Patients’ perception of quality of tuberculosis healthcare service in South West Nigeria

Background: Nigeria has the highest burden of tuberculosis (TB) in Africa and is among the 14 countries in all the 3 world health organization global high-burden countries for TB, TB/HIV and MDR-TB. The aim of this study was to assess patients’ perception of the quality of TB healthcare in Southwest Nigeria Methods: The study utilized the cross-sectional design, and data was collected from drug-sensitive TB clients receiving care at health facilities providing TB healthcare services Results: The average time clients spent to get to TB facilities from home was 23 minutes, the average waiting time was 6.7 minutes, and the average medical visit time was 17 minutes. Sixty-seven percent of respondents strongly agreed that doctors explained medical test result with them and 68.7% strongly agree that they wanted the medical doctors to spend more time with them. The mean score for convenience of accessing drugs was 4.8±0.5 mins, mean score for convenience of accessing laboratory test was 4.7±0.6 mins and mean score for convenience of accessing chest x-ray was 3.8±1.4 mins. Overall, the quality of TB care was perceived to be good. Conclusions: Overall, the quality of TB services is very good from the perspectives of the patient, however, there is need to improve integrated patient-centered TB healthcare services by medical doctors. In addition, access to chest x-ray services should be improved to enhance quality of TB services.

Weight gain and menstrual abnormalities between users of Depo-provera and Noristerat

Background: Progesterone only injectable contraceptive provides long acting contraception against unwanted pregnancy. Alterations in menstrual pattern are a well known side effect of this effective contraceptive method. Objective of this study was to compare the weight gain and pattern of menstrual abnormalities in users of Depot Medroxyprogesterone Acetate (DMPA) and Norethisterone Enanthate (Noristerat) in LASUTH.Methods: Retrospective comparative study conducted over a 3year period (January 2013 to December 2015) and involving 237 subjects who used injectable hormonal contraceptive (either DMPA or Noristerat). Case records of all the subjects were retrieved and information obtained on socio-demographic data, parity, previous contraceptive method and reason for discontinuation within one year of usage. Other information including subjects’ weight, menstrual cycle length and pattern, and side effects were collected at 3, 6 and 12 months for DMPA group and 2, 4 and 12 months interval for Noristerat group. Data obtained were analyzed using statistical packages for social sciences (version 19).Results: The combined mean age was 34.15±1.36 years. The mean weight at commencement was 68.16kg for DMPA and 66.61kg for Noristerat users while after a year, it significantly increased to 71.27kg for DMPA and 69.07kg for Noristerat users (P<0.05). No change in menstrual pattern was noted in 10% of DMPA and 7% of Noristerat users while 60% of DMPA and 57% of Noristerat had amenorrhoea by the end one year period. Five percent each of DMPA and Noristerat users perceived weight gain as problem significant enough to discontinue both methods respectively. Overall, 24% of DMPA and 19.1% of Noristerat users discontinued use after one year.Conclusions: There were significant weight gain between users of DMPA and Noristerat which was not considered a problem. Amenorrhoea was the commonest menstrual abnormality responsible for discontinuation of either method.

Multiple perturbed collocation tau method for solving nonlinear integro-differential equations

ABSTRACT: The purpose of the study was to investigate the numerical solution of non-linear Fredholm and Volterra integro-differential equations by the proposed method called Multiple Perturbed Collocation Tau Method (MPCTM). We assumed a perturbed approximate solution in terms of Chebyshev polynomial basis function and then determined the derivatives of the perturbed approximate solution which are then substituted into the special classes of the problems considered. Thus, resulting into n-folds integration, the resulting equation is then collocated at equally spaced interior points and the unknown constants in the approximate solution are then obtained by Newton's method which are then substituted back into the approximate solution.Illustrative examples are given to demonstrate the efficiency, computational cost and accuracy of the method. The results obtained with some numerical examples are compared favorable with some existing numerical methods in literature and with the exact solutions where they are known in closed form

Phytochemical Screening and Antimicrobial Studies of Stem and Root Extracts of Crateva adansonii

Aim: This study was designed to explore the phytochemical and antimicrobial screening of the stem and root extracts of Crateva adansonii. Place and Duration of Study: Sample: Iyesi village, Ota, Ogun State, and analysis carried out at Department of Chemistry and Department of Biological Sciences, Covenant University, Ota, Ogun State and for duration of three months (November 2016 to February 2017). Methodology: Standard universal procedures were employed for both phytochemical and antimicrobial analysis. Results: The result obtained from the stem and root extracts of Crateva adansonii indicated the presence of flavonoids, terpenoids, alkaloids, and cardiac glycosides. Root extract was found to be richer in source of phytochemicals when compared to the stem extract. However, the highest antibacterial activity was observed against selected bacteria by both stem and root extracts. The potency of the root extract was observed to be higher than the stem extract against Bacillus cereus, Staphylococcus aureus, Aspergillus niger and Serratia spp. Conclusion: The preliminary studies on the stem and the root of Crateva adansonii extracts revealed their antimicrobial potential which could be further investigated for global utilization in pharmaceutical treatment, natural therapies, food preservation and cosmetic applications.

Cholinesterase inhibitory activity and structure elucidation of a new phytol derivative and a new cinnamic acid ester from Pycnanthus angolensis

ABSTRACT The leaves of Pycnanthus angolensis (Welw.) Warb., Myristicaceae, are used as memory enhancer and anti-ageing in Nigerian ethnomedicine. This study aimed at evaluating the cholinesterase inhibitory property as well as isolates the bioactive compounds from the plant. The acetylcholinesterase and butyrylcholinesterase inhibitory potentials of extracts, fractions, and isolated compounds were evaluated by colorimetric and TLC bioautographic assay techniques. The extract inhibited both enzymes with activity increasing with purification, ethyl acetate fraction being most active fraction at 65.66 ± 1.06% and 49.38 ± 1.66% against acetylcholinesterase and butyrylcholinesterase, respectively while the supernatant had 77.44 ± 1.18 inhibition against acetylcholinesterase. Two new bioactive compounds, (2E, 18E)-3,7,11,15,18-pentamethylhenicosa-2,18-dien-1-ol (named eluptol) and [12-(4-hydroxy-3-methyl-oxo-cyclopenta-1,3-dien-1yl)-11-methyl-dodecyl](E)-3-(3,4-dimethylphenyl)prop-2-enoate (named omifoate A) were isolated from the plant with IC50 of 22.26 µg/ml (AChE), 34.61 µg/ml (BuChE) and 6.51 µg/ml (AChE), 9.07 µg/ml (BuChE) respectively. The results showed that the plant has cholinesterase inhibitory activity which might be responsible for its memory enhancing action, thus justifying its inclusion in traditional memory enhancing preparations.

Survey of Knowledge and Source of Information Relating to Reproduction and Sexually Transmitted Infections among Senior Secondary Schools Students in a Military Barracks in Nigeria.

Context: Adolescents seek health information from diverse sources. When such information is appropriately sought, correct and complete, it ensures an understanding of their reproductive health needs and encourages healthy sexual decision making and behaviors. Objective: To determine the level of knowledge and source of information about reproduction and sexually transmitted infections among senior secondary schools students in Ojo military barracks, Lagos. Materials and Methods: A cross-sectional study of 400 senior secondary schools students in Ojo military barracks, Lagos, selected using multistage sampling technique was done. Data collection employed pretested, self- administered structured questionnaires. Data was analysed using statistical package for social sciences version 17. Tests of statistical significance were carried out using chi square and t tests. A p value of <.05 was considered significant. Results: Majority of them 391(97.8%), were in the age group (10-19 years) while the mean age was 152.4 for males and 152.2 for females respectively. Information on sexual and reproductive health was sought from the electronic media by 238(59.5%), 115 (52.0%) males and 123 (68.7%) females; peer group 231(57.8%), 120 (54.3%) males and 111 (62.0%) females as well as print media and other sources with a statistically significant difference in this practice between the males and females (P=.01). Only 38 (9.5%) had very good knowledge. The sexually experienced were less knowledgeable than the non-experienced (3.71.3 and 3.91.3 respectively; P<.05). Knowledge was found to increase with age (P<.05). Females had more knowledge than males (P<.05). Conclusions: Overall knowledge was assessed as fairly good, while key sources of information were the electronic media and peer groups. Interventions including peer education are recommended to ensure that these sources provide veritable information on reproductive health.

Dental Practice; Human Immunodeficiency Virus Transmission and Occupational Risks: Views from a Teaching Hospital in Nigeria

Background: More than 40 oral manifestations of human immunodeficiency virus (HIV) infection have been recorded and between 70 and 90 of persons with HIV infection will have at least one oral manifestation at some time during the course of their disease. Oral health-care workers (OHCWs) are therefore; key players in the prevention and management of HIV-infection. Aim: The aim of this study was toassess the perceptions of the OHCWs from a Teaching Hospital in Nigeria toward HIV transmission in dental practice and occupational risk. Subjects and Methods: A cross-sectional study. A self-administered questionnaire was used for data collection. A total of 113 OHCWs comprising students; house officers; resident doctors; dental nurses and consultants participated. Analysis was by Statistical Package for the Social Sciences version 17 (SPSS Inc.; Chicago; IL; USA). Data analysis included descriptive statistics (frequency distribution and cross tabulation). Results: More than half 64/113 (56) of the respondents were in the age group 20-30 years and females 68/113 (60). Though 88 (100/113) of the respondents demonstrated a good knowledge about HIV transmission; 82/113 respondents (72) disagreed that the risk of HIV transmission in the dental clinic was very low. 82.4 (93/113) did not know that saliva contains anti-HIV activity while 46 (52/113) agreed that pure saliva does not contain the virus except when contaminated by blood. 86.7 (98/113) of the OHCWs disagreed that dental professionals have a lower risk of being infected with HIV compared with other health-care providers. Conclusion: The OHCWs studied manifested some inaccurate perception of occupational risks as regards HIV transmission in dental practice. This could lead to potential stigma and discrimination of people living with HIV/acquired immune deficiency syndrome and thus hindering efforts geared at curtailing the spread of the virus

A survey of facial nerve dessection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria

Objective: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear; Nose; and Throat (ENT) Surgeons. Materials and Methods: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear; Nose; and Throat Surgeons in Nigeria; on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy; limited superficial parotidectomy; and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. Result: About half (47.5) of them routinely used the antegrade technique; while only a few (12.5) used the retrograde technique. A large number of them (40); however; used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60) and limited superficial parotidectomy (62). However; the retrograde approach was the technique of choice by most of them (47) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. Conclusions: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated

Acetylcholinesterase and butyrylcholinesterase inhibitory activity of some selected Nigerian medicinal plants / Atividade inibitória da acetilcolinesterase e butirilcolinesterase de algumas plantas medicinais da Nigéria

Plants have been found to be useful as memory enhansers as well as antiaging. Twenty two of such plants from sixteen families were investigated for their acetylcholinesterase (AChE) and butyrylcholinesterase (BuChE) inhibitory activities using the in vitro Ellman's spectrophotometric and in situ bioautographic methods with physostigmine as standard. At least three morphological parts were examined for each of the plants investigated and the test concentration was 42.5 µg/ mL. Some plants were active on both enzymes though with some morphological parts being more active than others. The root bark of Spondias mombin showed the highest activity to the two enzymes; 64.77 percent and 83.94 percent on AChE and BuChE respectively. Other plant parts of the selected plants exhibited some remarkable selectivity in their actions. Those selectively active against AChE were Alchornia laxiflora stem bark (41.12 percent) and root bark, Callophyllum inophyllurn root bark (56.52 percent). The leaves of C. jagus (74.25 percent), Morinda lucida leaves (40.15 percent), Peltophorum pterocarpum leaves and stem bark (49.5 percent and 68.85 percent, respectively), physiostigmine gave 90.31 percent inhibition. Generally higher activities were found against BuChE. Bombax bromoposenze leaves, root bark and stem bark were particularly active. The inhibition was over 80 percent. Other selective plant parts are the leaves Antiaris africana, Cissampelos owarensis aerial parts (78.96 percent), Combretum molle leaves and stem bark (90.42 percent and 88.13 percent, respectively), Dioscorea dumentorum root bark and tuber (over 87 percent), G. kola leaves, Markhamia tomentosa root bark, Pycnanthus angolensis stem bark and Tetrapleura tetraptera leaves. Most of these plants are taken as food or are food ingredients in Nigeria and may account for the low incidence of Alzheimer's disease in the country and may play certain roles in the mediation of the disease.

As plantas podem ser úteis para estimular a memória, bem como serem usadas para combater o envelhecimento. Vinte e duas plantas, de dezesseis famílias, foram investigadas in vitro oara verificar sua atividade inibidora das enzimas acetilcolinesterase (AChE) e butirilcolinesterase (BuChE) pelo método espectrofotométrico de Ellman in situ e métodos de bioautografia utilizando fisostigmina como padrão. Pelo menos três partes morfológicas de cada planta foram analisadas e a concentração de ensaio foi de 42,5 µg/mL. Algumas plantas foram ativas em ambas as enzimas, embora com algumas partes mais ativas que outras. A casca da raiz de Spondias mombin apresentou a maior atividade as duas enzimas, 64,77 por cento para AChE e 83,94 por cento para BuChE. Outras partes das plantas selecionadas apresentaram boa seletividade em suas ações. As plantas seletivamente ativos contra AChE foram as casca do caule e casca da raiz de Alchornia laxiflora (41,12 por cento), e casca da raiz de Callophyllum inophyllurn (56,52 por cento). As folhas de C. jagus (74,25 por cento), folhas de Morinda lucida (40,15 por cento), folhas e casca do caule de Peltophorum pterocarpum (49,5 por cento e 68,85 por cento, respectivamente), physiostigmine inibiu 90,31 por cento. Em geral, atividades melhoras foram apresentadas contra BuChE. Folhas, casca da raiz e casca do caule Bombax bromoposenze foram particularmente ativos. A inibição foi acima de 80 por cento. Outras partes de algumas espécies também foram seletivas, como as partes aéreas de Antiaris africana, Cissampelos owarensis (78,96 por cento), folhas e casca do caule de Combretum molle (90,42 por cento e 88,13 por cento, respectivamente), casca da raiz e de tubérculos de Dioscorea dumentorum (mais de 87 por cento), folhas de G cola, cascas de raiz de Markhamia tomentosa, casca do caule de Pycnanthus angolensis e folhas de Tetrapleura tetraptera. A maioria destas plantas são utilizadas como alimentos ou ingredientes alimentares na Nigéria e podem ser responsáveis pela baixa incidência da doença de Alzheimer no país e desempenhar determinadas funções na mediação da doença.

Pregnancy Epulis Associated With Life Threatening Haemorrhage in a Nigerian Woman

Pregnancy tumour is a clinical term used to identify a pyogenic granuloma that occurs in pregnant women. Pregnancy tumour is not uncommon; but severe bleeding associated with the lesion necessitating blood transfusion is rare. We report a rare case of mandibular gingival pregnancy tumour with a life-threatening haemorrhage in a 25-year-old Nigerian woman. The patient had lost an estimated 2 litres of blood before presentation. Her packed cell volume was 8at presentation. The patient was managed by infusion of fluid; transfusion of 4 units of blood and ligation of the facial artery; and excision of the lesion. Following an uneventful healing; she was discharged 10 days later with a PCV of 40.5. Following subsequent review there was a recurrence 2 months later that regress after 1 month. She was subsequently lost to further follow up