Evaluation of Some Haematological Metrics among Smokers in Port Harcourt, Rivers State, Nigeria

Introduction: Smoking is extremely toxic and has had a significant negative impact on society. One of the leading contributors to preventable illness and mortality has been found to be cigarette smoking. Aim: The goal of this study is to evaluate a few haematological metrics among smokers in Port Harcourt, Rivers State, and to verify the idea that smoking cigarettes either has a negative or favorable impact on these variables. Methodology: In this cross-sectional study, 100 participants between the ages of 20 and 45 were included, 50 of whom were smokers and 50 non-smokers. Venipuncture was used to obtain blood samples from the patients, which was then put into an EDTA vial for a full blood count (FBC) and other haematological analysis. The full blood count and erythrocyte sedimentation rate (ESR) were done using Haemo Auto Analyzer, Model XP-300 KOBE Japan by SYSMEX and the Westergreen method respectively. In order to analyze the data, Graph Prism Pad 6.2 and Microsoft Office Excel 2016 were both used. Using the student's independent t-test, a comparative study of mean and standard deviation values for the various parameters for test and reference ranges was conducted. Results: According to the findings, the average age of 50 smokers was 43.6200± 9.7250 years and that for the 50 non-smokers was 42.7800± 6.5440 years, which was statistically insignificant with p valve of 0.6130. Smokers’ haemoglobin level was 14.5080 ± 1.5590 (g/dL) and non-smokers was 12.1340 ± 0.70410 (g/dL). According to statistics, the level of Hb was significantly higher in smokers compared to non-smokers (P<0.0001). In comparison to non-smokers, the RBC count dramatically increased in smokers (P<0.0001) greater than in non-smokers at 5.2550 ± 0.6629 (x1012/L) and 4.6340 ± 0.5530 (x1012/L) respectively. While the total leucocyte count (TLC) in smokers is 8.0500 ± 1.8796 (x109/L), compared to 6.8580 ± 1.2454 (x109/L) in non-smokers. Statistics show that smokers have a higher total leucocyte count than non-smokers (P<0.0002). Smokers' platelet count is 255.7600±61.8351 (x109/L) while non-smokers' is 216.5800±35.5752 (x109/L).The study has statistically shown that smokers' platelet counts rose considerably in comparison to non-smokers (P<0.012). Conclusion: It may be concluded that uninterrupted smoking has an undue negative impact on haematological parameters such that increase occur in values of Hb, RBC, TLC and platelets. Significantly, these changes may increase the risk of serious health issues such as heart related defects, hardening of the arteries, Vaqu

Study on Malaria and Haemoglobin Interaction in Pregnant Women

Comparative observational study was carried out on the prevalence of malaria among pregnant women attending antenatal clinics in General Hospital, Bori (GHB) and Braithwaite Memorial Specialist Hospital, Port Harcourt (BMSH). Four hundred women were involved in this study of which two hundred per study location. Pregnant women with pyrexia of unknown origin, HIV and those on anti malarial drugs were excluded. Consents were obtained from participants and confidentiality upheld. Ethical approval was obtained from the ministry of health and from the selected health facilities. Sample collection was performed according to the recommended reference guideline for phlebotomy. Collected samples were used to assay for Haemoglobin using cyanomethamoglobin method, and malaria parasite using the Giemsa staining technique. Statistical analysis was performed for percentage, frequency, for descriptive statistics and inferences deduced at p-value=0.05. All statistical analyses were performed using Statistical Package for Social Sciences. Questionnaires were issued to obtain their demographic data. The prevalence of malaria was high among pregnant women with haemoglobin level 8.0–10.9g/dl from BMSH (17.9%) and GHB (35.9%). Infection was not dependent on locality at P-value < 0.05. Awareness of malaria in pregnancy should be supported. Anaemiain pregnancy should be treated and comorbidity of malaria and anaemia in pregnancy should be handled with urgency.

Occurrence Rate of Human Immunodeficiency Virus (HIV), Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Co -infection among Expectant Mothers Attending Antenatal Clinic in Rivers State University Teaching Hospital

The global burden of co-infection with human immunodeficiency virus (HIV), hepatitis B and C virus (HBV and HCV) has a negative impact in Sub-Saharan Africa.WhenHIV, HBV and HCV co-exist, they become life threatening and with high fatality rate particularly in gestation in which transmission occurs vertically, causing fetal and neonatal hepatitis. The study aimed at examining the occurrence rate of Human Immunodeficiency Virus (HIV), Hepatitis B virus (HBV) and Hepatitis C Virus (HCV) co -infection among expectant mothers attending antenatal clinic in Rivers State University Teaching Hospital (RSUTH).The study population comprised of one hundred and fifty (150) pregnant women. Venous blood was used in the study and screened for hepatitis B surface antigen (HBsAg), anti-HCV, and anti-HIV antibodies using commercially available immunoassay test kits. The prevalence of HCV, HIV and HBsAg among the pregnant subjects in relation to agegroup 21-30 and 31-40 in the study revealed a seropositive percentage of 0.7% and 1.3%. The other groups, however, showed no positive result among the three viruses.Furthermore, 0.7% of the pregnant women in their first, second and third trimester were co-infected with HCV and HBsAg while 1.3% out of 36.7% and 0.7% out of 61.3% of pregnant women within the age groups21-30 and 31-40 respectively were seropositive for HIV. In relation to gestational age, it was seen from the study that 0.7% of the pregnantwomen in their first, second and third trimester were seropositive for HCV and HBsAg respectively, while 2% of the HIV seropositive pregnant women were in their first trimester. The overall seroprevalence of HCV, HIV and HBsAg as revealed in the study showed that infection was found to be 2% respectively among the pregnant women. The reduced prevalence of hepatitis B (HBsAg), hepatitis C (HCV) and human immunodeficiency virus (HIV) infection observed in the study among pregnant women attending antenatal care in the Rivers State University Teaching Hospital may be attributed to the increase in the awareness amongst the general populace in Port Harcourt especially couples about the consequences of sexually transmitted diseases such as HIV, Hepatitis B as wellas Hepatitis C.In other words, there is reduction in seroprevalence of HBsAg, HCV and HIV which is premised on the efficacy of sensitization particularly on HBV vaccination and preventive protocols for HIV.

Isolation, Identification and Mode of action of Partially Purified Bacteriocins from Lactic Acid Bacteria in Fermented Cassava Grits

The study on the isolation, identification and mode of action of partially purified bacteriocin from lactic acid bacteria found in fermented cassava grits was carried out. Fermented cassava grits were collected from different garri processing plants and transported with cold box to the laboratory for analysis. The viable microbial count after the partially purified bacteriocin from the various lactic acid bacteria isolates were grown against the food borne bacteria (Staphylococcus aureus and Bacillus subtilis) ranged from 0.98 x 103 CFU/ml for partially purified bacteriocin from isolate 6 at 8 hrs to 9.2 x103 CFU/ml for isolate 3 at 24 hrs. Similar results were obtained against Bacillus subtilis with microbial counts that ranged from 1.02 x102 CFU/ml for isolate 3 at 8 hrs to 9.2 x 102 CFU/ml at 24 hrs. Isolates 6, 7, 10 and 11 were bactericidal to both Staphylococcus aureus and Bacillus subtilis while isolate 3 was bacteriostatic. The viable microbial count after the partially purified bacteriocin was grown against the foodborne bacteria (Escherichia coli and Salmonella typhi) ranged from 1.0 x102 CFU/ml for partially purified bacteriocin from isolate 3 at 8 hrs to 7.1 x 102 CFU/ml for partially purified bacteriocin from isolate 6 at 24 hours. The microbial count against Salmonella typhi ranged from 6.50 x 102 CFU/ml for isolate 6 at 8 hrs to 8.5 x 102 CFU/ml for isolate 7 at 24 hrs. Partially purified bacteriocins from isolates 3 and 7 were bacteriostatic while isolates 6, 10 and 11 were bactericidal to Escherichia coli and Salmonella typhi. This result showed that the partially purified bacteriocins were very efficacious in killing or inhibiting the growth of some foodborne pathogens which can be applied in biopreservation.

Adolescents' knowledge and use of sexual and reproductive health services in the Federal Capital Territory, Nigeria

Contraceptive knowledge is vital to promoting youth health. It has been proven to lower the high rates of unwanted pregnancies,and STIs including HIV/AIDS. The aim of the study was to examine the level of contraceptive knowledge and use among youths in Federal Capital Territory (Abuja) Nigeria. The study adopted an explanatory sequential mixed-method research design. A total of 500 young people between the ages of 15 and 25 were interviewed. The majority of the youth (58.2%) were sexually active,with sexual debut starting within age 15-19. The prevalence of contraceptive knowledge was very high (78.8%), while (34.6%) were not using any type of contraceptives, even among the educated youth notwithstanding their level of education. It was concluded that there is a wide disparity between contraceptive knowledge and use which need to be bridged. There is a need to review policies regarding sexual and reproductive health, as well as sexuality education among youth in Nigeria. (Afr J Reprod Health 2022; 26[6]:80-88).

Itinerário terapêutico de pacientes com dor lombar crônica atendidos em ambulatório de fisioterapia / Therapeutic itinerary of patients with chronic low-back pain attending outpatient physiotherapy clinic

Objetivo: avaliar o itinerário terapêutico de pacientes com lombalgia crônica. Métodos: estudo qualitativo envolvendo a utilização de entrevista semiestruturada em profundida-de, para coleta de dados sobre o itinerário terapêutico de dez pacientes com lombalgia crônica atendidos em clínica de fisioterapia de um hospital terciário. Os dados foram analisados por meio da análise de conteúdo temática. Re-sultados: os temas emergentes foram: início da dor lombar, sintomas que iniciaram a jornada para o cuidado, etapas to-madas para encontrar alívio para a dor, percepção do entre-vistado sobre o atendimento recebido, interferência da dor na vida normal, família e relações, práticas múltiplas nas quais pacientes com dor lombar crônica se envolvem, per-cepção da eficácia das múltiplas práticas e obstáculos para buscar atendimento. Conclusão: pacientes com dor lombar crônica seguem caminhos diferentes em busca de atendi-mento. A dor lombar crônica alterou significativamente a vida dos pacientes e os tornou propensos a praticar o plu-ralismo médico. (AU)

Mothers' perception of COVID-19 infection in their under-five children presenting in a tertiary health institution in South-East Nigeria and associated factors

Background: Maternal attitude to health-seeking behavior of their under-five children in the COVID-19 pandemic is not well-known. Objectives: This study is aimed at determining mothers' perception of COVID-19 pandemic among their under-five children and associated factors. Methodology: This is a prospective and observational study carried out in two health institutions in South-East Nigeria. Results: Most subjects, 243 (65.3%) noted that someone without showing symptoms of COVID-19 could transmit the virus. Of the mothers of children under-five, 271 (72.8%) highlighted the possibility of COVID-19 infection in the under-five. A small number of participants 53 (14.2%) showed awareness that people should cough into their elbows as a way of preventing the transmission of COVID-19. A small number of participants, 160 (43.0%) had a good perception of COVID-19. Majority of mothers who were married, 148 (44.7%) showed a good perception of COVID-19 when compared with those who were single, 12 (29.3%); however, this is not significant, (χ2 = 3.550, P = 0.060). A large number of participants who have attained tertiary education, 92 (48.9%) had a good perception of COVID-19 which is higher than that seen in mothers with secondary education 68 (37.0%) (χ2 = 5.444, P = 0.020). Participants who were 30­34 years had 1.8 times higher odds of good perception of COVID 19 compared with mothers who were more than 35 years (adjusted odds ratio = 1.803, 95% confidence interval = 1.026­3.170). Conclusion: Although most mothers affirm that a child could be infected by COVID-19, a small number of them actually had a good perception of COVID-19 infection. Good perception of COVID-19 among the under-five is enhanced by the high level of education and age of 32­34 years.

Biochemical and liver histological changes in rats exposed to sub-lethal dose of Uproot-pesticide and the protective potentials of nutritional supplements

This study determined the therapeutic potentials of vitamin C, glutathione, and garlic on the hepatic andhistological changes induced by uproot-pesticide on albino Wistar rats. All animal groups (except normalcontrol) received intraperitoneally 50 mg/kg body weight of uproot-pesticide (a commercially formulatedglyphosate-based herbicide) on alternate days and daily oral administration (except Uproot control) of 20 mg/kg body weight of glutathione, vitamin C, and garlic as nutritional supplements singly and in combination for28 days. Liver function and oxidative stress parameters of the liver were determined using blood and liversamples. Histological studies were done on the liver tissue. The values obtained showed significant variationof measured parameters in Uproot control compared to groups administered nutritional supplements and thecontrol. These variations indicated oxidative liver damage and significant therapeutic potential of the nutritionalsupplements. Other observed significant and non-significant changes were discussed.

Lewis Blood Group Percentage Distribution among Indigenes of Ogoni Ethnicity in Rivers State, Nigeria

Aim: We attempted to determine the frequencyand percentage distributionof Lewis blood group antigens among indigenes of Ogoni ethnicity in Rivers State, Nigeria.Study Design:The study consisted of 101 Ogoni people, who were apparently healthy and free from transfusion transmissible infections confirmed by serological screening. Ogoniland is located along the Niger Delta Eastern edge, and to the north-east of the Imo River and Port Harcourt city. All subjects were recruited and their blood samples were collected. The presence of Lewis-a and -b (Lea/Leb) blood group was examined using Anti-Leaand Lebmonoclonal antibody, respectively (Lorne Laboratories).Results:Leaand Lebblood group was observed in 17.8%and 11.9%, respectively.Conclusion:Leaand Lebin this population was observed less frequently than those in other population previously reported. The Lewis antigen was reported to be associated with thrombotic disorders and Helicobacter pylori infection. Further studies may be directed to examine the association between Lewis blood group antigens and the risk of these conditions in Ogoni subjects

Preliminary Investigations on the Health Benefits of Citrullus colocynthis (L.) Schrad Seeds

Aims: To evaluate the composition of Citrullus colocynthis (L.) Schrad seed as a means of assessing its health and possible therapeutic benefits. Study Design: Test-tube Lab Research. Place and Duration of Study: Federal Institute of Industrial Research, Oshodi, Nigeria, between June 2018 and March 2019. Methodology: Intact dehulled Citrullus colocynthis (L.) Schrad seeds were analyzed for their proximate and elemental content using standard methods and atomic absorption spectroscopy, respectively. The seed oil was extracted with n-hexane via cold maceration and the extracted oil was analyzed for its physiochemical properties. The fatty acid profile was determined using gas chromatography-mass spectrometry. Results: The proximate analysis values were determined to be 6.51%, 51.46%, 21.62%, 13.26%, 3.76% and 3.39% for the moisture, crude fat, crude protein, crude fiber, ash and total carbohydrate content respectively. Results of the elemental analysis show the seed contains; 3653.0322 mg/kg Na, 6639.7818 mg/kg K, 2329.0612 mg/kg Ca, 235.6057 mg/kg Fe, 5252.5884 mg/kg Mg, 27.9056 mg/kg Zn and 7.0068 mg/kg Pb. The predominant fatty acid detected with an area percentage of 20.31 was cis-11-octadecenoic acid. Other fatty acids detected include cis-9, cis-12-octadecadienoic acid, cis-9-octadecenoic, hexadecanoic acid, octadecanoic acid and icosanoic acid. Squalene, a biosynthetic precursor of cholesterol, was detected with an area percentage of 8.54. Conclusion: The evaluation of the compositional data provided evidential support for its beneficial health impact particularly in regards to nutritional and cardio-vascular health.

The Effect of Ethanolic Seed Extract of Citrullus lanatus (Watermelon) on Blood Glucose Level and Lipid Profile of Diabetic Wistar Rats

Aims: This study investigated the effect of ethanolic seed extract of Citrullus lanatus (ESECL) on blood glucose level and lipid profile in Alloxan-induced diabetic male Wistar rats. Study Design and Methodology: 30 male adult wistar rats were grouped randomly into six experimental groups of five rats each. Diabetes was induced by intraperitoneal injection of 100 mg/kg of alloxan monohydrate, dissolved in normal saline, while the normal control group (group 1) was given the vehicle only. Three days after induction of diabetes, were treated further for four weeks with ESECL at doses of 100, 200 and 400 mg/kg for groups 4, 5, and 6 respectively. Animals in Group 3 were treated with Glibenclamide (2.5 mg/kg), while group 2 served as the negative control group. Results: Administration of ESECL caused significant decrease in blood glucose levels in groups 4, 5 and 6 compared to rats of group 2 (p=0.00125). There was also significant decrease in the levels of cholesterol (TC) , triglycerides (TG), low density lipoprotein (LDL), with increase in high density lipoprotein (HDL) in Groups 4, 5 and 6, compared to Group 2 rats (p=0.00125). The results obtained from the rats of the group receiving extract were similar to that obtained from Groups 3. Conclusion: Thus, this study suggests that this extract could possibly normalize abnormalities in blood glucose levels and lipid profiles in diabetic conditions in a dose dependent manner.

Assessment of Protein C and Protein S of Pregnancy Loss Victims

Background: The haemostatic changes that result in thrombophilia during the pregnant state have been linked to pregnancy loss. Objective: Assessment of Protein S, and Protein C assays in pregnancy loss victims in Abia State, South East, Nigeria. Materials and Methods: This was a cross-sectional study involving women in their reproductive years. Study population was stratified into 3 groups and the Protein C and Protein S concentrations measured and compared among the three groups. Results: A total of 130 apparently healthy Nigerian women of child-bearing age were enrolled in the study. The study groups consisted of 70 women who had just lost a pregnancy, 30 women with normally progressing pregnancy and 30 nonpregnant women. The protein C concentration for the pregnancy-loss subjects was significantly lower than that of the normal pregnancy at p ? 0.01 while that of Protein S showed non-significance (p > 0.05). Conclusion: Protein C deficiency is associated with increase in pregnancy loss.

Does Melatonin and Melatonin Agonists Improve the Metabolic Side Effects of Atypical Antipsychotics?: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Atypical antipsychotics (AAPs) are increasingly used for the treatment of psychotic disorders but are known to be associated with metabolic abnormalities. This study is a systematic review and meta-analysis of randomized controlled trials (RCTs) studying the effectiveness of melatonin for the amelioration of AAP-induced metabolic syndrome. The MEDLINE (accessed via PubMed), Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials, PsycINFO, LILACS, CINAHL, and OpenGrey databases were searched for RCTs without language restrictions. Inclusion criteria were randomized, double-blind clinical trials comparing melatonin or melatonin agonists with placebo for the amelioration of AAP-induced effects at any age with selected components of metabolic syndrome as outcome measures. Two reviewers independently selected articles and assessed quality using Cochrane risk of bias and concealment tools. Of 53 records, five RCTs were eligible for the systematic review and three for the meta-analysis. The meta-analyses showed no statistically significant difference in any anthropometric or metabolic variable considered. Analysis according to psychiatric diagnosis from one RCT showed significant decreases in diastolic blood pressure (5.5 vs. −5.7 mmHg for the placebo and melatonin groups, respectively; p=0.001), fat mass (2.7 vs. 0.2 kg, respectively; p=0.032), and triglycerides (D) (50.1 vs. −20 mg/dl, respectively; p=0.08) in the bipolar group but not the schizophrenia group. Although limited to five RCTs with small sample sizes, evidence from RCT indicates that melatonin improves AAP-induced metabolic syndrome. This beneficial effect seems more significant in patients with bipolar disorder than those with schizophrenia. Further RCTs are needed to definitively establish the potential ameliorative effect of melatonin and to justify its efficacy as an add-on therapy to curtail AAP-induced metabolic syndrome.

Determinants of adherence to antiretroviral therapy among HIV-Positive women accessing prevention of mother to child transmission services in Ebonyi State, Nigeria

Background: Mother-to-child transmission (MTCT) of HIV accounts for over 90% of all pediatrics infection globally. Strict adherence to antiretroviral drugs is needed to achieve maximal reduction of HIV transmission in pregnancy. Objective: To determine the level of adherence among HIV infected pregnant women on Prevention of Mother to Child Transmission. (PMTCT) antiretroviral therapy and to establish the factors that contribute to poor adherence. Methods: A cross sectional study was conducted in which 268 HIV positive pregnant women were recruited by systematic sampling method from PMTCT clinic of Federal Teaching Hospital Abakaliki. Pre tested interviewer administered questionnaire was used for data collection. Information on socio-demographic characteristics, knowledge of PMTCT, barriers to PMTCT and obstetric characteristics were obtained. Knowledge on PMTCT was accessed and a score of <4 out of 5 indicated poor knowledge. Adherence Level was calculated using the respondent self-report using (3 day recall) and a value < 95% indicated poor adherence. Data were analyzed using descriptive statistics, Chi square and logistic regression (p ≤ 0.05). Results: The mean age was 30.7 ± 4.2 years. Two hundred and nineteen (81.7%) of the respondents were married, 124 (46.3%) were traders and 141 (52.6%) had secondary education. The prevalence of good adherence was 89.2% and 227 (89.0%) had good knowledge of PMTCT. Fear of being identified as HIV positive (21%) pregnancy related illness (13.7%) and forgetfulness (12.5%) were the most common reasons for non-adherence. Partner's support (OR=.03, 95% CI=0.01-0.09, p=0.001), and duration of ART (OR=4.39, 95% CI=1.3- 14.5, p=0.019) at bivariate analysis were found to be significantly associated with good adherence. Partners support (OR=0.027, 95%CI=0.01-0.09) retained the association with good adherence after controlling for cofounders. Conclusion: The study identified that stigmatization and pregnancy related illnesses were related to poor adherence while having Partners support improve adherence to HAART

Metastatic skin nodules in breast cancer: a report of five cases

Background: Breast cancer is the most common cause of cancer related death in female patients admitted in surgical wards of tertiary hospitals. It is common in elderly women and now being reported even in younger patients. Despite enlightenment campaigns patients still present with very late disease. Aim: This is to report five cases of metastatic skin nodules in breast cancer; an auditing tool of the breast cancer awareness campaign. Case Report: The first was a 55-year-old female who presented with a history of generalized skin nodules and progressive weight loss. She was pale and cachectic. Her pulse rate was 110 per minute and blood pressure was 90/50 mmHg. The second was 60-year-old female who presented with right breast lump and and multiple anterior chest wall nodules. The third was a 35-year-old female who presented with a left breast lump. She had excision biopsy and was lost on follow up The fourth case was 48-year-old female who presented with left breast ulcer and multiple anterior chest wall nodules. Lastly, the fifth was a 58-year-old female who presented with left breast ulcer, skin nodules and paraplegia. All cases had metastatic nodules found on the examination at presentation. Biopsy of these nodules confirmed infiltrating ductal carcinoma. Three died while receiving treatment while two were lost on follow-up.Conclusion: Death arising from metastatic cutaneous breast cancer is a good index for surgical audit. The findings of these cases in our environment depict need for more effort in awareness campaign for reducing mortality from breast cancer

Bruising in children: Evaluation in cases of suspected non-accidental injuries in children (physical child abuse)

Background: Bruises commonly occur in children and are often due to minor accidental injuries. However, they can also occur in bleeding disorders or inflicted injuries (physical abuse) and is often the most common visible manifestation of child physical abuse.Objective: This paper aims at highlighting the factors that should raise concern about nonaccidental injury (physical abuse) in children presenting with bruising and the approach to their evaluation. Method: This paper is based ona manual literature search and review of relevant papers sourced from Pubmed using the search terms "bruising, non-accidental injuries in children, evaluation.Conclusion: It is instructive to carefully and thoroughly evaluate bruise in children utilizing peer review and the necessary ancillary tests. It is also advisable to always consider other possible causes of bruise and bruise-like lesions in forming opinion about suspected bruise as implications of false diagnosis are grave

First Report of blaCTX-M-15 Extended Spectrum Beta-Lactamase (ESBL) Producing E. Coli Isolated from Cloacal Swabs of Birds in South Eastern Nigeria

Introduction: In this study, we investigated the presence of some beta-lactamases namely SHV, TEM and the most widely spread extended spectrum beta-lactamase (blaCTX-M-15) genes in E. coli isolated from four different bird species including ducks, pigeons, weaverbirds and bats in Ebonyi State, Nigeria. Methodology: Genes for ESBL production was determined based on PCR amplification of the genes encoding the enzymes including TEM, SHV and CTX-M-15 using specific primers. One hundred and fifty cloacal swabs each from ducks and pigeons and 100 each from weaverbirds and bats were respectively collected using sterile swab sticks. Antibiotic susceptibility test on the isolates was conducted using disc diffusion method while the phenotypic determination of ESBL was carried out using Double Disc Synergy Tests (DDST). Observations: Results from this study showed that E. coli was present in all the 4 bird species investigated. Of the 117 isolates screened for ESBL production, only 3(5.56 %) and 9(16.67 %), respectively were positive from ducks and pigeons while none was positive from bats and weaverbirds. Results of the molecular studies showed that the ESBL producing E. coli from pigeons were negative for SHV genes, positive for TEM and CTX-M-15 while those from ducks did not harbour any of the beta-lactamase and ESBL genes investigated.  Conclusion: The detection of similar types of beta-lactamase and ESBL genes (TEM and CTX-M-15) in pigeon samples indicates the possible involvement of some bird species in the spread of multidrug resistant genes across human population. This is the first report of CTX-M-15 ESBL in bird species from Southeast Nigeria.

Surgical Inpatient Mortality in a Nigerian Tertiary Hospital

Background: There is paucity of literatures on audit of mortality in the surgical units of tertiary hospitals in the country. This has made the spectrum of mortality not to been known in some of the centers and therefore; there is a great disparity and dearth in apportioning health care services appropriately. Aim: The determination of the pattern of mortality in a surgical unit helps in planning; provision of quality surgical care and prioritizing of limited resources in developing countries. Methods: This is a retrospective study of all patients who died during admission into surgical wards of our hospital between 2007 and 2012. Data on demography and events leading to death were collected and analyzed from all surgical wards; the emergency unit; surgical outpatients; and theater records. Results: A total of 527 deaths occurred among the 8230 patients admitted during the 6-year period giving a mortality rate of 6.4%. Three hundred and forty-five (65.5%) were male; while 282 (34.5%) were females. The mortality rates in units were as follows: Burn and plastic (23.1%); general surgery (5.5%); neurosurgery (7.9%); urology (6.0%); orthopedics (3.8%); pediatric surgery (3.4%); and cardiothoracic surgery (11.9%). The yearly mortality rate were as follows; respectively: 2007 (7.1%); 2008 (6.0%); 2009 (4.5%); 2010 (6.5%); 2011 (7.2%); and 2012 (7.5%). About 84.6% of the patients died within 1 month on admission. The leading causes of mortality were trauma (41.8%) and cancer (32.4%). Most of the deaths (64.9%) occurred between 20- and 70-year-old. Conclusion: Trauma and cancer constitute a great deal of health burden in our region. Strong legislation and screenings with timely interventions are required

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among Rural Primary School Children in Southeastern Nigeria: Comparison of School and Home Settings

Background: Diagnosis of ADHD depends on manifestation of symptoms in at least two different settings. This therefore emphasizes the importance of multiple informants; parents and teachers. However perception could differ because of differences and inconsistencies across different settings. This is particularly important in rural settings in Africa where the educational attainment and outlook of teachers are very different from those of the parents. The study is aimed at comparing the presentations of children with ADHD in the rural area; across two different settings: home and school. Methods: The teachers of 181 rural primary school children in Ogberuru in Imo state; south eastern; Nigeria completed the school version of ADHD rating scale-IV; and their parents completed a Socio demographic questionnaire and the home versions of the ADHD rating scale IV. Results: Of the 18 symptoms of the condition; there were significant differences in the rate of identification in eight symptoms. These symptoms include 'being easily distracted' (p=0.0427); 'difficulty following through on instruction' (p=0.0026); 'fails to give close attention to details (p=0.0001); 'avoids tasks necessary for tasks' (p=0.0013); 'difficulty playing quietly (p=0.0059 ) ; 'talks excessively' (p=0.0023); 'intrudes on others' (p=0.0004); and 'seems not to listen when spoken to directly' (p=0.0002). They were all consistently more manifest in school settings than in their homes. Conclusion: Teachers identified ADHD symptoms more commonly than parents. They could therefore play critical roles in programs aimed at improving early identification and management of children with ADHD especially in rural Africa where healthcare facilities are scarce

Symptoms of Attention Deficit Hyperactivity Disorder (ADHD) among Rural Primary School Children in Southeastern Nigeria: Comparison of School and Home Settings

Background: Diagnosis of ADHD depends on manifestation of symptoms in at least two different settings. This therefore emphasizes the importance of multiple informants; parents and teachers. However perception could differ because of differences and inconsistencies across different settings. This is particularly important in rural settings in Africa where the educational attainment and outlook of teachers are very different from those of the parents. The study is aimed at comparing the presentations of children with ADHD in the rural area; across two different settings: home and school.Methods: The teachers of 181 rural primary school children in Ogberuru in Imo state; south eastern; Nigeria completed the school version of ADHD rating scale-IV; and their parents completed a Socio demographic questionnaire and the home versions of the ADHD rating scale IV. Results: Of the 18 symptoms of the condition; there were significant differences in the rate of identification in eight symptoms. These symptoms include 'being easily distracted' (p=0.0427); 'difficulty following through on instruction' (p=0.0026); 'fails to give close attention to details (p=0.0001); 'avoids tasks necessary for tasks' (p=0.0013); 'difficulty playing quietly (p=0.0059 ) ; 'talks excessively' (p=0.0023); 'intrudes on others' (p=0.0004); and 'seems not to listen when spoken to directly' (p=0.0002). They were all consistently more manifest in school settings than in their homes. Conclusion: Teachers identified ADHD symptoms more commonly than parents. They could therefore play critical roles in programs aimed at improving early identification and management of children with ADHD especially in rural Africa where healthcare facilities are scarce