Prevalence and pattern of bacteraemia among HIV-infected under-five children in a tertiary hospital in Kano, Nigeria

Background: Bacteraemia is an invasive bacterial disease of childhood that is associated with serious complications and high mortality especially in immunocomprised HIV infected children.Aim: To determine the prevalence and pattern of bacteraemia among HIV-infected Under-five children.Design: It was a prospective cross -sectional study.Subjects and Methods: One hundred and thirty four febrile HIVinfected children were recruited from the outpatient departments and emergency room of a tertiary hospital to determine the presence of bacteraemia, the etiologic agent and antibiotics susceptibility. An automated (BACTEC) incubator was used to detect bacteraemia, subcultures were done and identification and antibiotic susceptibility tests were done using standard laboratory procedures. Sociodemographic and clinical data were obtained using a proforma and data analysis was done using SPSS version 17.0 for windows. Results: The prevalence of bacteraemia in HIV-infected children was 14.2% (19/134). Salmonella typhi and Staphylococcus aureus were the predominant isolates, each accounting for 21% of all cases of bacteraemia. Most (81.3%) of the subjects were on HAART and its use had no effect on rate of bacteraemia. Fourteen (73.7%) and 12(63.2%) of the isolates were sensitive to ciprofloxacin and ceftriaxone respectively. Sensitivities to ampicillin, cloxacillin and co-trimoxazole were 0.0%, 5.3% and 5.3% respectively.Conclusion: Bacteraemia is a significant health problem among HIV-infected under-five children despite the high rate of HAART use. Treatment adherence should be strengthened among this population. There is need for improvement in personal and food hygiene, environmental sanitation and possibly introducing typhoid vaccine among under-five HIV-infected children

Knowledge, Perception and Practice of Medication Use Review among Community Pharmacists in Southwestern Nigeria

Background: Medication use review (MUR) is an emerging concept in medicine management that has recorded success in many developed countries.Purpose: To evaluate knowledge, perception and practice of MUR among community pharmacists (CP) in southwestern Nigeria.Method: A cross-sectional study was carried out among 100 CP recruited from Oyo and Osun states between January and March, 2015, using a pre-tested questionnaire. Demographic information and CP's knowledge, perception and current practice of MUR were evaluated using open-ended, closed-ended and Likert-scale questions. Respondents' scores for 6-item knowledge test questions and description of specific component of MUR services were categorised as score>3 (good knowledge) and score≤3 (poor knowledge). Descriptive statistics were used to summarize data. Ranked variables were evaluated using Kruskal-Wallis test at p<0.05.Results: Fifty-nine (59.0%) CP from Oyo and 41(41.0%) from Osun state participated. Sixty-five (70.7%) had score>3 indicating "good" knowledge of MUR, while 27 (29.3%) had score≤3 suggesting "poor" knowledge. Forty-two (42.0%) claimed to provide MUR service; of this, 14 (33.3%) had scores>3 indicating those who gave correct description of specific component of MUR. Lack of adequate time for counselling (49; 49.5%) and lack of specialized training for pharmacists (45;45.5%) were cited as barriers to MUR practice. Majority (51; 51.5%) agreed that MUR service should be incorporated into community pharmacy practice.Conclusion: Knowledge of MUR concept among community pharmacists in Oyo and Osun states is considerable, but description of specific component of MUR services by respondents was poor. There is therefore a need for continuous training on emerging concepts among pharmacists, so as to stimulate interest in patient-oriented service

Oral Amelanotic Melanoma

Malignant melanomas of the mucosal regions of the head and neck are extremely rare neoplasms accounting for less than 1of all melanomas. Approximately half of all head and neck melanomas occur in the oral cavity. Less than 2of all melanomas lack pigmentation; in the oral mucosa however; up to 75of cases are amelanotic. No etiologic factors or risk factors have been recognized for oral melanomas. Some authors have suggested that oral habits and selfmedication may be of etiological significance. Oral melanoma is rare but it is relatively frequent in countries like Japan; Uganda; and India. It is rarely identified under the age of 20 years. In Australia where cutaneous melanomas are relatively common primary melanoma of the oral mucosa is rare. The surface architecture of oral melanomas ranges from macular to ulcerated and nodular. The lesion is said to be asymptomatic in the early stages but may become ulcerated and painful in advanced lesions. The diagnosis of amelanotic melanoma is more difficult than that of pigmented lesions. The neoplasm consists of spindle-shaped cells with many mitotic figures and no cytoplasmic melanin pigmentation. Immunohistochemistry using S-100; HMB-45; Melan-A and MART-1 will help in establishing the correct diagnosis. Radical surgery with ample margins and adjuvant chemotherapy are appropriate management protocol for malignant melanoma. Oral melanoma is associated with poor prognosis but its amelanotic variant has even worse prognosis because it exhibits a more aggressive biology and because of difficulty in diagnosis which leads to delayed treatment

Metastatic breast cancer in a Nigerian tertiary hospital

Background: Late presentation of breast carcinoma is common in resource-limited countries with attendant poor outcome. Objective: To describe the pattern of clinical presentation and challenges of treating patients presenting with metastatic breast carcinoma in a Nigerian hospital. Method: Clinical records of all patients who presented with metastatic breast carcinoma between January 1991 and December 2005 at the Obafemi Awolowo University Teaching Hospitals Complex; Ile-Ife; Nigeria were reviewed. Results: More than half of all histologically confirmed breast cancer patients seen within the study period presented with metastatic disease. Their ages ranged between 20-81years with a mean age of 45.9 years. Only 3(6 of 202) were males. Twothirds had more than one secondary site on initial evaluation and the commonest sites were liver (63); lung parenchyma (51); pleura (26) and contralateral breast in 25. On immunohistochemistry; basal like tumours were found in 46.1. Mastectomy was done in 37 patients with fungating breast masses while only one third of those referred to a nearby center for radiotherapy had it done. One year survival rate was 27. Conclusion: Metastatic disease is common in Nigeria and treatment is limited due to resource limitations. Improved awareness of the disease is advocated to reduce late presentation

Status of Breast Self Examination Among Health Professsional Of Abia State University Teaching Hospital

Breast self-examination (BSE) is recommended for breast cancer screening but most Nigerian women do not perform BSE regularly. Breast cancer; a significant cause of mortality; can often be detected in an early stage. This may be achieved by mammography; physical examination by skilled practitioners or through breast self-examination. In this preliminary study; we present the responses received on breast self-examination among health professionals at the Abia State University Teaching Hospital; Aba; Abia State. One hundred questionaires were distributed to final year female medical students; house officers interns; pharmacists and nurses. Out of the 100 dstributed; respondents were 94 (94). Among the 94 it was found out that 79 (84) practice Breast self-examination; but the number that examine their breast monthly was only 45 (47.9). With this low level of monthly breast self-examination; there is the need to create the awareness and encourage the regular monthly practice. Among the repondents 74 (78.7) knew the gravity of breast cancer