Exactly 100 years ago insulin was discovered - What a lifesaving peptide! Banting and Macleod received the Nobel Prize in 1923. Since then proinsulin was found and then in 1975 preproinsulin was discovered by this author. The rather interesting story as to how this peptide was found is revealed here. Why so many decades later is also told. In July of 1973 I was given a two year NIH sponsored research fellowship in Immunology at UCLA. My project in Immunology was to translate mRNA from pure T cell lines to see whether the T cell receptor had any immunoglobulin component. My fellow PhDs taught me how to isolate mRNA and translate it in an in vitro system. This was a fairly new technique at that time. While proceeding with this work, I immediately had the novel idea to translate insulin. Why insulin?

Background: In our healthcare setting transmission of hepatitis B is a big challenge to handle for both patients and healthcare providers especially those in frequent contact with blood. Objectives: To determine Hepatitis B knowledge, attitude, and vaccination status among nurses of Tamale Central Hospital. Methods: This study was conducted using a descriptive cross-sectional survey. Data analysis was done with SPSS version 20. Bivariate analysis was done using chi-square to determine the relationships. Results: The study recorded a response rate of 92.5%. Majority (59.6%) had high, 36.4% had moderate and 4.0% had low knowledge hepatitis B. Hepatitis knowledge level was associated with: age X2 (4) = 17.789, P= 0.001, sex, X2(2) = 13.203, P = 0.001, educational level, X2(6) = 17.552, P = 0.007, nursing category, X2(4) = 19.226, P = 0.001, and duration of nursing practice X2(2) = 19.492, P = 0.001. About 42.9% had positive attitude toward hepatitis B prevention and attitude level towards hepatitis B was associated with: marital status X2(1) = 11.090, P = 0.001, residential address X2 (2) = 11.411, P = 0.003 and duration of nursing practice X2(1) = 4.769, P = 0.029. About 84.8% of nurses started vaccination against hepatitis B and 77.3% completed at least three doses of the vaccination. The only factor with a statistically significant relationship with vaccination completeness status was respondent marital status X2(1) = 8.063, P = 0.005. Conclusion: Nurses knowledge of hepatitis B was very good. And more than half of the nurses had a negative attitude towards hepatitis B prevention. In terms of vaccination more than three-fourth of them started and completed three doses of hepatitis B vaccination.

Background: periodontal disease with alveoli bone degeneration and losing teeth is seen in many people, including those with arthritis rheumatoid. Objective This study aims to evaluate the effect of non-surgical periodontal treatments on the severity of arthritis rheumatoid. Methods: this randomized control clinical trial was conducted on 60 patients who concurrently had arthritis and mild to moderate periodontitis. Patients divided into three groups of 20 subjects (group C had tooth cleaning and antibiotic therapy, group B had only tooth cleaning and group A was control). DAS28 questionnaire was filled out for all three groups at the beginning of the study. After ending the treatment and improvement, patients were examined in days 45 and 90 in terms of improvement indicators for arthritis rheumatoid. Data were finally analyzed by SPSS18. Results: the highest reduction rate of ESR, DAS28, CRP and RF was in different time periods in tooth cleaning intervention +antibiotic group and then, teeth cleaning group. The lowest reduction was seen in control group. RF, CRP and DAS28 indices showed significant differences in different time periods in tooth cleaning group and tooth cleaning+ antibiotic group (P<0.05). Conclusion: non-surgery periodontal treatment and RA indices, without considering the medicines used for treatment, had positive effect on the treatment of this disease.

Background: Pain management for lower extremity fracture surgeries can be challenging. The purpose of this study is to determine whether the use of ketamine and methadone are more effective than ketamine and morphine to reduce postoperative pain and morphine requirements in patients undergoing lower extremity fracture surgery. Materials and Methods: Seventy-five patients 18-65 years of age, ASA class I-III, were enrolled in this study, which scheduled for elective lower extremity orthopedic surgery involving fracture of femur or tibia were recruited for the study. Thirty-eight randomized to the Methadone group and 37 randomized into the Morphine group. Participants were randomized to either one of the two groups: methadone (2ug/kg fentanyl, 0.2 mg/kg ketamine and 0.2 mg/kg methadone IV) versus control (2 ug/kg fentanyl, 0.2mg/kg ketamine and 0.2 mg/kg morphine IV). The primary outcome was total morphine equivalent (MEQ) during the first 24 and 48 hours after surgery. Secondary outcomes included postoperative pain scores in PACU, at 24 and 48 hours, as well as postoperative nausea and vomiting (PONV). Results: There was no difference in intraoperative consumption of fentanyl between the Methadone group 360mcg and Morphine group 344mcg. In the first 24 hours postoperatively, the Methadone group consumed less MEQ compared with the Morphine group (36.1 mg vs 54.8 mg, p=0.0072), showed lower pain scores than the Morphine group (p=0.0146), and experienced more nausea and vomiting than the Morphine group. There were no differences in sedation in both groups. Conclusion: The intraoperative use of intravenous methadone significantly reduced post-operative opioid requirement in patients undergoing lower extremity fracture surgery. The results also demonstrated the methadone group had a higher rate of PONV.

There are three alternating states of vigilance throughout our lives: wakefulness, NREM, and REM sleep. We usually yawn before falling asleep. Yawning is an ancient reaction, an instinctive action, manifested in a person by drowsiness or boredom. Yawning is often associated with the need for stretching. Yawning is a less strong territorial reflex. During deep sleep muscular tone is sharply reduced. Relaxation of the muscles and the lowering of their tone, howeever, are not constant and necessary components of sleep. Analysis of EEG recordings soon revealed that sleep is by no means a uniform process, but can be divided into at least two sharply separated states: one is characterized by slow waves in the EEG that are completely separate from the activity of wakefulness: this so-called slow wave sleep; the other is the so-called paradoxical sleep. Hypnopedia, as a discipline, deals with the input of fixed information introduced during the period of natural sleep, also known as sleep learning. Our hypnopedia researches was a pleasant surprise, because they were able to reproduce texts they did not know with an efficiency of approx. 25%.