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Jun 2021 DOI 10.14302/issn.2639-3166.jar-21-3816
Elamin Elhaj WaleedCorresponding author
Department of Plant Protection, College of Agricultural Studies, Sudan University of Science and Technology, Khartoum State, Sudan.
African bollwormis a worldwide-spread species that shows a high degree of polyphagia and it is considered as one of the main agricultural pests in the world. Laboratory experiments were conducted in the Research Laboratory, College of Agricultural Studies, Sudan University of Science and Technology to evaluate the lethal effect of C. rotundusand D. stramonium on the H. armigeraand to investigate the synergistic effect of sesame oil and tested extracts by dipping methods. Five concentrations (4%, 6%, 8%, 10% and 12%) were used for each plant extract in a Completely Randomized Design. Tubers ethanolic extract of C. rotundus at 12% concentration caused 90% mortality after 72 hrs of application, whereas 12% concentration of seeds ethanolic extract of D. stramonium generate only 70% mortality after 72 hrs of exposure. When sesame oil was added to each concentration of ethanolic extract of C. rotundus and D. stramonium it exhibited a synergistic effect. In fact, the 10% concentration scored 53.3% and 76.7% mortality, however, when mixed with sesame oil the mortality increased significantly to 83.3% and 100% for D. stramonium and C. rotundus respectively after 72 hrs of exposure. This study clearly demonstrates that both tested plants have a lethal effect on the larvae of the African bollworm. However, tubers ethanolic extract of C. rotundus seems to be significantly more toxic than the seeds ethanolic extract of D. stramonium. This study also revealed that sesame oil has a synergistic effect when added to these plant extracts.
Jun 2021 DOI 10.14302/issn.2639-3166.jar-21-3817
Elamin Elhaj WaleedCorresponding author
Department of Plant Protection, College of Agricultural Studies, Sudan University of Science and Technology, Khartoum State, Sudan.
Helicoverpaarmigera is one of the most destructive pests of field crops worldwide. The Study was designed to investigate through laboratory screening the insecticidal activity of Ricinus communis, Cassia occidentalis and Bacillus thuringiensis var. Kurstaki (Btk) and their combinations against 2nd larval instar of H. armigera. Five concentrations (4%, 6%, 8%, 10% and 12%) of each plant extract and (0.62, 1.25, 2.5, 5, and 10 mg/ml) of Bt were used in this experiment. Mortality (%) was recorded after 24,48,72 and 96 hrs post treatment. The results showed that R. communis, C. occidentalis and Btkhave insecticidal activity against 2nd instar larvae of H. armigera. The highest concentration (12%) caused 80% and 70% larval mortality after 96 hrs for R. communis and C. occidental respectively. The statistical analysis revealed that there is a significant differences between all treatments and control. Additionally, all combinations (plant/plant or plant/Bt) increased the mortality %. The results also clearly demonstrate that the R. communis are significantly more toxic than C. occidental where the LC50 values were 6.4 % for R. communis and 8.1% for C. occidental. On the other hand LC50 value for Bt was 0.41 mg/ml. The binary mixture of R. communis and C. occidental have a potentiation effect after 48 hrs. Regarding the mixture of Bt and plant extracts the results revealed that R. communis and Bt mixture induced a potentiation effect whereas C. occidental and Bt mixture induced a an additive effects.
Jan 2021
Vladimir Leonidovich MartynovCorresponding author
Doctor of Medical Sciences, Associate Professor, National Research Nizhny Novgorod State University named after N.I. Lobachevsky (UNN), Russia
Annotation On the basis of 40 years of work on the treatment of 415 patients with gastroenterocolitis clinic, the author revealed the presence of refluxes due to anatomical defects of the Bauhinia valve (its failure) and the duodenum (chronic duodenal obstruction) at all levels of the gastrointestinal tract. After surgical correction of these anatomical breakdowns, the author states a significant improvement in all indicators of the state of both the digestive system and some extraintestinal manifestations, possibly the onset of precancer. The results obtained allowed the author to conclude that there are no "functional" disorders, this is only the level of our knowledge. Operations have been developed to correct the failure of the Bauhinia flap, intraoperative prevention of refluxes, and indications for methods of correcting chronic disorders of duodenal patency.
Dec 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3649
Luis Turabian JoseCorresponding author
Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia, Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain
The coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 1 has produced a significant change in the way general medicine is conducted. This shift has been remarkably quick towards telecare. The form of the clinical interview has changed, and with it communication and the doctor-patient relationship; Before COVID-19, all communication techniques and doctor-patient relationship, which were considered tried and true to establish a good relationship with patients, involved physical proximity 2. Now in many European countries and in the United States face-to-face consultations have been reduced to 10-20%, with most contacts now being provided remotely using symptom checkers, electronic messaging, and phone or video consultations 3.
May 2020 DOI 10.14302/issn.2692-5257.ijgp-20-3335
Luis Turabian JoseCorresponding author
Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia, Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain
The consultation is the activity of meeting and communication between an individual and the doctor for the knowledge and solution of a health problem. In today's busy world of general medicine, constant demands for the general practitioner (GP) arise: she or he should not only make a diagnosis not only should make a differential diagnosis during consultation, but must also establish a good relationship, explore patient ideas, concerns and expectations and negotiate a management plan, taking into account limited resources, the quality framework and results, having Information technology skills, plus, the need to promote health during any consultation. Normally the GP has only 10 minutes to achieve all that, as well as to manage your own emotions, agendas and uncertainty. In this way, novice doctors may find it difficult to move in this situation of complexity, and they can also observe a gap in the literature that really guides them in practice. Rigorous preparation is the key to success for many endeavours. Some tips to perform an efficient and safe consultation work in general medicine are suggested: 1) Focus on the next patient; 2) Preparing the consultation before entering the patient, memorizing the patient's previous history; 3) Establishing a connection with the patient; 4) Remembering the elements that must be in each consultation (the current reason, update other previous processes, chronic diseases and continued attention, "case finding", health promotion); 5) Striking a balance between empathy and assertiveness; 6) Putting in writing and contextualized the clinical record; and 7) Making reflection-safety questions, learning questions, and preparation questions for the next visit. Rigorous preparation is the key to success for the general practitioner in every consultation. Think about these topics of the consultation before doing it, and after it, prepare the next consultation of that patient. All these things are force multipliers.
Sep 2019 DOI 10.14302/issn.2470-0436.jos-19-2829
Abo Taleb EmanCorresponding author
Regional hospital for vitreo retina and eye care Sana'a Yemen.
Purpose To study outcome and spectral domain optical coherence tomography (SD-OCT) macular findings in patients who underwent surgery for spared macula giant retinal tear (GRT) retinal detachment. Methods a retrospective study of 12 patients with spared macula giant retinal tear (GRT) retinal detachment who underwent vitrectomy (N=7), vitrectomy with an encircling scleral buckle (n=4) and scleral buckle (n=1) with at least 3 months follow up after silicon oil removal (SOR) . Post-SOR macular SD-OCT scans were studied in all eyes. Results Final reattachment achieved in all eyes with single primary surgery. Post-SOR SD-OCT macular finding was photoreceptors layer disruption in 6 eyes, epiretinal membrane (ERM) in 4 eyes, Macular hole in 1 eye and choroidal neovascularisation in 1 eye. Significant correlation found between final Best-Corrected Visual Acuity (BCVA) and macular pathology on SD-OCT p value (0.048). Conclusion SD-OCT plays a high role in diagnosis of macular alterations that can be associated with poor functional outcome in anatomically successful GRT surgery with spared macula pre-operatively.
Apr 2019 DOI 10.14302/issn.2470-0436.jos-19-2480
Abo Taleb EmanCorresponding author
Regional hospital for vitreo retina and eye care Sana'a Yemen.
Purpose To describe spectral domain optical coherence tomography (SD-OCT) and enhanced depth image OCT (EDI-OCT) findings of multifocal serpiginoid choroditis (MSC) , including affected layer of retinal involvement, changes at the vitreoretinal interface, and response to therapy. Methods A retrospective review of 20 eyes (14 patients) with MSC. Each patient underwent a complete ophthalmologic examination, fundus photography, fundus autoflorecence (FAF) and OCT imaging of the affected retina at the initial visit and on each follow-up. Results In acute stage, SD-OCT showed hyperreflective areas involving the outer retinal layers which include retinal pigment epithelium (RPE), photoreceptor outer segment tips (POST), inner segment–outer segment (IS/OS) junction, external limiting membrane (ELM), and outer nuclear layer (ONL) with choroidal and intraretinal layer cells infiltrate. EDI-OCT showed increase choroidal thickness. As the lesions began to heal, irregular, knobby elevations of outer retinal layers appeared (RPE, POST, IS/OS junction, and ELM could not be distinguished) with significant decrease in choroidal and intraretinal cells. On complete healing, loss of RPE, POST, IS/OS junction, and ELM in SD-OCT scan and absent of the choroidal and intraretinal cells and continous hyperreflactivity of the choroid (increased penetrance). Conclusion SD-OCT and EDI-OCT provides high-resolution detail regarding ultrastructural changes in vitreoretinal interface, outer retina and choroid during the course of the lesion. Serial SD-OCT and EDI-OCT also provides further insight into response to therapy by observing choroidal and intraretinal cells.
Apr 2019 DOI 10.14302/issn.2998-4211.jalr-19-2658
C S SandeepCorresponding author
Research Scholar, CET, Trivandrum, University of Kerala
Alzheimer’s Disease (AD) is one amongst the overwhelming types of dementia that distresses the brain nerve cells leading to a perpetual loss in memory and creating a lot of difficulties for the family members in caretaking. The prediction of the disease at an earlier stage is a common problem. The most prevalent imaging modalities used for diagnosing AD are Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET) and Single Photon Emission Computed Tomography (SPECT). They can provide valuable information regarding the changes in internal and external brain regions and activities for diagnosing AD. But the relevant studies made on retina reveals that in addition to brain changes there are some variations on the retina layers of the AD patients. Therefore, the retina can be used as a biomarker for diagnosing AD. There are different techniques available for an eye examination. Most noticeable of them are Fundus Imaging and Optical Coherence Tomography (OCT). In this paper, we have focused on OCT retinal images of AD patients for the early diagnosis of AD.
Nov 2018 DOI 10.14302/issn.2640-690X.jfm-18-2485
Luis Turabian JoseCorresponding author
Specialist in Family and Community Medicine, Health Center Santa Maria de Benquerencia. Regional Health Service of Castilla la Mancha (SESCAM), Toledo, Spain.
The transcendence of the doctor-patient relationship is given by the confirmed fact of its influence on the results of health care. Several models of doctor-patient relationship can be described, but evidence of improved compliance, satisfaction and recall of physician information has been found in patient-centered consultations. Since these concepts of doctor-patient relationship and patient-centered consultation have multiple facets, they are complex to understand and teach. Using a metaphor is a tool that can be useful in these situations. We could say that the "good" doctor-patient relationship is a process where an "alliance" is created: a process in which the doctor adapts to the rhythm of the patient and little by little can help him move towards healthier scenarios; that is, detect "what dance the patient dances and like a good dancer, take a step back, another forward, dancing and pacing with the patient. But there is not a single type of "good" or "adequate" doctor-patient relationship; there is not "a single dance that the patient dances". If "the doctor has to dance with the patient", he has to know that there are many types of dance! The doctor will have to dance dances such as Cha-Cha (which has to be slow or very fast to dance), the Mambo (where the music is faster and the rhythm more complicated - the relationship with an urgent patient); the Merengue (which is danced like walking - informal doctor-patient relationship); el Pasodoble (that you have to dance with a haughty air, but not with rigidity -synchronizing assertiveness and empathy); The Salsa (where you have to learn the basic step separately - discontinuity of the doctor-patient relationship), among others.
Jan 2016 DOI 10.14302/issn.2574-4372.jesr-15-768
E. Trosko JamesCorresponding author
Food Safety Toxicology Center, Department of Pediatrics and Human Development, Michigan State University, East Lansing, MI 48824, USA.
The human OCT4 gene encodes a transcription factor that maintains pluripotency and self-renewal in Embryonic Stem (ES) cells. This gene generates several known transcripts by alternative promoter and alternative splicing (OCT4A, OCT4B and OCT4B1). Even though OCT4A is the main isoform responsible for stemness properties, several recent controversial studies claimed that this isoform is expressed in cancer cell lines and differentiated cells, in addition to the ES cells. Our in silico studies revealed that OCT4A promoter has a completely match binding site for hsa-miR-1285. This microRNA was detected in the human embryonic stem cells for the first time and further studies showed that miR-1285 can target some tumor suppressor genes,(TSGs), such as p53, and oncogenic genes, such as TGM2. Additional bioinformatics analysis of short RNA sequencing data from ENCODE cell lines showed that miR-1285 is expressed in different cancer cell lines and differentiated cells. In this study, we supposed that miR-1285 potentially can bind to the OCT4 promoter and might regulate transcription of the OCT4 in the human cancer cell lines and differentiated cells.
Mar 2026 DOI 10.14302/issn.2574-4518.jsdr-26-6010
Marmann PeterCorresponding author
Background/Aim Sleep disturbances are common and are associated with impaired daytime functioning, reduced quality of life, and increased health risks. Non-pharmacological neuromodulatory interventions have gained interest as alternatives to hypnotic medication. Pulsed electromagnetic field (PEMF) therapy has been proposed as a non-invasive approach to improve sleep quality and recovery, but evidence from large, well-controlled trials remains limited. The objective of this study was to evaluate the efficacy and safety of pulsed magnetic field therapy (PMT) on sleep quality, sleep-related symptoms, daytime functioning, and well-being in adults with heterogeneous sleep complaints. Materials and Methods In this remote, randomized, double-blind, placebo-controlled trial, 217 adults reporting non-restorative sleep, difficulties initiating sleep, or frequent nocturnal awakenings were assigned to active PMT using a PEMF device (Night Harmony Female/Male protocol) or a sham application for three weeks. Primary outcomes were changes in the Pittsburgh Sleep Quality Index (PSQI) global score and self-rated sleep satisfaction, restfulness, and sleep initiation difficulties. Secondary outcomes included sleep diary measures, daytime functioning, well-being (WHO-5), symptom burden (MYMOP), and daytime sleepiness (Epworth Sleepiness Scale). Analyses followed the intention-to-treat principle using ANCOVA with baseline values of the respective parameter as covariate. Results Both groups showed significant improvements over time in global sleep quality and most secondary outcomes (p < 0.001). Between-group differences in PSQI global score were not significant (p = 0.314). However, active PMT resulted in significantly greater improvements in subjective sleep satisfaction (p = 0.02) and restfulness (p = 0.02), particularly among participants with moderate to severe baseline sleep disturbances (p < 0.001 for both). Sleep continuity measures improved similarly in both groups. No serious adverse events were reported. Conclusions PMT produced modest but significant improvements in subjective restorative aspects of sleep beyond placebo effects and was well tolerated. Further studies using objective sleep measures and longer follow-up are warranted.
Dec 2025
Liu LipingCorresponding author
The incidence rate of melasma is notably high among patients with anxiety disorders. Aromatherapy primarily influences the physiological and psychological states of individuals through the inhalation or application of essential oils, thereby facilitating the treatment or alleviation of various conditions. This study aims to explore the action mechanism of complex lemon-angelica sinensis -boswellia essential oil (CEO) in treating anxiety disorders with melasma. We investigated the active ingredients, targets, and pathways of CEO in relation to anxiety and melasma using network pharmacology. We employed cell assays and conducted nebulized essential oil inhalation tests on CUMS mice to validate the intervention effects of CEO on anxiety. A total of 28 active components, including neryl acetate, 3-butenylphthalide and octyl acetate, and 26 cross-targets, such as ESR1, CCND1 and PIK3CA, were identified. GO and KEGG pathway analyses indicated that these cross-targets were primarily involved in endocrine regulation, cell proliferation, and apoptosis, specifically through PI3K/Akt signaling pathway and calcium signaling pathway. The experimental results demonstrated that CEO significantly reduced the secretion of NO, TNF-a and IL-6, as well as the mRNA expressions of ESR1, CCND1 and PIK3CA in cells compared to the inflammatory cell model. Furthermore, CEO notably decreased the forced swimming immobility time of mice and the levels of IL-1β, ESR1 and CCND1 in hippocampus when compared to model mice. These findings suggest that CEO may regulate ESR1, CCND1 and PIK3CA through its citral, 3-butylphthalate and neryl acetate, thereby influencing endocrine function, cell proliferation and apoptosis, inhibiting inflammation and anxiety-like behavior in CUMS-induced mice.
Nov 2025 DOI 10.14302/issn.2470-0436.jos-25-5503
H. Nelson MarkCorresponding author
Purpose Create a new diagnostic and therapeutic framework for patients with Exudative Age-Related Macular Degeneration (ARMD) and choroid imaging biomarkers of non-neovascular choroidal pathology who have persistent neovascular exudation during the course of monotherapeutic interventions. Methods Retrospective, longitudinal case series study of 25 eyes from 23 patients with the referral diagnoses of treatment resistant Exudative ARMD who had persistent neovascular exudation despite various monotherapies. Inclusion criteria required choroidal imaging biomarkers of non-neovascular pathology including a thickened subfoveal choroid (greater than 300 microns) and vessels (subjectively dilated choroidal vessels in Haller’s layer) on Optical Coherent Tomography (OCT), choroidal neovascularization on IVFA and OCT Angiography (OCTA), as well choroidal leakage noted on indocynanine green videoangiography (ICG). Treatment consisted of OCTA and ICG - Directed Photodynamic Therapy (PDT) Triple Therapy, hereafter described as Combination Therapy, to areas of choroidal hyperpermeability and choroidal neovascularization. Combination therapy consisted of an anti-Vascular Endothelial Growth Factor (VEGF) intravitreal injection on Day 0 followed by half-fluence PDT and 2 mg intravitreal triamcinolone acetonide on Day 3-14. Results All study patients had treatment resistant Exudative ARMD defined as persistent subretinal and/or intraretinal fluid during their course of monotherapeutic interventions. Complete resolution of all exudation occurred in 23 eyes (92.0%) at 8 weeks. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. The mean vision at baseline was 0.46 ± 0.42 LogMAR, best corrected visual acuity (BCVA). 8 weeks after treatment, the vision was 0.35 ± 0.38 LogMar, an improvement of over one line, and this was maintained at one year. The baseline central subfield thickness (CST) was 296.4 ± 136.1 microns and improved by 111.4 ± 105.4 microns at 8 weeks after treatment. Treatment duration was negatively associated with the Caucasian race. Conclusions Patients with subretinal and/or intraretinal fluid secondary to Exudative ARMD should have a complete baseline multimodality imaging study to confirm the presence of neovascularization and whether choroidal hyperpermeability coexists. This study shows that patients with Exudative ARMD and persistent neovascular exudation despite monotherapuetic interventions often have choroidal biomarkers of non-neovascular choroidal pathology and that ICG and OCTA-directed PDT Triple Therapy resulted in complete resolution of all exudation in 92.0% of patients at 8 weeks with a reduction in central subfield thickness (CST) of 111.4 microns. The vision improvement at 8 weeks was 0.11 ± 0.38 LogMar and was sustained over 1 year. The mean duration of action was 155.6 weeks, with 72.0% of eyes leak free greater than 100 weeks. Additionally, this study shows that the treatment that addresses both pathological processes is successful and should be considered as a primary protocol when the biomarkers are present at baseline or as a secondary protocol if indeed the neovascular leakage is persistent despite monotherapy. Summary Patients with an Exudative ARMD with persistent neovascular exudation despite anti-VEGF monotherapy and who have imaging biomarkers of non-neovascular choroidal pathology often have two pathophysiological processes: choroidal hyperpermeability and angiogenesis. A proposed framework provides the rationale for OCTA and ICG-directed PDT Triple Therapy which successfully resolves 92% of the leakage that was persistent after various monotherapeutics.
Nov 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5745
Poole JolyonCorresponding author
Background Healthcare worker stress, anxiety, burnout, and trauma have been widely documented across global healthcare systems. Staff in maternal and neonatal units frequently encounter emotionally distressing events and work under high pressure with limited resources. In Zambia, despite some gains in reducing maternal and neonatal mortality, fatality rates remain above national targets, exposing staff to repeated occupational trauma. Objective(s) This study aimed to assess the psychological well-being of staff in maternal and neonatal intensive care units, identify specific needs and stressors, and develop practical recommendations to improve resilience and support staff mental health. Methods A mixed-methods cross-sectional study was conducted at Ndola Teaching Hospital (NTH) and Arthur Davison Children's Hospital (ADCH), two major tertiary hospitals in Zambia. Data were collected over four days in February 2025. The study included 87 (out of 161) healthcare professionals, including nurses, midwives, and doctors. The Goldberg Anxiety and Depression Scale (GADS) and the Professional Quality of Life Scale Version 5 (ProQOL 5) were used to collect quantitative data, which were analysed using descriptive statistics and 95% confidence intervals (CI). Open-ended survey questions provided qualitative data, which were analysed using thematic analysis. Ethical approval was granted by the hospital ethics committee. Results High rates of clinical symptoms were observed. The overall prevalence of symptoms in the past 30 days was: anxiety (62%), depression (68%), burnout (50%), and secondary traumatic stress (46%). Junior doctors demonstrated the highest rates of depression (83%) and burnout (67%). The obstetrics and gynaecology and labour wards had the highest rates of secondary traumatic stress symptoms. Key qualitative themes identified were professional stressors, team and leadership issues, and the emotional burden of the work. Conclusion This study highlights an urgent need for both psychological and organizational support for maternal and neonatal healthcare staff in Zambia. The findings indicate that burnout and secondary traumatic stress are highly prevalent, particularly among junior doctors and those in high-risk wards. Targeted interventions at both systemic and individual levels are necessary to protect the well-being of healthcare workers and improve patient outcomes.
Oct 2025 DOI 10.14302/issn.2474-7785.jarh-25-5784
Marks RayCorresponding author
This mini review examines the potential efficacy of applying electromagnetic field therapy for purposes of reducing osteoarthritis pain and other related disease features such as frailty, muscle sarcopenia, obesity, bone loss and fragility, and cartilage derangements and degradation in the older adult. Based on selected English language literature published largely on PUBMED between January 2000 and October 2025, papers describing the impact and potential synthetic and disease modifying impact of electromagnetic stimuli are explored. These data reveal a high degree of promise in fostering joint tissue reparative efficacy trends post electromagnetic stimulation. Its usage may allay the extent of the disease and its degree of disablement, while facilitating function.
Sep 2025 DOI 10.14302/issn.2379-8572.joa-25-5687
A Shaw NigelCorresponding author
Depending upon the species, the brainstem auditory evoked potential (BAEP) consists of four or five major high frequency components. According to longstanding doctrine, each wave represents the sequential activation of successively higher nuclei and tracts from the 8th (auditory) nerve to the midbrain (inferior colliculus). Although this conceptual framework has acquired the status of near dogma, surprisingly little evidence exists in support. In the present analysis, a new interpretation of the electrogenesis of the BAEP is proposed which is simpler although it retains skeletal elements of the older explanation. The revised model is mostly derived from two distinct sources. In the first, the timing of the BAEP waves is compared with that of cortical activity for a range of mammals including humans, monkeys, cats, rats and guinea pigs. It is demonstrated that for each of these, the conduction time of the acoustic signal to the cortex from the putative midbrain component (wave IV or V) is so unrealistically long that it implies that the entire waveform must arise in the peripheral pathways of the auditory system. In the second, a retrospective analysis is made of click repetition rates on the BAEP using extradural electrodes. It was shown that at high rates of stimulation (about 100/sec), the behavior of the waveform is almost totally at variance with the expectations of the conventional model. The essence of the revised conception is that all BAEP waves are just variations of the compound action potential of the 8th nerve, albeit generated or regenerated via separate routes and different methods. Such an explanation would thereby account for their near uniform sharp morphology as well as creating the impression of a composite neuronal response. More specifically, in the case of a four component BAEP, wave I is assumed to be generated by the normal air conduction route in an identical manner to the conventional explanation. In contrast, wave ll is assumed to be generated via bone conduction in the temporal skull thereby bypassing the transduction process in the middle ear. Wave lll is assumed to be generated by the first echo of the bone-conducted sound wave. Likewise, the second rebound within the temporal bone serves as the stimulation to evoke wave lV. As the energy of the auditory stimulus gradually dissipates, it may still continue to generate a train of lower amplitude potentials. It is concluded that the BAEP may contain little or no brainstem or midbrain activity and therefore the term BAEP may be a misnomer. A more appropriate epithet might therefore be the auditory nerve evoked potential or ANEP.
Mar 2025 DOI 10.14302/issn.2644-1101.jhp-24-5387
K. Shin HannahCorresponding author
The formation of narratives while listening to music is seen across cultures, but narrative perception in Asian Americans who have bicultural identities is not well understood. This study analyzed the potential effect of cultural identity on adolescents’ ability to form narratives with East Asian music. Two groups of adolescents (n=42), Asian American (n=28) and Non-Asian American (n=14), listened to three music excerpts with varying degrees of Asian and Western influences. The most Asian-influenced excerpt was a Gugak Korean traditional piece titled T’ungae sanjo, performed on traditional Korean folk instruments and creating a distinctly East Asian sound. The Mixed excerpt, containing both Western and Asian influences, was from Tan Dun’s Eight Memories in Watercolor. It contained a Chinese folk melody while being performed on a Western instrument. Finally, the most Western-influenced excerpt was from Toru Takemitsu’s Rain Tree Sketch. The piece contained octatonicism, a musical technique prominent in modern Western composers’ works. Participants completed a survey containing a free response question where they described their imagined narratives and a survey containing 4 questions measuring narrative engagement. Chi-square tests, t-tests, and reflexive thematic analysis were used to yield the results from the data collected. Results demonstrated that the extent of narrativization was dependent on enculturation. Asian Americans, with their bicultural identities, demonstrated consistent narrativization across all excerpts. In contrast, non-Asian Americans narrativized significantly less for the traditional Asian excerpt. Within the free responses, both cohorts identified similar themes with the Western-influenced music, as they have had overlapping exposure to Western culture leading to shared thought patterns. However, there was substantial thematic variability between cohorts with the Asian-influenced music, as the two cohorts had different levels of exposure to Asian culture. This study thus reinforces the notion that enculturation has a profound effect on narrativization in music, demonstrated through Asian American adolescents’ abilities to narrativize to music containing both Asian and Western roots.
Aug 2024
Balachandra ShivaiahCorresponding author
Ambulatory blood pressure monitoring is widely used in pediatric patients to identify hypertension and its complications. Previous studies correlating obesity and hypertension using ABPMs showed increasing blood pressure loads with increasing BMI. However, BMI percentiles are more reliable indicators of obesity in children. Our study aimed to describe the association between BMI percentiles and systolic and diastolic blood pressure load using ABPM in children and adolescents. Retrospective analysis of ABPMs (Welch Allyn) was performed on a total of 115 patients between 7 and 18 years of age who were referred for elevated BP without a diagnosis of hypertension at our institution from Jan 2011 to Oct 2013. Patients were divided into 4 groups based on BMI percentile: <94th percentile, 94–98th percentile, 98–99th percentile, and >99th percentile. Analysis between blood pressure loads and BMI percentiles revealed greater mean systolic and diastolic loads with increasing BMI percentiles, but the P value was not statistically significant. Analysis of the systolic loads between children from different racial backgrounds revealed higher values in African American children than in Hispanic and Caucasian children, but the P value was not statistically significant.
Apr 2024 DOI 10.14302/issn.2329-9487.jhc-24-5040
Dangwe Temoua NaibéCorresponding author
Objective Hypertensive crisis is an increasingly frequent medical condition in our context. Its management in medical emergencies is a real challenge for physicians. Few data on hypertensive crisis are available in Chad. The aim of this study was to investigate the epidemiological, clinical and prognostic characteristics of hypertensive crisis in the medical emergency department of Reference National Teaching Hospital in N'Djamena. Patient and methods This was a prospective cohort study running from 1er March 2020 to October 31 2020. Patients presenting with a sudden and severe rise in blood pressure (systolic ≥ 180 mmHg and/or diastolic ≥ 110 mmHg) with or without acute target-organs damage, had been consecutively included and followed up over a period of one (01) month. Epidemic and clinical characteristics on admission, and morbidity and mortality parameters during the course of the disease were collected. The Kaplan-Meier method and the Cox model were used to analyze survival and factors associated with death, with a significance level of p<0.05. Results Of the 3978 hypertensive patients admitted to medical emergencies, 252 had a hypertensive crisis, i.e. a prevalence of 6.3%. Two hundred and seventeen (217) patients were included in the study, divided into 149 cases (69%) of hypertensive emergency and 67 cases (31%) of hypertensive hypertensive urgencies. The mean age of the patients was 55.2 ± 14 years (20 and 80 years) and 67% were male. Hypertension was known in 138 patients (64%). At least one complication was present on admission in 69% of patients. Complications were classified as cardiac (50.7%), neurological (38.2%), kidney impairment (46.5%) and ocular (46.1%). The average number of antihypertensive drugs used was 2 ± 0.83 14. Calcium antagonists (86.5%), diuretics (35.5%), converting enzyme inhibitors or angiotensin II receptor antagonists (33.3%) and betablockers (18%) were the pharmacological classes prescribed. Good compliance during follow-up was observed in 124 patients. One-month survival was 84% for all patients, with a 16% mortality rate. Factors associated with death were the duration of hypertension, and the occurrence of cardiovascular, renal dysfunction and ocular disease (p < 0.05). Conclusion Hypertensive crisis is a frequent pathology in sub-Saharan Africa, with high morbidity and mortality. Prevention requires early detection and effective management of hypertension.
Feb 2024 DOI 10.14302/issn.2997-2248.jwl-23-4791
Sahile AtinafaCorresponding author
The Trans boundary protection of migratory species is a common argument for international cooperation. Ecotourism supports these activities through long-term commitment from international conservation organizations, all interest groups and various political entities. However, due to anthropogenic influences and inadequate understanding of species ecology, sustainable conservation of migratory species is often challenging. Therefore, this review article evaluates the migration status, potential anthropogenic threats, and conservation directives from the perspective of ecotourism of the white-eared kob (Kobuskobleucotis, Lichtenstein and Peters, 1854). Ethiopia. Kobus kobleucotis migrate through the Boma-Gambella border ecosystems of Ethiopia and South Sudan at certain times of the year. This migration is anonymous and requires an understanding of the overall ecology of the species. Currently, the white-eared Kob population exceeds half a million, making it the second largest migration in Africa, after the wildebeest migration in the Serengeti, Tanzania. Kobs occur in groups of five to forty depending on sex and age and are nocturnal but inactive on the hottest days. Rich grasslands and permanent water sources are the preferred habitats for the species. However, the decline in grassland potential, frequent hunting, expanding settlements, changes in land use and land cover are potential threats to the white-eared kob in Gambella National Parks. Therefore, understanding the total ecological, anthropogenic and behavioral variables that influence the movement and status of the species is the ultimate parameter for conservation activity. Furthermore, entire migration corridors require sustainable management by balancing stakeholder interests and rural community development through nature-based tourism. It is also noted that solid economic and environmental incentives through nature-based tourism require adequate protection in Gambella and the surrounding regions.
Oct 2023 DOI 10.14302/issn.2769-2264.jw-23-4694
Alotaibi MajebCorresponding author
This study aims to determine an empirical relationship between the biological and chemical oxygen demands of industrial effluent running through the membrane bio reactor-based Al-Hasa common industrial wastewater treatment Plant. The relationship between these two parameters was investigated over one month (NOV– 2021 to OCT-2022). The values of R² show that its impossible to predict the result of BOD5 based on COD, however the result of r in AUG month shows a strong relation between them. The average biodegradability index over the one year is less than 0.6, showing that effluent is highly polluted, and biodegradation will not proceed. The plant’s performance in terms of BOD5 and COD removal was very poor over the whole year, however, the months AUG, SEP and OCT months shows a satisfactory performance, this is because a large amount of Industrial wastewater entering the plant contains both organic and inorganic components.
Oct 2023 DOI 10.14302/issn.2769-2264.jw-23-4633
Adeba DerejeCorresponding author
Dams are built to produce electricity, store water for irrigation, control flood hazards and other uses. The operation of dam has a complicated problem, which includes multiple decision variables, several conflicting and contradictory objectives together with significant uncertainty and risk. The objective of this study was to make an impact assessment that Fincha’a-Amarti dam operation can bring on the downstream activity. Fincha’a-Amarti dam downstream irrigation water requirement was done by using CROPWAT software. The SWAT model was also used to model the watershed and simulate the flow. Meteorological data and spatial data of the study area were used as an input of the model. The meteorological stations considered were Shambu, Fincha’a, Homi, Nashe and Harato. The study shows that downstream water requirement greater than the existing downstream water release during the months of: January, February, March, April, May, September, October, November and December; but existing water release is greater than downstream water requirement during wet season only. Therefore, the study concludes that there is downstream water stress except during wet season.
Jul 2023 DOI 10.14302/issn.2691-6622.ijar-23-4578
Fleurette Moumegni Monthe LilianeCorresponding author
The growth characteristics of Conraua goliath (Boulenger, 1906), an endemic and endangered species in Cameroon, were evaluated in its natural habitat between October 2021 and November 2022 in order to contribute to its domestication and conservation. For this purpose, 139 specimens (55 males, 55 females, and 29 individuals of undifferentiated sex) were collected by fishermen from 3 sites (Loum, Penja, and Nlonako) in the Department of Moungo, Coastal Region of Cameroon. The frogs were measured, and their growth parameters were determined after dissection and macroscopic and microscopic observations. The maximum size observed is 33.5 cm (SVL) and 2529 g body weight (BW), and the minimum size is 5.3 cm (SVL) and 12 g body weight (BW). This species is more abundant in the rainy season, in frogs between 18 and 24 cm, and has a Caucasian and uni-modal size structure. Independent of sex and season, this species has a significant and high regression coefficient between length, weight, and isometric growth pattern. However, this growth varies according to sex. It ranges from isometric in males (b = 2.82) and undifferentiated sexes (b = 2.85) to negative allometry in females (b = 2.21). The condition factor K ranges from 3.28 to 14.24 (mean: 7.80 ± 1.95) and fluctuates according to the sex and size of the frog. According to our results, this species has a large size and a high growth rate and could therefore be an excellent candidate for domestication to ensure its conservation. However, studies on reproductive characteristics are needed to complete this work.
May 2023 DOI 10.14302/issn.2642-9241.jrd-23-4566
Krishna C VeligandlaCorresponding author
Safe and effective antitussive therapy remains a significant area of unmet need for cough management. Antitussive drugs are commonly used cough suppressants and include centrally acting (opioids and non-opioids) cough suppressants and peripherally acting antitussives. Authors searched PubMed, Google Scholar and additional studies from reference lists via cross-referencing to identify studies assessing levodropropizine for the treatment of cough. Of the 748 studies identified, 13 were included. Recent clinical evidence, guideline recommendations and findings from this review suggest that levodropropizine is a peripheral antitussive which reduces cough intensity, frequency, and nocturnal awakenings in children and adults and provides better efficacy outcomes with a more favourable risk/benefit ratio compared to centrally acting antitussive agents which pose greater safety concerns and present an unacceptable risk–benefit profile. This review is aimed at Indian primary care physicians for making effective cough management decisions where the clinical evidence needs to be translated to clinical practice. Key Messages The usage of currently available centrally acting antitussive agent is greatly limited by their central depressing action and frequent side effect. The findings of this review indicate that levodropropizine is an effective antitussive agent and well tolerated in the management of cough in patients of all ages.
Apr 2023 DOI 10.14302/issn.2644-1101.jhp-23-4473
W.G. Gruessner RainerCorresponding author
An opinion essay examines hospital immunity doctrines and alleged sham peer review, outlining legal context, patient‑safety implications, and avenues for due process.
Feb 2023 DOI 10.14302/issn.2639-3166.jar-22-4389
Haroun Mohamed Adam AbubakerCorresponding author
The greater wax moth (Galleria mellonella L.) is one of the most destructive insect pests that threaten apiculture. Laboratory experiments were conducted in the Research Laboratory, College of Agricultural Studies, Sudan University of Science and Technology during the period from the 2nd_ of April to 29th_ of October 2021 to evaluate the lethal effect of Bee glue (proplis) and Bacillus thuringiensis var. Kurstaki (Btk) on the G.mellonella. Five concentrations (5%, 7.5%, 10%, 12.5% and 15%) of proplis extract and (0.62,1.25,2.5,5 and 10 mg/ml) of Bt were used for each proplis extract and Bt in a Completely Randomized Design. Powder ethanol extract of proplis at 15% concentration caused 83.3% mortality after 96 hrs of application, where as 10mg//ml concentration of Bt gave 93.3% mortality after 72 hrs of exposure. The statistical analysis revealed significant differences between all treatments and control. Additionally, all treatments (proplis/ /Bt) increased the mortality %.
Jan 2023 DOI 10.14302/issn.2329-9487.jhc-22-4362
PIO MachihudeCorresponding author
Objective To describe the epidemiological, clinical and arterial Doppler ultrasound aspects of abdominal aortic aneurysm (AAA). Material and Methods This is a prospective study with descriptive and analytical aims carried out from January 2019 to March 2022 (3 years) at the cardiovascular exploration center (CEC) "Saint-Esprit" of the association of the people's doctors for the research on cardiovascular diseases (AMP-MCV), at the clinic "Le Printemps" and at the University Hospital of Kara. All patients who underwent arterial Doppler ultrasound of the lower limbs for any reason in these centers during the study period were included. Ultrasound scans were performed or confirmed by a physician with a diploma specializing in vascular Doppler ultrasound. Results We retained 32 Doppler ultrasound scans out of 739 performed for AAA with a frequency of 4.38%. The mean age was 73.5± 9.07 years. The sex ratio M/F was 1.4. The cardiovascular medical history (84.38%) found was: hypertension (33.33%), diabetes (18.52%), dyslipidemia (33.33%) and a combination of diabetes and hypertension (14.81%). The circumstances of discovery were: downstream MI ischemia (72%), incidental finding on abdominal ultrasound (15.63%) and De bakey sign (6.25%). The location of the aneurysms was subrenal (84.4%), suprarenal (9.4%) and both (6.2%). AAAs were fusiform (71.9%) and saccular (28.1%). The size of the aneurysms was greater than 5 cm in 78.17% of patients. High blood pressure increases the probability of the occurrence of subrenal AAA while dyslipidemia increases the occurrence of fusiform AAA. Diabetes increases the probability of occurrence of AAA larger than 7cm. AAAs were thrombosed in 75% of patients. There were extensions of the aneurysms to the iliac arteries in 70.59%. Downstream embolic complications represented 46.88%, in the form of occlusions and tight stenoses. Spontaneous mortality was 81.24%. Conclusion Arterial Doppler ultrasonography is a very important tool in the screening, positive and lesion diagnosis of AAA. The risk factors for AAA are: age over 60 years, male gender, hypertension, diabetes and dyslipidemia. Early detection remains essential, because the spontaneous prognosis is poor.
Mar 2022 DOI 10.14302/issn.2641-4538.jphi-22-4113
L ProvvidentiCorresponding author
Postgraduate School of Public Health, Department of MESVA, University of L’Aquila (Italy).
Objectives Our study aims to determine the trend of the antibody titer and assess the efficacy of the vaccine. Methods It was conducted on 983 healthcare professionals between 27 February 2020 and 22 October 2021 at the Local Health Authority (ASL) of Rieti. Workers voluntarily underwent serological testing before vaccination (T1), at least 15 days after vaccination (T2), and at least 150 days after vaccination (T3). We picked individuals who had received two doses of the vaccine. As for positivity, we assessed incidence – and therefore symptomatology – in three time intervals. We used a contingency tables for the analysis and tested the relation to the chi-square test and ANOVA test. Regarding differentials in terms of antibody capacity, we considered different time intervals: the methodological approach was the same. Results The average value of the dimeric serological testing at T1 was equal to 28.80 AU/mL, which increased to 220.55 AU/mL at T2, and then decreased to 143.62 AU/mL at T3 (P = 0.000). At T2, the number of people with a protective titer was equal to 95.96% of the total; at T3, it was equal to 96.39% (P = 0.019). Before the vaccination campaign, 75 workers tested positive (25 paucisymptoms, 4 severe symptoms). After vaccination, 14 workers tested positive: almost all were asymptomatic. Conclusion Vaccination determines a statistically significant variation of the average value of antibody titer, a statistically significant reduction of positive swab tests and a better prognosis.
Jun 2021 DOI 10.14302/issn.2474-3585.jpmc-21-3851
A. Njukeng PatrickCorresponding author
Global Health Systems Solutions, Douala, Cameroon
Background The rapid and ongoing spread of antimicrobial-resistant organisms threatens the ability to successfully prevent, control, or treat a growing number of infectious diseases in developed and developing countries. This study was designed to convey more insight on the profile of antimicrobial resistance and the capacity of laboratories conducting antimicrobial susceptibility testing in Cameroon. Methods A multicentre cross-sectional study was conducted from October 2019 to March 2020 in the Deido Health District. Laboratories that carry out culture and sensitivity testing within the Deido Health District were identified and assessed to determine their capacity as well as the quality of results from microbiological investigations. Information on antimicrobial susceptibility of various isolates was collected using tablet phones in which the study questionnaires had been incorporated. Results Gaps identified in antimicrobial susceptibility testing that cut across laboratories included; insufficient standard operating procedures, inadequate records on personnel training and competency assessment, lack of safety equipment such as biosafety cabinet, stock out and non-participation in external quality assurance program. The turnaround time for antimicrobial susceptibility testing ranged from 3 – 7 days. Out of the 1797 samples cultured, 437(24.3%) had at least one isolate. A total of 15 different isolates were identified with Candida albicans being the most frequent 178 (40.7%), followed by Escherichia coli 80(18.3%). Among the 15 classes of antimicrobial drugs used in this study, the overall resistance of the isolates showed that five classes had class median resistance above 40% (Cephalosporins, Penicillins, Beta-lactam, Macrolides, and Polyenes). Conclusion This study has shown the need to develop a coordinated national approach to fight antimicrobial resistance. Scaling-up of antimicrobial susceptibility testing will, therefore, require strengthening the microbiology units of laboratory systems as well as ensuring the use of laboratory data for decision making.
Mar 2021 DOI 10.14302/issn.2474-3585.jpmc-20-3557
E. ADETONA AdesojiCorresponding author
FWACP (LAB. MED), FMCPath, MPH (Health Policy and Management), MBBS; UCH, Ibadan
Background Breast cancer is one of the most common types of cancer affecting women globally. It has shown increasing morbidity and mortality rates over the past years. Several screening methods ranging from simple breast self-examination to a highly sensitive test procedures for early detection and treatment are available, but uptake is a challenge. Lack of a national screening programme in the country makes available regional screening programme unsuccessful. This study aims to assess the factors affecting the uptake of breast cancer screening programme among female staff in a tertiary hospital, Southwest Nigeria. Method This descriptive cross-sectional study involves 375 participants selected by a stratified random sampling technique, with proportional allocation to population size and the use of a semi-structured questionnaire. Respondents were questioned on their basic knowledge of breast cancer symptoms, risk factors and treatment, over a score of 50 and above, were set as the cut-off mark to determine good knowledge of breast cancer. Patients attitudes towards breast cancer screening as well as factors affecting uptake were also measured. Descriptive statistical analysis was done using SPSS-20 while the predictors of the uptake of screening were determined using logistic regression at p ≤ 0.05. Results There were 360 respondents, comprising of 13.3% clinical and 86.7% non-clinical female staff within the age bracket of 20 to 58 years (38.2±0.42 years). Out of the respondents, 97.8% have heard about breast cancer but only 52.3% had been screened while 65.5% had “Good knowledge” of breast cancer. Positive attitude to breast cancer screening was displayed in 52.5% while over 90% claimed to be practicing breast self-examination. Only 36.1% of respondents above 40 years old have had mammography done. Most frequent barriers to screening uptake include cost, poor accessibility to screening facilities, shyness (unfamiliar screener), unavailability of female doctors, careless attitude, fear of cancer and other more pressing family problems. Using logistic Regression at p ≤ 0.05, females with a negative attitude, young unmarried (less than 30years) and lack of easy accessibility to screening facilities were significant factors affecting uptake of breast cancer screening services. Conclusion Due to knowledge-uptake gap of breast cancer screening revealed in this study. It is therefore obvious from these findings that a concerted effort is needed to actively remove these barriers by repeated education, training and re-training strategies among health workers and to improve their uptake and level of advocacy and campaign for breast cancer screening among their patients and clients.
Oct 2020 DOI 10.14302/issn.2768-0207.jbr-20-3568
Mango LucioCorresponding author
Head for Higher Education in Healthcare, University of International Studies (UNINT) – Rome, Italy
The Coronavirus emergency represents an epochal challenge for all world health organizations. In these times of profound destabilization of healthcare organizations, become urgent some thoughts on how to deal with the organization and re-engineering process as well as on concepts, relatively new, such as "resilience" and "business continuity". The company management need having to predict, design and plan a profound process of change in their Clinical and Corporate Governance. With the implementation of phases 2 and 3 of management of the pandemic and the coexistence of doctors and citizens with the new Coronavirus, it has become a priority to develop territorial models of assistance to established or suspected Covid patients, starting with the creation of monitoring networks based on the model of the “sentinel” general practitioner. One of the main concerns of Healthcare, since the beginning of the Covid-19 emergency has been to get closer to the citizen-patient. It is therefore necessary to find stimuli to restart with new methods of care, new health and social-health services, moving the current care paradigm for Covid-19 from the hospital to the territory, optimizing the constituent elements of the districts, primary care and general practice in a multidisciplinary approach.
Sep 2020 DOI 10.14302/issn.2328-0182.japst-20-3526
Bekele AnbessaCorresponding author
Pharmacy School, Health Institute, Jimma University, Ethiopia
Background Self-medication (SM) can be defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. A number of individuals in developing countries do not attend physicians for their illnesses; instead they commonly use self-medication. Self-medication could be using drugs existing in home like over the counter (OCT) drugs, traditional medicine, prescription only drug. Self-medication is not always bad, hence for the over the counter drugs it is beneficial. Inappropriate storage and use of medicines at home could have a direct influence on public health, the environment and the health-care services and it increases the risk of self-medication. Objective To assess the practice of self-medication and drug storage among South Sudanese community in Addis Ababa. Materials and Methods A cross sectional study design was conducted in Addis Ababa city from April 22 to April 26/2019. Data was collected by semi structure-questionnaire consisting questions on general demographic, socio-economic as well as on perceived illness/ symptoms in the past four weeks and actions taken for it. The data collected was screened before it is analyzed. Data analysis was done by using calculator. Results From the total 297 respondents 286 (96.2%) had reported self-medication in the last one month before the study period. The most common types of ailments for which the respondents reported to have practiced self-medication were cough, cold and sore throat 90(30.3%), followed by headache 66(22.2%), diarrhea 52(17.5%) ,abdominal pain 47(15.8%), fever 21(7.07%) and vomiting 10(3.3%). The reasons given for self-medication were; the illness was minor 226(76%) and previous experiences with similar ailments 31 (10.4%) were found to be the two major reasons given by the respondents for self-medication in this study. The majority of the respondents 242(81.4%) who practiced self-medication obtained information on self-medication from friends and 29(9.7%) obtained information from family members. The most frequently used group of drugs used for self-medication were analgesics/antipyretics 177(59.5%) and antimicrobial which account 75(25.2%) each followed by antihelmenthics 24(8.08%).The main source of drugs for SM was in pharmacy 220(74.07%) followed by leftover drugs 41(13.8%) while drug retail outlet, and neighbors and relatives were the suppliers to 12.13% respondents each. Conclusion and Recommendation A significant number of respondents (96.2%) use S/M from those perceived illness. Majority of the self-medicated individuals used due to minor illness. The most common category of drugs used was analgesics/antipyretics and antimicrobials. And the reason reported for using S/M was minor illness and previous experience with the illness. Most of respondents obtained drugs easily from pharmacy. So, pharmacies are the major sources of drugs used for S/M. The increased of drugs storage to treat similar illness/symptom and drugs left over from previous use contribute to the increase in the S/M practice. Common drugs store reported by respondents who store modern drugs were analgesic/antipyretic. Most of the respondents stored the drug in locked cabinets. A lot is need to be done in educating the public including the health care providers on the type of illnesses that can be self-diagnosed and self-treated, the type of drugs to be used for S/M, and the proper use of drugs. During dispensing of drugs emphasis should be given to all drug consumers and dispenser because of resistance and side effects of drug is the main challenging problem even in the world. Food, Medicines and Healthcare Administration and Control Authority (FMHACA) needs to effectively implement laws on drug handling and dispensing so as to take necessary measures on illegal providers of drugs.
Sep 2020 DOI 10.14302/issn.2694-2275.jzr-20-3537
O AzuonwuCorresponding author
Department of Medical Laboratory Science, Medical Bacteriology/Virology/Parasitology Unit, Rivers State University, Nkpolu-Oroworukwo, Port Harcourt, Nigeria.
This study investigated the potential pathogenic bacteria that are associated with domestic dog stool in Port Harcourt Metropolis. Convenience sampling techniques were used for sample collection outcome. A total of fifty dog stool samples were collected aseptically into a sterile stool container from different locations (Agip Estate, Rumuokoro Community, Government Residential Area, Sand-fill Borokiri, Port Harcourt Township, and Rivers State University lecturers’ quarters) all within Port Harcourt City. Bacteriological analysis was determined using standard microbiological analytical and identification techniques. Statistical analysis was performed using Statistical Package for Social Science version 21 for frequency, percentage, prevalence rate and correlation at 0.01 and 0.05 level of significance. Potential pathogens with associated percentages that were isolated are E coli (20.0%), Klebsiella species (16.0%), Pseudomonas species (4.0%), Proteus species (28.0%), Bacillus species (4.0%), Staphylococcus aureus (14.0%), and unidentified [other Staphylococcus species] (4.0%). However, the research further revealed that Proteus species (28.0%), was the most prevalent pathogen, while Bacillus species (4.0%), Pseudomonas species (4.0%), and Streptococcus species (4.0%), were the least prevalent among pet dogs studied. The correlation analysis showed no significant relationship between isolates with socio-demographic data of pet owner and Pet biodata respectively. From the analysis, correlation coefficient values of .269 and .124 were obtained for Age of Pet Owner and Gender of Owner respectively. It also show a direct correlation but by implication, a very weak, non-significant (p<0.05) relationship existed between the organisms isolated and the variables (Age of Pet Owner and Gender of Pet Owner). However, no relationship exists between isolates and visit to vet Doctor (r-0.038; p>0.05). Furthermore, negative non-significant correlation (p>0.05) was observed for marital status of Pet Owner (r=-.158) and Age of Pet (r=-.023) and isolate. Also, correlation association between isolates and some risk factors using the correlation analysis matrix revealed an indication of an indirect but moderate association between isolates and Caressing (r=-.347, p=0.01). However, other risk factors like vaccination (r=.042), Feeding Pattern(r=.125), Pet Bathing (r=.220) and Eating with pet in same plate (r=.146), did not prove statistical significance at p>0.05. The results from the study strongly suggest that pet dogs carry potential pathogenic organisms in their faecal matter that can serve as a source of infection to the pet owners. It is, therefore, very critical that these pets should be treated and possibly vaccinated frequently, even as their faecal matters should be well disposed to prevent possible zoonotic infectious epidemic outbreak in our global communities.
Sep 2020 DOI 10.14302/issn.2470-0436.jos-20-3400
Abo Taleb EmanCorresponding author
Regional hospital for vitreo. Retina and eye care at Sana'a, Yemen
Aim To compare the efficacy of combined anti-VGEF (IVB) with steroids versus pure anti-VEGF for the treatment of macular edema secondary to retinal vein occlusion (RVO). Methods In this prospective study, 51 eyes were randomized into 2 groups according to treatment of clinically identified macular edema secondary to retinal vein occlusion within 4 weeks of onset: Group 1 (19 eyes) was given intravitreal Bevacizumab (IVB) (1.25mg/.05ml) + Triamcinolone (IVTA) (2mg/.05ml); Group 2 (22 eyes) was given pure intravitreal Bevacizumab (IVB) (1.25mg/.05ml) at baseline, at month 1, and at month 2. The outcome of the study represented the EDRTS letters gain, IOP change and (CRT) by using Spectral domain optical coherence tomography (OCT) at month 1, 2, 3 and 6 in each group. Both central retinal vein occlusion (CRVO) and branch retinal vein occlusion (BRVO) patients with at least 6 months FU were enrolled in the study. Results EDRTS letters gain was (20.37±15.28, 28.05±16.68, 35.16±17.12, 36.47±18.17) in group1 and (14.50±14.56, 18.41±14.56, 20.59±16.13, 21.06±15.72) in group2 at month 2,3 and 6 p value (0.18, .04, 0.004, 0.002). Mean IOP pre-injection (14.00±2.67) in group 1 and (13.5±5.89) in group 2. Group 1 has transient increase in IOP at month 1 and then return to baseline over 6 months. CRT from baseline to final FU decrease by 264.82 (µm) ±147.66 in group 1 and 308.42(µm) ±226.78 in group 2 with no significant difference between two group p value 0.57. There was no significant difference in EDRTS letters gain between CRVO patients and BRVO patients at month 1, 2, 3 and 6 p values (0.83, 0.23, 0.29, 0.13). Conclusion Early treatment macular edema in RVO patients by combined anti-VGEF+ steroid effectively improve functional outcome better than pure anti-VGEF injection.
Jul 2020 DOI 10.14302/issn.2691-6622.ijar-20-3490
Nsangou Amidou KpoumieCorresponding author
Department of Animal Sciences, University of Dschang, Cameroon
Zooplankton production and growth performance of post-larvae of common carp according to the level and frequency of fertilization with chicken droppings were studied between May and October 2017 at the IRAD pisciculture station in Foumban. To this end, two doses of hen droppings, namely 450 g/m3 (D450) and 600 g/m3 (D600), were each applied at two application frequencies (weekly (F2) and bimonthly (F1)). Thus, 1200 post-carp larvae were distributed in 12 identical concrete tanks (1.2m x 0.75m x 1m) each filled with 400 liters of water. The 2 doses applied at 2 frequencies were applied randomly in the 12 tanks in a complete random device comprising 3 treatments and 2 repetitions. Six days after fertilization, each tank was sown with zooplankton at a density of 7 individuals per liter (ind/l). The loading was carried out 12 days after fertilization at a density of 100 ind/m2. The results show that regardless of the dose and the frequency of droppings applied, the production of zooplankton was optimal 10 to 12 days after fertilization. Considering the growth performance, the tanks receiving the 600 g/m3 dose every 2 weeks presented the highest significant values (p <0.05). On the other hand, the survival rate (36% on average) was not significantly influenced (p˃0.05) by the dose and the frequency of fertilization. The 600 g/m3 dose applied every two weeks can be recommended for the rearing of post-larvae common carp.
May 2020 DOI 10.14302/issn.2637-6075.jpae-20-3305
A.J ThatheyusCorresponding author
PG & Research Department of Zoology, The American College, Madurai, Tamil Nadu, India.
Mosquitoes depend on blood meal for the development of their eggs into offsprings. By knowing the biting behaviour of mosquitoes, we may control mosquito-borne diseases and manage the mosquitoe menace successfully. The present study has been designed to study the biting behaviour of the filarial vector, Culex quinquefasciatus Say, in Madurai, Tamil Nadu, India from July to November 2006. This period was selected as mosquitoes are prevalent during this rainy season. Biting was more during September, October and November and the maximum of 28 caught/man/hour was recorded in November. It is predominantly an exophilic biter, but biting was also noticed as maximum inside the house during July in the study. The density of the biting population in the first floor was more than that of the second floor, which indicated the existence of vertical stratification in the biting behaviour of Cx quinquefasciatus.
Mar 2020 DOI 10.14302/issn.2690-6759.jpar-20-3285
G. Abraham DogoCorresponding author
Department of Veterinary Parasitology and Entomology, Faculty of Veterinary Medicine, University of Jos, Jos - Nigeria
The incidence of gastrointestinal parasites in Zebu and N’dama breeds known to be trypanotolerant cattle from some ranches in Jos Plateau was investigated at the peak of the raining season, August to October, 2018. A total of 150 cattle from some Ranches in Jos Plateau were randomly selected for faecal sampling out of which 85 were Zebu (Bos indicus) and 65 were N’dama (Bos taurus) breeds respectively. The samples were analyzed for ova of gastrointestinal parasites using the simple flotation and sedimentation techniques and the results were interesting. The strongyloids, Oesophagostomumradiatum had the highest incidence of 4.7% followed by the Trichostrongylus species with 4%. Fasciolagigantica and Haemonchusplacei both were 3.3%. Then Paramphistomumcervi 2%; bovine hook worm, Bunostomumphlebotomum 1.3%, Taenia saginata1.3%, Schistosoma bovis 1.3% and Nematodirusspathiger 0.7%. The incidence of nematodes, cestodes and trematodes in this study in the raining season was significant (p<0.05) and could pose production and economic threat to institutional farms and ranches in the development of livestock and dairy industries in Nigeria. There should be a strong policy on the control of gastrointestinal parasites in the country for farmers to benefit from their contribution in ensuring food security.
Jan 2020 DOI 10.14302/issn.2474-3585.jpmc-19-3146
K. Sharma SaritaCorresponding author
Associate Professor, Department of Community Medicine, Government Medical College Nagpur
Background Emotionally intelligent doctors are better able to perceive the need of the patient. In today’s world, where patient satisfaction is one of the most important criteria for a successful medical practice, emotional intelligence of doctors plays a vital role. Objectives To study emotional intelligence of post graduate medical students. Methods It is a cross-sectional study conducted in Government Medical College and Hospital, Nagpur during January- February 2019. The study participants were one hundred first - year post graduate students. Data collection was done using quick emotional intelligence self administered questionnaire. Data was entered in Microsoft office excels and analyzed with the help of epi info. Results In the present study total 100 post graduate students were assessed of which 56% were male. Emotional awareness and emotional management was better in male post graduate students in comparison with the females and the difference was found to be statistically significantly. The scores of the other two domains were almost equal in both. More than half of the study participants had a satisfactory EI score i.e. 25-34. Conclusion Male post graduate students had better EI. Most of the study participants had a satisfactory EI score.
Dec 2019 DOI 10.14302/issn.2690-6759.jpar-19-3081
Ibrahim SangaréCorresponding author
Institut Supérieur des Sciences de la Santé, Université Nazi BONI, Bobo-Dioulasso, Burkina Faso
Malaria and typhoid fever are two endemic infectious diseases in developing tropical countries including Burkina Faso. There are two distinct infectious diseases with many similar clinical signs. In each sanitary area, it is important to describe the "typhomalaria" epidemiology to elaborate adequate diagnosis algorithm and efficient treatment protocol. A cross-sectional study was carried out from July to October 2014 in the lab department of University Hospital Souro SANOU, Bobo-Dioulasso. All microscopy positive malaria during the study period was included. Serodiagnosis of Widal and Felix was performed systematically in all Plasmodium spmalaria cases. Titers of antibodies anti-agglutinin O equal or higher than 1/400 and/or 1/800 for anti-agglutinin H antibodies were considered positive for Salmonella sp. A total of 283 malaria cases were included in this study, majority falciparum malaria. In this malaria cases, 91 patients were seropositive for Salmonella sp. "Typhomalaria" co-infection prevalence was 34.3% (CI 95% (28.8%; 40.1%)). The patient with the normal hemoglobin rate had the highest prevalence of co-infection (46.7% versus 30.9; p=0.02). Malaria and typhoid fever co-infection was high (approximately 1/3 of malaria cases) in University hospital of Bobo-Dioulasso. This study revealed the need to explore typhoid fever in malaria confirmed cases, especially in persistent fevers and non-anemic situation despite adapting antimalarial treatment.
Oct 2019 DOI 10.14302/issn.2691-6622.ijar-19-2991
H Radwan ECorresponding author
Zoology Department, Faculty of Science, Damanhour University, Egypt
The purpose of this study is to evaluate the impact of organic pollution of EL-Mahmodia canal on the fish (Oreochromis niloticus)muscles tissues collected from two sites at EL-Mahmodia canal in summer and winter 2017. EL-Mahmodia canal is exposed to excessive of effluents which impact fish. The present results showed high concentrations of organic pollutants, particularly in winter. Organic pollutants were analyzed using the gas-chromatography-mass spectrometry (GC-MS). A variety of environmental screening studies concerning varieties of water pollutants in Egypt, the target of the present study was to scan the organic pollutants of El-Mahmodia stream at El-Beheira Governorate, Egypt within the muscles of Tilapia fish. Within the present study, it was found that; the analysis of fish muscles in summer season showed a high level of organic pollutants. The organic pollutants that are reported in the muscle of fish in the polluted site were reported as; Dimethomorph-(E), Hexestrol, Diisobutyl phthalate, Diamyl phthalate, Di-n-propyl phthalate, Chlorpyrifos, Phorate sulfoxide, Exaltolide (15-Pentadecanolide), Chlorfenapyr, Pyridate, Ethofumesate, Bis (2-ethylhexyl)phthalate, Dicyclohexyl phthalate, Di-n-octyl phthalate, Tricresylphosphate, meta-, XMC (3, 4-Dimethylphenyl N-methyl, XMC (3,5-Dimethylphenyl N-methyl, Hexestrol, Thymol, Kinoprene, Diisobutyl phthalate, Diisobutyl phthalate, Di-n-hexyl phthalate, Di-n-hexyl phthalate, Carbofuran-3-keto, Tefluthrin, cis-, Carbofuran-7-phenol, Carbofuran, Dicyclohexyl phthalate, Di-n-propyl phthalate, Di-n-propyl phthalate, Bis(2-ethylhexyl)phthalate, Ethofumesate, Hexestrol, Kinoprene, Di-n-hexyl phthalate, Exaltolide (15-Pentadecanolide), Spiroxamine metabolite (4-tert-b), Chlorfenapyr, Tricresylphosphate, para, Tricresylphosphate, meta-, Tricresylphosphate, ortho-, XMC (3, 5-Dimethylphenyl N-methyl, XMC (3,4-Dimethylphenyl N-methyl, Fluroxypyr-1-methylheptyl ester, Cashmeran, Propargite metabolite (Cyclohexa), and Quinoclamine. The present results showed that Diisobutyl phthalate, Bis(2-ethylhexyl)phthalate, Pyridate and Ethofumesate were detected in winter season in the polluted site, whereas, Bis (2-ethylhexyl) phthalate, and Pyridate were the only organic pollutants that were found in winter in the reference site. The accumulation patterns of organic pollutants percentage in the polluted site in summer in the muscles of O. niloticus were in the following order: Chlorpyrifos> Diamyl phthalate> Diisobutylphthalate> Di-n-butylphthalate> Diamyl phthalate> Bis (2-ethylhexyl) phthalate, whereas, in the reference site in summer, it was Chlorpyrifos> Chlorfenapyr> Di-n-butylphthalate> Diisobutylphthalate> Hexestrol> Di-nhexyl phthalate. The accumulation patterns of organic pollutants in the polluted site in winter in the muscles of O. niloticus, were in the following order: Bis(2-ethylhexyl)phthalate> Pyridate> Ethofumesate, whereas in the reference site it was; Bis (2-ethylhexyl)phthalate> Pyridate.
Sep 2019 DOI 10.14302/issn.2641-4538.jphi-19-3005
Rutayisire ErigeneCorresponding author
Mount Kenya University, School of Health Sciences, Department of Public Health, P.O. Box 5826, Kigali Campus, Rwanda
Background Globally, about 10 to 25% of the volume of bio-medical waste from hospitals and healthcare institutions presents a serious health risks to patients, healthcare personnel, and anybody who comes in contact with it. The waste management practices in Rwanda healthcare facilities are poor and need improvement. Objectives To assess the knowledge and practices regarding bio-medical waste management among healthcare personnel at Kabgayi district hospital in Southern Province of Rwanda. Materials and Methods A cross-sectional study design was conducted. A total of 200 healthcare personnel were selected randomly out of 400 target population including doctors, nurses, social workers, and cleaners. Structured questionnaire was used to collect data. Descriptive analysis using frequency and proportions were used. Chi-Square test was used to determine the association between the variables and level of significance was set at p ≤ 0.05. Results The study found that about half (49.0%) of healthcare personnel had good knowledge about waste management. We found that the majority of healthcare personel 133(66.5%) had poor practices towards bio-medical waste management. The factors associated with good practice were better knowledge on bio-medical waste management (p=0.013) and older age group (p=0.001). Conclusion/Recommendations The level of in both knowledge and practice towards bio-medical waste management among healthcare personnel was low. Continuing education and training programmes and short courses on bio-medical waste management should be carried out to improve the knowledge and practices towards bio-medical waste management among healthcare personnel.
Aug 2019 DOI 10.14302/issn.2470-5020.jnrt-19-2983
Léhleng AGBACorresponding author
Neurology Department, University Hospital Center of Kara, Kara University, PoBox 18 Kara (Togo)
Although it is a vaccine-preventable disease, tetanus is frequently found in sub-Saharan Africa. Because of its rarity, this disease poses two problems for doctors of the 21st century: to make early diagnosis in order to refer patients to appropriate care structures, and to continue to ensure correct prevention of an affection that few current doctors have met. In it generalized form, the diagnosis of tetanus is easy, but when the beginning is localized, tetanus can be change with other diseases leading to a diagnostic wandering and a delay of adequate management. We report a case of tetanus in an 18-year-old male, who was received for neck pain and stiffness of the neck with a positive Kernig sign associated to fever since 48 hours. Initially treated for meningitis, the patient will develop at day 3 of hospitalization, the signs of generalized tetanus which led to evoked the diagnosis of tetanus. This diagnosis was reinforced by the notion of a rusty nail injury to the soles of the right foot 3 weeks before hospitalization and the absence of anti-tetanus vaccination. After using tetanus serum and vaccination with antibiotics (Metronidazole and Penicillin) and Diazepam in association with stripping of the wound under the foot, the patient was improved. This case illustrates that any neurological sign with the first trismus must evoke until proof of the contrary, a tetanus especially in case of association with a wound even if the immunization schedule is up to date.
Jun 2019 DOI 10.14302/issn.2377-2549.jndc-19-2765
Heidari AlirezaCorresponding author
Faculty of Chemistry, California South University, 14731 Comet St. Irvine, CA 92604, USA
Tetrodotoxin (TTX) is a potent neurotoxin. Its name derives from Tetraodontiformes, an order that includes pufferfish, porcupinefish, ocean sunfish, and triggerfish; several of these species carry the toxin. Although tetrodotoxin was discovered in these fish and found in several other aquatic animals (e.g., in blue–ringed octopuses, rough–skinned newts, and moon snails), it is actually produced by certain infecting or symbiotic bacteria like Pseudoalteromonas, Pseudomonas, and Vibrio as well as other species found in animals. Parameters such as FT–IR and Raman vibrational wavelengths and intensities for single crystal Tetrodotoxin (TTX)are calculated using density functional theory and were compared with empirical results. The investigation about vibrational spectrum of cycle dimers in crystal with carboxyl groups from each molecule of acid was shown that it leads to create Hydrogen bounds for adjacent molecules. The current study aimed to investigate the possibility of simulating the empirical values. Analysis of vibrational spectrum of Tetrodotoxin (TTX) is performed based on theoretical simulation and FT–IR empirical spectrum and Raman empirical spectrum using density functional theory in levels of F/6–31G*, HF/6–31++G**, MP2/6–31G, MP2/6–31++G**, BLYP/6–31G, BLYP/6–31++G**, B3LYP/6–31G and B3LYP6–31–HEG**. Vibration modes of methylene, carboxyl acid and phenyl cycle are separately investigated. The obtained values confirm high accuracy and validity of results obtained from calculations. Molecular structure of Tetrodotoxin (TTX) 1–42.
May 2019 DOI 10.14302/issn.2328-0182.japst-19-2738
BARON AuroreCorresponding author
USMP Fleury Merogis, CH Sud Francilien
Rationale Prisons are major reservoirs of hepatitis C virus (HCV) in which a therapeutic approach has been particularly difficult so far. Prevalence of viral hepatitis C (HCV) is higher in prison environment in France than in the general population and is estimated to be 4,8%. The impact in prison environment is little-known as based on local studies. Inmate health care falls under USMP (prison setting medical unit), hospital specific units as by the january 18, 1994 law. Access to antiviral c treatment for inmates has always been difficult in France, would it be for interferon and ribavirin or use of protease inhibitors, with less than 20% of treated patients. French recommendations for HCV screening recommend systematic screening of inmates. The arrival of all oral therapies by direct antiviral agents (DAA) with shorter treatment times was an opportunity for doctors to propose a treatment and the patient to accept it. In 2014, the French guidelines recommended that HCV carriers in prison should systematically be treated independently of the stage of fibrosis. Objective of the Study PH8 Our objective was to evaluate the completion rate of an 8-week antiviral C treatment by sofosbuvir / ledipasvir regimen in non-cirrhotic genotype 1 patients in deprivation of liberty and achieve sustained virological response (SVR) and to measure the effectiveness of an 8-week treatment (by protocol analysis). Methodology prospective non-interventional multicenter trial among inmates with chronic hepatitis C genotype 1 with METAVIR fibrosis score F0 to F2 and who will receive a daily combination of sofosbuvir / ledipasvir for 8 weeks. Results 6 prison medical units included 115 consenting patients: there were 81% men, mean age 41 years (21 to 64 years). Route contamination was drug injection for 85%. HCV genotype was 1a for 74%, 1b for 24% and 2% none differenciated 1. Fibroscan mesure was available in 89 patients (mean score 3,5 KPa). Fibrotest was available in 37 patients with mean value 0.21. Eleven patients had Fibroscan and Fibrotest; 69% of patients were F0, 22% F1 and 9% F2. Average time between diagnosis and start of treatment was 3 weeks. We are sure that 109 patients (95%) completed DAA 8 weeks treatment; only 2 stopped DAA treatment before 8 weeks and 4 had no follow up after end of detention. HCV viral load was measured at W2 for 90 patients (78%), at W4 for 92 patients (78%), at end of treatment for 92 patients (78%), one month after treatment for 90 patients (78%) and 3 months after for 95 patients (93%). Only one viral load was positive, one month after treatment. Patient was retreated by sofosbuvir / velpastasvir. All HCV viral load 3 months after treatment negative; one patient took DAA only 6 weeks was cured. Conclusions In these study PH8, we observed completion rate of 94% for included patients in patient with 8 weeks ledipasvir/sofosbuvir regimen; data missed for only 4 patients and one relapsed. Short DAA treatment was efficient in prisoners and could be preferred in specific population.
Dec 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2333
Joseph Afe AbayomiCorresponding author
Community Medicine Department, Equitable Health Access Initiative, Lagos, Nigeria
Introduction: The introduction of preexposure prophylaxis (PrEP) against incident HIV infection has changed the epidemiology of disease as continuous treatment with tenofovir and emtricitabine among high risk groups can reduce the relative risk for incident HIV infection by over 90%.However,despite the approved use of TDF+FTC, as a fixed dose combination of emtricitabine 200 mg and tenofovir disoproxil fumarate 300 mg, for oral PrEP since 2012 , it does not appear to have become widely accepted and in use among healthcare workers especially those in low income countries. Researches are therefore needed to consider the awareness and practice of health workers towards the availability of PrEP services in this part of the world. Healthcare workers are expected to be promoters of the use of PrEP services. Method: A cross sectional questionnaire-based study conducted in southern Nigerian over a 6 months period. Data were collected from 250 healthcare workers using interviewer-administered questionnaires. The data analysis was done using statistical package for the social sciences (SPSS) for windows version 20.0 software (SPSS Inc; Chicago, IL, USA). Frequency counts were generated for all variables and statistical test of significance was performed with chi-square test. Significance was fixed at P < 0.05 and highly significance if P < 0.01. Results: A high proportion of the respondents(>60%) were highly educated healthcare workers(majorly Nurses and medical doctors) and about half (55%) having at least 10yrs working experience in the health sector with most especially on the HIV program(>90%), majority (94%) of the health workers were aware about ARV pre-exposure prophylaxis but very few ( 6% )could give the standard definition for PrEP as the use of ARV drugs by HIV negative persons to prevent the acquisition of HIV.Most(67%) of them gave wrong definition for PrEP and worse still about one fifth (20%) had no idea what PrEP was all about. Most (70%) could not correctly identify all the ARV drugs in a standard PrEP regimen while about 35% had no idea at all of the approved ARVs used for PrEP. Though PrEP services was not available at any of the facilities where the respondents were working ,the approved drugs(TDF+FTC) for PrEP were available at about 40% of the health facilities(public and private) and 15% community pharmacies in the vicinity of the respondents . Only 60% of the respondents were willing to access PrEP service for themselves if indicated while 35% would not use such services even if it is indicated for reasons which include concern about adverse effects and safety.Awareness of PrEP was significantly associated with the ability of the healthcare workers to identify the correct ARV regimen, ARV dosages and also correct indication for PrEP. Awareness was also associated with the knowledge of the correct proven efficacy for PrEP(>95%) and high likelihood of seeing a patient placed on PrEP and willingness to use PrEP based on personal indication Conclusion: The level of awareness of PrEP among healthcare workers was very high at about 90% yet many(60%) could not give correct standard definitions of PrEP, PrEP ARV regimen, dosages and level of efficacy of PrEP. Also none of the respondent had PrEP services available either at their center or any known referral centers. This is unacceptable in a country with second highest HIV burden in the world and has adopted PrEP in her national HIV guideline with ongoing PrEP demonstration studies. The few healthcare workers who were able to mentioned this information were more likely to have seen a patient placed on PrEP and were more willing to use PrEP based on personal indication. Recommendations: There is need to deepen the and knowledge of PrEP among healthcare workers especially those in poor resource settings by engaging them through update courses outreach, educational resources, campaigns/seminars and workshops and various job aids. All healthcare service providers should be very comfortable to carry out HIV risk assessment of their clients and provide PrEP to those indicated directly or indirectly through referral
Nov 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2359
Gedik HabipCorresponding author
Department of Infectious Diseases and Clinical Microbiology, Health Sciences University, Bakırköy Sadi Konuk Training and Research Hospital, İstanbul, Turkey.
Objective: This study aimed to assess the knowledge and attitude levels of pediatricians in terms of the pertussis vaccine. Materials and Methods: A survey study was carried out to evaluate the knowledge and attitude levels of pediatricians working in Istanbul in terms of the pertussis vaccine between May 1, 2015 and July 1, 2015. Results: A total of 104 pediatricians who comprised of 53 male and 51 female physicians, participated in this study. It was found that 35.6% of them at low-level, 51% at middle-level and 13.5% at a high-level of knowledge. The knowledge-level scores of the pediatricians who had children were significantly higher than those of pediatricians who had not a child on pertussis vaccine. Moreover, the knowledge-level scores of the specialist doctors in terms of the pertussis vaccine were significantly higher than those of the assistant doctors. It was significant that pediatricians who had children suffering from chronic diseases had greater knowledge-level scores in terms of the pertussis vaccine than those who had children without any disease. Conclusion: The knowledge and awareness of physicians in terms of the pertussis vaccine should be increased with in-service trainings, as the surveyors presented an insufficient knowledge level.
Sep 2018 DOI 10.14302/issn.2328-0182.japst-18-2281
Ali Arain AshiqueCorresponding author
Assistant Professor of Pharmacology.
The role that Vitamin D plays in human health is no more hidden in this modern age where every individual carries the knowledge treasure in the pocket (The internet) but the unjustified deficiency or insufficiency is still a research question waiting for the answer from research community all over the world. Normal levels (30-50 ng/ml) are necessary for the development of teeth and bones in children and bone mineralization in adults. The deficiency or insufficiency causes rickets, arthralgia, arthritis, osteoporosis and Osteomalacia. Study Design: Observational study. Study Setting: Department of Orthopedic LUMHS Jamshoro. Study Duration: from April 2017 to Oct 2017. Sampling: 600 patients were selected through Consecutive sampling. Statistical Analysis: Descriptive statistics like mean, Standard deviation, minimum, and maximum were calculated Using SPSS version 22.Mean of two genders was compared using t-test setting <0.05 as level of significance. Results: Mean serum vitamin –D level was 16.11+10.07ng/ml in men while it was 16.63+11.73 ng/ml in women. 62% of the study population was found deficient (<20ng/ml) while 16.33% were having insufficient levels (<30ng/ml) and only 12% showed normal levels (30-50ng/ml). There was no significant difference between the two genders, p value 0.59 Conclusion: Vitamin –D deficiency is very common in both genders with no significant difference between males and females.
Aug 2018 DOI 10.14302/issn.2324-7339.jcrhap-18-2202
AA OkechukwuCorresponding author
Department of Pediatrics, University of Abuja Teaching Hospital, Gwagwalada.
Background: Ideally, disclosure of HIV status to infected children and adolescents should involve both health care workers and parents/caregivers. Most studies on disclosure in children have focus mainly on parents/caregivers with little information on health care workers. We conduct this study to evaluate the practice, perception of the healthcare workers in our health facility on disclosure to infected children and adolescents. It is envisaged that such information will help in the design of better strategies on disclosure in our environment. Methods: A cross sectional hospital based study was conducted among health care workers at the special treatment clinic, and heart to heart unit of the University of Abuja Teaching Hospital, Gwagwalada from January to March 2017 for the above objective. A structured questionnaire was used to collect information on disclosure among the healthcare workers, which include among others: their bio-data, knowledge, perception, and practice on disclosure in the two service areas of the hospital. Results: Of the 80 health care workers interviewed, 60(75.0%) were females, 11(13.8%) were doctors, 9(11.3%) nurses, 17(21.3%) monitoring/evaluation/record clerks, and 16(20.0%) were either voluntary counseling and testing counselors or adherence counselors. Their mean age and duration in service in the two areas were 39.70±7.10 and 7.93±4.99 years respectively. Over half 48(60.0%) of the health care workers were unaware of the hospital having guideline on disclosure, 64(80.0%) have not been trained, and 68(85.0%) does not know any key information on disclosure. While all 80(100%) felt that disclosure was a good practice for better adherence, only 16(20.0%) had actually disclosed, with 6(37.5%) not seeking any formal permission from parent/caregivers before disclosing. Ages 8-16 years was recommended by 60(75%) as the appropriate age to disclose, however 28(35.0%) recommended age 14-16 years. Over half of the respondents 58(72.5%) admitted that disclosure should be a shared responsibility between themselves and the caregivers, most however perceive their role as only preparing the parents/caregivers for disclosure, and providing ongoing counseling to both the parents/caregivers and the children and adolescents. Lack of training on disclosure, and none availability of guideline in the health institution were major setback on the ability of the healthcare providers to fully participate in disclosure process. Conclusion: While healthcare providers support the idea of disclosing at mid and late adolescent, their perceived role was that of support and provision of ongoing counseling. Lack of training and none availability of disclosure guideline affects their perceived role. There is need to train and retrain healthcare workers on disclosure guideline, and making such guideline available in the health facilities.
Aug 2018 DOI 10.14302/issn-2470-0436.jos-18-2222
B. Iguban EleonoreCorresponding author
Department of Ophthalmology and Visual Sciences, University of the Philippines Manila, Philippines.
Objective: The aim of the present study is to determine the efficiency of third year ophthalmology residents from a tertiary hospital in performing preliminary retinal examination to identify eyes at risk retinopathy of prematurity on the basis of retinal fundus findings up to International Classification of Retinopathy of Prematurity (ICROP) Zone II. Methods: This is a single-center, cross-sectional, prospective comparative research conducted from June to October 2015 at a tertiary training hospital in the Philippines. All infants referred for retinopathy of prematurity screening within the study period where included. The presence of retinal vessel dilatation and tortuosity were identified by third year ophthalmology residents using indirect funduscopy. The residents’ fundus findings were then compared to that of a retina consultant who is proficient in the diagnosis and management of retinopathy of prematurity (ROP). The Kappa index was used to rate inter-observer agreement. The correlation between ROP risk factors and the presence of abnormal retinal vessels were assessed using odd ratio computations. Fisher’s exact test was used to determine the correlation between retinopathy of prematurity and the presence of retinal dilatation and tortuosity. The McNemar’s test was also applied to determine significant differences in the retinal findings of the consultant and ophthalmology residents. Results: A total of 82 eyes of 41 premature infants were evaluated to determine if retinal findings observed by ophthalmology residents were comparable to that of a retina consultant. Odds ratios show that age of gestation, birth weight, and history of blood transfusion are significantly associated with the presence of retinopathy of prematurity. Retinal vessel tortuosity and dilatation are also more common among infants diagnosed with retinopathy of prematurity. There was no significant difference between the retinal vascular findings of the retina consultant and the third year ophthalmology resident in terms of identifying retinal vessel dilatation and tortuosity (P < 0.05). Conclusion: After sufficient and in-depth ophthalmology training, third year ophthalmologists, who will be general ophthalmologists in the future, can reliably identify eyes at risk for severe retinopathy of prematurity on the basis of retinal vascular dilatation and/or tortuosity.
May 2018 DOI 10.14302/issn.2381-862X.jwrh-18-2090
Yao Gbagbo FredCorresponding author
University of Education Winneba, Department of Health Administration & Education. P.O. Box 25 Winneba, Ghana.
Background: The Ghanaian culture expects women of reproductive age to reproduce. This makes pregnancy an acceptable occurrence in most tertiary institutions in Ghana. Although Ghanaian Universities allow pregnancy in school, challenges associated with pregnancies do not exempt pregnant students from following the academic requirements of the universities. This study therefore explores students’ experiences of copying with pregnancy in an academic environment in Ghana. Methods: This was a case study, quantitative and qualitative design using structured questionnaires and semi-structured interview guides respectively for data collection. Respondents comprised twenty (30) pregnant full time and part time female students from campuses of University of Education, Winneba. Data collection was between October 2016 and May 2017. Quantitative data were analysed using statistical package for social sciences (SPSS) version 23. The qualitative data was transcribed and manually analysed thematically. Results: The study found that majority of participants were adults between ages 26 and 30 years. More than half of them (66.7%) had no child and this was their first pregnancy which they felt was mistimed as it occurred during schooling, posing some physiological, financial and academic challenges which compelled students to devise various coping strategies to combine academic work and pregnancy amidst limited University provisions for pregnant students. Conclusions: The study results have policy and programme implications for meeting women’s needs for pursuing academic and reproductive goals concurrently. The study recommends that public universities in Ghana should institutionalise programmes on preconception counselling and coping with pregnancy in academic environment to enable female students make informed decisions on exercising their reproductive rights in whilst in the university to ensure positive maternal health outcomes.
Feb 2018 DOI 10.14302/issn.2329-9487.jhc-18-1932
Erne PaulCorresponding author
Faculty of Biomedical Sciences, Universita della Svizzera Italiana, Lugano, Switzerland
The aim of this study was to assess the use of ambulatory acoustic cardiography during the initial data collection of the longitudinal study of a rural population in Switzerland (n=297, mean age 48.9 ±16.5 years, 57% female). Ambulatory acoustic cardiography non-invasively can assess sleep disordered breathing (SDB) and provides markers of left ventricular systolic and diastolic dysfunction. The percentage of the third heart sound detected during sleep decreased significantly across age groups (age < 40 years, 40-60 years, > 60 years) for both genders (males, p=0.04; females, p=0.02). The percentage of a fourth heart sound detected exhibited an increasing trend for both genders with age suggesting increased diastolic dysfunction with aging. Mean electromechanical activation time (EMAT) during sleep was within the normal range across age groups and both genders (male 93.7 ± 11.6 ms, female 94.6 ± 13.0 ms), and did not vary significantly with age. A large proportion of subjects had a high likelihood of sleep disordered breathing (17.6%). Baseline characteristics categorized by SDB severity indicate increasing age, male gender and being overweight (BMI ≥ 25) to be associated with greater SDB severity. Acoustic cardiography findings categorized by SDB severity reveal increased nocturnal non-dipping heart rate, presence of atrial fibrillation, prolonged QRS duration and QTc interval, increased percentage of fourth heart sound detected, and longer EMAT to be significantly associated with greater SDB severity. Overall, acoustic cardiography detected a very low prevalence of systolic dysfunction, age-related increases in diastolic dysfunction and a moderate prevalence of sleep disordered breathing.
Dec 2017 DOI 10.14302/issn.2576-6694.jbbs-17-1869
de Cassia Stocco RitaCorresponding author
Genetics Laboratory, Butantan Institute, São Paulo-SP, Brazil
Introduction Bovine papillomavirus (BPV) is the etiological agent of bovine papillomatosis, infectious and neoplastic disease, characterized by the presence of multiple papillomas that can regress spontaneously or to persist and progress to malignancies when in association with environmental cofactors. Although recognized that the BPV can induce DNA damages, the viral role following cancer initiation remains unresolved. Based on this, we stablished cell lines derived from cutaneous papilloma, fibropapilloma and esophageal carcinoma to study the BPV action on epithelial-mesenchymal transition (EMT). Our results showed strong evidences that the virus action can contribute to EMT and, therefore, metastasis. Aim In this study, we analyzed the expression levels of the EMT markers (cytokeratin 10, STAT3 Y705, Oct-3/4 and vimentin) in paraffin-embed samples, using the same tissues that originated the cell lines previous studied, aiming to validate the results observed using cell lines. Material and Methods Expression levels of these markers was analyzed by immunohistochemistry and the collagen composision by Picrosirius red staining. Results We verified an overexpression of these markers in fibroblastoid cells present into the epidermis and ketarinocyte-like cells into the dermis present in dermo-epidermal junction. These data reinforce our previous results using cell cultures, validating both systems (cell culture and paraffin-embed tissues) as useful models to study the natural history of BPV-infected lesions. Conclusion Altogether, the results from these systems indicate that the BPV promote the cancer progression and metastasis through the transdifferentiation of an epithelial to mesenchymal cells (EMT).
Nov 2017 DOI 10.14302/issn.2324-7339.jcrhap-17-1679
Tesfahuneygn GebrehiwetCorresponding author
Tigray health research institute, Mekelle
Background: Point-of-care diagnostic tests (POCTs) are increasingly used in both developing and developed countries. They allow same day testing and treatment at remote locations where no laboratory support is available. Quality control measures, which are routinely used in laboratories, have not been widely implemented for POCTs. This aimed to assess the integrity of the entire laboratory testing process, and aims to educate and improve performance in quality of HIV rapid testing. Methods: A health facility based cross section study was conducted from April to June 2016.Randomly selected health facilities were participated in the external quality assessment. Onsite evaluation and panel test were used to collect data using structured checklists and formats. Data was entered and analyzed using SPSS version 16. Results: Between April to June 2016, a total of 60 health facilities (145 testing points) from governmental health facilities (hospitals and health centers) were participated in the study. Among the participated testing points 41% have no designated area, 40% have no clean water for hand washing and 51% have no national test algorithm. The average performance of testing points was varies from 89.6% to 99.1% (Laboratory 99.1%, ANC 90.4%, TB clinic 91.4% and VCT 89.6%). In a multivariable logistic regression model, didn’t follow national testing algorithm to report client test results have statistical significance. Conclusions: High quality test results underpin accurate diagnosis and appropriate treatment for patients. But in the study area the score of proficiency testing result and coverage of training is slightly low comparing to other findings. Therefore following national testing algorithm to report client test results, training and monitoring are critical points to improve the proficiency testing score of testing points.
Aug 2017
Toren OrlyCorresponding author
Hadassah Hebrew University Medical Center, Mount Scopus
Aim: To assess the extent and directions of internal hospital turnover of registered nurses and to examine the associated factors and stressors. Background: Internal turnover of hospital nurses is mainly horizontal. Occurring on a large scale, it could lead to dropout of skilled personnel, burdening hospitals both financially and in terms of human resources, affecting the quality of care. Methods: A secondary analysis based on data from the national study on "Patterns and trends of the nursing workforce in Israel". A structured telephone interview was conducted of 2,098 hospital nurses (October 2008-February 2009). Results: The rate of internal turnover between hospital departments was 29.7%. The main departments from which nurses moved were medical and surgical. The main departments from which nurses moved were oncology departments, Intensive Care Units, nursing administration. The major work-related stressor concerned salary (59%), two predictors of internal turnover were nurses with children under the age of 18 and academic degree nurses. Conclusions and Implications for Health Policy: Internal turnover rate in Israeli hospitals is moderate, with high rates in medical and surgical departments. It is vital to identify the main factors associated with high turnover rates and implement focused managerial retention strategies and other intervention programs.
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-16-1354
Frumence GastoCorresponding author
Department of Development Studies, School of Public Health and Social Sciences, Muhimbili University of Health and Allied Sciences, Tanzania.
Tanzania is among the developing countries experiencing rapid growth of an ageing population, which has an implication in healthcare expenditure especially in resource poor settings where majority of elderly people cannot afford to pay for the cost of accessing health services. The country has developed the Tanzania National Health Policy (2007) and National Ageing Policy (2003), which, among other things, recognize the importance of having a healthcare system that provides free basic services to the vulnerable elderly population. This study aimed at exploring health service providers’ and managers’ perspectives on the factors facilitating or prohibiting access to health services among elderly people in Tanzania. The study adopted a qualitative approach and data were collected using semi-structured interviews. A total of 24 in-depth interviews were conducted with district healthcare managers, heads of public healthcare facilities, and health service providers. The data generated were analysed for themes and patterns. The results show that Tanzania’s healthcare system has made some efforts to implement the national exemption policy to ensure better access to health services for the elderly. Some of these efforts include: having in place a system to identify and exempt elderly people from paying for health services and giving them special priority during treatment. However, there are some barriers hindering elderly people’s access to health services. Among others include: lack of specific consultation rooms and doctors for serving the elderly, and lack of sufficient drugs and other medical equipment in most government-owned healthcare facilities. In summary, the healthcare system has created a good environment for the implementation of exemption policy aiming at enhancing accessibility of health services among the elderly population in the country. However, such environment cannot function effectively without addressing the identified barriers. It is recommended that the government should allocate adequate human and non-human resources to the healthcare system to enable it to function effectively, including the provision of health services to the elderly.
Jun 2017 DOI 10.14302/issn.2470-0436.jos-17-1442
Kocamis OzkanCorresponding author
Ozkan Kocamis, Ahi Evran University, Medical School Ophthalmology Clinic, irsehir, Turkey
Objective: Determining the effects on macular ganglion cell layer thickness in patients using isotretinoin by utilization of optical coherence tomography. Material and Methods: Sixty eyes of 30 patients using isotretinoin and 60 eyes of 30 control group patients in the same age range were included in this study. The average age of the patients using isotretinoin was; 21.2 ± 3.62 years, whereas the average age of the patients in the control group was 22.7 ± 3.7 years. The thickness of the macular ganglion cell layer (GCL), the retinal nerve fiber layer (RNFL) and subfoveal macular thickness of all patients were measured with optical coherence tomography (OCT). Results: The macular ganglion cell layer thickness in the OCT of the patients using isotretinoin was measured as 61.6±4.6 µm, 62.4±4.4µm, for the right and left eye respectively, whereas the thickness in the control group was measured as 60.6±4.1µm, 61.2±4.9µm respectively. The retinal nerve fiber layer thickness in the OCT of the patients using isotretinoin was measured as 74.8±11.3µm, 76.2±12.3µm, for the right and left eye respectively, whereas the thickness in the control group was measured as 72.2±10.5µm, 74.1±1.9µm, respectively. Conclusions: No statistically significant difference was observed in the macular ganglion cell layer thickness, retinal nerve fiber layer thickness and macular thickness in terms of both the right and left eyes between the control group and patients using isotretinoin.
May 2017 DOI 10.14302/issn.2470-5020.jnrt-17-1503
TOUDOU DAOUDA MoussaCorresponding author
Department of Neurology, Hassan II University Teaching Hospital, Sidi Harazem Road, PO Box 1835, Atlass, Fez, Morocco.
Introduction Bacterial meningitis complicates rarely pituitary macroadenomas. The aim of our systematic review is to study the features of the association between bacterial meningitis and pituitary macroadenoma. Methods We conducted a literature search in both MedLine and Google Scholar database from 1967 to October 2016 and reviewed all cases described of the association between bacterial meningitis and pituitary macroadenoma apart from any surgical act and without pituitary apoplexy. Results We found 14 articles describing 16 patients aged of 22-69 years old with a male predominance (sex ratio 4.3). Two patients (12.5%) had a well-documented clinical history of pituitary macroadenoma prior to the diagnosis of bacterial meningitis. Rhinorrhea has been found as the most common symptom through six patients (37.5%). Through the CSF culture, bacterial meningitis among patients suffering of pituitary macroadenoma commonly was due to Streptococcus pneumoniae. The examination in 18.75% of cases revealed signs related to pituitary macroadenoma (ophthalmoplegia and blindness). Six patients (37.5%) had received a treatment by dopaminergic agonist alone and 4 patients (25%) were treated with dopaminergic agonist associated with surgical treatment. Surgical treatment consisted of closure of the osteomeningeal breach in 12.5% (2/16) and tumor resection in 31.25% (5/16). Three patients (18.75%) had benefited tumor resection without prior agonist treatment. The mortality was 12.5% (2/16). Conclusion Our systematic review shows that bacterial meningitis represents a rare initial symptom leading to the diagnosis of invasive pituitary macroadenoma.
Feb 2017 DOI 10.14302/issn.2474-3585.jpmc-16-1103
M. Chaudhary SanjeevCorresponding author
Associate Professor, Government Medical College,Gondia
Background : DOTS is the current international strategy for tuberculosis control endorsed by the World Health Organization and the International Union against Tuberculosis and Lung Diseases. Maharashtra achieved full coverage under RNTCP in October 2003. The programme was launched in Nagpur in the last quarter of 2002. Three years after its launch, it is the ideal time to assess the performance of programme to identify the operational challenges. Methods: This is a cross sectional study carried out in 'Sadar Tuberculosis Unit' of Nagpur Municipal Corporation with the objective to study performance of some aspects of RNTCP. Programme performance was explored through laboratory records review and non participant observations of all four designated microscopy centres. DOT centres were observed for accessibility, identifiability and the facilities provided to patients visiting for treatment. Performance of some operational aspects of RNTCP was assessed using standards, norms, procedures etc described in programme guidelines. Results: It was observed that the TB unit was manned with RNTCP- trained supervisory team. Three of four microscopy centres were established in multispecialty health facilities. Adequate space for sputum microscopy was available at two centres. Laboratory technician was available at three centres. Separate tables for smearing and staining were available at three centres. Sink, staining racks, spirit lamp, binocular microscope and drugs in patient - wise boxes were available in all four centres. Laboratory registers were completely and correctly filled in all centres. No false positive or false negative error was found in rereading of AFB smears. Conclusions: It is concluded that the performance of the programme at the unit is satisfactory. Still some aspects of the programme components need to be strengthened at microscopy centres for better performance of RNTCP.
Oct 2016 DOI 10.14302/issn.2377-2549.jndc-16-1212
Babaee SaeedCorresponding author
Faculty of Chemistry and Chemical Engineering, Malek Ashtar University of Technology, Lavizan Avenue, Tehran, P.O. Box 16765/3454, Iran
Application of nickel in different industries has been developed and so contamination of natural water is a great concern due to its potentially toxic effects on living beings. Therefore, fast monitoring of Ni2+ in aqueous samples is important. In this work, we fabricated a sensitive optical sensor for determination of nickel in mineral water samples and hydrogen peroxide solutions. The optode was prepared by incorporation of 1-(2-pyridylazo)-2-naphthol and sodium tetraphenylborate in a plasticized poly (vinyl chloride) membranes containing dioctyladipate as a plasticizer. The influence of several parameters such as pH, base matrix, solvent mediator and ligand concentration were optimized. Comparison the obtained results with previously reported sensors revealed that the proposed method, in addition to fast and simplicity, provided good linear range (1.70–85.20 µmol L-1) and low detection limit (0.17 µmol L-1). The precision (relative standard deviation) was better than 1.55% for 7 replicate determinations of 17.10 µmol L-1 of Ni in various membranes.
May 2016 DOI 10.14302/issn.2377-2549.jndc-15-923
Wang FengqingCorresponding author
Key Laboratory of Pharmaceutical, College of Pharmaceutical Sciences, Hebei University, Baoding, 071000, P. R. China.
A hybrid monolithic column was prepared using octavinyloctasilasesquioxane (OVS) as a monomer, benzoyl peroxide/dimethylacetamide (BPO/DMA) as initiator, ethylene glycol dimethacrylate (EDMA) as cross-linker, 1-dodecanol as porogenic agent and dimethylbenzene as cosolvent. A tidy skeleton, much bigger specific surface area (22.4 m2/g) and lower swelling property of the monolithic column with OVS added than the one without OVS added were determined with Scanning Electron Microscopy (SEM), Nitrogen adsorption/desorption measurements (BET) and swelling test with elute of different concentration of acetonitrile in water. Fourier-transform infrared spectra (FTIR) was taken to characterize the composition of groups. Moreover, a better separation performance for benzene series compounds under reversed phase liquid chromatography (RPLC) mode was obtained using the monolithic columns with OVS added than those without.
Feb 2016 DOI 10.14302/issn.2324-7339.jcrhap-13-255
Roos RonelCorresponding author
University of the Witwatersrand, Faculty of Health Sciences, Department of Physiotherapy
People living with HIV (PLWH) are at risk of developing chronic lifestyle diseases such as ischaemic heart disease (IHD). Physical inactivity is a modifiable risk factor for IHD. The level of ambulation physical activity in individuals living with HIV in a South African context is unknown. The aim of this study was to assess the physical activity levels and other risk factors for IHD in PLWH on antiretroviral therapy (ARV). An observational study was conducted from October 2010 to June 2012 at an outpatient clinic in Johannesburg, South Africa. Two hundred and five individuals who were on ARV for 6-12 months were screened. Physical activity was measured with the Yamax SW200 pedometer over a seven day period. Physical activity of the sample was reduced at 7673.2 (±4017.7) steps/ day with women walking less than men 6993.3 (±3462.6) and 10076.3 (±4885.6)respectively. Body mass index was increased to 25.6 (±5.4) kg/m2 with women noted to be overweight [26.6 (±5.5) kg/m2]. Independent predictors of being overweight were systolic blood pressure, waist and hip circumference, CD4 count and daily fruit and vegetable intake. Smoking was less common in the study population with 16.1% of the sample being current smokers and 25.9% former smokers. Individuals’ mean perceived stress levels were 19.9 (±7.8) on the Cohen’s Perceived Stress Scale. The ambulation physical activity level of individuals living with HIV requires modification to assist with reducing risk factors of IHD.
Jun 2015 DOI 10.14302/issn.2374-9431.jbd-12-164
Lima-Gomez VirgilioCorresponding author
Hospital Juarez de Mexico, Av. IPN 5160 Colonia Magdalena de las Salinas, CP 06770, México City, México.
Objective: To identify the efficacy of focal photocoagulation to maintain or achieve best corrected visual acuity (BCVA) ≥20/40 in eyes with clinically significant macular edema (CSME) that had a focal angiographic pattern. Material and Methods: Non-experimental, retrospective, longitudinal, descriptive study in type 2 diabetic patients of any gender, who had CSME with focal angiographic pattern, who received focal photocoagulation from January to October 2012, with a register of BCVA before and 3 weeks after photocoagulation. 101 eyes from patients aged 35-74 years (mean 60.1±8.15) were assigned to one of two groups: 1, with BCVA before treatment <20/40 (n=60), and 2, with BCVA ≥20/40 (n=41). The proportion of eyes with BCVA≥20/40 after treatment was identified, in the sample and within each group. Results: In group 1 BCVA improved in 34 eyes (56.7%), did not change in 15 (25%), and worsened in 11 (18.3%); in group 2 BCVA improved in 10 eyes (24.4%), did not change in 18 (43.9%) and worsened in 13 (31.7%). Post treatment BCVA was ≥20/40 in 57 eyes (56.4%, 95% confidence intervals 46.8-66.1%), 21 of them from group 1 (36.8%) and 36 from group 2 (63.2%). Conclusion: Treating CSME with focal photocoagulation was efficacious to maintain BCVA ≥20/40 in 87.8% of eyes with that rank of vision preoperatively, and to achieve BCVA ≥20/40 in 35% of eyes without it. Early detection and treatment of CSME is required to increase the proportion of eyes with BVCA that provides visual independence, preferably when visual function is still good.
Jun 2015 DOI 10.14302/issn.2381-862X.jwrh-14-622
E. Evensen AnnCorresponding author
Department of Family Medicine, University of Wisconsin School of Medicine and Public Health, 100 North Nine Mound Road, Verona, WI
Basic Life Support in Obstetrics (BLSO®) is a novel, simulation-based, emergency obstetrics training program for health care workers who perform deliveries infrequently, such as paramedics and nurses. Advanced Life Support in Obstetrics (ALSO®) is intended for regular maternity care providers such as physicians and certified nurse midwives. This paper describes a pre/post study of 111 learners in two ALSO and two BLSO courses taught in Addis Ababa, Bonga, and Jimma, Ethiopia in October, 2012. The study objective was to assess the effectiveness of ALSO and BLSO training programs to improve Ethiopian health care workers’ confidence in managing common obstetrical problems. A previously-validated survey tool was given immediately pre- and post-course and six months post-course. The survey tool included demographic questions and Likert scales to self-assess comfort managing 13 common obstetric emergencies including postpartum hemorrhage, maternal resuscitation, and preeclampsia. Ninety-seven ALSO and BLSO learners completed pre- and immediate post-training questionnaires. Nineteen ALSO learners completed the 6 month post-training questionnaire. Immediately post-course, participants in ALSO and BLSO courses reported increased comfort in all 13 areas assessed. ALSO participants had increased comfort at 6 months in all areas except breech delivery. Participation in a novel emergency obstetrics training program increases Ethiopian health workers’ self-assessed confidence in addressing common obstetrical emergencies. This increase in confidence persists in most topic areas for at least six months. This paper describes the first formal evaluation of BLSO and contributes to the growing body of evidence regarding the value of ALSO training in a low- and middle-income country.
Feb 2015 DOI 10.14302/issn.2381-862X.jwrh-14-532
Elie NKWABONGCorresponding author
Department of Obstetrics & Gynecology; University Teaching Hospital/ Faculty of Medicine and Biomedical Sciences, Yaoundé (Cameroon).
Objective: To identify risk factors for ≥4500 g macrosomic babies given that maternal and neonatal complications of macrosomia increase with birth weight. Design: Cross sectional analytical study. Setting: The Yaoundé University Teaching Hospital and Central Maternity, Cameroon from October 1st, 2012 to June 30th, 2013. Population: 42 women who delivered ≥4500 g babies and 126 women who delivered babies of 4000 to <4500 g were recruited. Methods: Data were analysed using SPSS 18.0. Analyses included the student t-test and the Fisher exact test. The level of significance was P<0.05. Main outcome measures: Fetal sex and birth weight, gestational age at delivery, maternal age at delivery, parity, mother's pre-gestational body mass index (BMI), weight gain during pregnancy, father's BMI and past history of ≥4000 g macrosomia. Results: Main risk factors for ≥4500 g macrosomic babies were maternal weight gain of ≥16 kg (OR 4.2, 95%CI 2.0-8.9), maternal age ≥30 (OR 3.8, 95%CI 1.8-8.2), post term (OR 2.3, 95%CI 0.9-5.6), past history of ≥4000 g macrosomia (OR 1.9, 95%CI 0.9-4.1) and male sex (OR 1.3, 95%CI 0.6-2.8). Conclusion: To reduce the risk of ≥4500 g macrosomic babies, women at risk should make efforts to gain less than 16 kg bodyweight during pregnancies. Moreover, post term pregnancies should be avoided.
Sep 2014 DOI 10.14302/issn.2372-6601.jhor-14-499
L. Edwards ChristopherCorresponding author
Department of Psychiatry, Division of Medical Psychology, Duke University Medical Center.
Medical advances in obstetrics and hematology have encouraged researchers to investigate the reproductive risk in women with Sickle Cell Disease (SCD) attempting motherhood. However, few hematological studies have been completed focused specifically on the reproductive mental health of Black women with SCD. Historically women with SCD have been guided away from childbirth under the premise that they were not emotionally or physically capable of managing children. One question that remains unclear, from the limited research available in this area, is whether the presence of children serves to influence mood and pain in Black women with SCD. The current study examined the effects of the presence of children on self-reported pain and depressive symptoms and the relationship between pain and psychological functioning in African American women with SCD. Self-reported rates of depression, pain intensity, and pain severity were evaluated in 70 African American females with SCD. Results of Analysis of Covariance (ANCOVA) did not find differences in reported mood or pain between women with and without children. The current study serves as an initial observation upon which replication of the current findings and future prospective studies can be conducted. The study may ultimately mature into an area of research that guides reproductive decision-making for women with SCD and their doctors.