Showing papers in "African Health Sciences in 2017"
TL;DR: This comprehensive, evidence-based meta-analysis and systematic review concisely presents the evidence of decreased sperm concentration in the African male over past 50 years with possible causative factors to serve the scientific research zone related to male reproductive health.
Abstract: Purpose: This meta-analysis, following our previous reports those documented an overall 57% diminution in mean sperm concentration around the globe over past 35 years and 32.5% decline in past 50 years in European population, attempts to report the declining trend of sperm concentrations in African population between 1965 and 2015. Methods: In the course of retrieval of data following MOOSE guidelines and PRISMA checklist, we found a total of fourteen studies that have been conducted during that period on altering sperm concentration in the African male. Results: Following analysis of the data, a time-dependent decline of sperm concentration ( r = -0.597, p = 0.02) and an overall 72.6% decrease in mean sperm concentration was noted in the past 50 years. The major matter of concern is the present mean concentration (20.38×10 6 /ml) is very near to WHO cut-off value of 2010 of 15×10 6 /ml. Several epidemic diseases, genital tract infection, pesticides and heavy metal toxicity, regular consumption of tobacco and alcohol are reported as predominant causative factors. Conclusion: This comprehensive, evidence-based meta-analysis and systematic review concisely presents the evidence of decreased sperm concentration in the African male over past 50 years with possible causative factors to serve the scientific research zone related to male reproductive health. Keywords: Semen quality, sperm concentration, sperm count
70 citations
TL;DR: While there is a positive relationship between healthcare expenditures and female and male life expectancy, it is found that healthcare had a stronger effect on improving life expectancy in females than in males.
Abstract: Background: Over the last decade, total healthcare expenditures, comprised of both public and private healthcare expenditures, have increased in most East African countries At the same time, health outcomes such as infant mortality rates, life expectancy at birth and other health outcome indicators have improved Objectives: This paper examines the association between healthcare expenditures and health outcomes for eight East African countries: Burundi, Eritrea, Ethiopia, Kenya, Rwanda, Sudan, Tanzania, and Uganda In this study, health outcomes are defined as an improvement in adult life expectancy and a reduction in the number of neonatal, infant, and under-five deaths Methods: We implemented a panel data regression technique, analyzing both cross-sectional and time series information This combined method has been used in healthcare studies by several authors Data obtained from world development indicators for the years 2000-2014 was used for the panel study Results: First, we documented that there is a strong, positive association between total healthcare expenditures and total life expectancy While we identified a positive relationship between healthcare expenditures and female and male life expectancy, we found that healthcare had a stronger effect on improving life expectancy in females than in males Moreover, we found a negative relationship between healthcare expenditures and the number of neonatal, infant, and under-five deaths Conclusion: The results of this study have important policy and management implications for the eight East African countries From a policy perspective, it is necessary to understand if a greater allocation of resources to the healthcare sector is worthwhile and to determine whether to encourage private healthcare investment From the management perspective, investing in more private institutions, such as hospitals and clinics, is essential for health outcomes in the average country The results of this study can be used by the World Health Organization as well as other non-governmental organizations that provide financial assistance to East African countries Keywords: Healthcare expenditures, health outcome, life expectancy, infant deaths, under-five deaths, neonatal deaths
63 citations
TL;DR: The strategy of contact tracing has a great potential to significantly reduce the incidence of cases of Ebola virus disease, however, its success is eventually determined by the level of trust between the community and the public health system and the quality of the diagnostic & treatment services.
Abstract: Background: The 2014 outbreak of Ebola virus disease which emerged in the month of March in the year 2014 in Guinea has been declared as a public health emergency of international concern. Objectives: The objectives of the review article are to assess the role of contact tracing in the Ebola outbreak and to identify the challenges faced by the health workers while performing contact tracing. Methods: An extensive search of all materials related to the Ebola outbreak and contact tracing was carried out in PubMed, Medline, World Health Organization website and Google Scholar search engines. Keywords used in the search included Ebola virus disease, West-Africa, contact tracing, World Health Organization. Overall 60 articles were selected and included in the discussion. Results: Contact tracing is an important strategy in epidemiology and refers to the identification and diagnosis of those individuals who have come in contact with an infected person. It ultimately aims to reduce the time span required to detect and treat a case of an infectious disease and hence significantly minimize the risk of transmission to the subsequent susceptible individuals. In-fact, contact tracing continues to remain an important measure, as it aids the epidemiologist in containing the infection. Conclusion: The strategy of contact tracing has a great potential to significantly reduce the incidence of cases of Ebola virus disease. However, its success is eventually determined by the level of trust between the community and the public health system and the quality of the diagnostic & treatment services. Keywords: Ebola virus disease, West-Africa, contact tracing, World Health Organization
60 citations
TL;DR: The endophytic fungi from camptotheca trees are a reliable source for natural anticancer compounds and the fungal CPT exhibited effective activity at inhibiting cell growth and inducing apoptosis on Vero cells.
Abstract: Background: Camptothecin (CPT) is a potent drug against cancers, originally from plants. The endophytic fungi could produce the secondary metabolite same as the host and is used as medicine. Objectives: The aim of this paper was to investigate an endophytic fungal CPT with anti-neoplastic activity. Methods: Endophytic fungi were isolated from Camptotheca acuminata in China. CPT from strain S-019 was characterized by TLC, HPLC and EI-MS analysis. Anti-tumor activity of fungal CPT was detected by MTT and fluorescent dye methods using Vero and PC-3 cells. Results: A total of 94 endophytic fungi strains were isolated from tissues of C. acuminata and 16 fungi strains displayed cytotoxic activity on Vero or PC3 cells. Of which, the fungal strain S-019, classified as Fusarium solani , displayed impressive cytotoxic activity on cancer cells and was found to produce CPT by analysis of TLC, HPLC and EI-MS methods. Bioassay studies confirmed that the fungi CPT had potent cytotoxicity on Vero cells and induced apoptosis of Vero cells. Conclusion: The endophytic fungi from camptotheca trees are a reliable source for natural anticancer compounds. The endophytic fungi could produce CPT same as plant. The fungal CPT exhibited effective activity at inhibiting cell growth and inducing apoptosis on Vero cells. Keywords: Endophytic fungi, camptothecin, anti-tumor, Camptotheca acuminate
60 citations
TL;DR: Treadmill walking exercise training is an effective treatment policy to improve quality of life, systemic inflammation and psychological wellbeing in Alzheimer's.
Abstract: Background: Alzheimer’s disease has a destructive drawbacks on the patient and his/her entire family as this disease badly affects the behavior, cognition and abilities to do activities of daily living (ADL). The physical and mental benefits of exercise are widely known but seldom available to persons suffering from Alzheimer’s disease. Objective: The aim of this study was to measure quality of life, systemic inflammation and psychological well-being response to aerobic exercises in Alzheimer’s. Methods: Forty Alzheimer elderly subjects were enrolled in two groups; the first group received treadmill aerobic exercise, while the second group was considered as a control group and received no training intervention for two months. Assessment of tumor necrosis factor-alpha (TNF-α), interleukin-6 (IL-6), Rosenberg Self-Esteem Scale (RSES),Beck Depression Inventory (BDI), Profile of Mood States(POMS) and SF-36 health quality of life (SF-36 HRQL) were taken before and at the end of the study. Results: There was a 25.2%, 19.4%, 23.5%, 21.3%, 17.7% , 11.7%, 12.5% and 10.1 % reduction in mean values of TNF-α, IL-6, BDI, POMS, health transition SF-36 subscale, bodily pain SF-36 subscale, role functioning: emotional SF-36 subscale and mental health SF-36 subscale respectively in addition to 15.7%, 13.1%, 12.6%, 11.1%, 13.2% and 11.2 % increase in mean values of RSES, physical functioning SF-36 subscale, role functioning:physical SF-36 subscale, general health SF-36 subscale, Vitality SF-36 subscale and Social functioning SF-36 subscale respectively in group (A) received aerobic exercise training, so that there was a significant reduction in the mean values of TNF-α, IL-6, BDI & POMS and increase in the mean values of SF-36 HRQL subscale scores, RSES in group (A) as a result of aerobic exercise training, while the results of group (B) who received no training intervention were not significant. Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study (P<0.05). Conclusion: Treadmill walking exercise training is an effective treatment policy to improve quality of life, systemic inflammation and psychological wellbeing in Alzheimer’s. Keywords: Aerobic exercise, quality of life, psychological well-being, systemic inflammation, Alzheimer's
53 citations
TL;DR: The high prevalence of early sexual exposure among the students calls for urgent interventions to stem the trend and help to reduce the devastating negative psycho-social and health sequels.
Abstract: Background: Early adolescent sexual activity remains a recurring problem with negative psychosocial and health outcomes. The age at sexual debut varies from place to place and among different individuals and is associated with varying factors. The aim was to determine the prevalence and risk factors of early sexual debut among secondary school students in Ido-Ekiti, South-West Nigeria. Methodology: This was a cross-sectional study. The respondents were selected using multi-stage sampling technique. Pre-tested, semi-structured, self-administered questionnaire was used to collect data. Data was analyzed using SPSS version 15. Results: More than two-thirds, 40(67.8%), had early sexual debut. The prevalence of early sexual debut was about 11%. The mean age of sexual debut was 13.10±2.82; the mean age for early sexual debutants was 11.68±1.98. The mean number of sexual partners was 2.44±1.99. Male gender, having friends who engaged in sexual activities had association with early sexual exposure (p<0.05). Alcohol intake had the strongest strength of association for early sexual debut among the students. Conclusion: The high prevalence of early sexual exposure among the students calls for urgent interventions to stem the trend. This will help to reduce the devastating negative psycho-social and health sequels. Keywords: Sexual debut, prevalence, risk factors, Nigeria
49 citations
TL;DR: In this paper, the role of miR-126 in coronary artery disease (CAD) patients and the potential gene targets in atherosclerosis was explored by analyzing the placenta growth factor (PLGF) levels of 60 CAD patients and 25 healthy control subjects.
Abstract: Objective: This study aimed to explore the role of miR-126 in coronary artery disease (CAD) patients and the potential gene targets of miR-126 in atherosclerosis. Methodology: A total of 60 CAD patients and 25 healthy control subjects were recruited in this study. Among the 60 CAD patients, 18 cases were diagnosed of stable angina pectoris (SAP), 20 were diagnosed of unstable angina pectoris (UAP) and 22 were diagnosed of acute myocardial infarction (AMI). Plasma miR-126 levels from both groups of participants were analyzed by real-time quantitative PCR. ELISA was used to measure plasma level of placenta growth factor (PLGF). Results: The results showed that the miR-126 expression was significantly down-regulated in the circulation of CAD patients compared with control subjects ( P <0.01). Plasma PLGF level was significantly upregulated in patients with unstable angina pectoris and acute myocardial infarction (AMI) compared with controls (both P <0.01) the miR-126 expression in AMI was significantly associated with PLGF. Conclusion: miR-126 may serve as a novel biomarker for CAD. Keywords: miR-126; PLGF; PCR; coronary artery disease; atherosclerosis
44 citations
TL;DR: Strategies to end child marriage in the study area should include mass and compulsory education of girls, provision of other options to early marriage and childbearing and involvement of fathers in preventing and ending the practice.
Abstract: Background: Efforts toward liberation of the girl-child from the shackles of early marriage have continued to be resisted through tradition, culture and religion in some parts of Nigeria. Objective: This study therefore examines the maternal health implications of early marriage on young mothers in the study area. Methods: Multistage sampling technique was employed to obtained data from 200 young mothers aged 15-24 years who married before aged 16 years. Findings: The study reveals that more than 60% had only primary education while more than 70% had experienced complications before or after childbirth. Age at first marriage, current age, level of education and household decision-making significantly influence (P<0.005) maternal health risks in the study area. The study establishes that respondents in age group 15-19 years are 1.234 times more likely to experience complications when compared with the reference category 20-24 years. Entitlements and freedom that are highly relevant to reduction of maternal mortality, provided by international treaties are inaccessible to young women in the study area. Conclusion: Strategies to end child marriage in the study area should include mass and compulsory education of girls, provision of other options to early marriage and childbearing and involvement of fathers in preventing and ending the practice. Keywords: Child marriage, maternal health risks, Nigeria, mortality, entitlements and freedoms
44 citations
TL;DR: By focusing on five target areas such as the educational system, health services, community-based initiatives, local or regional policies and national strategies, current framework in Nigeria can be modified to prepare for changing demographics in aging.
Abstract: Background: Globally, national health systems are challenged to build successful aging models to prepare for biomedical, psychological and social changes. The integral component of psychosocial health in overall quality of life and well-being, however, is underscored and requires greater focus. Changing demographics in Nigeria, in addition to cultural considerations and absence of a social security system, present unique challenges to elderly. Objective: We aimed to review the literature that describes the current situation and challenges in psychosocial health status in the elderly in Nigeria and provide recommendations that promote health and well-being during the aging process. Results: Four primary factors affect psychosocial health status of elderly Nigerians, namely: changes in family dynamics, increased demand for healthcare services, increased economic stress, and decreased functional independence. Conclusion: Like other developing countries, the Nigerian national system faces similar challenges in preparing a national framework that can maximize coverage to citizens in the midst of demographic changes in aging. By focusing on five target areas such as the educational system, health services, community-based initiatives, local or regional policies and national strategies, current framework in Nigeria can be modified to prepare for changing demographics in aging. Keywords: Aging, family support, Nigeria, psychosocial
39 citations
TL;DR: There was generally high sensitivity to nitrofurantoin and gentamycin by most of the uropathogens isolated, and high resistance to the common antibiotics such as nalidixic acid and erythromycin thus a need for a bigger study that can be used to effect the change of the current recommendations in the Uganda Clinical Guidelines as regards empirical management of CA-UTIs.
Abstract: Background: Urinary tract infections (UTI) are a common medical problem affecting the general population and thus commonly encountered in medical practice, with the global burden of UTIs at about 150 million people. Because uropathogens largely originate from colonic flora, they are easy to predict, and this is the rationale for empirical treatment in Community Acquired-UTI (CA-UTIs). With the increasing prevalence of drug-resistant bacteria among adults with CA-UTI in Uganda, it is no longer adequate to manage CA-UTIs on empiric regimen without revising the susceptibility patterns of common CA-UTI causative agents. Thus in this study we set out to identify: The factors associated with CA-UTIs, the common uropathogens and the drug sensitivity patterns of the common uropathogens cultured. Methodology: This was a cross-sectional study that was conducted in adults who presented with symptoms of a UTI at Mulago Hospital, assessment center. There were 139 patients who consented to the study and were recruited, an interviewer administered questionnaire was used to collect information from the study participants as regards demographic, social and clinical characteristics and Mid Stream Urine (MSU) samples were collected for urinalysis, culture and antibiotic susceptibility testing using the Kirby-Bauer disc diffusion technique was applied to the isolates.Numeric data were summarized using measures of central tendency while the categorical data was summarized using proportions and percentages. Results: Age, female sex and marital status were factors that were significantly associated with CA-UTIs. Fifty four (54) cultures were positive for UTI with 26 giving pure growths. The commonest uropathogen isolated was Escherichia coli at 50%, this was followed by Staphylococcus aureus at 15.4%. The sensitivity of Escherichia coli to Ampicillin and Nitrofurantoin were78.6%, 64.3% respectively, and the sensitivity of Staphylococcus aureus to ciprofloxacin, Nitrofurantoin and gentamycin were 100%, 66.7% and 66.7% respectively. Conclusion: There are known factors associated with CA-UTIs such as age, female sex. There was generally high sensitivity to nitrofurantoin and gentamycin by most of the uropathogens isolated, and high resistance to the common antibiotics such as nalidixic acid and erythromycin thus a need for a bigger study that can be used to effect the change of the current recommendations in the Uganda Clinical Guidelines as regards empirical management of CA-UTIs. Keywords: Community-acquired urinary tract infections, assessment centre, Mulago Hospital Uganda
39 citations
TL;DR: DPN occurs in 1 in 4 of newly diagnosed diabetic patients in Mulago hospital and was independently associated with increasing age, which would play an important role in identifying this problem.
Abstract: Aims: To determine the prevalence and associated risk factors of diabetic peripheral neuropathy (DPN) among newly diagnosed diabetes mellitus patients in Mulago Hospital. Methods: A cross-sectional study was conducted among 248 newly diagnosed adult diabetic patients. Using the standard Neuropathy Symptom Score (NSS) and Neuropathy Disability Score (NDS) criteria, we screened them for neuropathy. Data on the socio-demographics, age, duration of symptoms and history of diabetic ulcer were analyzed using a multiple logistic regression. A p -value <0.05 was considered significant. Results: The majority of study patients (62.1%) were male. The overall prevalence of DPN was 29.4 %. Nearly sixteen percent had moderate neuropathy and only five percent had severe neuropathy. Age above 60 years was significantly associated with the presence of DPN; (OR 3.72; 95% CI 1.25 – 11.03; p =0.018). The history of ever having a foot ulcer was significantly associated with peripheral neuropathy (OR 2.59; 95% CI: 1.03 – 6.49, p = 0.042). Conclusion: DPN occurs in 1 in 4 of newly diagnosed diabetic patients in Mulago hospital. Two thirds of these patients had moderate to severe neuropathy. DPN was independently associated with increasing age. Early diagnosis of diabetes mellitus, increased diabetes knowledge and regular blood sugar screenings would play an important role in identifying this problem. Keywords: Diabetic peripheral neuropathy, associated factors, newly diagnosed, diabetes mellitus
TL;DR: Most participants emphasized the necessity of sexual health education not only because of medical concerns, but also from the perspective of social issues, and providing these services should be considered a priority.
Abstract: Background: Sexual health education for Iranian engaged couples is always ignored in the premarital education program. Objectives: The aim of this study was to explore the necessity of sexual health education for Iranian engaged couples. Materials and methods: This qualitative study was conducted in Rasht, Iran. The studied sample consisted of 38 engaged men and women; and also 9 health experts and policymakers. We used interview guides to collect data. The data was analyzed through content analysis method. Results: Analyzing participants’ perspectives revealed six themes including: (1) socio-cultural changes, (2) emerging social pathologies, (3) inadequate sexual knowledge; (4) challenges in providing sexual health services, (5) individual consequences and (6) social consequences. Conclusion: Most participants emphasized the necessity of sexual health education not only because of medical concerns, but also from the perspective of social issues. Providing these services should be considered a priority. Keywords: Sexual health, health education, qualitative study, Iran
TL;DR: Metformin can act as a quorum sensing inhibitor and virulence inhibiting agent that may be useful in the treatment of Pseudomonas aeruginosa infection.
Abstract: Background: Quorum sensing is a mechanism of intercellular communication that controls the production of virulence factors in Pseudomonas aeruginosa. Inhibition of quorum sensing can disarm the virulence factors without exerting stress on bacterial growth that leads to emergence of antibiotic resistance. Objectives: Finding a new quorum sensing inhibitor and determining its inhibitory activities against virulence factors of Pseudomonas aeruginosa PAO1 strain. Methods: Quorum sensing was evaluated by estimation of violacein production by Chromobacterium violaceum CV026. Molecular docking was used to investigate the possible binding of metformin to LasR and rhlR receptors. The inhibition of pyocyanin, hemolysin, protease, elastase in addition to swimming and twitching motilities, biofilm formation and resistance to oxidative stress by metformin was also assessed. Results: Metformin significantly reduced the production of violacein pigment. Significant inhibition of pyocyanin, hemolysin, protease and elastase was achieved. Metformin markedly decreased biofilm formation, swimming and twitching motilities and increased the sensitivity to oxidative stress. In the molecular docking study, metformin could bind to LasR by hydrogen bonding and electrostatic interaction and to rhlR by hydrogen bonding only. Conclusion: Metformin can act as a quorum sensing inhibitor and virulence inhibiting agent that may be useful in the treatment of Pseudomonas aeruginosa infection. Keywords: Metformin, Pseudomonas aeruginosa , quorum sensing, virulence inhibition
TL;DR: The findings of this study showed that intimate partner violence during pregnancy was associated with a low birth weight of the new born and health sectors should train health care providers on how to screen, counsel, treat and follow up abused women.
Abstract: Background: Violence by intimate partner during pregnancy has many adverse pregnancy outcomes. Thus, that's why we sought to determine association between intimate partner violence during pregnancy and adverse birth outcomes. Methods: A facility based cross-sectional study was conducted among 183 recently delivered women from March 31- April 30, 2014 in public health facilities of Hossana Town. The data were collected through structured questionnaire and record review. Women who were not mentally and physically capable of being interviewed and those admitted for abortion were excluded. Ethical clearance was obtained from Jimma University. Logistic regression analysis was employed to determine the association between intimate partner violence and adverse birth outcomes. Results: About 23 % of women experienced intimate partner violence during pregnancy. The result of this study indicated an association of intimate partner violence with low birth weight of the new born (AOR:14.3,95% CI: (5.03, 40.7). Intimate partner violence was not associated with still birth, pre-term birth and Apgar score less than 7 at 5 minutes. Conclusion: The findings of this study showed that intimate partner violence during pregnancy was associated with a low birth weight of the new born. Health sectors should train health care providers on how to screen, counsel, treat and follow up abused women. Keywords: Intimate partner violence, birth outcomes, Ethiopia
TL;DR: A lower than expected prevalence of DM was observed, which could be explained by the lack of traditional risk factors for DM (overweight, age over 45 years, hypertension and smoking) in Mozambique.
Abstract: Introduction: Data regarding the association between diabetes mellitus (DM) and tuberculosis (TB) in Africa are scarce. DM screening among TB patients in Mozambique was carried out. Methods: The study was implemented from January to August 2016 in three Urban Health Centers in Beira, Mozambique and recruited adult (>18 years) patients newly diagnosed with pulmonary TB. Results: Three hundred and one patients were enrolled (67.4%, males mean age 31.7(SD 11 years). Diabetes was diagnosed in only 3 patients (1%) and impaired glucose tolerance (IGT) in an additional 6 subjects (2%). Conclusion: A lower than expected prevalence of DM was observed, which could be explained by the lack of traditional risk factors for DM (overweight, age over 45 years, hypertension and smoking) in Mozambique. Keywords: Diabetes mellitus, pulmonary tuberculosis, Beira, Mozambique
TL;DR: Mainly obstetric factors contribute to low Apgar score.
Abstract: Background: New born babies with low Apgar scores are at an increased risk of perinatal morbidity and mortality. Objective: To assess proportion and factors associated with low 5 th minute Apgar Apgar score among singleton newborn babies in Gondar University referral hospital; North West Ethiopia. Methods: A cross-sectional study was conducted on singleton 261 live births from March - May, 2013. Data was collected from mother/newborn index using a structured and pre-tested questionnaire. It was then cleaned, coded and entered using EPI INFO version 3.4.3, then analyzed with IBM SPSS statistics versions 20.0. Logistic regression was used to identify significant variables with low 5 th minute Apgar score. Result: The proportion of low 5 th minute Apgar score in this study was 13.8%. Factors that were significantly associated with low 5 th minute Apgar score were: non-vertex fetal presentation, prolonged labor, presence of meconium stained liquor, induced/ augmented labor and low birth weight. Conclusion: Mainly obstetric factors contribute to low Apgar score. Improving labor management through implementing regular use of partograph, 1:1 midwife-client ratio and advanced electronic fetal monitoring technology is recommended. Keywords: Apgar score, Gondar University referral hospital
TL;DR: Interventions aimed at decreasing PLF rate should be through a tailored approach, and should target at risk sub-groups based on place of residence.
Abstract: Background: Prelacteal feeding (PLF) is a barrier to exclusive breast feeding. Objective: To determine factors associated with PLF in rural and urban Nigeria. Methods: We utilized data from the 2013 Nigerian Demographic and Health Survey. Bivariate and multivariate analyses were used to test for association between PLF and related factors. Results: Prevalence of PLF in urban Nigeria was 49.8%, while in rural Nigeria it was 66.4%. Sugar or glucose water was given more in urban Nigeria (9.7% vs 2.9%), plain water was given more in rural Nigeria (59.9% vs 40.8% ). The multivariate analysis revealed that urban and rural Nigeria shared similarities with respect to factors like mother’s education, place of delivery, and size of child at birth being significant predictors of PLF. Mode of delivery and type of birth were significant predictors of PLF only in urban Nigeria, whereas, mother’s age at birth was a significant predictor of PLF only in rural Nigeria. Zones also showed variations in the odds of PLF according to place of residence. Conclusion: Interventions aimed at decreasing PLF rate should be through a tailored approach, and should target at risk sub -groups based on place of residence. Keywords: Pre-lacteal feeds, mothers, infants, urban, rural, Nigeria
TL;DR: Postural modification may help in rehabilitation of patients with dysphagia by affecting bolus flow to improve speed and safety of swallowing by closure of airways to prevent aspiration.
Abstract: Background: Swallowing is a systematic process. Any structural, physiological or neurological disturbance in this process may cause dysphagia. Although there are studies that report head/neck movements during mastication, there are fewer studies that show the effect of different head/neck postures on difficulty while swallowing. Objectives: To observe the effect of different body postures on the self-perceived difficulty while swallowing in normal healthy subjects. Methods: Participants were asked to swallow 25 ml of water in one go while sitting upright, sitting with head/neck flexed, head/ neck extended and lying supine. Following this, they had to rate their self-perceived difficulty while swallowing on a scale of 0-10, 0 being most easy and 10 being most difficult. Results: 186 subjects with mean age 32.7 SD 9.04 participated in this study. It was found to be least difficult to swallow when subjects were asked to swallow in upright sitting position. Statistically significant differences were found between sitting upright, sitting with head/neck flexed, head/neck extended and lying supine. Conclusion: Postural modification may help in rehabilitation of patients with dysphagia by affecting bolus flow to improve speed and safety of swallowing by closure of airways to prevent aspiration. Keywords: Swallowing, posture, dysphagia
TL;DR: Girl-child education and women empowerment are required to improve utilization of services in Afon community and ante-natal care providers need to be trained to improve quality of care in the discharge of their duties.
Abstract: Background: Nigeria accounts for only 2% of the world’s population, but contributes up to 10 % of the global estimates of maternal deaths. The study assesses the utilization of antenatal and delivery services by women of reproductive age in Afon community. Methodology: It was a descriptive cross-sectional study that collected both quantitative and qualitative data using semi-structured interviewer administered questionnaire and focus group discussions (FGD). Interviews were house-hold based. FGD had two homogenous groups. Data was analysed using Epi-info version 3.5.1 software package. Level of statistical significance was set at p <0.05. Results: There was a high level of utilization of antenatal/delivery services in the community. Barriers to utilization of ANC/ delivery services include lack of money, distance from health facility, long waiting time, poor attitude of health workers and no permission from husbands. Level of education and employment status were significantly associated with utilization of ANC/ delivery services. Conclusion: Girl- child education and women empowerment are required to improve utilization of services. Ante-natal care providers need to be trained to improve quality of care in the discharge of their duties. Keywords: Utilization, antenatal services, Nigeria
TL;DR: The use of multi-dimensional approach and narrative exposure therapy led to expedite diagnosis and treatment of vaginismus in a case of unconsummated marriage between a couple after 6 years.
Abstract: Background: Unconsummated marriage is a problem among couples who would not be able to perform natural sexual intercourse and vaginal penetration. This disorder is more common in developing countries and sometimes couples would come up with non-technical and non-scientific methods to overcome their problem. Multi-dimensional approach and narrative exposure therapy used in this case. Methods: This study would report a case of unconsummated marriage between a couple after 6 years. The main problem of this couple was vaginismus and post-traumatic stress. Results: Treatment with multi-dimensional approach for this couple included methods like narrative exposure therapy, educating the anatomy of female and male reproductive system, correcting misconceptions, educating foreplay, educating body exploring and non-sexual and sexual massage and penetrating the vagina first by women finger and then men’s after relaxation. The entire stages of the treatment lasted for four sessions and at the one-month follow-up couple’s satisfaction was desirable. Conclusion: Unconsummated marriage is one of the main sexual problems; it is more common in developing countries than developed countries and cultural factors are effective on intensifying this disorder. The use of multi-dimensional approach in this study led to expedite diagnosis and treatment of vaginismus. Keywords: Unconsummated marriage, couple’s therapy, vaginismus, behavioral therapy
TL;DR: Glyceryl trinitrate can be an antivirulence agent in the treatment of Pseudomonas aeruginosa topical infections such as burn infections and demonstrates the ability to inhibit pyocyanin, protease, biofilm and tolerance to oxidative stress.
Abstract: Background: Targeting quorum sensing is an alternative approach to antibiotics.Targeting quorum sensing-regulated virulence will disarm the pathogen without exerting pressure on its growth. As a result, emergence of resistance is avoided and the immune system can easily eradicate bacteria. Objectives: Investigation of the possible inhibition of quorum sensing-regulated virulence of Pseudomonas aeruginosa by glyceryltrinitrate. Methods: The quorum sensing inhibiting activity of glyceryl trinitrate was assessed by inhibition of violacein production in Chromobacterium violaceum ATCC 12472. Its ability to inhibit pyocyanin, protease, biofilm and tolerance to oxidative stress was evaluated. Docking study was performed to study the interference of glyceryl trinitrate with the binding of autoinducers with LasR and rhlR receptors. Results: Glyceryl trinitrate exerted a significant biofilm inhibiting and eradicating activities. It decreased the production of quorum-sensing dependent violacein production. It significantly inhibited the production of pyocyanin and protease and diminished the tolerance against oxidative stress. Molecular docking study showed that glyceryl trinitrate interferes with the binding of autoinducers to their receptors. It could bind to Las Rand rhlr receptors with binding energy of -93.47 and -77.23, respectively. Conclusion: Glyceryl trinitrate can be an antivirulence agent in the treatment of Pseudomonas aeruginosa topical infections such as burn infections. Keywords: Glyceryl trinitrate, Pseudomonas aeruginosa , quorum sensing, virulence inhibition
TL;DR: Hydxyurea use is low among Nigerian SCD subjects despite its proven efficacy/clinical prospects in the developed nations, and large scale multicenter studies and clinical trials are needed to form a basis for developing standard local treatment protocol for its use.
Abstract: Background: The clinical prospects of hydroxyurea therapy in the management of sickle cell disease (SCD) require evaluation in the Nigerian setting to develop indigenous guidelines This survey examines the pattern of hydroxyurea therapy, its clinico-haematologic benefits and safety profile in Nigerian SCD subjects Methods: A cross sectional pilot survey was carried out among 60 adult SCD subjects over 3 months Data on clinical phenotypes, relevant haematological parameters and details of hydroxyurea therapy were obtained using a structured questionnaire through an interview process and case file review Results: The median age was 30 years Thirty-four (567%) of the subjects are aware of hydroxyurea therapy in SCD Twenty-four (40%) SCD patients had previously used hydroxyurea Only 4 subjects were fully compliant Reasons for non-complianceincluded poor knowledge and lack of funds In particular, hydroxyurea reduced leucocyte count and increased mean red cell volume (MCV) in compliant subjects Conclusion: Hydroxyurea use is low among Nigerian SCD subjects despite its proven efficacy/clinical prospects in the developed nations Large scale multicenter studies and clinical trials are needed to form a basis for developing standard local treatment protocol for its use Keywords: Hydroxyurea therapy, Nigerian sickle cell disease, pattern of use, clinical effects, patient’s compliance
TL;DR: High soft drink intake, lack of exercising and limited calcium and vitamin D supplementation are the combined lifestyle factors leading to osteopenia and osteoporosis among young Saudi females.
Abstract: Aim: To analyze risk factors leading to osteopenia and osteoporosis among young female students. Methods: Quantitative Ultrasonography measurements were performed in the calcaneal region of 101 young Saudi females. Dietary habits, exercising and sun exposure were assessed using questionnaires. The association between the different studied factors was assessed by Pearson test and multiple linear regression model. Results: Participants diagnosed with either osteopenia or osteoporosis (>33%.) showed significant higher soft drinks consumption, reduced exercise, limited intake of milk and dairy products, calcium and vitamin D supplementation compared to the healthy group. Multiple regression analysis showed that T-score and Z-score were negatively associated with soft drink intake and positively associated with exercising, milk and dairy products consumption, and calcium and vitamin D supplementation use ( p <0.05) Conclusion: High soft drink intake, lack of exercising and limited calcium and vitamin D supplementation are the combined lifestyle factors leading to osteopenia and osteoporosis among young Saudi females. These findings might serve as a basis of nutrition education intervention to promote healthy bones among this population. Keywords: Lifestyle factors, osteoporosis, osteopenia, young women, Saudi Arabi
TL;DR: Anxiety and depression is prevalent among family carers of cancer patients and being a relative carer predisposes you to increased risk of developing anxiety and depression, and incorporating evidence based psychological therapies into usual care and targeting family carer is imperative.
Abstract: Background: The process of caregiving may cause emotional distress in form of anxiety and depression among family carers of cancer patients. Little is known about the prevalence of anxiety and depression among family carers of cancer patients in Uganda. Objectives: To determine the prevalence of anxiety and depression and related factors associated with abnormal levels of anxiety and depression among family carers of cancer patients in a cancer care and treatment facility in Uganda. Methods: After obtaining ethical approval, we recruited family carers of cancer patients to this cross-sectional study. Data was collected with the use of the Hospital Anxiety and Depression Scale(HADS) standardized tool. Results: A total of 119 family carers were recruited from the Uganda Cancer Institute. The prevalence of anxiety and depression among family carers was high (45% V. 26 %); Abnormal levels of anxiety (ALA)(OR 0.27, 95% CI, p= 0.01) and depression (ALD)(OR 0.37, 95% CI, p=0.05) were significantly associated with being a relative carer. Conclusion: Anxiety and depression is prevalent among family carers of cancer patients. Being a relative carer predisposes you to increased risk of developing anxiety and depression. Incorporating evidence based psychological therapies into usual care and targeting family carers is imperative. Keywords: Anxiety, depression, cancer patients, Uganda
TL;DR: Generally, structural empowerment (relatively strong) correlates with nurses' organizational commitment and is concluded that a high structural empowerment increases the organizational commitment of nurses.
Abstract: Background: The demanding nature of nursing work environments signals longstanding and growing concerns about nurses' health and job satisfaction and the provision of quality care Specifically in health care settings, nurse leaders play an essential role in creating supportive work environments to avert these negative trends and increase nurse job satisfaction Objective: The purpose of this study was to examine the relationship between structural empowerment and organizational commitment of nurses Methods: 491 nurses working in Zanjan hospitals participated in this descriptive-correlational study in 2010 Tools for data collection were Meyer and Allen’s organizational commitment questionnaire and “Conditions for Work Effectiveness Questionnaire-II” (CWEQ-II) Data was analyzed by SPSS16 The statistical tests such as variance analysis, t-test, pearson correlation coefficient and linear regression were used for data analysis Results: According to the findings, the perception of nurses working in hospitals on "Structural Empowerment" was moderate (1598±329) Nurses believed "opportunity" as the most important element in structural empowerment with the score of 318 ±079 Nurses working in non-academic hospitals and in non-teaching hospitals had higher organizational commitment than others There was a significant relationship between structural empowerment and organizational commitment Conclusion: Generally, structural empowerment (relatively strong) correlates with nurses’ organizational commitment We concluded that a high structural empowerment increases the organizational commitment of nurses Keywords: Structural empowerment, organizational commitment, nurses, Zanjan
TL;DR: It is concluded that amentoflavone has a significant inhibitory effect on uterine tumors in rats and its mechanism may be by elevating Bax protein expression, down-regulating Bcl-2 expression, forming homodimers Bax/Bax, and reducing plasma estradiol and progesterone to promote apoptosis of uterine fibroid cells.
Abstract: Background: Xiang Fu ( Cyperus rotundus L) enters the liver, spleen and triple warmer meridians, and has qi stagnation-removing, qi circulation-promoting, menstruation-regulating and pain-relieving effects. Besides, it can improve ovarian function, and has hypolipidemic, hypoglycemic and neuroprotective actions. Objectives: To study the biflavone constituents in Cyperus rotundus L and to investigate the effect and mechanism of amentoflavone on inhibition of uterine tumors. Modern chromatographic techniques were applied for isolation and purification of compounds, which were then structurally elucidated based on their physicochemical properties and spectral data. Methods: Female SD rats were injected with diethylstilbestrol and progesterone to establish the pathological model of uterine fibroids. The rats were then randomly divided into amentoflavone high-, medium- and low-dose groups, mifepristone group, model group and blank control group (n=10 in each group), and these administered for six consecutive weeks. 24 h after the last administration, the rats were sacrificed, changes in uterine coefficient were observed, and morphological features of apoptotic cells in uterine smooth muscle tissues were detected. Afterwards, serum estradiol and progesterone levels were determined by radioimmunoassay, as well as NOS level in uterine fibroid tissue homogenates. Pro- and anti-apoptotic genes Bcl-2 and Bax were determined by immunohistochemical assay. Results: Four biflavone constituents were isolated and obtained. Amentoflavone could markedly reduce the uterine coefficient in model rats, lower serum estrogen levels in rats with uterine fibroids, improve the pathological conditions of uterine tissues, markedly reduce the number of Bcl-2- and Bax-positive dots in smooth muscles, and significantly inhibit the tumor-like proliferation in model rats (P<0.01), which were most obvious in the amentoflavone high-dose group. Conclusion: It concludes that amentoflavone has a significant inhibitory effect on uterine tumors in rats. Its mechanism may be by elevating Bax protein expression, down-regulating Bcl-2 expression, forming homodimers Bax/Bax, and reducing plasma estradiol and progesterone to promote apoptosis of uterine fibroid cells. Keywords: Cyperus rotundus L., biflavone, chemical constituent, anti-tumor
TL;DR: Transferable resistance genes in association with MGEs are present in Nigerian P. mirabilis thus their potential in disseminating resistance is found.
Abstract: Background: Globally, and particularly in developing countries, the menace of anti-microbial resistance is an accelerating problem. In Nigeria, increase in bacterial resistance has been phenotypically established but due to high cost, few molecular studies have been reported. Objectives: This study screened for presence of transferable resistance genes and mobile genetic elements (MGEs) such as integron among multi-drug resistant (MDR) P. mirabilis . Methods: A total of 108 P. mirabilis strains collected from five tertiary hospitals in SouthWest Nigeria were subjected to antibiotic susceptibility study using disc-diffusion method. Transferable resistance genes and MGEs were amplified using Polymerase chain reaction (PCR) analysis and amplicons sequenced. Results: Varied resistance was observed against all the antibiotics tested. About 56% of the isolates were MDR including those from 0-12 years old children. PCR analysis revealed the presence of aac(6’) -Ib (33.3%), plasmid mediated quinolone resistance (PMQR) genes [qnrA (36.7%), acc(6’) -Ib-cr (5%)], TEM (48.3%), CTX-M (6.7%) and integrons class 1 (58.3%) and class 2 (26.7%). Sequencing analysis revealed bla TEM-1 , bla CTX-M-15 associated with ISE cp1 and eight different arrays of gene cassettes: aadA1 , aadA1-qacH , aadB-aadA2 , aadA5 , dfrA7 , dfrA15 , dfrA17 , dfrA17-aadA5 . Conclusion: Transferable resistance genes in association with MGEs are present in Nigerian P. mirabilis thus their potential in disseminating resistance. Keywords: Multidrug resistance, resistance determinants, integrase, gene cassettes, Proteus mirabilis
TL;DR: HRV and allostatic load scores give comparable results as health risk indicators and vagal, rather than sympathetic, measures of HRV should be introduced into allostatics load assessments, in line with the concept of vagal tone as a regulator of allostasis.
Abstract: Background: Uncertainty often exists about the comparability of results obtained by different health risk indicator systems. Objectives: To compare two health risk indicator systems, i.e, allostatic load and heart rate variability (HRV). Additionally, to investigate the feasibility of inclusion of HRV indicators into allostatic load assessments and which HRV indicators are best to introduce. Methods: Allostatic loads were calculated based on blood pressure, waist-to-hip ratio, BMI, cholesterol, HDL-C, LDL-C, CRP, albumin, glycosylated haemoglobin, blood glucose and cortisol excretion. Allostatic load scores were compared to HRV results obtained by frequency domain, time domain and Poincare analyses. Results: Negative correlations were found between allostatic loads and total HRV, for all periods and all HRV analytical techniques ( r =-0.67, p =0.0001 to r =-0.435, p =0.035), and between allostatic loads and vagal measures of HRV for supine ( r =-0.592, p =0.001 to r =-0.584, p =0.001) and the first 5 minutes standing ( r =-0.443, p =0.021 to r =-0.407, p =0.035), with all HRV techniques. Heart rate responses declined with increases in allostatic loads. Conclusion: HRV and allostatic load scores give comparable results as health risk indicators. Baseline total HRV and vagal, rather than sympathetic, measures of HRV should be introduced into allostatic load assessments. Results are in line with the concept of vagal tone as a regulator of allostatic systems. Inclusion of heart rate responses to orthostatic stress, into allostatic load assessments, warrants further investigation. Keywords: Psychosocial stress; allostatic load; heart rate variability
TL;DR: Aerobic exercise is an effective treatment policy to improve depression related to systemic inflammation in patients with chronic obstructive pulmonary disease.
Abstract: Background: Depression is a highly prevalent co-morbidity in Chronic Obstructive Pulmonary Disease (COPD) which was shown to be associated with a worse course of disease, including reduced quality of life and increased symptoms burden, healthcare use, and even mortality. It has been speculated that systemic inflammation may play a role in the presence of depression. Currently, physical activity is an important lifestyle factor that has the potential to modify inflammatory cytokines and depression, however our understanding of how to use exercise effectively in COPD patients to alleviate depression related systemic inflammation is incomplete and has prompted our interest to identify the type and intensities of effective exercise. Objective: The aim of this study was to measure the changes in depression related systemic inflammation of aerobic exercise training in COPD patients in Jeddah area. Material and methods: Eighty patients with moderate severity of COPD participated in this study and were divided into two groups; the first group received aerobic exercise, whereas the second group received no exercise training for 12 weeks. Results: The mean values of tumor necrosis factor-alpha (TNF-α), interleukin-4 (IL-4), interleukin-6 (IL-6), C-reactive protein (CRP) and Beck Depression Inventory (BDI) scores were significantly decreased in in group (A) after treatments, but the changes in group (B) were not significant .Also, there were significant differences between mean levels of the investigated parameters in group (A) and group (B) at the end of the study. Conclusion: Aerobic exercise is an effective treatment policy to improve depression related to systemic inflammation in patients with chronic obstructive pulmonary disease. Keywords: Aerobic exercise; depression; inflammatory cytokine; chronic obstructive pulmonary disease
TL;DR: It was showed that demographic, socio-economic, environmental and health related variables have an import ant effect on determinants of obstetric fistula in Ethiopia.
Abstract: Background: Obstetric fistula is a maternal morbidity creating devastating health problems for the women. Continuous and uncontrollable leaking of urine or faeces from vagina can lead to life changing stigmatization for women in third world countries. The underlying factors and consequences of this problem are not yet fully identified and adequately documented in Ethiopia. Methods: This study is based on the Ethiopian Demographic and Health Survey data (EDHS, 2005). The survey collected information on a total of 14,070 women who were interviewed face to face on their background characteristics as well as reproductive health issues, out of which 3178 women had complete measurements and were considered in this study. Descriptive and binary logistic regressions techniques were used using demographic, socio-economic, health and environmental related variables as explanatory variables and status of obstetric fistula as a response variable. Results: The results showed that geographical region, place of residence, educational status, age at first birth, age at first marriage, employment status, place of delivery and follow up of antenatal care during pregnancy were significant determinant factors of obstetric fistula in Ethiopia. Conclusion: The study showed that demographic, socio-economic, environmental and health related variables have an important effect on determinants of obstetric fistula in Ethiopia. Keywords: Obstetric fistula, logistic regression, determinant factors