Showing papers in "International Journal of Medicine and Medical Sciences in 2014"

An assesment of the spatial pattern of malaria infection in Nigeria

Abstract: Malaria transmitted by female anopheles mosquitoes is a major cause of death in many developing countries of the world. In Nigeria, malaria prevalence is as high as 80 to 85% and is the most common cause of outpatient visits to health facilities. The malaria situation in Nigeria is very burdensome and it impedes human development. The degree of malaria infestation varies from region to region in Nigeria. This spatial attribute of malaria infestation across regions necessitate the needs for malaria mapping among researchers. Also, the rate of malaria infection across space depends on dynamic processes involving complex climatic, environmental, physical, and social variables operating differently in space. This complexity makes the analysis of the spatial pattern of malaria infection in Nigeria important. Such analysis can explain the variations, providing a basis for policy intervention. It is against this background that this paper examines the spatial patterns of malaria infestation in Nigeria. Malaria data for fifteen years (1993 to 2007) were collected from the World Health Organisation (WHO) Data Bank, Roll Back Malaria/Epidemiological Unit of both the Federal and State Ministries of Health for twenty-three states in Nigeria. The pattern of spatial variation in the rate of malaria infection was analyzed using principal component analysis (PCA). The results indicate that seasonal variations play significant roles in malaria infection in Nigeria. It also shows high concentration of malaria infections in some few states. This paper therefore recommends that deliberate effort should be made to increase the distribution of treated mosquito nets and drugs in the affected states and an increment in the financial allocation to the affected states by the Federal Ministry of Health with a few to reducing the effect of the disease in the affected states. Key words: Assessment, spatial, patterns, malaria, infection, Nigeria.

Risk factors of non-communicable diseases among female university students of the Health Colleges of Taif University

Abstract: Two-thirds of 2010 deaths worldwide were caused by non-communicable diseases (NCDs), with cardiovascular diseases, hypertension and diabetes mellitus coming top as the causes of mortality. In 2008, 26.6 per 1000 female population deaths, and 46 per 1000 male population deaths in Saudi Arabia were attributed to non-communicable diseases. Data about the magnitude of NCDs among young population in the Kingdom of Saudi Arabia (KSA) are scarce. The aim of this study was to assess the prevalence of risk factors of non-conmmunicable diseases among female university students. Total coverage was carried out and a cross sectional study was done using the Arabic version of the The WHO STEPwise approach to surveillance (WHO STEPs) approach. The study showed that 3.1% of the students were current smokers, 61.7% were physically inactive; most of the students were not consuming adequate amounts of fruits and vegetables. The prevalence of overweight, mild obesity and sever obesity among the students was (28.6, 15 and 3.1%, respectively). 2.5% of the students had unacceptable fasting blood glucose level, 31.1% had unacceptable fasting blood cholesterol level and 33.6% had unacceptable fasting blood triglycerides. A significant negative correlation was found between the body mass index (BMI) and the actual metabolic equivalents of task (MET) minutes of physical exercises. And a significant positive correlation was found between the BMI and blood cholesterol and triglycerides levels, waist circumference and the waist hip ratio. The study emphasises on the importance of implementing awareness programmes on non-communicable diseases among young Saudi population to adopt healthy life styles. Key words: Risk factors, non-communicable diseases, female university students, health colleges, Taif.

Reasons for admission and mortalities following admissions in the intensive care unit of a specialized hospital, in Ethiopia

Abstract: Many studies have been conducted in the intensive care unit (ICU). But little is known about the outcomes of ICU admissions. This is particularly the case in the ICU of developing countries. Thus, the aim of this study was to assess reasons and outcomes of admissions in the ICU of Jimma University Specialized Hospital (JUSH). A longitudinal study was conducted in the ICU of JUSH from February 7 to April 15, 2011. All patients admitted to the ICU during the study period were followed till discharge or death. Data was coded and entered into the Statistical Package for Social Sciences (SPSS) windows version 16.0 to generate descriptive statistics. Sixty nine patients admitted to the ICU during the study period were followed prospectively till discharge or death. Diseases of cardiovascular origin (30.4%) followed by surgical interventions (18.8%) were the major reasons of ICU admission. There were 26 (37.7%) deaths during the study period in the ICU. Mortality rate in the ICU was found to be significantly high. Diseases of cardiovascular origin were the major reasons for ICU admission. Hence, responsible bodies need to seek for possible ways of reducing this unacceptably high mortality in the ICU by devising quality control mechanisms. Key words: Reasons of admission, outcome of admission, intensive care unit.

Lower gastrointestinal bleeding: Spectrum of colonoscopy findings in Ado-Ekiti, Nigeria

Abstract: Lower gastrointestinal bleeding (LGIB) is a common ailment seen at emergency departments. It is a significant cause of morbidity and mortality in the elderly worldwide. The aim of this study was to determine the aetiology and management outcome of LGIB in our centre and compare it with results elsewhere. Sixty-eight consecutive patients who underwent colonoscopy for LGIB were recruited into this study. The study was carried out at the Ekiti State University Teaching Hospital (EKSUTH), Ado-Ekiti, Nigeria from January, 2010 to December, 2012. Ethical approval for the study was obtained from hospital’s Ethics Committee and all the patients gave their individual signed consent. Relevant data were retrieved and analyzed using statistical package for social sciences (SPSS) version 15.0 (SPSS, Inc., Chicago, Illinois, USA) for statistical analysis using the t-test for quantitative variables and χ2 test for qualitative variables. Differences were considered to be statistically significant if P value was less than 0.05. The male: female ratio was 1.83:1. The mean age of the studied population was 56.04 ± 10.60 (age range 30 to 75). The indications for colonoscopy were; melena (11.8%), haematochezia (52.9%) and both (35.5%). Findings at colonoscopy were; haemorrhoids (35.3%), colorectal cancer (16.2%), polyps (14.7%), anal fissure (13.2%), arteriovenous malformations (5.9%) and diverticulosis (4.4%). Normal findings were reported in 10.3%. While haemorrhoids, anal fissure, colorectal cancer, polyps and diverticulosis were more prevalent in the male populations, arteriovenous malformation was more prevalent in the females. Co-morbidities found included; diabetes (14.7%), chronic liver disease (14.7%), hypertension (36.8%), diabetes and hypertension (16.2%) and renal disease (5.9%) of the studied population. These findings were found to be statistically significant (χ2 = 68.535, p = 0.001, α = 0.05 that is, 95% confidence interval). Haemorrhoids followed by colorectal cancer are the commonest colonoscopy findings in our environment. It is recommended that colonoscopy should be embraced for routine cancer screening and surveillance in our society. Key words: Colonoscopy, lower gastrointestinal bleeding, emergency departments.

Indigenous knowledge of communities around Lake Victoria Basin regarding treatment and management of tuberculosis using medicinal plants

Abstract: This survey was aimed to determine the indigenous knowledge of communities around Lake Victoria Region regarding the treatment and management of Tuberculosis. Opinion leaders suggested the names and locations of known Traditional Medical Practitioners (TMPs) in the study locale. A sample of 102 TMPS from Kenya, Uganda and Tanzania residing around Lake Victoria Basis in East Africa participated in the study. Snow ball sampling technique was used to draw 22 TB patients claimed to have been treated by TMPs. It was established that local people have remarkable detailed knowledge of species identity, characteristics and their specific uses in the treatment and management of Tuberculosis. The main parts of the plants used include the root, bark, leaves and seeds in various combinations. It is concluded that local people have vast knowledge regarding the treatment of tuberculosis which is largely confined to the elderly, exploit the medicinal plants non- sustainably, and use crude plant extracts as concoctions for treating and/or managing TB. It is recommended that traditional knowledge should be documented, and top priority be given to the conservation of the habitat by launching special programs for raising people's awareness about sustainable utilization of medicinal plant species and conservation.

Incidence of thrombocytopenia in seropositive dengue patients

Abstract: Dengue has become a major health concern globally in recent decades. Dengue infected patients manifest a spectrum of symptoms and in severe cases the fate is mortality. A hallmark of dengue infection is thrombocytopenia which causes concern for the patients and treating doctors. This study aimed to evaluate the incidence of thrombocytopenia in seropositive dengue patients. Bleeding manifestation was also investigated in dengue patients to evaluate its association with the severity of thrombocytopenia. In this study, 750 individuals were screened for dengue infection by detecting immunoglobulin M (IgM) against dengue virus in their serum. Enzyme-linked immunosorbent assay (ELISA) was performed for detection of IgM antibody and 250 individuals were found to be seropositive. Platelet counts were performed on whole blood of seropositive patients using Sysmex XE-5000 Automated Hematology Analyzer. Among 250 dengue patients, 2% had severe thrombocytopenia, 65.2% were found to have mild to moderate thrombocytopenia and 32.8% had normal platelet counts. Bleeding was related to the severity of thrombocytopenia as 80% of patients having platelet count lower than 25000/μl showed bleeding manifestations. Key words: Dengue, thrombocytopenia, seropositive, immunoglobin M (IgM), enzyme-linked immunosorbent assay (ELISA), platelet count.

Histopathological study of prostatic lesions on needle biopsies with serum prostate-specific antigen (PSA)

Abstract: Prostate develops from a series of endodermal buds from the lining of primitive urethra and the adjacent portion of urogenital sinus during the first 3 months of intra-uterine life. A prostate needle biopsy is a surgical procedure in which a small sample of tissue is removed from the prostate gland and examined under the microscope by a pathologist. In all investigated individuals, the level of prostate-specific antigen (PSA) was determined in identical way. PSA was estimated in venous blood by electro-chemiluminescence method. Histopathological analysis of obtained material was done on standard hematoxylin-eosin (H&E) preparations. Out of 60 patients studied, most of the patients 30 (50%) were diagnosed with benign prostatic hyperplasia (BHP). Higher levels of PSA (>20) was found in 57.1% of patients of BHP with chronic prostatitis table 11. Out of the total number of adenocarcinoma patients, 77.8% of the patients were having preoperative PSA levels greater than 20. In our study, the positive predictive value for increasing PSA levels was 8.3% for PSA 4 ng/ml, 24.2% for PSA >10 ng/ml and 83.3% for PSA >100 ng/ml. Key words: Prostate, lesions, histopathology, needle biopsies, serum prostate-specific antigen (PSA).

Cardiac tumors in children- A review

Abstract: Primary cardiac tumors despite the potential for more frequent recognition with the advent of echocardiography are rare. The incidence of cardiac tumors ranges from 0.0017% to 0.28% in the general population. Primary cardiac tumors are much less common than metastatic tumors of the heart; and of the primary cardiac tumors, over 75% are benign, 3 of which are made up of myxomas, rhabdomyomas and fibromas. The most common primary sites are the lung, breast and cutaneous melanoma. The common malignant tumors are rhabdomyosarcoma and angiosarcoma. Key words: Tumors, children, myxomas, rhabdomyomas, fibroma, lipoma.

Interplay between nitric oxide (NO) and glucose 6-phosphate dehydrogenase (G6PD) activity in primary hypertension

Abstract: Essential hypertension is one of the most prevalent non-communicable diseases in sub-Saharan Africa and elsewhere in people of sub-Saharan origin. This study investigated the role of nitric oxide (NO) and glucose 6-phosphate dehydrogenase (G6PD) activity in aetiology of essential hypertension. An analytical cross-sectional design was applied to 89 essential hypertensive participants and 89 healthy normotensive participants, making a total of 178. Blood was collected for G6PD activity and serum levels of nitric oxide, glucose, creatinine, urea and electrolytes. Analysis of variance was employed to establish whether there was a difference in mean levels of NO between those that were G6PD deficient and those who were not. Lower NO levels were observed in those who were G6PD deficient though the difference was not statistically significant. A logistic regression was used to investigate the association of age, sex, NO levels, and G6PD deficiency with essential hypertension as the dependant variable. It was established that with an increase in NO levels there was less likelihood of developing hypertension (odd ratio (OR)=0.99), whereas individuals with impaired G6PD activity were 2.9 times more likely to develop hypertension than those with normal activity (OR=2.9). Our conclusion was that NO is important in prevention of hypertension through its vasodilator effect on arterioles. Key words: Hypertension, nitric oxide (NO), glucose 6-phosphate dehydrogenase (G6PD), reactive oxygen species.

Whole-body vibration and benefits for people with osteoarthritis: A systematic review

Abstract: Whole body vibration (WBV) can be an important tool to treat patients with osteoarthritis (OA). The purpose of this study was to systematically review published research concerning the use of WBV in people with OA. In PubMed and Scopus, the number of publications (NP) is respectively to the keywords arthrosis, 289,586 and 10,569, osteoarthrosis, 299,158 and 3,952, arthritis, 251,453 and 236,849 and osteoarthritis, 56,323 and 80,008. Putting together the information found in the analyzed 4 papers, the numbers of subjects were ranging from 15 to 52 and frequencies ranging from 24 to 40 Hz. Self-report of the status of disease (WOMAC) was used in 2 papers, while the pain levels were evaluated by the visual analog scale (VAS) in 2 papers. Different tests were used in these studies, as (i) TUG, (ii) step test, (iii) 20-meter walk test, (iv) timed get up and go test (TGUG), (v) chair stand test (CST), (vi) 6-minute walk test (6MWT), (vii) knee muscle strength (extension/flexion) and (viii) proprioception (threshold for detection of passive movement (TDPM) to evaluate the effects promoted by the exercises due to the WBV. In conclusion, these studies indicate that the WBV could bring some benefits to patients with OA. Key words: Osteoarthrosis, arthrosis, arthritis, PubMed, Scopus, whole body vibration, oscillating/vibratory platform.

Medical treatment of the complication of first trimester pregnancy loss with misoprostol

Abstract: The objective of the study was to evaluate the efficacy of misoprostol in patients with complication of first trimester pregnancy loss. After the departmental approval, a total of 102 women with first trimester pregnancy failure were recruited for treatment with misoprostol. The inclusion criteria were gestational age of less than 12 weeks and hemodynamically stable. The exclusion criteria were patients with history of hypersensitivity to prostaglandin, bronchial asthma and hemoglobin less than 9 g. Main outcome measures were the successful resolution of miscarriages without surgical intervention; secondary outcomes were incidence of pain, vaginal bleeding, infection, pyrexia and gastrointestinal side effects. A total of 102 women were included in the study. Age ranged from 16 to 40 years and parity ranged from 0 to grand multipara. Women were not selected according to parity but parity was a random occurrence. No relationship was found between parity and response to treatment with misoprostol. Incomplete abortion was found in 82 (80.39%), an embryonic pregnancy in 7 (6.86%) and early fetal demise in 13 (12.74%). 62.74% women completely expelled the conceptual products on treatment with misoprostol alone, while 38 (37.25%) patients required surgical evacuation due to incomplete expulsion of conceptual products. Mean induction to expulsion interval was 15.66 h. Main side effects noted were pain, pyrexia, nausea, vomiting and diarrhea. More than one side effect was noted in 7 (22.54%) patients. Treatment of early pregnancy loss with misoprostol is efficient, acceptable and cost effective for patients with complications of first trimester pregnancy loss. Key words: Misoprostol, medical treatment, miscarriage.

Vaginal birth or repeat caesarean section: womens preferred mode of delivery after a primary caesarean section in Maiduguri, Nigeria

Abstract: Vaginal birth after caesarean section (VBAC) is an acceptable option for delivery in a woman with one prior lower segment caesarean section (CS) and in the absence of an obvious contraindication to vaginal delivery. This was a cross sectional study that sought to explore the preferred mode of delivery (VBAC or CS) in a cohort of post operative patients that had a primary CS and the reason for such preference using a self administered, structured and pretested questionnaire. The study was conducted between 1st January, 2013 and 30th November, 2013 and consenting women were recruited consecutively. Two hundred and forty five consenting women completed the questionnaires. Majority of the women, 73.5% (180) prefer VBAC in their next pregnancy while 26.5% (65) prefer a repeat CS. The commonest reasons for preference for VBAC were faster recovery, 68.8% (124) and being a natural method of child birth 25.6% (46). The most common reasons for preferring CS were to avoid labour pains, avoid the stress of labour and safety of the baby in 49.5% (32), 24.6% (16) and 15.4% (10), respectively. Maternal age ≥35 years and having attained tertiary level of education maintained statistically significant relationship with preference for CS after controlling for confounding variable. Only 6.1% (15) of the women reported that they will not accept CS under any circumstance and 31% (76) will accept it reluctantly. We advocate the need for counselling of antenatal women as well as public education campaigns so that women can make informed choices. Key words: Vaginal birth after caesarean section (VBAC), caesarean section (CS), anaesthesia, aversion, labour.

Emergency contraception: A different perspective on knowledge and use among female undergradutes in a non-residential tertiary institution in Nigeria

Abstract: This study assessed the knowledge and use of emergency contraception among female undergraduates of a non-residential tertiary institution in Lagos, Nigeria. It was a descriptive cross-sectional study conducted in March, 2011 amongst 363 consenting female undergraduates using pre-tested, structured questionnaires. Respondents were recruited by multistage sampling technique whilst data analysis was done using Epi Info Version 3.5.1 Statistical Software with level of significance set at P<0.05. About 26.7% of the respondents were aware of emergency contraceptives, with their major sources of information being friends (55.7%) and doctors (34%). Few (16.5%) respondents were aware that emergency contraceptives are effective within 72 h of use. The proportion of usage of emergency contraceptives amongst respondents who had heard of emergency contraceptives was 21.7%. It was concluded that information sharing strategies on emergency contraception may prove useful in deterring untoward consequences of unprotected sexual experiences amongst the youths. Key words: Contraceptives, emergency, female, undergraduates, tertiary.This study assessed the knowledge and use of emergency contraception among female undergraduates of a non-residential tertiary institution in Lagos, Nigeria. It was a descriptive cross-sectional study conducted in March, 2011 amongst 363 consenting female undergraduates using pre-tested, structured questionnaires. Respondents were recruited by multistage sampling technique whilst data analysis was done using Epi Info Version 3.5.1 Statistical Software with level of significance set at P<0.05. About 26.7% of the respondents were aware of emergency contraceptives, with their major sources of information being friends (55.7%) and doctors (34%). Few (16.5%) respondents were aware that emergency contraceptives are effective within 72 h of use. The proportion of usage of emergency contraceptives amongst respondents who had heard of emergency contraceptives was 21.7%. It was concluded that information sharing strategies on emergency contraception may prove useful in deterring untoward consequences of unprotected sexual experiences amongst the youths. Key words: Contraceptives, emergency, female, undergraduates, tertiary.This study assessed the knowledge and use of emergency contraception among female undergraduates of a non-residential tertiary institution in Lagos, Nigeria. It was a descriptive cross-sectional study conducted in March, 2011 amongst 363 consenting female undergraduates using pre-tested, structured questionnaires. Respondents were recruited by multistage sampling technique whilst data analysis was done using Epi Info Version 3.5.1 Statistical Software with level of significance set at P<0.05. About 26.7% of the respondents were aware of emergency contraceptives, with their major sources of information being friends (55.7%) and doctors (34%). Few (16.5%) respondents were aware that emergency contraceptives are effective within 72 h of use. The proportion of usage of emergency contraceptives amongst respondents who had heard of emergency contraceptives was 21.7%. It was concluded that information sharing strategies on emergency contraception may prove useful in deterring untoward consequences of unprotected sexual experiences amongst the youths. Key words: Contraceptives, emergency, female, undergraduates, tertiary.

An insight review on immunopathogenesis of bovine and human mycobacteria infections

Abstract: Mycobacterium is one of the first infectious agents to spring to mind in connection with chronic or persistent infections. The causative organism of bovine tuberculosis is Mycobacterium bovis (M. bovis), a member of the Mycobacterium tuberculosis complex (MTBC), which includes Mycobacterium tuberculosis (M. tuberculosis), M. bovis, Mycobacterium africanum (M. africanum), Mycobacterium microti (M. microti), Mycobacterium canetti (M. canetti), Mycobacterium caprae (M. caprae) and Mycobacterium pinnipedii (M. pinnipedii), and many of the species and subspecies of MTBC show specific host association. Immunity against mycobacteria is multifactorial and it is believed that the host innate immunity provides initial resistance to mycobacteria before the adaptive cell-mediated immunity fully develops. There are still many unsolved problems associated with the pathogenesis and immune response to tuberculosis. Therefore multi-disciplinary approach to develop more complete understanding of the pathogenic strategies is mandatory. Special consideration to bovine tuberculosis might help scientists to devise proper mechanisms to prevent human tuberculosis as they are closely related. Key words: Granuloma, immune evasion, immunity, mycobacteria, pathogenesis.

A theoritical study of Curcuma longas anticancer agents, curcumin I and curcumin II, n blood and gas by using density functional theory (DFT) and hartreefock (HF)

Abstract: The active compounds of Curcuma longa (Curcumin I and Curcumin II) were investigated by using density functional theory (DFT) and hartree–fock (HF) in blood and gases. Curcumin II react with the radicalic forms of the molecules that cause cancer cell formation easily. On the other hand, the free energy of Curcumin I is higher than Curcumin II. Hence, hydrogen bonds formation of Curcumin II is more than Curcumin I. So, medical experimental studies can be done for these two substances. Key words: Curcumin I, Curcumin II, density functional theory (DFT), hartree–fock (HF).

Biochemical, haematological and histological effects following Escravos crude oil ingestion by Chinchilla rabbits

Abstract: The negative consequences of crude oil exploration and exploitation on the health status of exposed individuals cannot be over emphasized, regardless of its financial benefits. Besides, consumption of this crude oil by the rural populace living in oil rich regions as traditional medicine for illnesses have raised local and international questions as to its safety. The aim of this study was to investigate the pathological effects related to Escravos crude oil ingestion by Chinchilla rabbits. A total of thirty Chinchilla rabbits of age twelve to fourteen weeks and weighing 1.2 to 1.45 kg was used. Crude oil was orally given at the dose of 15, 20, 25 and 30 mg/kg body weight, corresponding to groups B, C, D and E, respectively for 28 days, while group A was the Control. The result showed a significant increase in the total white blood cell, monocyte, granulolytic leucocyte, platelet counts, C-reactive protein and serum creatinine (p < 0.05). Microscopy of the stained tissue sections showed marked deposition of collagen fibers, glomerulonephritis and atrophic glomeruli among others. There is an agreement between the biochemical, haematological and histological findings. Thus, Escravos crude oil is suggested to have a potential to cause haematoxicity and alter the architecture of the kidney. Key words: Rabbits, creatinine, C-reactive protein, collagen fibers, Escravos crude oil, granulolytic leucocyte, kidney, microscopy, monocytes, platelets.

Risk factors for common cancers in Nigeria: Knowledge, attitudes and practice among secondary school students in Kaduna, Nigeria

Abstract: Cancer is an important cause of morbidity and mortality worldwide and is increasingly becoming a major public health issue in developing countries including Nigeria. The objective of this study was to assess the knowledge, attitudes and practice of cancer risk factors among secondary school students with the aim of promoting healthy lifestyles. A structured self questionnaire was administered to 405 senior secondary school students who consented to participate. Data obtained were analysed using MINITAB and Statistical Package for Social Sciences (SPSS) statistical packages. A significant proportion (27.9%) did not know that cancer can result from habits learned in youth and there was poor knowledge about sexually related risk factors (early sexual exposure, repeated sexually transmitted infections, promiscuity). There was inaccurate knowledge about causes of cancer with 18.8% believing that cancer is caused by evil spirits. The commonest cancer risk factors practiced by the students were early sexual exposure (11.6%), smoking (9.6%), alcohol ingestion (6.9%), and promiscuity (6.4%). There is room for improvement of knowledge and attitudes about cancer risk factors among adolescents in order to minimize adoption of risky lifestyles. There is a need to educate adolescents on cancer risk factors and integrate promotion of healthy lifestyles in health-related activities targeted at young people. Key words: Cancer risks, factors, lifestyles, adolescents, Kaduna.

Effect of chronic administration of Aloe vera extract on plasma biochemistry in rabbits

Abstract: Due to excessive use, synthetic medicines are going to be expensive and resistant, their residues accumulate in blood, that is why slowly and gradually they become resistant. Alternatives to synthetic medicines are herbal medicines that are cheap, with minimum or no side effect. Previous studies found that liquid extract of Aloe vera plant proved beneficial for animal’s health as it has immune-modulating, hypolipidemic, hypoglycemic and haematinic effects. The aim of this study was to investigate the effect of A. vera extract on plasma biochemistry. A total of twenty (n = 20) male rabbits were selected and divided into 4 groups; P, Q, R and S with five (n = 5) in each group. The group P was kept as control while group Q, R and S were given oral A. vera extract at the dose of 200, 300 and 400 mg/kg body weight, respectively daily for 21 days. Blood samples were taken on various days; 0, 7, 14 and 21 of treatment. Research has found that A. vera significantly (p < 0.05) decrease cholesterol level, that is indication that A. vera has influence on adipose tissues. Key words: Aloe vera, haematology, plasma biochemistry.

A study on resistance loss of multidrug resistant (MDR) Pseudomonas aeruginosa strains after treatment with dilutions of acridine orange

Abstract: This study investigated the loss of resistance of multidrug resistant (MDR) Pseudomonas aeruginosa strains after exposure to dilutions of acridine orange. Five pure axenic strains of P. aeruginosa coded PA1 to PA5 obtained from five infected human sources which included middle ear, urethra, trachea, wound and urine were obtained from the Medical Microbiology Department of the University of Benin Teaching Hospital, Nigeria and stocked on sterile Nutrient agar slants. Slant cultures were sub-cultured aseptically on sterile MacConkey and Blood agar plates and incubated aerobically at 37°C for 24 h to confirm for P. aeruginosa. Gram staining and oxidase test were carried out on resulting colonies. Antibiotic sensitivity test was done by agar disc diffusion method on all confirmed strains on sterile Mueller-Hinton agar plates before and after treatment with acridine orange (AO). P. aeruginosa strains that showed ≤50.0% reduction in resistance markers (RM) after treatment with 0.35, 0.55, 0.75 and 0.95 µg/ml dilutions of AO were noted. Minimum inhibitory concentration (MIC) assay was done using gentamicin on PA5 strain with all four dilutions. All five strains showed 100% resistance against augmentin, nalidixic acid, nitrofurantoin, cotrimoxazole, amoxicillin and tetracycline. Sensitivity was recorded for ofloxacin and gentamicin with 14.6±9.5 and 8.4±4.4 mm zones of inhibition, respectively for all the strains except strain PA3 which was resistant to 8 (100.0%) of antibiotics used. Strains PA1, PA2, PA4 and PA5 were each resistant to 6 (75.0%) of the antibiotics tested. There was loss of RM of 52.1±18.6 and 54.7±37.6% to ofloxacin after treatment with 0.35 and 0.55 µg/ml dilutions, respectively by all MDR P. aeruginosa strains. Loss of RM to gentamicin by strains PA1, PA2, PA4 and PA5 after 0.35 µg/ml acridine orange treatment was recorded as 0.0, 61.5, 58.3 and 60.0%, respectively with a mean±standard error (SE) of 45.0±15.0%. With 0.55 µg/ml dilution, 97.6±28.3% loss of RM was recorded while less than 45.0 and 35.0% loss of RM were recorded for 0.75 and 0.95 µg/ml dilutions, respectively. Acridine orange dilutions of 0.35 and 0.55 µg/ml recorded two-fold (5 µg) and four-fold (2.5 µg) reduction in MIC of gentamicin, respectively. The implications of these findings are discussed. Key words: Resistance loss, Pseudomonas aeruginosa, treatment, dilutions, acridine orange.

Occurrence of hepatitis B and C amongst patients on antiretroviral drug therapy (ART) in a treatment centre in Calabar, Nigeria

Abstract: The occurrence of hepatitis ‘B’ and ‘C’ virus amongst patients on antiretroviral drug therapy (ART) was studied. Two hundred (200) human immunodeficiency virus (HIV) positive subjects on ART and 100 apparently healthy HIV negative subjects (control) were recruited for the study. The subjects aged 1 to 75 years were screened for hepatitis B and C viral antibodies using hepatitis B and C test strips manufactured by ACON Laboratories. Questionnaire were also administered. CD4 counts of the subjects were determined using CyFlow Counter manufactured by GEM Laboratories, Germany. Fourteen (7%) of the subjects were positive for hepatitis B virus (HBV) infection, 6 (3%) for hepatitis C virus (HCV) and 2 (1%) for mixed infections. In the control group, a prevalence of 6 (6%) was recorded for HBV, 4 (4%) for HCV and none for mixed infections. Among the test group, subjects in age group 51 to 60 years had the highest prevalence rate for HBV (25%), 31 to 40 years for both HCV (7.3%) and mixed infection (3.6%). There was no statistically significant difference in infection according to age P=0.475. Males had a higher prevalence rate (9.1%) than the females (5.4%) for HBV, but there was no statistically significant difference in HBV infections according to gender P=0.404. In HCV infection, males had a higher prevalence rate (5.7%) than females (0.9%), but there was no statistically significant difference in HCV infection according to gender P=0.089. Subjects with CD4 counts in the range of 1401 to 1600 had the highest infection rate (50%) for HBV and 201 to 400 for HCV (7.7%) and mixed infection (5.1%). This work has shown that HBV and HCV are common among patients on ART and the need for routine screening of this category of patients in order to aid in the effective management of co-infections. Key words: Hepatitis B, Hepatitis C, antiretroviral therapy, HIV, Calabar.

Trichomonas vaginalis cases presenting at the Komfo Anokye Teaching Hosptial, Ghana over a period of 11 years: 1994 to 2004

Abstract: The study aims at establishing the trend of Trichomonas vaginalis infections diagnosed at the Komfo Anokye Teaching Hospital (KATH) in Kumasi over an eleven (11) years period (1994 to 2004). The retrospective study involves the yearly distribution of the infection as well as the monthly distribution relating them to the ages and sex. The mean ages of males and females infected were 28.8 and 26.0 years, respectively. The prevalent age groups mostly infected were found to be 18 to 31 for both males and females. The age distribution of T. vaginalis cases from the high vaginal swab (HVS) records gave a standard deviation of 3.47 and the standard deviation of the age distribution for males from the urine routine examination (R/E) was 5.13. Analyses of records of T. vaginalis suggest that even though there has been a drastic decline in prevalence, the infection still persist and requires efforts to ensure its absolute extinction. The monthly distributions did not reveal any particular month in which transmission of the infection remains constantly high. This suggests that the climatic seasons (rainy or dry/cold or warm) have no effect on the rate of transmission. More pragmatic measures are needed to ensure better records keeping of the infection at KATH. New and more efficient methods such as cultures and polymerase chain reaction (PCR) should be employed to increase efficiency in the detection of the organism in patients. Another study is being designed to ascertain the level of T. vaginalis from 2005 to date. Key words: Sexually transmitted infection, Trichomonas vaginalis, Komfo Anokye Teaching Hospital (KATH).

Expression of toll-like receptor (TLR)-2 and TLR4 in monocytes following stimulations by genital secretions of HIV infected and uninfected women with symptomatic vulvo-vaginal candidiasis

Abstract: Vulvo-vaginal candidiasis (VVC) is a common condition in human immunodeficiency virus (HIV)-infected women. Toll-like receptor (TLR) 2 and TLR4 are key pattern-recognition receptors of the innate immune system in sensing Candida albicans. The aim of this study was to assess the expression of TLR2 and TLR4 signaling pathways in HIV-infected and uninfected women with VVC. Cervico-vaginal fluids (CVF) were obtained from 7 HIV infected and 11 HIV uninfected clinic attendees in KwaZulu-Natal between June, 2011 and December, 2011. VVC was diagnosed clinically and confirmed by Gram stain and culture of genital samples. Monocytes were isolated from a healthy adult volunteer, pre-incubated with anti-TLR2, anti-TLR4 and a combination of anti-TLR2/anti-TLR4 monoclonal antibodies. Monocytes were then stimulated by CVF. Levels of cytokines were measured by Luminex® multiplex immunoassays. Compared with baseline concentrations, stimulation with CVF of HIV+VVC+ women post-TLR2 blockage increased IL-6, IL-10 and IL-13 production by 165.5, 162.5 and 106.7%, respectively. Using paired T-tests, there was a significant difference in the increase of the concentrations of IL-6 (P = 0.04), IL-10 (P = 0.003), and IL-13 (P = 0.031) when comparing stimulation by CVF of HIV+VVC+ versus stimulation by CVF of HIV-VVC+ patients. There was a linear correlation between genital HIV RNA loads and mean level production of IL-6 (r = 0.722; R2 = 0.679; P = 0.067) as well as IL-8 (r = 0.910; R2 = 0.833; P = 0.004). Findings suggest potential roles of TLR2 in the pathogenesis of VVC among HIV-infected women. Key words: Symptomatic VVC, HIV, TLR2 and TLR4.

Anatomical variants, clinical presentation and pathological findings in patients suffering from chronic rhinosinusitis underwent functional endoscopic sinus surgery

Abstract: In this study, we investigated the different anatomical variations and clinical modes of presentation of chronic rhinosinusitis and their association with final histopathological diagnosis. This prospective randomization research was conducted on a total of 284 patients with chronic rhinosinusitis who underwent functional endoscopic sinus surgery from March, 2009 to September, 2012. The study population (284 patients) included 170 males (59.8%) and 114 females (40.1%), with a mean age of 29 years. The most frequent symptoms were nasal obstruction (24.3%); headache (21.9%), nasal congestion (18.5%) and post nasal discharge (16.6%). The nasal septums were significantly deviated in 207 (79.2%) subjects. Inferior turbinate hypertrophy was observed in 102 (35.9%) patients. Bulla ethmoidalis was reported in 32 (11.3%) participants. Uncinate bulla and concha bullosa were identified in 12 (4.2%), 12 (4.2%) patients, respectively. According to pathological report, majority of the patients (184 patients, 64.7%) had chronic inflammation in sinuses went after polyp in 46 patients (16.9%). Our study revealed anatomical variations were common in patients with chronic rhinosinusitis. Identification of different variations will guide the surgeons during functional endoscopic sinus surgery. Key words: Chronic rhinosinusitis, functional endoscopic sinus surgery, anatomical variations.

Assessing the surgical anatomy of the ethmoid sinus in adult Nigerians using computerized tomography scan

Abstract: We undertook this study to describe the morphology and anatomical variations of ethmoidal sinus in adult Nigerians using computerized tomographic scan, bearing in mind the significance of this sinus in inflammatory pathologies of the other paranasal sinuses and endoscopic sinus surgery. This was a descriptive study of computerized tomographic scans of the paranasal sinuses of 114 subjects constituting 228 ethmoids. All the slides were examined to identify the ethmoidal sinuses and the various anatomical variations. The dimensions of the ethmoids were also measured. There were 83 (72.8%) males in this study. The mean age was 45.6 ± 19.3 years. The means of the length, anterior width, posterior width and height of the ethmoid were 41.4, 11.8, 16.7 and 30.1 mm, respectively. Keros Type III olfactory fossa was found in 163 sides (71.5%). Agger nasi cell was the commonest variation present in 102 sides (44.7%). The most frequent pattern of attachment of uncinate process seen is to the lamina papyracea (191, 32%). We concluded that the dimensions of the ethmoids among the Nigerians studied are similar to findings in other studies. The predominant type of olfactory fossa depth and pattern of insertions of uncinate process suggest that the study population may be at higher risk of certain complications during functional endoscopic sinus surgery (FESS). Key words: Anatomical variations, olfactory fossa, Nigerians.

Rhabdomyosarcoma followed six episodes of squamous cell carcinoma in a Nigerian albino: A case report

Abstract: Beginning from 1975, a Nigerian albino aged 27 years developed squamous cell carcinoma that recurred a total of seven times, the last being a rhabdomyosarcoma in 2005 at the age of 61 years. In this context, we are aware of published cases of carcinoma but not of sarcoma. With special reference to albinism, squamous cell carcinomas superabound. If at all, resections are scarcely carried out more than once. Key words: Rhabdomyosarcoma, squamous cell carcinoma, albino, Nigeria.

Flowcytometric analysis of aldehyde dehydrogenase activity in mononuclear cells from umbilical cord blood

Abstract: Aldehyde dehydrogenase (ALDH) is a cytosolic enzyme that is responsible for the oxidation of intracellular aldehydes. Elevated levels of ALDH have been demonstrated in murine and human progenitor cells compared with other hematopoietic cells, and this is thought to be important in chemoresistance and purification techniques and an indication of the proper function of the cell. A Flowcytometric method for the assessment of ALDH activity in viable cells recently has been developed. Forty six cord blood samples from mothers which underwent normal delivery of full term infants were obtained, after informed consent. Mononuclear cells were obtained by Ficoll-Paque density centrifugation and ammonium chloride red cell lysis. Percentage of viable cells was determined by trypan blue exclusion dye. Cells were labeled with Aldefluor reagent (Vancouver Canada) as described by the manufacturer. Cells were then stained with phycoerythrin (PE)–conjugated anti-CD34 (Miltenyi Biotec, Cologne, Germany) antibodies for 30 min at 4°C. Cells were washed and re-suspended in phosphate-buffered saline (PBS) with 2% fetal calf serum. Cells were then analyzed on coulter epics flow cytometer. The mean percentage of ALDH enzyme expression among the CD34+ cells in the cord blood samples was 61.3% with a minimum of 28% and a maximum of 94.6%. Significant correlations were found between the white blood cell (WBCS) count in the cord blood samples and both the CD34+ cell count and the count of ALDH expressing cells, while no correlation was found between the CD34+ cells count or the ALDH expressing cells count in the cord blood samples and either the sex or the weight of the newborn. Identification and isolation of cells on the basis of ALDH activity provides a tool for their isolation and further analysis. In summary, a high ALDH-1 activity identifies CD34+ cells in cord blood. Key words: Umbilical cord blood, stem cells, aldehyde dehydrogenase (ALDH), CD34.

The ENT TEN: Ten rules of thumb in otorhinolaryngology that every doctor must know A review

Abstract: This review, titled ‘THE ENT TEN’, is a review of ten important rules of thumb in otorhinolaryngology that every doctor must know. It is a collection of vital tips and pearls that that if every doctor, especially family physicians, knew, would significantly increase the rate of early diagnosis of potentially life-threatening conditions and improve the quality of life of patients with several non life-threatening but disabling conditions. It is suggested that all doctors memorize these points. Key words: Otorhinolaryngology, rules of thumb, early diagnosis, preventing disability, improving quality of life, deafness.

In vitro discovery of highly chelatable root extract of thorn apple (Datura stramonium)

Abstract: This study investigated the in vitro chelating ability, antioxidant activity, total phenolic and flavonoid contents of 70% ethanolic extract of thorn apple (Datura stramonium). The ethanolic root extract of the plant displayed potent chelating ability (70%) at the lowest concentration (2%) investigated. The chelating ability of the extract showed concentration dependency. There were significant decreases in vitro chelating ability of the root extract from 2 to 10% concentrations (P 0.05) and significant from 8 to 10% (P 0.05). The ethanolic root extract failed chelate ion at the highest concentration (10%) (-20.0% activity). Key words: Phytotoxicology, clinical toxicology, iron-overload, clinical medicine, natural product.

Evaluation of antibacterial profile of methicillin resistant Staphylococcus aureus (MRSA) isolated from hospitals in Imo state, Nigeria

Abstract: Awareness of the threat of methicillin resistant Staphylococcus aureus (MRSA) is growing. Oxacillin and methicillin are penicillinase-stable penicillins, and strains that are oxacillin and methicillinn resistant are historically termed MRSA. To determine the existence of MRSA strains patients attending treatments in hospitals in Imo state, 200 clinical specimens were examined using conventional method such as culture and sensitivity. The specimens include urogenital swabs, nasal swabs, wound swabs, pus and blood. Out of the 200 samples collected, 23.68% showed resistance to oxacillin, 25.00% of the isolates from Owerri Zone were MRSA, while 23.81% of isolates from Okigwe Zone yielded MRSA, and 20.00% from Orlu Zone yielded MRSA. The mean for zones is 25.33 ± 13.05. Children under the age of 10 have the highest incidence of (57.14%) of S. aureus isolates resistant to oxacillin, followed by the elderly people of age group 51 to 60 years (27.27%). The young adults between the ages of 21 to 30 have the least incidence (10.00%) and the mean for age groups is 43.66 ± 6.26. The mean for clinical specimens is 15.20 ± 22.16. Wound specimens produced the highest incidence (40.00%) among clinical specimens followed by pus (33.33%) and blood has the least occurrence (00.00%). Males produced the highest incidence between the sexes (26.67%) and women (21.74%), and the mean for sexes is 38.00 ± 11.31. This shows that MRSA exists in hospitals in Imo state and considering the danger, it portends to healthcare setting, and efforts are needed to contain its spread. Key words: Methicillin, antibiotics, zones, sex, children, specimen, infections.

A Cd36 polymorphism associated with eight-times increased susceptibility to cerebral malaria in Central Sudan

Abstract: Malaria is one of the biggest known health threats in Africa. Erythrocytes infected with falciparum malaria adhere to a variety of host receptors, including CD36. Cerebral malaria (CM) is a major life-threatening complication of Plasmodium falciparum infection. The human protein CD36 is a major receptor for P. falciparum-infected erythrocytes and contributes to the pathology of P. falciparum malaria. The aim of the present study was to determine the role of the adhesion molecule CD36 in children with CM at Central Sudan. A case-control study included 70 children with cerebral malaria (CM) and 84 controls were enrolled in this study. The method was a mutational analysis for the polymorphism in the CD36-188 T > G using polymerase chain reaction-restriction fragment length polymorphism analysis (PCR-RFLP) where the distribution of CD36 to 188 T > G genotypes differed significantly between CM patients and controls and children carrying the mutant G allele were associated with eight-times increased relative risk for susceptibility to cerebral malaria (P-value = 0.005; odds ratio = 7.962; 95% CI = 1.571 to 29.903). Key words: Plasmodium falciparum, cerebral malaria, erythrocytes, Central Sudan.