Western Journal of Medical and Biomedical Sciences
Western Journal of Medical and Biomedical Sciences (WJMBS) is the official journal of University of Medical Sciences, Faculty of Basic Clinical Sciences, Ondo-city, Ondo State Nigeria. WJMBS is a quarterly double-blind, peer-reviewed, online and print institutional journal. The journal invites high quality or cutting-edge research works from all fields of medical and biomedical sciences for publication consideration. The journal publishes quarterly in March, June, September, and December. The editorial board ensures that accepted articles are published within three months from the date of initial manuscript submission.
Risk of Transfusion Transmissible Infections: Our Experience in a Tertiary Health Care Facility in North-central, Nigeria
The risk of transfusion transmissible infections (TTIs) is a challenge in most developing countries. We investigated the risk of transfusing infected blood following screening with the rapid diagnostic test (RDT) technique. Blood donors were initially screened for human immune-deficiency virus, hepatitis B virus, hepatitis C virus and syphilis using the rapid diagnostic test. Five hundred and forty (540) of them negative to the RDT for the four agents were subsequently screened with Enzyme linked immunosorbent assay (ELISA). A total of 72 (13.3%) prospective donors that tested negative to RDT for the TTIs tested positive to the ELISA technique. Further analysis showed that twenty-three (4.3%) donors were positive to HIV, 23 (4.3%) to hepatitis B, 20 (3.7%) to hepatitis C and 6 (1.1%) to VDRL. Three donors (0.6%) were found to be positive to both HIV/HBV, 3(0.6%) to HIV/ HCV, 2 (0.4%) each to HIV/VDRL, HBV/ HCV and HBV/VDRL. There were no correlations of ELISA positivity with gender, age, marital status, blood group and the packed cell volume of the donors. The risk of transfusing infected blood using rapid diagnostic test (RDT) technique for screening is high. This can be significantly reduced by using ELISA testing techniques for screening blood for transfusion. All blood transfusion centres in Nigeria should as a matter of urgency commence the screening of blood donors with ELISA in order to curb the spread of these infectious agents.
Copyright (c) 2020 Western Journal of Medical and Biomedical Sciences
Assessment of Awareness of Occupational Health Problems, and the Practices of Safety Measures among Welders in a Semi-Urban Town in South-South Nigeria
Welders are exposed to a variety of occupational hazards with untoward health effects. However, little is known of welders' awareness and knowledge of occupational health hazards, and their practices of safety measures to reduce the occurrence of preventable hazards in their workplaces. This study assessed the awareness of occupational hazards and practice of safety measures among welders in a sub-urban community in South-South, Nigeria. A structured questionnaire was administered to 58 welders in Ekpoma Edo State, Nigeria. Information was sought on their socio-demographic characteristics, their awareness of occupational hazards and practice of safety measures. Their workshops were inspected for the availability and the expiring date of fire extinguishers. Data were analyzed using statistical package for social sciences (SPSS) version 21. Chi-square test and Fisher Exact test were used to test for significance at a p-value of <0.05. All the welders were aware of one or more workplace health problems. There was a statically significant association with the type of welding flame used. The frequently used protective equipment were safety goggles (81%), insulated safety gloves (56.9%) and work suits/coverall (50%). The level of awareness of occupational hazards was high, with sub-optimal utilization of protective measures against the hazards. There is, therefore, the need for health and safety education for these workers for their health promotion and the reduction in exposure to harm in the workplace and the increase of productivity.
Novel Corona Virus Disease: A Narrative Review of the Guidelines and Protocol for Care in the Context of a Pandemic
Emerging diseases such as COVID 19 have put an added strain to the already weak health systems in resource limited countries such as Nigeria. Guidance on how to manage suspected or confirmed COVID 19 cases in pregnancy are evolving and constantly being updated as the infection is better understood. We present a review of the available guidelines in pregnancy. Google scholar and Pub Med were searched for maternal guidelines on women infected with COVID 19. No period limitations were used in the search. Terms imputed into the search engine were 'COVID 19', 'pregnancy'.' Maternal guidelines' and 'pregnant women' In total, 23 articles were detected and analyzed for practical recommendations. Seven were discarded because they did not provide practical guidelines for care. Recommendations were classified into prevention for Antenatal patients, Treatment of the pregnant woman with COVID 19, Management in labor and postpartum periods in women with COVID 19. Many of the recommendations for pregnant women with COVID 19 have limited evidence supporting their implementation and further studies are needed to improve the strength of recommendations for this emerging disease. No consensus or clear evidence exists regarding timing of delivery or route ofdelivery and patients are best managed on individualized basis.
Effect of Ethanol Extract of Moringa Oleifera leaves on T-cell Proliferation
Immunity boosting is an important use of Moringa oleifera (family Moringaceae) commonly called Horseradish or “Tree of Life” in ethnopharmacology. The positive health promoting actions might be due to their action on immune cells. The aim of this study was to investigate T-cell mediated immunity boosting property of the ethanol extract of the leaves of M. oleifera using Jurkat cells. Toxicity profile was evaluated using trypan blue exclusion assay, and the probable mechanism of death evaluated by staining cells with annexin V and 7AAD. The effect of extract on proliferation was measured by staining with CSFE. The pattern of homing for CD3 and CD54 or CD28 activated T-cells in presence or absence of M. oleifera was monitored by estimating expression of CCR7. The result showed a concentration dependent significant increase in death by necrosis for inactivated Jurkat cells. Pre-stimulation with CD3 and CD54 or CD28 shifted the probable mechanism of death to apoptosis in a dose dependent manner. CFSE assay showed that inhibition of proliferation by M. oleifera was concentration dependent. The extract killed more than 50% of Jurkat cells atconcentration higher than 80μg/ml. Expression of CCR7 was relatively higher in CD3 and CD28 pre-stimulated Jurkat than CD3 and Cd54. The study suggests that the ethanol extract of M. oleifera leaves possesses positive immunomodulatory activity mediated via CCR7 expression. This finding justifies the traditional use of M. oleifera extract in immunity boosting.
Current Status of Intestinal Parasites among Pre-school Children inEke, Okpokwu Local Government Area, Benue State, Nigeria
Intestinal parasitic infection is a disease of public health importance in developing countries like Nigeria. Conducive environmental factors in developing countries accelerate parasitic growth and development. This study was set up to determine the current status of parasitic infection of preschool children in Benue State. A cross sectional study design was used in this study and computer generated table of random numbers was used to select the respondents. Univarate and bivarate analysis were computed using SPSS version 23. In bivarate analysis variables with p values <0.05 were considered statistically significant. The overall prevalence of intestinal parasite was 58.0 % (n=94) and the mean age of the children was 27.8 months. Ascaris lumbricoides was the most prevalent parasites. Families using pit latrine had the highest prevalence of parasitic infestation with the prevalence of 69.2% (n=64). There was a statistically significant association between parasitosis and methods of waste disposals such as pit latrines, open dumping and water closet (p≤0.05).
Informed Consent for Blood Transfusion: Physicians' Perceptive at a Tertiary Healthcare Hospital
Blood transfusion have the potential to save lives and frequently provide considerable benefits, but it has associated risks. Notwithstanding, the process of obtaining permission for blood transfusion may not be done satisfactorily. The study was carried out to evaluate physicians' opinion, attitude and practice of the transfusion consent process at Federal Medical Centre, Yenagoa, Bayelsa State, Nigeria. Physicians from distinct departments were beckoned to fill out an unidentified questionnaire on transfusion consent. A total of 141 physicians replied to the study. More than 90% of the participants acknowledged the significance of the transfusion consent process. An aggregate of 123 (87.2) participants had prescribed blood, out of which 119 (84) obtained informed consent before blood transfusion. The advantages and hazards of blood transfusion was interpreted routinely by 108(90.8) and 81(68.1) of the study participants, respectively. Contrarily, a lower proportion of the participants 56(47.1) explained the available options to blood transfusion. The likelihood to decline consent after receiving education on blood transfusion was the most identified limitations to the practice of informed consent in transfusion at the studied institution. This study demonstrates decisive perspective of the evaluated physicians on the value of transfusion consent. Nonetheless, strategies should be set up to ensure that options to blood transfusion are included systematically in the transfusion consent process.
Indoor Air and Surface Fungal Contamination in the Special Care Baby Unit of a Tertiary Hospital in Jos, Nigeria
Fungi frequently contaminate the indoor air as well as surfaces of hospital equipment and furniture. This pose a significant risk for neonates in the Special Care Baby Unit. This study aimed to determine the rate of fungal contamination of indoor air and surfaces of the special care baby unit of a tertiary health facility in Jos, Nigeria. The study was carried out at the special care baby unit of the Jos University Teaching Hospital. Indoor air samples were obtained using sedimentation method whereas samples from surfaces were collected using sterile pre-moistened cotton tipped swab sticks. The swab sticks were inoculated onto sabouraud dextrose agar plates which were incubated along with indoor air culture plates for seven days. Univariate analysis was carried out using STATA (version 14IC). Fungal contamination rate of the special care baby unit was 20.2%. Aspergillus species (29.6%) was the most predominant fungus isolated. Most of the fungi were isolated from the outborn term and outborn preterm rooms of the special care baby unit. The fungi isolated include Aspergillus spp, Candida spp, Penicillium spp, Cladosporium spp, Curvularia spp, Fusarium spp, Paecillomyces spp, Alternatia spp, and Rhodotorulla spp. Fungi are a major cause of indoor air as well as surface contamination in special care baby unit of the hospital. Routine cleaning and disinfection will lead to a reduction in the fungal load.
African Livelihood; An Impetus to the Care of Children Living with HIV in Nigeria: A Qualitative Analysis
The cultural framework of African livelihood can influence the care given to the children living with HIV. The study aimed to analyze how African way of life in clan vitals tend to influence the care of children living with HIV in the Nigerian context. A grounded theory approach was adopted for this study with Strauss and Corbin's sequential analysis. Nurse practitioners, children living with HIV and their caregivers, and stakeholders practicing within the confines of HIV care participated in this study. Focus group discussions and interview methods were involved in the process of data collection. Strauss and Corbin's analytical sequence was adopted in the data analysis in a bid to project the codes and the emerging concepts. Major themes that emerged among the findings which positively impacts care include: Influence of communal living in healing the minds; children's integration in the cultural setting; friends/neighbors helping the sick and shared neighborly interaction and mutual help while the ones posing challenges to the care include: heightened poverty and inadequacy of resources within community structures; uninformed socio-cultural context with illiteracy and ignorance; and social stigma within the cultural framework. The study concluded that communal living is a crucial element in the parameters of assistive care provision to the children living with HIV on the African continent.
Unexpected Low Covid-19 Mortalities Across Africa: What Could have Happened?
COVID-19 mortalities have continued to be surprisingly low across Africa against all the earlier predictions. This has baffled the global scientific community and several hypotheses and theories have been propounded to explain the underlying factors for this unexpected occurrence. We found out that none of the theories is free of technical flaw, no matter how as plausible as it may appear it does not fully explain this phenomenon. Hence, we conclude that the mystery behind COVID-19 on African soil is yet to be unraveled. Meanwhile preventive measures already on ground should be sustained to keep the disease permanently low.
Sexual Activity and Contraceptive use among University Female Undergraduates in Makurdi, North-Central Nigeria
High sexual activity with low contraceptive use among young women could give rise to complications such as unwanted pregnancies and sexually transmitted infections. This study was aimed at determining sexual activities and contraceptive usage among female undergraduate students. It was a cross-sectional study using pretested self-administered questionnaires to collect data on socio-demographic variables, sexual activities and contraceptive use. Out of the four hundred and thirty-one (431) students studied, three hundred and four (70.5%) were sexually active. The average age of sexual debut was 19.5 years. One hundred and twenty-seven (41.8%) had more than one sexual partner. Money was the reason for sex in more than one- third (37.4%). Contraceptive awareness and usage among the respondents was 414(96.1%) and 255(85.0%) respectively. The male condom was the commonest 160(52.4%) contraceptives used. Majority 285(65.9%) of the respondents believed contraceptive use could prevent pregnancy and sexually transmitted infections. There was a significant relationship between awareness of contraception and level of study (0.003). Those who were sexually active were more likely to use a contraceptive method (<0.000001) and contraceptive method users were less likely to have an STI (0.000003). The study showed a high level of sexual activity, contraceptive knowledge and usage. Girl child education, provision and promotion of utilization of reproductive health services should be sustained to safeguard the sexual health of young women.
Ameliorative Effects of Aqueous Extract of Avocado Pear Seed on Castor Oil Induced Diarrhea in Experimental Animals
Diarrheal diseases affect billions of people globally and is the second leading cause of death in children under 5 years. Despite the efforts of governmental and non-governmental organizations to prevent or cure this disease, the burden of diarrheal diseases continues to be high. Therefore, there is need to further discover effective antidiarrheal drugs that are readily available and cheap to obtain with little or no side effects. Herbs and natural products have been used in the treatment of diarrhea; hence this study was carried out to investigate the effects of aqueous extract of avocado pear seed (AEAPS) on castor oil induced diarrhea in experimental animals. Fifty female Wistar rats weighing 100 – 120 g were used. The antidiarrheal effects of 200 mg/kg, 400 mg/kg and 600 mg/kg of AEAPS was carried out by investigating its effect on; faecal pellet output, castor oil induced diarrhea, intestinal enteropooling and intestinal transit time of charcoal meal. Result showed that 400mg kg and 600 mg/kg AEAPS significantly (P< 0.05) reduced the number of faecal pellets from rats and the number of wet faecal pellets in castor oil induced diarrhea. The AEAPS at a dose of 400 mg/kg, 600 mg/kg and loperamide significantly (P< 0.05) inhibited intestinal enteropooling by 69.37%, 57.66% and 72.07% respectively. The treatments also significantly (P< 0.05) inhibited intestinal transit by 21.75%, 21.45% and 24.96% respectively relative to that in castor oil treated rats. The results suggest that AEAPS possess antidiarrheal effects that it exerts through antisecretory and antimotility mechanisms.
Serum Levels of Anti Glutamic Acid Decarboxylase and Insulin Auto Antibodies in First Degree Relatives of Patients with Diabetes Mellitus
Antibodies to Glutamic Acid Decarboxylase (anti-GAD) and Insulin Auto Antibodies (IAA) mediate the autoimmune destruction of pancreatic islet cells and have been used to predict the risk of future development of Diabetes Mellitus (DM). These circulating antibodies are usually detected in body fluids and tissues several years before the onset of hyperglycemia. This helps in identifying individuals at risk of future development of DM thereby providing a good lead time for secondary preventive measures such as Therapeutic Lifestyle Changes to be introduced. This study determined the prevalence of Anti-GAD and IAA as a major risk factor for developing DM among First Degree Relatives (FDR) of DM patients in Kano, Northwestern Nigeria. This was a cross-sectional descriptive study carried out on 100 randomly selected FDR of individuals with DM in the diabetic clinic of Aminu Kano Teaching Hospital (AKTH). Control group recruited were 100 apparently healthy subjects with no family history of DM. Anti-GAD and IAA were measured using Enzyme Linked Immunosorbent Assay (ELISA) based technique. GAD Ab levels >32 ng/mL and IAA levels >39 ng/ml were considered positive for Antibodies. Data obtained was analyzed using statistical package for social sciences (SPSS) version 20.0. Anti-GAD and IAA were present in 81% (O.R= 1.9, 95% CI= 1.0-3.7, p= 0.050) and 66% (O.R= 1.9, 95% CI= 1.7-5.6), p <0.001) of FDR of DM patients compared to controls 69% and 34%. The mean level of Anti-GAD was also higher among the FDR of diabetics compared to controls (68.4±31.9 vs 45.3±22.4, p <0.001). The mean IAA level was also higher among the FDR of diabetics compared to controls (61.0±20.7 vs 51.8±11.7, p <0.001). This study demonstrated a high Anti-GAD and IAA positivity among first degree relatives of diabetics compared to controls underscoring the importance of screening for risk factors. Preventive measures like lifestyle changes can be appropriately applied among to slow the progression to diabetes mellitus.
Copyright (c) 2021 Western Journal of Medical and Biomedical Sciences
Prevalence and Nature of Adult Hematological Malignancies Using Bone Marrow Aspiration Cytology in a Tertiary Health Facility: A Seven Year Retrospective Review
Bone Marrow Aspiration (BMA) is a procedure that is often used to evaluate patients with haematological disorders including haematological malignancies (HMs) which account for about 6.5% of all cancers worldwide. There is paucity of data on the prevalence and pattern of HMs from BMA cytology in Nigeria. We carried out a retrospective review to determine the prevalence and distribution of HMs among adult patients who had BMA cytology at Benue State University Teaching Hospital (BSUTH) from June 2012 to July 2019. A total of 158 BMA reports extracted from the marrow and clinic medical records were reviewed. Out of 158 adult BMA cytology reports, HMs accounted for 78(49.4%) of all haematological disorders. There was no significant gender difference. The Male 38(48.7%) to Female 40(51.3%) ratio (M:F) was 1:1.1. Their ages ranged from 16 to 85 years with the median age of 54.0 years. Out of the 78 HMs, Lymphoid neoplasms were the most prevalent 47(60.3%), the leukaemias were higher 53/78(67.9%) compared to the non-leukaemic neoplasms. Of the 53 leukaemias, those of chronic lymphoid types were more 24/53(45.3%), followed by the chronic myeloid 15/53(28.3%). Chronic lymphocytic leukaemia (CLL) was the predominant leukaemia 24/53(45.3%) as well as the most prevalent HM 24/78(30.8%), followed by chronic myeloid leukaemia (CML) 19.2%(15/78). Others were myelodysplastic syndrome (MDS) 11.5%(9/78), acute lymphoblastic leukaemia (ALL) 10.3% (8/78), multiple myeloma (MM) 10.3%(8/78), acute myeloblastic leukaemia (AML) 7.7%(6/78), non-Hodgkin's lymphoma (NHL) 6.4%(5/78), Small lymphocytic lymphoma (SLL) 2.6%(2/78) and Hodgkin's lymphoma (HL) 1.3%(1/78). In conclusion, we established high prevalence of HMs among patients who had BMA cytology evaluation at BSUTH with the preponderance of lymphoid malignancies. We advocate for inclusion of HMs in the National Health Insurance Scheme (NHIS) for full implementation and to prioritise provision of modern diagnostic equipments and treatment options for quality and optimal management of leukaemias in the center.
Pattern of Plasma Lipid Profile among HIV Positive Patients on Anti-Retroviral Therapy
There are improvements all over the world in the management of HIV/AIDS. However, adverse reactions of drugs used in the treatment are still being observed. Patients on treatment with anti-retroviral drugs are to take these medications for life. Prolonged intake of these drugs needs to be investigated. This study was therefore set up to investigate some associated body derangements involving prolonged anti-retroviral medications such as dyslipidemias. This research was conducted on 260 patients who were HIV positive. Patients who were obese, those on lipid modifying drugs and those who are diabetic or hypertensive were excluded from the study. Parameters of lipid profile except low density lipoprotein – cholesterol were analyzed by the use of commercial kits manufactured by Randox Laboratoty, Alden, USA, low density lipoprotein – cholesterol was calculated by the use of Friedewald equation. The plasma HDL-c is significantly higher in female (2.77±1.22) subjects than male (2.36±0.92) subjects (p=0.015). There were no statistically significant differences among the groups considering duration of therapy. Greater percentage of our study population had taken ARD for a period less than 5 years. And there was no significant trend observed in the parameters of lipid profile. The study found no significant association between the parameters of lipid profile and duration of therapy. The greater percentage of our studied population had only taken therapy for less than five years. A regular check on lipid profile may throw more light on this subject.
Glycaemic Index of Commonly Eaten Dough Staple Foods among Diabetics and Non-Diabetics in Makurdi
Starchy dough food is the most commonly consumed food in Nigeria. However, the recent disease epidemiological changes from communicable to non-communicable diseases, has implicated changes in occupational choice from farming to sedentary works and consumption of predominantly dough starchy food as a notable culpable cause. Hence, this study examined the glycaemic impact of the commonly eaten staple starchy foods in Nigerian subjects. Therefore the study aims to determine glycaemic Index of commonly eaten dough foods on healthy subjects and diabetics. This was a cross-sectional study carried out on 16 healthy staff and diabetic patients from Benue State University Teaching Hospital. Each participant ingested food products (pounded yam, amala, fufu and garri) (equivalent of 50g glucose) and 50 g of reference meal. Samples were taken for blood glucose at intervals of0, 30, 60, 90,120 mins. The area under curve was determined using trapezoid method for different time intervals. The sum of area under curve for each test food was divided by the sum of area under curve for standard glucose and multiplied by 100 to determine the glycaemic index of the food products respectively. In this study the glycaemic index for diabetic group after intake of pounded yam, amala, garri and fufu were 80.95%, 69.32%, 84.08% and 97.04% respectively and for apparently healthy group it was 80.81%, 71.63%, 80.59% and 94.81% respectively. Glycaemic index for pounded yam, amala, fufu and garri is high in diabetics and healthy subjects. However, Cassava meals had higher glycaemic index compared to amala which is a yam product. Therefore, consumption of these starchy dough foods should be less frequent and in smaller portions in individual at risk of diabetes mellitus and diabetics.
Radiation Safety Knowledge and Practice Amongst Doctors in a Teaching Hospital in the Niger Delta Region of Nigeria
It is important that doctors of the various specialties in a health facility requesting for radiological examinations are knowledgeable about the effect of ionizing radiation. When referring doctors know the amount of radiation their patients receive there will be justification for such investigations in line with the guiding principle of radiation protection – As Low As Reasonably Achievable (ALARA) - to minimize risk to the patient. The objective of this study is to assess the knowledge and practice of radiation protection and safety amongst doctors in a Teaching Hospital in the Niger Delta, Nigeria. This is a cross-sectional descriptive study using a self-administered structured questionnaire among 131 doctors in Delta State University Teaching Hospital (DELSUTH), Oghara. Data was analyzed using the IBM SPSS v.21. Eighty-eight (67.2%) respondents had a good knowledge of radiation safety while 49 (37.4%) of respondents had a good practice of radiation protection and safety. There was an association between the department of respondents (p=0.009), awareness of body parts sensitive to radiation (p=0.005) and their knowledge of radiation safety. Also, there was an association between the department of respondents (p=0.016), their years of experience (p=0.016) and the practice of radiation safety. Knowledge of radiation safety was high while the practice of radiation protection and safety was low amongst respondents. Gender, department of doctor and awareness of body parts that are sensitive to radiation were associated with good knowledge; while department and years of experience was associated with good practice. It is recommended that doctors receive regular updates on radiation hazards, risks and protection in order to reduce the risk of exposure of patients and health workers to unnecessary ionizing radiation.
Chemical Composition and Antibacterial Activity of Essential Oil Extracted from Citrus sinensis L., Citrus limon L. and Zingiber officinale Roscoe
Post harvest loss is a serious problem in Nigeria and a major drawback towards food security. Hence, discovery of potential agents capable of minimizing post harvest loss is urgently needed. This research is directed at investigating the in vivo antimicrobial activity of essential oils against bacterial pathogens isolated from Ipomoea batatas Lam. Citrus sinensis and Citrus limon peels and Zingiber officinale essential oils were extracted using hydro-distillation and their chemical constituents determined by gas chromatography mass spectrometry (GC-MS). Morphological and biochemical methods were employed for bacterial identification. A total of 22 terpenes were identified in Citrus sinensis comprising 13 monoterpenes, 8 sesquiterpenes and 1 diterpene. Citrus limon had 31 terpenes 15 of which are monoterpenes, 15 sesquiterpenes and 1 diterpene while a total of 30 terpenes were identified with Zingiber officinale comprising of 12 monoterpenes and 18 sesquiterpenes. Three of the four isolated bacteria identified from Hannah sweet potato were pathogenic: Erwinia carotovora, Bacillus licheniformis and Pseudomonas fluorescens. Pseudomonas fluorescens was more sensitive to the essential oils at (p=0.05). Citrus sinensis (64.29%, 9.0±0.00 mm) was three fold more active than Citrus limon (21.43%, 3.0±0.00 mm), while Zingiber officinale (53.57%, 7.5±0.71 mm) was two and a half fold more active than Citrus limon. Results obtained in this study showed that essential oils extracted from Citrus sinensis and Zingiber officinale exhibited substantial antimicrobial activity against bacterial induced sweet potato rot. Therefore, essential oils extracted from Zingiber officinale and Citrus sinensis could be used to control post harvest bacteria induced rots in injured sweet potatoes.
Criminalization Versus Decriminalization of Cannabis use in Nigeria: What is the Fuss About?
The continued criminalization and punitive approaches to cannabis use in Nigeria and elsewhere have not yielded positive expected outcomes. Many countries are now adopting new measures to cannabis control policies that are evidence-based, cost effective prevention, treatment and or interventions in favor of punitive approaches. There is large volume of scientific research supporting the need for decriminalization of cannabis use and put in place laws that prevent harsh criminal penalties for possession of small amount or use. In addition, government should review policies to support research and development of pharmaceutical cannabinoids and promoting research on the medical use of these compounds for the common good of humanity.
If all Microorganisms Vanish from the Surface of Planet Earth,what becomes of Man?
Microorganisms were the earliest biological creatures of the universe here on earth and have existed over billions of years ago and bacteria specifically have given rise to all other higher multicellular plants and animals including man. Since microbes are responsible for disease and have caused several millions of deaths in the past among humans, one would wish all these microbes suddenly should be wiped out in order to preserve man. Most often the advantages of bacteria to man are listed but often not seen as justifiable enough to warrant the continued existence of bacteria and archibacteria here on planet earth. The authors looked at the advantages and disadvantages of microbes and also what would happen to man if all microbes are suddenly wiped out from the earth. And found out that it would be a catastrophic event in which global warming will continue to increase rapidly due to increase of Co2 and decrease of oxygen, all ruminants such as cows and sheep will all die, all plants will die, all refuse dumps, dead animals, dead plants, toxic wastes and accumulated human excreta will not undergo biodegradation and recycled back to the environment.In conclusion the advantages of microbes to man far outweigh their disadvantages of causing diseases and if all microbes vanish from the surface of the earth, in no distant time man as well will vanish.
Vaccine Development Amidst Covid-19 Pandemic and Explorations for its Cure: Which Side of the Divide are we on? A Perspective Research Work
With the continuous effects of COVID-19 pandemic on various aspects of human, material as well as economic endeavours across the globe, intensive research for a lasting cure to the disease include quest for development of effective drugs and vaccines. This paper is a synopsis of the global COVID-vaccination efforts. It reviewed and constellated materials on COVID-19 vaccine production, its distribution, administration and overall impact on the control of the COVID-19 pandemic and highlights lessons learnt. Information on candidate COVID-19 vaccines recommended for Emergency Use Authorization (EUA) were obtained from various media sources and search engines (Google scholar, PubMed, Electronic and print media, Newsletters). The results were analyzed using descriptive statistics. We observed the urgency posed by COVID-19 pandemic, did not allow for thorough clinical trials for all the currently available vaccines before their widespread public consumption and there is asymmetrical vaccine distribution and uptake between the low and moderate income countries. The unmet COVID-19 vaccine needs in Africa have been inadequate for several reasons. The vaccines have nevertheless shown immense efficacy and effectiveness. Whether there will be sustained effectiveness and resilience of these vaccines to mutant newer strains of the corona virus in the future remains unknown. With the little evidence of mutant strains, episodic waves of infections and benefit of a lead time, the gap in the global vaccine distribution and administration needs to be more ambitious and focused in terms of international collaborations and media risk communication to improve supply and uptake of vaccines particularly in Africa.
Determinants of Street Littering in an Urban Setting in South-South Nigeria
Littering is an inherent societal problem which has been marginalized in waste management efforts most especially in some low- and middle-income countries. Though its effect might seem negligible to the individual, its consequences on the environment remain substantial. The objective of this survey is to determine the socio-demographic and behavioural determinants of street littering among inhabitants in an urban Local Government Area (LGA) in Benin City. A descriptive cross-sectional study was carried out in Oredo LGA of Benin City amongst 422 respondents with an interviewer administered structured questionnaire using a cluster sampling technique. Data were analysed using the SPSS version 16 statistical software. The mean age of respondents was 30.01 (±19.53) years. Respondents' most common method of litter disposal was either by putting them into waste bins (52.6%) or burning the trash (28.7%). Legislation (43.4%) and availability of street bins (40.5%) were the most effective measures identified to curb littering behavior. There was a statistically significant association between street littering tendencies and age (p<0.001), gender (p<0.001) and educational status (p<0.009) of the respondents. In conclusion, age, gender and educational status of respondents were significantly associated with littering behaviour. Environmental policy review, improved health promotion activities and provision of anti-littering infrastructure is recommended.
Post-Partum Haemorrhage at the Federal Medical Centre, Yenagoa, South-South Nigeria: A 5-Year Review
Postpartum haemorrhage complicates about 3 – 5% of deliveries. It is the leading cause of maternal morbidity and mortality worldwide, especially in sub-Saharan Africa (of which Nigeria is a part), where it significantly contributes to the burden of maternal and perinatal morbidity and mortality. The objective of this study was to determine the incidence, maternal and perinatal outcomes of postpartum haemorrhage at the Federal Medical Centre, Yenagoa, South-South, Nigeria. This retrospective survey was conducted between 1st January, 2016 and 31st December, 2020. Data were retrieved, entered into a pre-designed proforma, and analysed using IBM SPSS version 25.0. Results were presented in frequencies and percentages for categorical variables and mean and standard deviation for continuous variables. Out of 4,571 deliveries within the study period, postpartum haemorrhage complicated 66, representing a case incidence rate of 14.4 per 1,000 deliveries. Majority of the women were multiparous (53, 80.3%) and unbooked (56, 84.4%). Primary postpartum haemorrhage was the more common (56, 84.8%) type of postpartum haemorrhage, with uterine atony being the most (39, 59.1%) implicated aetiology. The most common (12, 18.2%) perinatal complications were birth asphyxia and admission into special care baby unit. There were five cases of maternal mortality, giving a maternal mortality rate of 10.9 deaths per 10,000 pregnant women. Postpartum haemorrhage remains one of the leading causes of maternal morbidity and mortality, especially in developing countries. Antenatal booking, recognition of risk factors and active management of third stage of labour are key in the prevention of postpartum haemorrhage and its associated complications. Women should be encouraged to book for antenatal care early, and be regular at the visits, as this will help recognise danger signs early and establish plans to prevent postpartum haemorrhage.
Operating Room Drugs and, Consumables Distribution Systems: Knowledge, Attitude and, Practice among Operating Room Workforce in a Tertiary Hospital in the Developing World
Drug and consumables distribution system in the operating room is key to the smooth running of the operating room in any hospital. Technological advancements have led to the development of newer and more efficient distribution systems. We aim to assess the knowledge, attitude and, practice of drug and consumable distribution systems among operating room workforce of a tertiary hospital in Nigeria. The study was a questionnaire-based cross-sectional study among the various categories of professionals of the operating room workforce. Two sets of questionnaires with structured questions on the knowledge, attitude and practice of operating room drug and consumables distribution system were administered one after the other on the operating room personnel. 282 of 363 operating room workforce consented and responded to the questionnaires. The workforce is made up of surgeons 198 (70%), physician anaesthetists 28 (10%), nurse anaesthetists 25 (9%) and, perioperative nurses 31 (11%). Their mean age was 42.61+8.74 years, 175 (64%) aged between 30 and 49 years with male to female ratio of 2.9:1. The majority 243 (86%) of respondents did not know the meaning of an operating room drug and consumable distribution system. After explanation, it was discovered that 228 (81%) had experienced the individual prescription order system with its associated wastages 195 (69%), medication errors 130 (46%,) and, delay or scheduling of cases 183 (65%). This study revealed poor knowledge of drug and consumables distribution system among operating room workforce in our institution. The study centre uses individual prescription order system with significant untoward effects. We recommend improved awareness of the theatre workforce on drug and consumable distribution systems.
Differences in Lipid Profile Findings in HAART Naive vs HAART Treated HIV Positive Patients
This study was to assess the lipid profile changes present in HIV positive HAART treated vs. HAART Naive patients. Data was obtained from seventy six patients each in three groups (HAART treated, HAART Naive and Controls) who met the inclusion criteria after a written informed consent was obtained. Ethical approval was obtained from the Research and Ethics Committee of the University of Benin teaching Hospital, Benin City, Nigeria. The mean age for the treatment naïve patients was 41.39 ± 7.23years while HAART treated and normal controls had mean age of 44.01 ± 7.13years and 42.95 ± 9.55years respectively. There were statistically significant differences in most anthropometric measurements of patients in all three groups. Also, Obesity was present in 7.9% of HAART treated and 6.6% of HAART naive patients. Abnormal waist circumference was also noted in 65.8% of patients in both HIV positive patient groups while an abnormal waist hip ratio was present in 43.4% and 48.7% of HAART treated and HAART naive patients respectively. Elevated total cholesterol and abnormalities in the HDL levels were most prevalent abnormal lipid profile parameters. This study showed derangements in anthropometric and lipid profile parameters in HIV positive patients compared to controls with alterations in total cholesterol levels in HAART treated patients. These effects are possibly indicative of HAART's impact on lipid metabolism through multi-factorial mechanisms which would need to be elucidated by further studies.
Haematological Correlates of Helicobacter pylori Infection Amongst Children Receiving Care in a Private Setting in Port Harcourt, Rivers State
Helicobacter pylori is a spiral shaped, gram-negative bacterium that basically colonizes the digestive tract of humans. It is an established cause of anaemia, leucopenia and thrombocytopenia and affects 70-95% of children in developing countries. We carried out a retrospective study of 140 children, presenting with abdominal discomfort and/or vomiting in a private hospital in Port Harcourt, South-South, Nigeria. Positive serology for H.pylori was established using IgG test kit and Full blood counts were done with an autoanalyzer. Sixty four (45.7%) of the children studied were serologically positive for H.pylori infection, while 54.3%(76) were negative. H.pylori was detected in virtually all age groups of children studied. Ten (15.6%) of the children with H.pylori positive serology had anaemia, 3.1%(2) had leucopenia and 12.5%(8) had leucocytosis. None of these was statistically significant. The overall seroprevalence of H.pylori in the children studied was high. Similarly, there was a high prevalence of haematologic derangements in the children with positive H.pylori assay compared to those children with negative serology for H.pylori. This was however not statistically significant. Routine screening of children with symptoms of abdominal discomfort for H.pylori and commencement of treatment for those with positive serology results is not recommended without confirmatory test.
Penile Gangrene following Penile Bandaging for Uncontrollable Bleeding Benign Prostatic Hyperplasia: A Case Report
Benign Prostatic Hyperplasia (BPH) is one of the most common ailments that affect elderly men. Frequently, affected patients present with lower urinary tract symptoms and complications such as urinary retention and haematuria. Haematuria complicating BPH can be very daunting and challenging to manage, pushing the surgeon sometimes to employ some unconventional and unorthodox methods when all management protocols in his armamentarium are exhausted. The complications resulting from these unconventional methods of managing bleeding BPH may be costly with high morbidity and mortality. Penile gangrene, a generally rare entity has not been reported (to the best of our knowledge) as a complication of these unorthodox methods of managing bleeding BPH. Here, we present the case of a 62-year-old man who had his penis bandaged and suspended for two days following an episode of uncontrollable haematuria in the Accident and Emergency Unit of a tertiary health facility. He subsequently developed penile gangrene necessitating his presentation to our facility after discharging against medical advice. He eventually had suprapubic cystostomy and control of the haematuria. Subsequently, he had a prostatectomy and penile refashioning. This case report emphasizes the challenges of managing bleeding BPH and the dangers of employing unconventional and unorthodox treatment protocol in the management of bleeding BPH.
Nephrocurative Effect of Flavonoids-Rich Fraction of Irvingia gabonensis Seed Extract against Acetaminophen-induced Kidney Damage in Mice
This paper investigated the nephrocurative effect of flavonoids-rich fraction of Irvingia gabonensis seed extract in acetaminophen-induced kidney damage in mice. The total flavonoids content of the different fractions of the extracts were reported to be higher in the Ethyl acetate fraction with a value of 47.20mg QE/g followed by Methanol 30.41mg QE/g, Chloroform 20.10mg QE/g, and Petroleum ether with 12.40mg QE/g. Further studies on the flavonoids-rich extract (Ethyl acetate fraction) revealed a significant difference (p < 0.05) between the inhibitory power of the flavonoids-rich fraction of Irvingia gabonensis (IG) seed extract and that of Vit. C. Accordingly, the IC of the 50 flavonoids-rich fraction of Irvingia gabonensis seed extract (47.97μg/ml) calculated was observed to be higher than that of Vit. C. standard (25.76μg/ml). Studies on the nephrocurative effect indicate a positive result with significant deference across the group and an ultimate normalization of the kidney biomarkers. The curative effect of the extract is assumed to be dose and time depended on a drastic decrease in kidney biomarkers after four weeks of extract administration. Toxicity study of the extract also revealed the extract to be safe at ≤3000mg/kgbw. This study to an extent has proven that Irvingia gabonensis seeds are a promising source of alternative raw material in pharmaceuticals for kidney toxicity treatment. Therefore, the flavonoids rich fraction of Irvingia gabonensis seed extract may have curative effect in the treatment of kidney diseases.
Emerging Covid-19 Variants and Vaccine Efficacy, an Eye on the Future
When COVID-19 outbreak commenced in late 2019 and was fast spreading across the globe, all efforts of the global scientific community was targeted at finding prevent further spread and get a lasting cure. These efforts culminated in the emergence of several drugs and eventually vaccines. The vaccines have substantially slowed down the spread of the disease. While vaccines appear to have started having a firm grip on the disease, the emerging viral variants from the continued mutation of SARS-CoV-2 appear to have started responding differently to the vaccines licensed for Emergency Use Authorization (EUA) by the World Health Organization (WHO). It is clear from documented records that AstraZeneca, Moderna, Johnson & Johnson, Pfizer BioNTech, SinoVac, Sputnik, Soberana, Abdala, Novavax, and Cansino have all been effective against Alpha and Beta Kappa and Gamma variants of the virus among other variants and marginally with the Delta variant. Although, cases of breakthrough infection with other variants in fully vaccinated individuals have been rare so far, this is different with the Delta variant that has started showing visible signs of vaccine escape with high levels of breakthrough infections and evidence of severe morbidities and record of mortalities as well. Given that vaccine escape of some strains of Delta variant has already commenced; composition of newer vaccines should using computational modeling target variants of Delta which may even be more resistant and deadly.
The Clinical Utility Of Urinary N-Acetyl-Β-D-Glucosaminidase [NAG] Creatinine Ratio In The Assessment Of Diabetic Nephropathy In A Tertiary Hospital In Eastern Nigeria
Tubular injury, as shown by the detection of tubular damage markers in the urine, is a critical component of the early course of Diabetic Nephropathy (DN). Urinary excretion of tubular markers such as urinary N- acetyl-β-D glucosaminidase (NAG) may be useful in assessing an initial malfunction or damage of the renal tubules in the early stage of DN. This study was to assess the clinical usefulness of NAG/creatinine ratio in evaluating kidney dysfunction in type 2 diabetes mellitus (DM) patients.This was a cross-sectional analytical study of 283 type 2 DMpatients at the Federal Medical Centre (FMC), Owerri, Nigeria. Ethical approval was obtained from the Research and Ethics Committee of FMC, Owerri. Data obtained was analyzed using IBM-SPSS version 21.0. A p-value of <0.05 was considered significant for all statistical comparisons.The mean age of patients studied was 56±13.41 years. Of the patients studied, 87 patients were normoalbuminuric while 196 had microalbuminuria. The mean NAG/creatinine ratio for normoalbuminuric diabetics was significantly lower (p<0.001) than values obtained in patients with microalbuminuria. In addition, 28.7% and 57.7% of normoabulminuric and microalbuminuric diabetics respectively had elevated urinary NAG/creatinine ratio.Higher Urinary NAG excretion in microalbuminuric diabetics represents an early marker of incipient diabetic nephropathy buttressing that early NAG excretion at elevated levels is a significant marker of susceptibility to DN and its assessment may help identify diabetics with predisposition to DN.
Major Depressive Disorder, Correlates and Quality of life amidst COVID-19 Pandemic in patients attending General Out Patients of a Tertiary Hospital, North Central Nigeria
Studies have shown high rate of symptoms of depression during COVID-19 pandemic. However, few studies have examined the prevalence of Major Depressive Disorder and Quality of Life with in clinical setting. This study therefore looked at the prevalence of Major Depressive Disorder, Sociodemographic factors and its association with Quality of Life. The cross-sectional descriptive study was carried out among patients attending General Out Patients Department of the Jos University Teaching Hospital (JUTH) from June to August, 2020.The study consisted of 361 participants among which 93(25.8%) had depression and 268(74.2%) were without depression. The age range was 18 to 76 years with the mean (SD) being 31±10 years. There were 181(50.1%) males and 180(49.9%) females with mean (SD) of 32±10 and 31±10 respectively with no significant statistical difference (p = 0.238). The characteristics of the participants were similar between those with depression and those without depression except for monthly income (p = 0.01), Perceived impact of COVID-19 related stress (p = 0.001) and change in alcohol consumption (p = 0.01). Binary logistic regression revealed that the significant predictor variables were: gender with females slightly more than the males to have depression (p = 0.05), those with perceived high impact of COVID-19 related stress were 7.6 times more likely to develop depression than those with perceived low impact (p = 0.001) and those who reported increased consumption of alcohol amidst COVID-19 were 3.6 times more likely to have depression than those who did not drink alcohol (p = 0.001). This high prevalence of depression calls for urgent need to develop programmes and tools targeting this vulnerable group of general out patients' attendees. Furthermore, educational sensitization and awareness, and up to date information on COVID-19 which is still eminent should be provided to reduce the impact of perceived stress related to the pandemic.