Pregnant women awareness and attitude on use of patient information leaflets (PILs) in Ado Local Government, Ekiti State, Nigeria

Patient information leaflets are valuable documents that inform and guide users, particularly pregnant women, about medication. Thispaper examined pregnant women's awareness and attitude toward the use of patient information leaflets. Thestudy employed a cross-sectional survey design, using a structured questionnaire for data collection. Purposive sampling technique was used in selecting three public comprehensive health centres in the Ado Local Government Area in Ekiti state, Nigeria,for two weekswhileconvenience sampling technique was used in selecting the patients. Participants included 120 pregnant women who attended antenatal clinics during the antenatal meeting days. Data were collected atthe antenatal clinicsusing a questionnaire. Ninety copies of the questionnaire were returned and found useful for the study. The results showed that most of the pregnant women were aware of the patient information leaflets enclosed in medicine packs and the extent of use was encouraging. The pregnant women had a positive attitude to the patient information leaflet. Also, the respondents had a high level of patient information leaflet use. Reading difficulty (=2.91) was one of the biggest challenges for pregnant women when going through the patient information leaflets. The study also found that pregnant women's awareness and attitudes influenced their use of patient information leaflets. Among other things, it was recommended that health information professionals collaborate with healthcare professionals and pharmaceutical companies to ensure the accuracy, readability and cultural appropriateness of patient information leaflets for pregnant women.

Cross-species surveillance and risk factors associated with Avian Coronavirus in North-Central and South West Regions of Nigeria

@#Infectious bronchitis viral (IBV) (Avian coronavirus) diseases is among the major reproductive diseases affecting the avian production in Africa. There is scanty information on its current status and vaccination compliance among captive wild birds (CWB) and indigenous chickens (LC) in Nigeria. This study aimed to assess the exposure and the risk factors associated with IBV in CWB and LC from North-central and South west regions of Nigeria. Sera samples from 218 LC and 43 CWB were examined for IBV IgG using enzyme linked immunosorbent assay. Also, owners of LC and managers of CWB were interviewed using a pre-tested structured checklist. An overall IBV prevalence of 42.9% (112/261) was obtained. Captive wild birds and indigenous chickens had 11.6% (5/43) and 49.1% (107/218) prevalence respectively with a significant difference (p< 0.0001, OR= 7.3, 95% CI= 2.8-19.3). Also, geo-location indicated significant difference in IBV exposure among birds (p<0.034). Furthermore, the study showed that there had never been laboratory screening on all acquired wild birds for exposure to infectious agents in the study location while none of these birds (LB/CWB) had history of vaccination. Since IBV is endemic in Nigeria, the use of vaccine for prophylactic measure should be advocated among LC and CWB owners in order to avoid unnecessary losses. Also, the essence of screening for infectious agents in newly acquired wild birds should be considered crucial for health sustenance and public safety.

Disease and treatment-related factors associated with tuberculosis treatment default in Khartoum State, Sudan: a case–control study

Defaulting on tuberculosis [TB] treatment remains a challenge to controlling TB. This case-control study aimed to identify determinants of treatment default among TB patients attending treatment clinics in Khartoum State from May to July 2011. Cases were TB patients who defaulted on treatment and controls were those who completed treatment. Of the 2727 TB patients attending the clinics, 328 [14%] had defaulted. Of these, 185 had resumed treatment before data collection and 143 had not and were eligible as cases. Of the 143, 27 could not be traced and 11 declined to participate. Thus, 105 cases and 210 controls were included and interviewed. The variables significantly associated with treatment default were: rural residence [OR: 2.68; 95% CI: 1.51–4.73], not being on a DOTS programme [OR: 2.53; 95% CI: 1.49–4.30], having side-effects from treatment [OR: 1.94; 95% CI: 1.14–3.29], and having a history of TB [relapse, multidrug-resistant TB or treatment failure] [OR: 5.11; 95% CI: 2.69–9.69]. Attention should be paid to these groups at risk of defaulting to encourage treatment adherence and continuation

Raising awareness of health care providers about MERSCoV infection in public hospitals in Mecca, Saudi Arabia

It is important that health care workers have good knowledge, attitudes and practices [KAP] towards MERS-CoV, especially in Mecca because of the MERS-CoV threat during hajj and umrah. This study aimed to assess KAP of health care providers in public hospitals in Mecca about MERS-CoV infection and evaluate the effectiveness of a health education intervention to improve KAP. KAP was assessed among 281 participants using a self-administered questionnaire who then underwent the health education intervention using a combination of methods. After 3 months, 188 participants responded to the post-intervention evaluation. Significant post-intervention improvement was found in the median scores for knowledge [P < 0.001], attitude [P = 0.022] and cumulative KAP [P < 0.001]; scores improved irrespective of age group and gender. Practice scores did not improve significantly, although reported practices were good before the intervention. The positive effects of the intervention support efforts to continuously implement health education interventions for health care providers in Mecca

The impact of religion and culture on diabetes care in Nigeria

This study aimed to relate the psychosocial effects of religion and culture with the awareness; knowledge and attitude of Nigerians regarding diabetes preven-tion and care. Data was collected from a sample of 1500 individuals in communities where secondary and tertiary health care centres are situated from 12/02/2012 to 25/03/2012. The study population in-cluded a higher proportion of females (65%); with the majority between 19 and 29 years old (56%). Most were unemployed (67%) or in the teaching profession (24%). Over half (58%) respondents were Christian; while 41% were Muslim; and 1% were traditional worshippers. Over 25% believed that diabetes was due to witchcraft or a punishment from God. Also; 28% believed that diabetes was caused by an infection; and 16% and 10% believed diabetes could be caused by witchcraft or by God; respectively. Nearly all (90%) believed that diabetes was potentially fatal. We conclude that many diabetic patients have inadequate knowledge about the causes of diabetes and its complications

Prevalence of and predictive factors for nonalcoholic fatty liver disease in Sudanese individuals with type 2 diabetes: is metabolic syndrome the culprit?

Non-alcoholic fatty liver disease [NAFLD] is a common global chronic liver condition. The prevalence of NAFLD among individuals with type 2 diabetes is estimated to be as high as 75%. The aim of this study was to determine the prevalence of NAFLD among individuals with type 2 diabetes in Sudan. This was a cross-sectional hospital-based study, which was carried out at the Jabir Abu-Elizz diabetic centre in Khartoum; 167 outpatients with type 2 diabetes were enrolled. NAFLD was diagnosed based on ultrasound, following exclusion of significant alcohol intake and secondary causes of liver diseases. NAFLD was defined as hepatic steatosis in the absence of alcohol intake, medication, previous liver disease and negative results for the serological test for hepatitis B and C. Logistic regression analysis was used to determine independent risk factors for the development of NAFLD in individuals with type 2 diabetes. The number of female subjects was 89 [53.3%], and most subjects [145, 86.8%] were between the ages of 40 and 70 years. The overall prevalence of fatty liver among individuals with type 2 diabetes was found to be 50.3%. Age, duration of diabetes, hypertension and HbAlc levels appeared to have no impact on the prevalence of NAFLD. The possible predictors of NAFLD were overweight, obesity, central obesity, high triglyceride level and low high-density lipoprotein cholesterol [HDL-c] level. A higher prevalence of NAFLD was observed in individuals with three components of the metabolic syndrome. NAFLD was observed in half of the diabetic population, and its occurrence correlates positively with metabolic syndrome risk factors

IL-17 assay in adult T-cell leukemia/lymphoma patients with dermatophytosis

Assess IL-17 level as proinflamtory cytokine and predictor for the outcome of inflammatory process in ATLL patients with dermatophytosis. Isolation and identification of different types of dermatophytes infecting patients with ATLL. 58 subjects were included in this study [16 adult patients with adult T-cell leukemia / lymphomaclinically diagnosed to have dermatophytosis, 14 adult patients with adult T-cell leukemia / lymphoma clinically diagnosed to have no dermatophytosis, 12 age and sex matched patients clinically diagnosed to have dermatophytosis and 16 Age and sex matched apparently healthy Controls]. Sampleswere examined microscopically using 20% KOH and cultured on into SDA containing chloramphenicol [0.5%] with/without cycloheximide [0.5%] and Dermatophyte test medium [DTM]. in the non-ATLL patients with dermatophytosis, the serum IL-17 level was significantly increased compared with the healthy controls. In ATLL patients either with or without dermatophytosis, the IL-17 levels were significantly lower than those in the healthy controls. There was no significant difference in the IL-17 level between ATLL patients with dermatophytosis and those without dermatophytosis. Again, it is suggested that ATLL patients have low levels of IL-17, which cannot be enhanced by the presence of dermatophytosis. Among patients with ATLL with dermatophytosis [Group I] T. rubrum was the commonest dermatophyte causing infection; 64% of samples [tineacorporis 46%, tineaunguium 18%], whereas T. mentagrophytes was the 2[nd] commonest dermatophyte; 27% [tineaunguium 27%], lastly T. tonsurans; 9% [tineacorporis 9%]. In patients with Non-ATLL with dermatophytosis [Group III] T. rubrum was also the commonest dermatophyte causing infection; 64% of samples [tineacorporis 7%, tineaunguium 14%, tineapedis 43%], whereas T. mentagrophytes was the 2nd commonest dermatophyte; 29% [tineaunguium 7%, tineapedis 22%], lastly T. tonsurans; 7% [tineacorporis 7%]. Our data provides clinical evidence linking Th17 cells to immune deficiency in ATLL and opens a new avenue in the study of tumor immunotherapy based on promoting Th17 cell population

Non alcoholic fatty liver disease [NAFLD] in a Sudanese population: What is the prevalence and risk factors?

Non alcoholic fatty liver disease [NAFLD] is a common clinical condition associated with obesity and considered as possible precursor of more serious disease like Non alcoholic steatohepatitis [NASH], cirrhosis and hepatocellular carcinoma. There is very little research work carried concerning NAFLD in African countries in relation to prevalence and risk factors. Therefore, the aim of this study is to determine the prevalence of NAFLD and risk factors among asymptomatic co-patients accompanying patients admitted to gastroenterology wards at the National Centre for GI and Liver Diseases, Ibn Sina Hospital [Khartoum, Sudan]. Subjects with liver disease, excess alcohol intake [the intake of more than 21 units of alcohol per week for men and 14 units for women per week] and pregnancy were excluded from this study. The age, sex, body mass index [BMI], history and duration of diabetes and hypertension were recorded. Ultrasound was offered followed by clinical examination and blood sample was taken for assessment of liver function from each subject [total number of participants was 100]. NAFLD was diagnosed in 20 patients, giving prevalence of 20%. There was no statistical significance between the two sexes. The mean age of subjects with NAFLD was 53 years old and without NAFLD was 40 years [p < 0.05]. Importantly, the prevalence of NAFLD increased with age and BMI. Due to small number of diabetic individuals and hypertension, these two conditions were not statistically significant when related to NAFLD. The estimated prevalence of NAFLD in our study is 20% and this figure is comparable to the prevalence of NAFLD in Asian countries. Males and females were nearly equally affected and the prevalence of NAFLD increased with age and BMI, malting obesity a main risk factor

Evaluation of pan-dermatophyte nested PCR in diagnosis of onychomycosis in comparison with direct microscopy and culture

This work aimed to compare nested PCR using novel primers targeting the pan-dermatophyte-specific sequence of the chitin synthase 1 gene [CHS1] with KOH microscopy and culture isolation for diagnosis of clinically suspected onychomycosis. This study was conducted during the period from December, 2012 to October 2013. Forty patients attending Outpatient Dermatology and Andrology Clinic in Benha University Hospital. This study was done on forty patients 15 cases were female and the other 25 cases were males with abnormal nails. Their ages ranged from 22 to 77 years. As many as 19 patients were living in rural areas, while 21 patients came from urban areas. Nail scrapings were collected and examined using direct KOH microscopic examination, culture and PCR using double sets of primers. As regard direct microscopy by KOH examination; 33 [82.50%] cases were positive, while 7 [17.5%] were negative. Culture was positive only in 19[47.5%] of nail samples revealing different fungi. Dermatophytes were isolated from 15[37.5%] cases; most of them were T. mentagrophytes. And in 4 cases the only isolated non dermatophytic organism was Aspergillus Niger spp. [10.00%]. Nested PCR was positive in 26 [65.00%] nail samples. It is concluded that nested PCR targeting the CHS1 gene may be considered the gold standard for detection of dermatophytes in patients with onychomycosis and can aid the clinician in initiating prompt and appropriate antifungal therapy. PCR is a very powerful tool for microbiology and clinical mycology. It can detect very small amounts of nucleic acids. This technique may also play an important role in large-scale studies and in the management of problematic cases of onychopathies

Comparative analysis for the detection of tuberculosis by conventional and flurosence microscopy.

Total of 300 TB patients sample were collected from NIDCH (Indoor and Outdoor) for six months period where three different specimens (sputum, pus, BAL) were collected among different age group (male and female). In sputum sample, percentage of identified samples in Auramine-O stain was 41% whereas in Z-N stain 32%; in pus sample, Auramine stain is 22% and Z-N stain 15%; In BAL sample, Auramine stain is 12% and Z-N stain is 10%. Therefore, out of 300 samples, 25% of positive samples were identified by Auramine-O staining whereas 19% of positive samples were identified by Z-N stain. In all the cases Auramine-O is found better for identification of TB than Z-N. In sputum, male positive 10%, female positive 3.66%; in pus sample, male positive 5% and female positive 2.33%; in BAL sample, male positive 3% and female positive 1%. Age group of 26 to 45 years were found high rate of TB in male patients.

Non-polio enteroviruses aseptic meningitis: embaba fever hospital admissions 2010-2011

Human enteroviruses [EV] cause a wide spectrum of both common and uncommon illnesses among all age groups. Enterically transmitted. The objective of this study was to identify non-poliovirus EV as a cause of viral aseptic meningitis [VAM] by two methods [cell culture and Real time PCR]. From October 2010 to August 2011 cerebrospinal fluid [CSF] samples were collected from 85 patients Embaba fever hospital admitted with symptoms of aseptic meningitis of any age and both sexes. The 85 CSF samples were inoculated into RD [human rhabdomyosarcoma] cell line in three blind passages to amplify isolates producing EV-like CPE. A total of 14 [16.5%] out of 85 CSF samples showed EV-like CPE. By Real time PCR 11 out of the 14 culture positive samples and 5 out of the 14 source of virus isolation original CSF were non polio EV positive. The frequency of non-polio EV meningitis hospital admissions was in the summer season [50%], spring [25%], late autumn [16.6%] and least frequency in winter [8.4%]. non-polio EV meningitis was detected in 6 out of 41 male patients [14.5%] and in 6 out of 44 female patients [13.5%]. Also non-polio EV meningitis was detected in all ages with marked increase of incidence in young children [41.6%] and old age [50%] and less in adult [8.4%]. Our data showed that the non-polioviruses EV was associated with the majority of VAM during 2010 - 2011 at the Embaba fever hospital which serves Embaba, Shoubra Elkheema, Qualyba and neighbors localities in Egypt. Rapid detection of non-polio EV meningitis is essential for making decisions about patient management and treatment

Semi-empirical correlation for binary interaction parameters of the Peng-Robinson equation of state with the van der Waals mixing rules for the prediction of high-pressure vapor-liquid equilibrium

Peng-Robinson equation of state is widely used with the classical van der Waals mixing rules to predict vapor liquid equilibria for systems containing hydrocarbons and related compounds. This model requires good values of the binary interaction parameter k[ij]. In this work, we developed a semi-empirical correlation for k[ij] partly based on the Huron-Vidal mixing rules. We obtained values for the adjustable parameters of the developed formula for over 60 binary systems and over 10 categories of components. The predictions of the new equation system were slightly better than the constant-k[ij] model in most cases, except for 10 systems whose predictions were considerably improved with the new correlation

Evaluation of serodiagnosis of tuberculosis in comparison with traditional methods

Tuberculosis is an enormous tool of morbidity and mortality. The vast majority of tuberculosis patients live in developing countries, where the diagnosis of tuberculosis relies on the identification of acid-fast bacilli on unprocessed sputum smears using conventional light microscopy. Microscopy has high specificity in tuberculosis-endemic countries, but modest sensitivity which varies among laboratories [range 20% to 80%]

Thus, the development of rapid and accurate new diagnostic tools is imperative. Immune-based tests are potentially suitable for use in low-income countries as some test formats can be performed at the point of care .In the present study, the diagnostic value of 16-kDa and 38- kDa mycobacterial antigens was investigated in patients who were diagnosed as open pulmonary tuberculosis. The humoral immune response was analysed in a group of 60 TB patients, and in control group consisting of 15 healthy volunteers and 15 subjects with pulmonary diseases other than TB. The sensitivity, speciflty, positive predictive value and negative predictive value of the test were determined at 45%, 93.3%, 93.1% and 45.9%, respectively. In conclusion, the ELISA test has a very good speciflty and an acceptable sensitivity and positive predictive value. It is thought that it could be used in combination with other methods to increase diagnostic accuracy, especially for culture-negative tuberculosis cases, which are difficult to diagnose

best stain for morphological study of human seminal fluid's smears

There is a high need for proper evaluation of the morphological features of human sperms. The importance of this lies in the field of andrology, male fertility and in vitro fertilization. The wet smears can give rough clue about the shape of the sperms, but it is neither accurate nor reproducible. This study aimed to determine the best stain which can be used for seminal fluid cytology. This study was conducted in Port Sudan, Red Sea State, Sudan in the period from October 2006 to September 2007. The total number of patients was 50. Samples which were collected from normospermic patients [NSP] were prepared by direct smear technique. Samples which were collected from oligospermic patients [OSP] and azoospermic patients [ASP] were prepared by direct smear technique and also by indirect smear techniques [concentration method]. Smear samples were stained by freshly prepared Harris's Haematoxylin, Papanicolaou stain, May-Grunwald Giemsa stains [MGG], supra vital stain, Giemsa stain and leishman's stain. In this study, the best stain was Harris's Haematoxylin [80% excellent for the head of sperm, 70% good for the neck, 59% excellent for the tail, 42% very good for cells in background]. Harris's stain was followed by papanicolaou stain and the third best stain was supra vital stain. MGG was better than Giemsa in staining of semen smears [75% good versus 25% good] in overall performance. The worst stain was Leishman's stain. Stained smears must be used for the morphological study of semen samples. Harris's Haematoxylin is the best stain for semen cytological features. Stains which used for the semen samples should be freshly prepared

Malignant Phylliodes Tumours: Results of Breast Conserving Surgery and Immediate Reconstruction

Background: Malignant phylliodes tumour (MPT) is a rare breast tumor. Surgery is the mainstay in treatment but varies from local resection to modified radical mastectomy. In this study; we present our experience using wide local excision or subcutaneous mastectomy and immediate breast reconstruction in the management of MPT. Methods and Results: Twenty-three recurrent MPT and ten patients with histological evidence of MPT were included. All patients with recurrent MPT (n=23) had subcutaneous mastectomy; tow centimeter wide excision of the scar and immediate breast reconstruction with either Latissimus Dorsi (LD) myocutaneous flap (n= 10) or Latissimus Dorsi muscle flap (n=13). Seven of the newly diagnosed patients had wide local excision of the tumor; reconstruction with LD muscle flap; tow had wide local excision and reduction of contra lateral breast; and one had subcutaneous mastectomy and silicon implant. The margin resection varied between five and fifteen centimeter in wide local resection group and subcutaneous mastectomy group respectively and the size of tumors varied between five and fifteen centimeters in diameter. Discussion: During the follow up period; which ranged between twenty-four and eighty-four months one local recurrence; was recorded (3.03) and none of the patients had distant metastasis or regional lymph nodes involvement. This approach has secured wider excision of MPT; offered breast reconstruction; and has reduced the chances of recurrence in our patients

Qualitative and quantitative estimation of phenytoin in hair of epileptic patients by thin layer chromatography [TLC] and high performance liquid chromatpgraphy [HPLC]

The Two methods [TLC and HPLC] were applied to the head hair of epileptic patients who are orally treated with 100, 150, 200 and 300 mg of phenytoin daily. The detection of phenytoin in human hair revealed that, by TLC phenytoin was present in all hair samples. Zwikker's reagent and the dithiazone reagent were the best spraying reagents when the eluent was methanol to chloroform 1:9 by HLPC, phenytoin was present in hair samples at concentrations ranged from 4.3-9.5 ng/mg after administration of 100-300 mg/day of phenytoin respectively with a retention time 6.16 min when the mobile phase was Acetonitrile 70% to methanol 30%. The results show a linear correlation between the drug concentration in human hair and the daily dosage of phenytoin

Multileaf collimator versus tray mounted cerrobend blocks in head and neck cancer irradiation

The objective was to perform a direct comparison of cerrobend blocks to "Best fit" single field Multileaf collimator [MLC] shapes. Output measurements were made on a primus Linear Accelerator [Siemens], 29 leaves per side for Photon beam energy 6MV at source-to- axis distance [SAD 100cm]. The data was measured for different field sizes at different depths. The field sizes dependent factors were measured at the maximum depth 1.6cm for this energy. The penumbra widths were measured at 10cm depth in solid phantom by using Kodak films, their values were 5-6mm for isodose lines [80%-20%] and 16- 17mm for isodose lines [90%-10%]. The average MLC factor [MLC reading divided by block reading] was found to be 1. Also the comparison between the isodose mapping was obtained by the Multidata system for shaping treatment field in Head and Neck Cancer with both MLC and Cerrobend blocks at clinical depth 5cm

Adjuvant chemotherapy in surgicallyresect able locally advanced colorectal carcinoma: fluoro-uracilbiomodulationby folinicacid versus interferon

Surgical curative resection of locally advanced colorectal cancer [stage B2 and C] is unfortunately followed by high risk of recurrent malignancies. Ultimate control requires effective adjuvant therapy. The aim of this study was to evaluate efficiency of two regimens of modulation of adjuvant 5 fluorouracil [5 FU] by folinic acid versus interferon after surgical resection of locally advanced colorectal carcinoma. 105 patients with histologically proven colorectal carcinoma [stage B2 and C only] were included in this study. Patients were subjected to surgical treatment with operative resection followed by randomization into 3 groups, each of 35 patients. Group A received 5 FU alone, group B received in addition calcium leucovarin [L V], while group C received interferon in addition to 5 FU. Patients were followed up for a median of three years. All groups were comparable as regard age, sex, histological type, stage and clinical presentation. Three years overall and disease- free survival were relatively higher in patients of group B and C, that received 5 FU modulators. Also recurrence rate was less in group B and C than in group A, but not reaching a significant level. The clinical stage of the disease was the most important prognostic factor followed by the histopathological differentiation of the tumour. Most of patients tolerated chemotherapy with transient mild to moderate degree toxicities. Hematological and gastro intestinal toxicities were comparable in the 3 groups in group C there was mild toxicities related to interferon

efficacy of the volatile oils of three plants for controlling lucilia sericata

Myiasis is one of the most important parasitic diseases, which affects the human welfare. The volatile oils of 3 plants were tested against adult Lucilia sericata. The LC50 was 80 ppm by Anethum graveolens, 180 ppm by Conyza dioscoridis and 130 ppm by Mentha microphylla. The slope functions were 1.9, 1.79, and 2.2, respectively. The whole results discussed

Value of the quantitative buffy coat capillary tube test [QBC] in the microscopic diagnosis of bancroftian filariasis

The diagnostic performance of the commercial quantitative buffy coat capillary tube technique was compared with the standard diagnosis of filariasis by microscopical examination of Giemsa stained thick blood films. The comparison was conducted among 83 subjects. The QBC test was highly sensitive than the thick blood film in detection of microfilaremic patients. The percentage of positive cases among 35 subjects with fever and enlarged lymph nodes in the axilla or in the groin was 48.6% versus 42.8% by thick blood film. The sensitivity was 94.4% versus 83.3% in 18 subjects with lymphatic varices or hydrocele. The sensitivity of the QBC capillary tubes was poor [20%] versus 6.6% among 30 filarial patients with different degrees of lymphatic edema. It is concluded that the QBC capillary test is very simple, rapid and convenient as a diagnostic method for microfilaremic patients but not suggested to be used neither in the quantitation of the parasite numbers or in species identifications