Frailty has emerged as an important clinical measurement among older adults because of its negative health outcomes.

This study measured the prevalence and factors associated with frailty among older adults aged 60 years and above at a Geriatric Centre in Nigeria.

In this descriptive cross-sectional study, 971 older adults were recruited consecutively. Data on sociodemographics characteristics and clinical parameters were obtained using an interviewer-administered questionnaire and physical examination performed. The Frailty syndrome and Frailty Index were assessed using the Fried Frailty Criteria (FFC) and Canadian Study of Health and Aging (CSHA) scale respectively. Bivariate and multivariate analyses were carried out using SPSS version 21 at a p <0.05.

The mean age of the participants was 71.3 (± 7.1) years with a female to male ratio of 2.41. Based on FFC scale, 498 older persons (51.3%) had frailty syndrome while only 148 (15.2%) were frail using the CSHA scale. The measure of agreement (Kappa statistics) was 0.22 (p<0001) indicating weak agreement between the two scales. Logistic regression analysis revealed increasing age (OR=1.948 [1.219-3.113]), multiple morbidities (OR= 1.584, [1.177-2.201]), depression (OR= 5.050, [2.501-9.442,]), imbalance or increased risk of fall (OR 1.623, [1.192-2.211,]), and inability to perform IADL (OR= 0.599 [0.535-0.670,]) to be the most significant determinants of frailty syndrome while obesity (OR=0.660, [0.449-0.971]), unusually appeared a deterrent.

The prevalence of frailty syndrome was high among the older adults. Targeted and timely interventions on the modifiable factors may delay progression into frailty and the eventual negative health outcomes.

The prevalence of frailty syndrome was high among the older adults. Targeted and timely interventions on the modifiable factors may delay progression into frailty and the eventual negative health outcomes.The wastewater generated from textile factories is linked to one of the main water pollution problems; therefore, it is important to reduce the pollutants in industrial effluents before their discharge into environment. The present study was to investigate the appropriateness zeolite-x and kaolin as effective adsorbents for removal of methylene blue from the textile wastewater. Batch adsorption experiments were carried out to assess parameters that influence the adsorption process. The prepared zeolite-x and kaolin were characterized by Fourier Transform Infrared and X-ray diffraction techniques. The results of this study showed that the particle size is 40.77 nm and 0.45 nm kaolin and zeolite-x respectively. The performance of zeolite-x adsorbent is best at the optimum pH 4 with removal efficiency of 97.77% and kaolin adsorbent at pH 6 with removal efficiency of 86.86%. The optimum contact time was obtained at 60 and 80 minutes for zeolite-x and kaolin respectively. While optimum adsorbent dosage was obtained at 0.4 and 0.6 grams with removal efficiency of 97.12% and 87.75% for the zeolite-x and kaolin adsorption experiment respectively. The confirmed square sum errors values are 1.0×10-4 and 1.0×10-3 for zeolite-x and kaolin, respectively. The Adsorption isotherms results have well fitted to Freundlich isotherm than Langmuir isotherm. The adsorption kinetics results were best fitted the pseudo second order model. The result shows that the zeolite-x has high removal efficiency than kaolin at the same operating conditions. Application of this method can be economically, environmentally, and socially feasible to address wastewater problems. check details Further research has to be carried out on the removal capacity of this adsorbent for organic dyes not only from the textile industry but also from leather industries and soap industries.

A micro-arteriovenous fistula (AVF) is a minute, short shunt between an artery and a vein that does not pass through a capillary. We investigated the association between micro-AVFs and lymphedema using computed tomography angiography (CTA) and venous blood gas analysis.

In 95 patients with lower limb lymphedema, the presence or absence of early venous return (EVR) was compared between patients with primary and secondary lymphedema. Furthermore, we investigated the difference in the timing of edema onset in patients with secondary lymphedema with or without EVR using CTA. In 20 patients with lower limb lymphedema with confirmed early EVR in a unilateral lower limb, the partial pressure of oxygen (PO2) was compared between the lower limb with EVR and the contralateral lower limb.

Secondary lymphedema with or without EVR occurred at an average of 36.0±59.3 months and 93.5±136.1 months, respectively; however, no significant difference was noted. PO2 was 57.6±11.7 mmHg and 44.1±16.4 mmHg in the EVR and non-EVR limbs, respectively, which was a significant difference (P=0.005).

EVR and venous blood gas analysis suggested the presence of micro-AVFs in patients with lower extremity edema. Further research is warranted to examine the cause of micro-AVFs, to advance technology to facilitate the confirmation of micro-AVFs by angiography, and to improve lymphedema by ligation of micro-AVFs.

EVR and venous blood gas analysis suggested the presence of micro-AVFs in patients with lower extremity edema. Further research is warranted to examine the cause of micro-AVFs, to advance technology to facilitate the confirmation of micro-AVFs by angiography, and to improve lymphedema by ligation of micro-AVFs.Many surgeons have demonstrated the validity of sternocleidomastoid muscle flaps for the reconstruction of head and neck tumors. We present a case in which we used an island sternocleidomastoid muscle flap to reconstruct a cheek depression after excision of a malignant parotid tumor. A 44-year-old woman presented with a right malignant parotid tumor. We performed total resection of the parotid gland and facial nerve with the sural nerve and reconstructed the facial nerve and cheek depression with an island sternocleidomastoid muscle flap. The sternal head of the right sternocleidomastoid muscle was cut at the cranial and caudal segments to elevate it as an island flap. We used the superior thyroid artery as the sole pedicle for the island muscle flap. At 1 year and 3 months after the operation, the mimic muscles had gradually recovered and progressed without complications such as Frey syndrome, cervical motor dysfunction, or concave deformation of the neck and cheeks.