gradual development in a maid employed in his house. From1862 to 1870, Charcot worked at La Salpêtrière, a Paris asylum for beggars, the aged, the infirm and the insane. There, he examined thousands of patients. His findings led him to correlate the signs and symptoms of MS with the disease-related anatomical changes seen at autopsy

Epidemiology

An estimated 2,500,000 people in the world have multiple sclerosis. Research suggests the proportion of women with MS is increasing and that roughly between two and three women have MS for every man with the condition.

The distribution of MS around the world is uneven. Generally, the prevalence increases as you travel further north or south from the equator. Those parts of Asia, Africa and America that lie on the equator have extremely low levels of MS, whilst Canada and Scotland have particularly high rates.

Types of multiple sclerosis

Relapsing-remitting MS (RRMS)

RRMS involves clear relapses of disease activity followed by remissions. Symptoms are mild or absent during remission, and there’s no disease progression during the remission period. RRMS is the most common form of MS at onset.

Clinically isolated syndrome (CIS)

CIS involves one episode of symptoms that are due to demyelination in the central nervous system. This episode must last for at least 24 hours.

The two types of episodes are monofocal and multifocal. A monofocal episode means one lesion causes one symptom. A multifocal episode means you have more than one lesion and more than one symptom.

Although these episodes are characteristic of MS, they aren’t enough to prompt a diagnosis. If lesions similar to those that occur with MS are present, you’re more likely to receive a diagnosis of RRMS. If these lesions aren’t present, you’re less likely to develop MS.

Primary-progressive MS (PPMS)

Neurological function becomes progressively worse from the onset of your symptoms if you have PPMS. However, short periods of stability can still occur.

Progressive-relapsing MS was a term people previously used for progressive MS with clear relapses. People now call it PPMS. The words “active” and “not active” are used to describe disease activity.

Secondary-progressive MS (SPMS)

SPMS occurs when RRMS transitions into the progressive form. You may still have noticeable relapses, in addition to gradual worsening of function or disability.

Risk factors of multiple sclerosis

These factors may increase your risk of developing multiple sclerosis:

Age: MS can occur at any age, but most commonly affects people between the ages of 15 and 60.

Sex: Women are about twice as likely as men are to develop MS.

Family history: If one of your parents or siblings has had MS, you are at higher risk of developing the disease.

Certain infections: A variety of viruses have been linked to MS, including Epstein-Barr, the virus that causes infectious mononucleosis.

Race: White people, particularly those of Northern European descent, are at highest risk of developing MS. People of Asian, African or Native American descent have the lowest risk.

Climate: MS is far more common in countries with temperate climates, including Canada, the northern United States, New Zealand, southeastern Australia and Europe.

Certain autoimmune diseases: You have a slightly higher risk of developing MS if you have thyroid disease, type 1 diabetes or inflammatory bowel disease.

Smoking: Smokers who experience an initial event of symptoms that may signal MS are more likely than nonsmokers to develop a second event that confirms relapsing-remitting MS.

Causes of multiple sclerosis

While multiple sclerosis is considered an autoimmune disorder, the exact cause hasn’t yet been found.

There are many theories regarding the reason that people develop MS. These theories range from vitamin D deficiency to a viral infection.

Even consuming too much salt is being looked at as possible causes. However, none of these theories have been proven, and the cause of MS remains unknown. It’s not contagious, and can’t be passed from person to person.

Symptoms of multiple sclerosis

MS causes a wide range of symptoms, sensations, and/or signs. For many patients, these symptoms come and go. Most people experience their first symptoms of MS between the ages of 20 and 40. Initial symptoms are often eye-related, such as pain when the eyes are moved, dimmed vision, or distortion of colors. Before a person is diagnosed, these signs and symptoms can seem mysterious or worrisome.

Here are some other potential signs and symptoms of MS:

Tiredness or fatigue

Numbness, prickling, or “pins and needles” sensations

Muscle stiffness

Problems thinking clearly, or being able to concentrate and remember things

Bladder problems

Problems with walking

Depressed mood

Diagnosis and test

Diagnosing multiple sclerosis (MS) isn’t always easy and in some cases may take time.

Your medical history and neurological exam can identify possible nervous system problems and are often enough to strongly suggest a diagnosis of MS. Tests may help confirm or rule out the diagnosis when your history and exam do not provide clear evidence of the disease. MRI and neurological exam may help doctors predict which people will develop MS after a first attack of symptoms.

Tests to diagnose MS

Magnetic resonance imaging (MRI) of the brain and spinal cord: This test is done to confirm a diagnosis of MS camera.

Lumbar puncture (sometimes called a spinal tap): This test may be done to evaluate cerebrospinal fluid. Most people with MS have abnormal results on this test.

Lumbar puncture

Evoked potential testing: This test can often reveal abnormalities in the brain and spinal cord  and in the optic nerves of the eyes that other tests may not detect.

Confirming the diagnosis

MS is diagnosed when it is clear from neurological tests and a neurological exam that lesions (damaged areas) are present in more than one area of the central nervous system (usually the brain, spinal cord, or the nerves to the eyes). Tests will also clearly show that damage has occurred at more than one point in time.

Some people have had only one episode of a neurological symptom such as optic neuritis, but MRI tests suggest they may have MS. This is known as a clinically isolated syndrome. Many of these people go on to develop MS over time.

Treatment of multiple sclerosis

There is no cure for MS, so treatment focuses on suppressing the autoimmune response and managing symptoms.

Medications

Several disease-modifying drugs are approved for the relapsing forms of MS.

Corticosteroids: Are the most commonly prescribed drugs for MS. They reduce inflammation and suppress the immune system. They mostly treat an acute flare-up of symptoms in certain types of MS.

Interferon Beta 1a or 1b: These may slow down the progression of symptoms, but they must be used with care, as they can cause liver damage.

Copaxone (Glatiramer): This aims to stop the immune system from attacking myelin. It is injected once a day. Flushing and shortness of breath may occur after receiving the injection.

Tysabri (Natalizumab): This is used for patients who either cannot tolerate other treatments or have not benefitted from them. It increases the risk of developing multifocal leukoencephalopathy, a fatal brain infection.

Mitoxantrone (Novantrone): This immunosuppressant is normally used only in the later stages. It can damage the heart, but if symptoms are worsening rapidly, it can help slow down the progression of disability.

Cannabis extract: Studies have suggested that this may help relieve pain, muscles stiffness, and insomnia.

Aubagio (teriflunomide): This is a once-daily tablet for adults with relapsing forms of MS.

Rehabilitation

Rehabilitation aims to help patients improve or maintain their ability to perform effectively at home and at work.

Programs generally include:

Physical therapy: This aims to provide people with the skills to maintain and restore maximum movement and functional ability.

Occupational therapy: The therapeutic use of work, self-care, and play activities to increase development and prevent disability.

Speech and swallowing therapy: A speech and language therapist will carry out special training.

Cognitive rehabilitation: This helps people manage specific problems in thinking and perception.

Vocational rehabilitation: This helps people with disabilities make career plans, learn job skills, get and keep a job.

Plasma exchange

Plasmapheresis involves withdrawing blood from the patient, removing the plasma, and replacing it with new plasma. The blood is then transfused back into the patient.

This process removes the antibodies in the blood that are attacking parts of the patient’s body, but whether it can help patients with MS is unclear. Studies have produced mixed results.

Vitamin D and Omega-3 supplements

Researchers have found a link between vitamin D deficiency and MS, but they are still investigating whether vitamin D supplements might help in treatment. Patients should not use supplements without first consulting their doctor.

It has been suggested that omega-3 fatty acid supplements may help patients with MS, but scientists in Norway concluded that they do not.

Hyperbaric oxygen therapy

It has been suggested that hyperbaric oxygen therapy (HBOT) may help people with MS, but this is unproven.

Prevention of multiple sclerosis

In general, there is no way to prevent multiple sclerosis (MS) or its attacks. For people with relapsing-remitting MS and secondary progressive MS, treatment with medicine may reduce the frequency of relapses and delay disability.

35 Russian diplomat expelled in Slovakia.

Slovakia, a member of the European Union, said Wednesday it had decided to expel 35 Russian diplomats based on information provided by intelligence services. 

The move comes a day after fellow EU countries Belgium, the Netherlands, Ireland and the Czech Republic all announced the expulsion of dozens of Russian diplomats suspected of spying, in coordinated action taken in the shadow of Moscow’s war in Ukraine.

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UK warns it’s citizens in Nigeria to avoid Seven Northern state.

The United Kingdom has warned its citizens against travelling to seven states in Northern Nigeria.

The Foreign, Commonwealth & Development Office which disclosed this on the UK government website cited Monday’s terrorist attack on the Abuja-Kaduna train.

It also cited last Saturday’s invasion of the Kaduna airport by bandits during which one person was killed. 

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DCP Abba Kyari, has rejected food offered him by the Nigerian Correctional Service.

The embattled former Commander, Intelligence Response Team, Abba Kyari, has rejected food offered him by the Nigerian Correctional Service after being remanded in prison custody on Monday.

The suspended Deputy Commissioner of Police, it was learnt, opted for the food prepared by his wife or other family members.

Kyari, who is under prosecution for drug trafficking alongside four other policemen, was denied bail by the Federal High Court sitting in Abuja.

The National Drug Law Enforcement Agency had in the charge before the court, accused Kyari and the other four officers of conspiracy, obstruction and dealing in cocaine worth 17.55kg.

The trial judge, Justice Emeka Nwike, ordered the drug agency to transfer the defendants to prison custody, shortly after he denied them bail.

The court held that the NDLEA placed sufficient materials before it to warrant the refusal of bail to Kyari and his co-defendants -Sunday Ubia, Simon Agirgba, and John Nuhu, who are former IRT members.

Findings on Wednesday showed that Kyari and his co-defendants have been settling down in the custodial centre but sources said the DCP has largely kept to himself since his arrival on Monday.

Our correspondent gathered that Kyari’s presence has generated some excitement among the inmates, some of who were investigated for various crimes by the IRT under the DCP.

An officer stated, We suspected that he may not eat the food being served here. So, we were not surprised when he opted for the food prepared by his wife or family members.

His presence has, however, generated excitement in the facility. Many inmates who had had some encounters with him and others who heard about his ongoing trial have been discussing the fact that a senior policeman like him was remanded in Kuje where some individuals he investigated are also serving time.

The NCoS spokesman, Francis Enobore, said inmates facing prosecution had the right to eat food prepared by their family members, noting that they are free to provide their food by themselves.

Our law allows us to request any inmate who wishes to do self-feeding to apply through a formal application to the officer in-charge of the custodial centre. Subject to the approval of the official in-charge, the applicant will make arrangements with whoever he wishes to bring food for him.

The caveat is that if the person fails to bring food, he would not be fed from the service’s kitchen. Again, whoever is bringing his food; it is compulsory the person tastes the food in the presence of the officer conducting the visit to ensure that the food is wholesome before passing it over to the inmate.

Enobore explained that no alcohol drink or cigarettes are allowed in the correctional centres, adding that 12 officers were facing sanctions for breaching the law on trafficking of illegal materials into the facility.

No alcoholic drink or cigarette is allowed in the facility. Wherever you found them in the yard, they are a product of trafficking and we deal seriously with such issues.

There is a long list before me now of officers to be dismissed for trafficking. Five will be dismissed while seven others will be reduced in rank, he said.

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Brain death is a clinical and legal definition of death. Sometimes.

Definition of Brain Death

Brain death is a clinical and legal definition of death. Sometimes, when a person is declared brain dead, their heart may still be still beating and their chest may rise and fall with every breath from the ventilator. The skin might be warm and a person who is brain dead may appear to be resting.

These physical functions may be present in a person who is brain dead because the physical damage is actually hidden in the brain, rather than visible on the body.

Brain cells do not effectively regenerate. This makes it difficult for the brain to recover from injury. Serious brain damage can occur due to a stroke, heart attack, or head trauma. When brain cells undergo permanent damage, they cannot be replaced. Major loss of brain function results in brain death.

How is Brain Death different from being in a coma?

A patient in a coma continues to have brain function. When brain death happens, all neurological activity stops and cannot be revived. Brain death is death – no improvement or recovery is possible.

Pathophysiology

The physiology of brain death is similar regardless of the etiology. Inadequate tissue oxygenation leads to a progressive cascade of further edema, increasing intracranial pressure, a further decrease in cerebral perfusion and eventual herniation, or complete cessation of blood flow and aseptic necrosis of brain tissue.

In anoxic brain injuries, mainly inadequate cardiopulmonary resuscitation following a cardiopulmonary arrest, tissue hypoxia leads to the release of cytotoxic material that leads to progressive cerebral edema, and eventually, the cascade described above.

For traumatic brain injuries or other intracranial injuries, the presence of increasing intracranial pressure as a result of injury beyond the mean arterial pressure will prevent adequate oxygenation of neuronal tissues. This situation will result in further injury, edema, and, eventually, the process initially described above.

Causes of brain death

Brain death can happen when the blood and/or oxygen supply to the brain is stopped.

This can be caused by:

Cardiac arrest  – when the heart stops beating and the brain is starved of oxygen

A heart attack – when the blood supply to the heart is suddenly blocked

A stroke – when the blood supply to the brain is blocked or interrupted

A blood clot – a blockage in a blood vessel that disturbs or blocks the flow of blood around your body

It can also be caused by:

A severe head injury

A brain haemorrhage

Infections, such as encephalitis

A brain tumour

Risk factors

Prehospital hypotension is the main risk factor for an early evolution to brain death in head trauma

Also, patients that have prolonged hypoperfusion and neurohormonal imbalance after the post resuscitation phase present an increased risk of brain stem death.

Signs of brain death

Some of the signs include:

The pupils don’t respond to light.

The person shows no reaction to pain.

The eyes don’t blink when the eye surface is touched (corneal reflex).

The eyes don’t move when the head is moved (oculocephalic reflex).

The eyes don’t move when ice water is poured into the ear (oculo-vestibular reflex).

There is no gagging reflex when the back of the throat is touched.

The person doesn’t breathe when the ventilator is switched off.

An electroencephalogram test shows no brain activity at all.

Complications

Brain death is associated with complex hemodynamic, endocrine, and metabolic dysfunction that can lead to major complications.

Untreated, this can progress to cardiovascular collapse with loss of valuable organs.

Other complications are as follows: intravenous vasopressor requirement, coagulopathy, thrombocytopenia, diabetes insipidus, cardiac ischemia, lactic acidosis, renal failure, and acute respiratory distress syndrome

Consequences of and Considerations in Brain Death

Once brain death has been diagnosed, a patient is declared dead. A single brain death examination, including the apnea test, is the minimum standard for diagnosing brain death in adults. However, in children, recent guidelines recommend 2 separate brain death examinations as the minimum standard.

Organ support, including mechanical ventilation and medications to maintain adequate blood pressure, may be continued after a declaration of brain death if the patient is a candidate for organ donation or is pregnant and a decision is made to continue support for the fetus.

Diagnosing Brain Death

There are a number of criteria for diagnosing brain death.

For a diagnosis of brain death to be made:

A person must be unconscious and fail to respond to outside stimulation

A person’s heartbeat and breathing can only be maintained using a ventilator

There must be clear evidence that serious brain damage has occurred and it can’t be cured

Ruling out other conditions

Before testing for brain stem death can begin, doctors must carry out a series of checks to ensure that the symptoms aren’t being caused by other factors, such as:

An overdose of illegal drugs, tranquillisers, poisons or other chemical agents

An abnormally low body temperature (hypothermia)

Severe under-activity of the thyroid gland

Once these factors have been ruled out, tests are carried out to confirm brain death. The diagnosis of has to be made by two senior doctors. Neither of them can be involved with the hospital’s transplant team.

The doctors will explain the tests to you and they’ll keep you informed about your loved one’s condition at all times.

Tests

The doctors will run a series of tests. Both doctors have to agree on the results for a diagnosis of brain death to be confirmed. The tests are carried out twice to minimize any chance of error.

The tests used to determine whether brain stem death has occurred are outlined below:

A torch is shone into both eyes to see if they react to the light.

The cornea (transparent outer layer of the eye), which is usually very sensitive, is stroked with a tissue or piece of cotton wool to see if the eye reacts.

Pressure is applied to the forehead and the nose is pinched to see if there’s any movement in response.

Ice-cold water is inserted into each ear, which would usually cause the eyes to move.

A thin, plastic tube is placed down the trachea (windpipe) to see if it provokes gagging or coughing.

The person is disconnected from the ventilator for a short period of time to see if they make any attempt to breathe on their own.

It will be diagnosed if a person fails to respond to all of these tests.

Occasionally, a person’s limbs or torso (the upper part of the body) may move, even after brain stem death has been diagnosed.

These spinal reflex movements are generated by the spinal cord and don’t involve the brain at all. Therefore, they won’t affect the diagnosis of brain death.

Reversing Brain Death: Far-fetched or feasible?

A determination of brain death means that the patient has died; brain death is irreversible. In fact, there is no clinical trial, transplant, surgery, medication, or treatment that can reverse brain death.

Terrible as 20 persons including women and children drown in river in Niger State.

According to Homepage news channel it was learnt that no fewer than 20 people, including women and children, have drowned in the Guni-Zumba River while trying to escape attacks on their communities.

It was gathered that the incident occurred on Wednesday morning when bandits simultaneously invaded Guni and Kurgbaku communities, forcing the residents to flee.

Homepage gathered that the victims were crossing the river to Zumba and Gwada internally displaced persons’ camps by boat.

Shehu Abubakar, a resident who lamented the lack of security in the area, said the boat was loaded beyond capacity, forcing it to capsize in the middle of the water.

Bandits invaded our communities this morning, and in an attempt to flee, some people drowned in the Guni-Zumba River.

Due to overloading, the boat capsized in the middle of the water. 

For now, we don’t know the number of casualties because we have not been able to rescue anybody but I can tell you that over 20 people, including women and children, were involved, he said. 

Michael Madaki, another resident, said, Bandits attacked Guni community in Munya LGA of Niger State, the villagers were trying to escape but their boat capsized.

The state police spokesperson, DSP Wasiu Abiodun, could not be reached for comments at the time of filing the report.

Homepage

Bandit conduct house to house search in Kubwa area in FCT.

Outrage as No fewer than 20 armed bandits stormed the Pipeline Extension area in Kubwa, Bwari Area Council in the Federal Capital Territory, Abuja, dispossessing residents of their belongings.

It was learnt that the bandits who operated for more than one hour stormed the area around 2am on Wednesday.

Eyewitnesses, who narrated the incident, said the armed hoodlums came with different dangerous weapons and injured the community local vigilantes, after which they robbed the area house-to-house.

The hoodlums also reportedly attacked and took away priced valuables such as phones, electronics and other gadgets.

One of the victims who spoke with Homepage said that the robbers threatened to kill his eight-year-old son if he did not give them money.

Another victim told news men that the police were asking them whether the robbers brought guns or they were ordinary street robbers, when the case was reported at the station.

Homepage