Waste management practices among dental surgery staff of major hospitals in Accra: a descriptive cross-sectional study

Introduction: the practice of dentistry in contemporary times produces considerable waste that could be harmful to individuals and the environment at large. In Ghana and many other jurisdictions, there are guidelines that outline how these wastes should be managed. This study was conducted to explore practices concerning dental waste management among dental surgery staff in some public facilities in Accra, Ghana. Methods: a descriptive cross-sectional study involving dental surgery staff of four major facilities in Accra was done. Overall, 124 staff from the selected facilities participated in the study, and 51 different dental surgeries were assessed. Data were collected using a structured questionnaire and an observation checklist. The questionnaire included questions on socio-demographics, as well as knowledge and practices regarding dental waste management. Results: there was unsatisfactory knowledge of waste disposal, while practices did not generally meet international recommendations and the Ministry of Health´s (MOH) guidelines. Though all respondents stored their sharp waste in puncture-proof containers, 98.4% did not label their clinical waste, while 62.9% would dispose of used X-ray fixers by pouring them down the drain. None of the 51 surgeries observed had more than one colour code available. Conclusion: there is a palpable need for education, monitoring, and empowerment concerning waste management in Ghana´s oral healthcare system.

Relationship between serum level of ionized calcium, magnesium, phosphate, vitamin D and parathyroid hormone with stages of CKD

Background: Chronic kidney disease is defined as either damage or a decreased Glomerular Filtration Rate of less than 60ml/min/1.73m2 for 3 or more months. There is destruction of renal mass with irreversible sclerosis and loss of nephron leading to a progressive decline in GFR.Secondary hyperparathyroidism hyperphosphataemia, hypocalcaemia and vitamin-D deficiency are common complications of CKD. Objective: To determine relationship between serum level of ionised calcium, magnesium, phosphate, vitamin-D and parathyroid hormone with stages of CKD. Method: This study was conducted at ABUTH Zaria. 125 consecutive adult patients in various stages of CKD who presented were enrolled and 125 apparently healthy matched for sex and age controls were also recruited. Results: 9% of patients were in stage-1, 16% in stage-2, 22% in stage-3, 12% in stage-4 and 41% in stage-5. Serum ionised calcium, vitamin-D and eCrCl showed a progressive decline as the stage of CKD advances, while serum phosphate, creatinine and iPTH showed a progressive increase as the stage of CKD advances. Changes in serum magnesium showed a slight change with advancing stages of CKD. The difference in mean serum levels of calcium, phosphorus, vitamin-D, parathyroid hormone, creatinine and eCrCl with different stages of CKD were statistically significant. eCrCl correlated negatively with phosphate and iPTH while serum creatinine correlated negatively with calcium and positively with phosphate and iPTH. Conclusion: Majority of CKD patients were in late stage. Correlation of analytes with stages was more in late stages and biochemical derangements occurred in late, rather than early stages of CKD

Serum adiponectin levels in pregnant women with gestational diabetes mellitus in Zaria, north west Nigeria: a cross sectional study

Background: Adiponectin is an adipocytokine that is exclusively produced by adipocytes with potent insulin-sensitizing property. It has been proposed to be involved in the pathogenesis of gestational diabetes mellitus, but its role is not clear; Findings from studies done across different ethnic groups are often inconsistent. Objectives: The aim of the study was to compare maternal serum adiponectin levels between Nigerian pregnant women with and without gestational diabetes mellitus. Materials And Methods: A cross sectional analytical study including one hundred and sixty nine pregnant women, 85 with gestational diabetes mellitus and 84 with normal gestation, who were evaluated between 24-28 weeks gestation. Diagnosis of gestational diabetes mellitus was made according to the WHO diagnostic criteria. Maternal serum level of adiponectin was measured and compared between pregnant women with gestational diabetes mellitus and the controls. Results: Mean maternal serum adiponectin level was significantly lower in pregnant women with gestational diabetes mellitus than in the controls (8.1 ± 1.6 vs. 10.1 ± 2.4 µg/ml, p< 0.05). When 2 2 subjects in the study groups were further categorized in to BMI < 25kg/m and BMI 25 kg/m , maternal serum adiponectin level remained significantly lower in the normal weight pregnant women with gestational diabetes compared to their BMI-matched controls (8.4 ± 1.7 vs. 11.4 ± 2.1 2µg/ml, p< 0.05). Among the overweight pregnant women (BMI 25 kg/m) on the other hand, there was no difference in maternal serum adiponectin level between pregnant women with gestational diabetes mellitus and the normal controls (7.8 ± 1.5 vs. 8.0 ± 1.1µg/ml, p> 0.05). Conclusion: It is concluded that normal weight Nigerian pregnant women with gestational diabetes mellitus in this study have lower serum adiponectin level compared to the normal weight pregnant women with normal gestation