Effect of Eosin Solution Exposed to Sunlight against Anopheles Mosquito Larvae

Mosquitoes are a menace for millions of people around the world, they are vectors for destructive microorganisms which cause diseases like Malaria, Dengue fever and Lymphatic filariasis, affecting people in developing countries and areas with tropical climates. Anopheles, a predominant genus transmits malaria, and the World Health Organization have shown that 350,000 lives especially children and pregnant women are lost annually by it. The aim of this study is to determine the effect of eosin solution exposed to sunlight on larvae of Anopheles mosquito. The use of control method was aid at eliminating the larva stages of the mosquito life cycle. A total of one hundred and twenty (120) Anopheles mosquito larvae were harvested using dipper with handle and net from drainages at Eagle Island and Rivers State University both in Port Harcourt. Five different concentrations of Eosin solutions were prepared in volumes of 1000 microlitre (µl), 800µl, 600µl, 400µl, 200µl after a stock solution of 1gram(g) in 100ml and a control, the physicochemical parameters of the solutions were determined using Extech model DO700 measuring instrument. Twenty (20) mosquito larvae, were carefully introduced into each of the concentrations, exposed to sunlight and observed for 24 hours (hrs) for a period of six (6) days for susceptibility. A hundred percent (100%) mortality was recorded in eosin volume of 1000µl and 800µl. The separate solutions of eosin showed significant effects of their concentrations on the Anopheles mosquito larvae of P-value 0.017 at P<0.05. The result obtained for the physicochemical parameters were; pH 5.24, temperature 30.4oC, conductivity 168µS/cm, salinity 0.08%, total dissolved solids 118 milligram per litre(mg/L) and dissolved oxygen was 6.5mg/L for the control. Changes occurred in the values of the dissolved oxygen before and after exposure to sunlight in all the dilutions. The results obtained showed that after 24 hrs, the mortality rate of the larvae increased, indicating that Anopheles mosquito larvae expose to concentrations of eosin solutions results in their mortality within 48 hrs. It may be concluded that this study has provided some evidence of larvicidal effect of eosin solution exposed to sunlight on larvae of Anopheles mosquito.

Hemichorea-hemiballismus in a patient with hyperglycaemic hyperosmolar state

Hemichorea-hemiballismus (HCHB) is a rare manifestation of hyperglycaemic hyperosmolar state caused by contralateral lesion in basal ganglia. A 74-year-old, known diabetic and hypertensive woman presented with one-week history of high-grade fever and loss of consciousness associated with involuntary movement of the right upper and lower limbs for 10 hours prior to presentation. Physical examination revealed pyrexia, tachycardia and altered sensorium. Blood glucose was 53.8 mmol/l, hemoglobin A1c (Hb A1c) 9.9% and brain computed tomography (CT) scan showed cerebral atrophy with bilateral basal ganglia hyperdensities. Escherichia coli was cultured from the urine. She did well on treatment with soluble insulin, rehydration and intravenous ceftriaxone. HCHB is a rare complication seen in patients with poorly controlled diabetes mellitus. This report highlights the reversibility of the disease with prompt diagnosis and appropriate insulin treatment. HCHB should be distinguished from other intracranial pathologies.

Evaluation of Some Cytokines, CD4, Hepcidin, Iron, and Some Haematological Parameters of Patients Living with Human Immunodeficiency Virus in Southeastern Part of Nigeria

A study to evaluate the levels of interferon-gamma, interleukins 6 and 10, hepcidin, iron status and some haematological parameters in persons living with human immunodeficiency virus was carried out. A total of 150 subjects aged 18-60 years were enlisted for this study. The subjects were grouped into: Group A (50 control subjects) and Group B (100 HIV subjects, 50 subjects were non ART HIV patients, 50 subjects were on Lamivudine, Tenofavir and Efavirenz). About 7ml of venous blood were collected from each subject;4.5ml of blood were placed into plain tubes for assay of interferon gamma, interleukins (6&10), hepcidin and iron and 2.5ml for FBC, CD4 count and HIV screening. The cytokines and hepcidinwere measured using Melsin ELISA Kits and Teco Diagnostics kits used for iron. Full blood count was determined by automation using Mindray BC-5300, China. The data was analysed with the statistical package for social science (SPSS) version 20 using ANOVA and the level of significance set at P<0.05. The results showed difference that was statistically significant (P<0.05) in IFN-γ (16.25±0.87pg/ml, 29.31±1.44pg/ml,18.49±1.48pg/ml, P=0.000),IL-6(7.98±0.22pg/ml, 11.08±1.21pg/ml,8.79±0.76pg/ml,P=0.000), IL-10(8.52±0.62pg/ml, 16.62±1.53pg/ml,10.39±1.06Pg/ml P=0.000), CD4 (1045.54 ±247.24Cells/L, 195.60 ±35.94Cells/L,10.39±1.06cells/L P=0.000), hepcidin (6.03±1.38ng/ml, 39.59 ±4.50ng/ml, 20.86±3.43ng/ml, P=0.000), Iron (86.29±7.27 μg/dl, 73.43±5.45 μg/dl,85.44±8.45μg/dl, P=0.000), TIBC (345.56±28.40 μg/dl, 287.19 ±8.21μg/dl,305.46±18.82μg/dl, P=0.000),%TSA (25.16±3.18%, 25.61±2.22%,28.08 ±3.42%,P=0.000) WBC (5.87 ±0.88 X 109/L, 4.69±0.72X 109/L,4.80±0.45X 109/L, P=0.000), Neutrophils (60.57±2.83%, 75.16±3.68%,69.04±2.90%, P=0.000), Lymphocytes (30.69 ±2.84%, 17.24±2.50%, 24.46±2.60%,P=0.000), Monocytes (5.59 ±1.2%, 4.18±1.12%,3.97±0.92%, P=0.000), Eosinophils (2.30 ±1.05%, 2.16±0.82%,1.67±0.57%, P=0.000), Basophil 0.86 ±0.39%, 1.31±0.94%, 0.86±0.44%,P=0.018), RBC (4.92±0.30 X 1012/L, 3.34±0.21 X 1012/L,3.60 ±0.18X 1012/L, P=0.000), Haemoglobin (14.75±0.90,g/dl, 10.05±0.65g/dl,10.80±0.53g/dl, P=0.000), PCV (44.25±2.70%, 30.14±1.95,32.56±1.50%, P=0.000), MCV(89.92±2.3fl, 79.49±1.28fl,88.15±2.08fl, P=0.029), MCH (36.12±1.53pg, 26.60±0.48P, P=0.002), Platelets (261.75±22.71 X 109/L, 246.16±9.93 X 109/L,189.32±17.00X 109/L, P=0.000), ESR (7.03 ±1.38mm/hr, 59.52 ±6.46mm/hr,43.34±4.82mm/hr, P=0.000) when compared among Control, Non ART HIV and ART positive subjects.g,28.57±1.78pg, P=0.000), MCHC (368.46±12.28g/l, 318.92±7.33g/l,333.56±22.61g/l. The study shows that interferon gamma, interleukin 6, interleukin 10 and hepcidin are some of the biomarkers in thepathogenesis of HIV. The infection of HIV increases the levels of the cytokines. The cytokines and hepcidin can be used as prognostic and diagnostic markers as their levels decreased with treatment of the patients

Prevalence of Rubella IgG Antibodies among Pregnant Women in Rivers State, Nigeria

Aim: Rubella virus is the cause of the communicable viral infection that can affect the foetus causing foetal loss or congenital rubella syndrome. Plasma samples from 180 pregnant women attending tertiary hospitals in River State, Nigeria were examined randomly to evaluate the prevalence of rubella virus (RubV) IgG antibodies.Study Design:Cross-sectional study.Place and Duration of Study:University of Port Harcourt Teaching Hospital (UPTH) and Braithwaite Memorial Specialist Hospital (BMSH) now Rivers State University Teaching Hospital (RSUTH) between September 2015 and August 2017 Methods: The sample of this study was composed of 180 pregnant women. ELISA was used to detect the RubV IgG antibodies andprevalence was correlated with sociodemographic factors.Results: The study result revered that 155(86.1%) were positive for RubV IgG while 25(13.9%) were negative for RubV IgG. Of the 90 samples examined from BMSH, 71(78.9%) were IgG-positive. From UPTH,84(93.3%) were positive for RubV IgG. The highest (100%) seropositivity for RubV IgG was found in age groups 39-43 years. No RubV IgG was recorded in age groups 44-48 years. Women in their third trimester had the highest prevalence of RubV IgG antibodies (94.7%). Those with secondary education had the highest prevalence of RubV IgG (93.4%). Vaccinated pregnant women had the highest prevalence (87.4%). Among the variables evaluated, education (p=0.023), occupation (p=0.040), marital status (p=0.001) and vaccination history (p=0.005) were the main correlates in this study.Conclusions: This study has shown evidence of immunity among expectant mothers in this study (86.1%) with 13.9% being vulnerable to rubella virus infection. Completion of adequate rubellavaccination along intensified surveillance of the vulnerable population remains the keystone for the control of congenital rubella syndrome in Nigeria

In Vitro Antimicrobial Susceptibility Testing Of Bacterial Isolates Causing Wound Infection In A Tertiary Care Hospital, Port Harcourt, Nigeria

A successful treatment of wound infection is determined by the proper identification and evaluation of the varied types of microorganisms that colonize the wound surface. Such evaluation will include an antimicrobial susceptibility profiling of the invading pathogen(s) in order to implement an effective and pathogen specific treatment. The antimicrobial susceptibility profile of the bacterial species isolated from wound infections was tested to provide basis for their prudent use as antimicrobials. The standard method of antibiotic sensitivity testing with single antibiotic disc was employed in the analysis. The bacterial isolates tested were Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumoniae. The organisms were isolated from samples collected from patients at different wards at the University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria. The number and percentage occurrence of each individual bacterium encountered varied among the isolates. Pseudomonas aeruginosa has the highest frequency of occurrence of 48.6% accounting for 36 of the 74 bacterial isolates. This was followed by Staphylococcus aureus and Escherichia coli accounting for 17 (23.0%) and 11 (14.9%) respectively. Klebsiella pneumoniae was the least prevalent bacteria species accounting for 10 (13.5%) of the total bacterial count. The study shows imipenem as the most potent antimicrobial agent against the isolates tested. The isolates were moderately sensitive to gentamicin, ciprofloxacin and levofloxacin, but highly resistance to ceftazidime, erythromycin, sulphamethoxazole/trimethoprim, cefepime, amoxicillin/clavulanic acid and aztreonam. The study further reiterates the need for prudent use and control of antimicrobials.

Sonographic Assessment of Normal Fetal Cerebral Lateral Ventricular Diameter at Different Gestational Ages

Abnormal dilatation of ventricles has been shown to be the most common abnormality of the brain & fetus in most of the geographical zones, but the normal dimension of the fetal lateral ventriclein south-southgeopolitical zones of Nigeria has not been evaluated.The aim of this study was to determine the normal feto-lateral ventricular diameter using ultrasound at different gestational ages. Measurement of the fetal-lateral ventricular diameter was obtained from 685 fetuses of pregnant mothers that met the inclusion criteria during routine ultrasound scan in Calabar metropolis. Measurement of the ventricular diameter was taken at the levelof the atria, measured according to Australian society for ultrasound in medicineguidelines.Original ResearchArticle

In vitro Antimicrobial and Antifungal Efficacy of Ethanol Crude Stem Bark Extract of Boswella dalzielle

The efficacy of Boswellia dalzielii(Frankincense) stem bark extract on some bacterial and fungal organisms was evaluated for its in-vitro antimicrobial activities against Staphylococcus aureus, Streptococcus pyogenes, Escherichia coli, Salmonella gallinarium, Aspergillus fumigatusand Candida albicans. The research work was carried out in Biochemistry andMicrobiology Laboratories of Federal College of Animal Health and Production Technology, National Veterinary Research Institute, Vom. Well diffusion method was carried out on nutrient agar. MIC, MBC and MFC of the test organisms were carried outon nutrient broth. The phytochemistry revealed the presence of saponin, tannin, flavonoids, cardiac glycosides,steroids, terpens and phenol in ethanol extracts while resin, alkaloid and glycosides were absent in hot water extracts. Alkaloid was also absent in ethanolic extract. The aqueous extractof the plant exhibited neither antibacterial nor antifungal effects against all test organisms usedin the study while the ethanolic extract of the plant showed both antibacterialand antifungal effectson the study organisms. The results of this study alsoshowed that the ethanolic extract of Boswellia dalzieliistem bark has activity against allbacteria species used in the study (broad spectrum activity). For gram-negative and positivebacteria, Salmonella gallinariumand Staphylococcus aureuswere the most sensitive whileEscherichia coli and Streptococcus pyogeneswere the least respectively. Candida albicanswas more sensitive than Aspergillus fumigatus. It was concluded that the test organisms weresusceptible to ethanol extracts of the plant and may be good source of antibiotics

Burden of Anemia among Pregnant Women with Asymptomatic Malaria Parasitaemia at Booking Visit in Abuja, Nigeria.

Background: Malaria parasitaemia in pregnant women is associated with adverse maternal and fetal complications including anemia. The study aimed at determining prevalence of anemia among pregnant women with asymptomatic malaria parasitaemia at booking in a tertiary hospital in Abuja, Nigeria. Methods: This was a cross-sectional descriptive study of consented 659 pregnant recruited consecutively at booking for antenatal care. Structured questionnaire was administered on each subject and then blood was taken for their packed cell volumes estimation using Hawksley`s microhaematocrit reader as well as thick and thin blood films for malaria parasites assessment.The data were analysed using 2008 EPI-info 3.5.1(CDC, Atlanta Georgia, USA).. Results: Out of 659 pregnant women screened, 255 (38.7%) had significant malaria parasitaemia. Among women with significant malaria parasitaemia, 176 (69.0%), 68 (26.7%) and 11 (4.3%) had mild, moderate and severe malaria parasitaemia respectively. Prevalence of anemia (PCV< 33%) in the entire study population screened was 38.4% (253/659). Among pregnant women with significant malaria parasitaemia, 163 of them were anaemic, giving prevalence of anaemia of 63.9% (163/255) while anemia was noted in 22.3% (90/404) of women with no malaria parasitaemia. The risk of anemia was significantly higher as the severity of parasitaemia increases among the study (P < 0.00001). Conclusion: Anaemia in pregnancy is common among asymptomatic women with malaria parasitaemia and the risk increased significantly as the severity of malaria parasitaemia increases depicting malaria as a common cause of anemia in our obstetric population. Routine screening for malaria infestation at booking is therefore recommended.

Reference Intervals for Serum Cystatin C and Creatinine of an Indigenous Adult Nigerian Population

Background and Aim: Estimation of the glomerular filtration rate (GFR) is important for the evaluation of patients with kidney disease. Some studies suggest that GFR estimated from serum cystatin C (Cys C) is more accurate than that from serum creatinine (SCr). For Cys C to be used for this purpose; normal values need to be determined for various populations. This study determined the serum Cys C levels and reference intervals (RIs) of a Nigerian population.Materials and Methods: Three hundred and four healthy adult subjects were analysed. Serum Cys C and SCr were determined by particle enhanced turbidimetric immunoassay and modified Jaffe kinetic method respectively. Data were analysed using the Statistical Package for Social Sciences version 17.0 (SPSS for Windows Inc.; Chicago; IL; USA). Estimation of RIs was done as per the International Federation of Clinical Chemistry guidelines.Results: The RIs for Cys C were 0.65-1.12 mg/L (median 0.86) for males; 0.62-1.12 mg/L (median 0.85) for females and 0.64-1.12 mg/L (median 0.86) for all the subjects. The RIs for SCr were 73-110 ?mol/L (median 89) for males; 65-102 ?mol/L (median 82) for females and 66-106 ?mol/L (median 86) for all the subjects. There was no significant gender difference in the RIs for serum Cys C; (P 0.05). The SCr levels and RI were significantly lower in females than in males (P 0.001).Conclusion: This study has determined the serum Cys C levels and RI of an indigenous healthy adult black population in Nigeria

Increasing Radiation Doses from Computed Tomography versus Diagnostic Reference Levels: How Compliance Are We.

Aim: To assess the radiation dose received in a clinical/real life setting by patients visiting selected radiological centres in Enugu, Enugu State, southeast of Nigeria for diagnostic computed tomography (CT) scans of the heads and thus assess compliance to the diagnostic reference levels (DRL). Study Design: A prospective cross-sectional survey design. Place and Duration of Study: CT Units of University of Nigeria Teaching Hospital, Memfys Hospital for Neurosurgery and Conquest Medical Imaging Limited in Enugu, Enugu State, Nigeria between April 2012 and January 2013. Materials and Method: Radiation doses absorbed by 98 patients (60 males and 38 females, age range 3-65years) that presented for CT scans of the head at the study centres were prospectively measured using lithium fluoride thermoluminescent dosimeter, LiF-TLD (TLD-100) chips. The mean absorbed dose, mean effective dose, collective dose and the per caput dose with their standard deviations were obtained. Results: The mean absorbed dose was 4.315 ± 3.815mSv (range 1.005-17.607mSv) and the mean effective dose was 2.244±1.984 mSv. In children (0-15years) the mean absorbed dose was 5.604±4.904mSv and mean effective dose, 2.914±2.278 mSv and these doses were higher than that of the adults. The annual collective dose was 224.40±198.4 person-mSv and the annual per caput dose was 5.9 x 10-7mSv. The calculated mean organ effective doses were 0.147±0.056mSv, 0.884±0.334mSv, 0.147±0.056mSv, 0.3540±0.134mSv and 0.147±0.056mSv for the brain, eye lenses, thyroid gland, red bone marrow and breast respectively. Conclusion: TLD chip were used to assess patients’ radiation dose in a clinical setting. The overall mean effective dose (2.244mSv) was in compliance with the recommended DRL. The radiation dose received correlated positively with the tube current (mA) and number of images obtained but negatively with the scan time, patients’ head AP dimension and age. Radiation risks from CT can be reduced through justification of the procedure and dose optimization.

Impacts of Obesity on Maternal and Fetal Outcomes in Women with Singleton Pregnancy at a Nigerian Clinical Setting.

Background: Obesity, an emerging public health concern in maternity care with increasing prevalence even in developing countries is associated with maternal and perinatal complications. This study sought to evaluate the impact of maternal obesity on pregnancy outcomes in a cohort of Nigerian women. Study Design: A prospective cohort study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Bingham University Teaching Hospital Jos, between January 2013 and September 2014. Methodology: A study of matched 324 obese [Body mass index (BMI) ≥ 30 Kg/m2] and 324 non-obese women (BMI 18.5 – 24.9 Kg/m2) with singleton pregnancies recruited at the antenatal clinic during their first trimester. They were followed-up to the postpartum period to ascertain development of antenatal, intra-partum, postpartum and fetal complications. Chi square or Fisher’s Exact test and student t-test were done to ascertain any relationship between obesity and the outcome variables using SPSS version 16 (SPSS Inc., Chicago, IL, USA) and P value < 0.05 was considered statistically significant. Results: In comparison with pregnant women with normal BMI, obese women faced higher risk of developing antenatal complications (P = 0.001, Odds Ratio (OR) 5.32, 95% Confidence Interval (CI) 1.90 – 14.94) especially gestational hypertension and pre-eclampsia (P = 0.002, OR 4.66, 95% CI 1.65 – 13.19), having caesarean section (P = 0.043, OR 0.48, 95% CI 0.23 – 0.99) and macrosomic baby (P = 0.005, OR 3.40, 95% CI 1.41 – 8.19). However, no statistical difference with respect to risk of spontaneous miscarriage (P = 0.313, OR 3.08, 95% CI 0.31 – 30.22), preterm delivery (P = 0.167, OR 3.16, 95% CI 0.62 – 16.15), genital tract injury (P = 0.407, OR 0.76, 95% CI 0.40 – 1.46), postpartum haemorrhage (P = 0.199, OR 1.75, 95% CI 0.74 – 4.13), low birth weight babies (P = 0.732, OR 1.27, 95% CI 0.33 – 4.90) and stillbirth (P = 0.080, OR 0.96, 95% CI 0.92 – 1.01). Conclusion: Maternal obesity is associated with elevated risk of hypertensive disorders, caesarean delivery and fetal macrosomia. It is imperative to implement a policy of identifying these women as high risk group at this clinical setting so as to institute appropriate materno-fetal surveillance and management strategies aim at enhancing their pregnancy outcomes.

Biochemical Changes in Albino Rats Exposed to Rice Husk Dusk at Abakaliki Rice Mill Industrial Area.

The effect of rice husk dust inhalation on some biochemical parameters was conducted on albino rats. Method: 100 albino rats were divided into five groups with each group containing twenty albino rats. Group A served as the control and were housed at the animal house away from rice dust while group B, C, and D were exposed to rice husk dust for two week, three weeks and four weeks respectively for dust inhalation. They were allowed access to rats feeds and deionized water ad libitium. Blood samples were collected from each group at the end of exposure by cardiac puncture. Glucose level was determined using the glucose reagent kit, acid phosphatase concentration was performed using reagent kits, creatinine and uric acid concentration was determined spectrophotometrically, the weight of the rats were recorded daily. Results: Result showed significant reduction in body weight of the exposed. The glucose level decreased significantly while the serum acid phosphatase and serum uric acid level showed a significant increase. Histological result showed various degrees of damage to the kidney of the exposed rats. Conclusion: We therefore conclude that rice husk dust inhalation induces glucose depletion, injury to the kidney and prostatic glands in the albino rat and impairs the renal function.

A qualitative study of causes of prescribing errors among junior medical doctors in a Nigeria in-patient setting

Aims: The aims of this study were to identify and understand the factors underlying prescribing errors in order to determine how to prevent them. Materials and Methods: A prospective qualitative study that involved face-to-face interviews and human factor analysis in a Tertiary Referral Hospital in Central Nigeria; from July 2011 to December 2011. Pharmacists in the study hospital prospectively reviewed prescription orders generated by doctors in selected wards (male and female medical; pediatric and the private wing wards) and identified prescribing errors. The 22 prescribers involved in the errors were interviewed; and given questionnaires to discover factors causing the errors. A model of human error theory was used to analyze the responses. Results: Responses from the doctors suggest that most errors were made because of slips in attention. Lack of drug knowledge was not the single causative factor in any incident. Risk factors identified included individual; team; environment; and task factors. Junior doctors were affected by the prescribing habits of their seniors. Organizational factors identified included inadequate training/experience; absence of reference materials and absence of self-awareness of errors. Defenses against error such as other clinicians and guidelines were absent or deficient; and supervision was inadequate. Conclusions: To reduce the risk of prescribing errors; a number of strategies addressing individual; task; team; and environmental factors such as training of junior doctors; enforcing good practice in prescription writing; supervision; and reviewing the workload of junior doctors must be established. Aims: The aims of this study were to identify and understand the factors underlying prescribing errors in order to determine how to prevent them. Materials and Methods: A prospective qualitative study that involved face-to-face interviews and human factor analysis in a Tertiary Referral Hospital in Central Nigeria; from July 2011 to December 2011. Pharmacists in the study hospital prospectively reviewed prescription orders generated by doctors in selected wards (male and female medical; pediatric and the private wing wards) and identified prescribing errors. The 22 prescribers involved in the errors were interviewed; and given questionnaires to discover factors causing the errors. A model of human error theory was used to analyze the responses. Results: Responses from the doctors suggest that most errors were made because of slips in attention. Lack of drug knowledge was not the single causative factor in any incident. Risk factors identified included individual; team; environment; and task factors. Junior doctors were affected by the prescribing habits of their seniors. Organizational factors identified included inadequate training/experience; absence of reference materials and absence of self-awareness of errors. Defenses against error such as other clinicians and guidelines were absent or deficient; and supervision was inadequate. Conclusions: To reduce the risk of prescribing errors; a number of strategies addressing individual; task; team; and environmental factors such as training of junior doctors; enforcing good practice in prescription writing; supervision; and reviewing the workload of junior doctors must be established

Well waters fluoride in Enugu, Nigeria

Abnormal fluoride levels in drinking water have been associated with adverse health effects. To determine the fluoride content of well waters in Enugu, southeastern Nigeria, water samples from 50 artisan wells chosen by multistage sampling procedure from the 5 zones of Enugu municipality were analyzed in duplicates for their fluoride content. The zonal mean values were 0.60, 0.70, 0.62, 0.62, and 0.63 mg/L for Abakpa Nike, Achara Layout, Obiagu/ Ogui, Trans Ekulu and Uwani, respectively [p<0.05]. The mean value for the whole city was 0.63 mg/L. Although, the mean level of fluoride recorded in this study is currently within safe limits [1.5 mg/L, WHO 2011], it is important to monitor continuously the fluoride content of well waters in the municipality in view of the increasing industrial activities going on in the city and heavy reliance on well water for domestic purposes and the widespread use of consumer products containing fluoride

Surgical Resident Doctor's Perspective of their Training in the Southeast Region of Nigeria

There are several problems militating against satisfactory residency training in Nigeria. These problems may not be effectively identified and resolved if the opinion of the trainee doctors is ignored. Objectives: To review surgical residents' perspectives of their training program in South-eastern Nigeria; with the aim of suggesting evidence-based innovative changes to enable the programs meet global trends and standards. Materials and Methods: A total of 90 semi-structured and pre-tested questionnaires were evenly distributed (30 per hospital) to the surgical residents at three tertiary healthcare facilities in South-eastern Nigeria. Information sought included sociodemographic variables; level in the residency training; rating of program and different aspects; learning environments/opportunities; and suggestions on ways to improve either part or overall program. Results: Analysis of 56 properly completed questionnaires (response rate=62.2) shows that the respondents were aged 29 to 53 years [mean(SD) = 35.3(1.7)]; mostly males (91.1) and junior residents (75). A significant majority of residents (47 or 83.8) rated the surgical residency training in their respective centers as inadequate. Grand rounds were roundly criticized as having misplaced objectives and tending toward fault-finding by Consultants. Suggested interventions for improvement included enhanced supervision/mentoring/teaching by senior colleagues; inclusion of didactic lecture sessions; research trainings; and foreign postings. Conclusion: There exist gaps between expectations of surgical residents and the training offered. These create needed support for an evidenced-based review of surgical residency training program to enable it meet the aspirations of trainees and the ever-changing trend in Medicine. More studies on surgical residents covering other regions of Nigeria; and including the trainers (Consultants); will be of immense value

Lassa fever in West African sub-region: an overview.

Lassa fever is an acute viral zoonotic illness caused by Lassa virus, an arenavirus known to be responsible for a severe haemorrhagic fever characterised by fever, muscle aches, sore throat, nausea, vomiting and, chest and abdominal pain. The virus exhibits persistent, asymptomatic infection with profuse urinary virus excretion in the ubiquitous rodent vector, Mastomys natalensis. Lassa fever is endemic in West Africa and has been reported from Sierra Leone, Guinea, Liberia, and Nigeria. Some studies indicate that 300,000 to 500,000 cases of Lassa fever and 5000 deaths occur yearly across West Africa. Studies reported in English, that investigated Lassa fever with reference to West Africa were identified using the Medline Entrez-PubMed search and were used for this review. The scarcity of resources available for health care delivery system and the political instability that characterise the West African countries would continue to impede efforts for the control of Lassa fever in the sub-region. There is need for adequate training of health care workers regarding diagnostics, intensive care of patients under isolation, contact tracing, adequate precautionary measures in handling infectious laboratory specimens, control of the vector as well as care and disposal of infectious waste.

Prevalence of hepatitis-B surface antigen among blood donors and human immunodeficiency virus-infected patients in Jos, Nigeria

Information is very scarce on the prevalence of hepatitis-B virus (HBV) infection among blood donors and patients with human immunodeficiency virus (HIV) infection in Nigeria. Hepatitis-B surface antigen (HBsAg) ELISA was used to determined the prevalence of HBsAg among 175 blood donors (aged 20-40 years) and 490 HIV-infected patients (aged 17-60 years) in Jos, Nigeria. Twenty-five (14.3 percent) of the blood donors and 127 (25.9 percent) of the HIV-infected individuals were HBsAg seropositive, indicating a higher HBV infection among HIV-infected persons than among healthy blood donors. A slightly higher HBsAg seroprevalence was recorded in the males (14.6 percent) than females (12.9 percent) of the blood donors. Among the HIV-infected patients, the males had considerably higher HBsAg seroprevalence than the females (31.8 vs 22.1 percent) with the highest prevalence of HBsAg occurring in the 51-60 years age group (44 percent), followed by those of 31-40 years (28.2 percent). Results confirmed the high endemicity of HBV infection in Jos, Nigeria and the significantly greater prevalence of HBV infection among HIV -infected patients than among blood donors.

Clinicians opinion on errors in ultrasound reports in South Eastern Nigeria

This study investigated clinicians opinion on common errors in ultrasound reports in South Eastern Nigerian. 238 clinicians from speicialities of internal medicine, surgery, general practice and obstetric/gynaecology selected through stratified random sampling were invloved in ths survey. A questionnaire with four response options ranging from 'very often' to 'never' were used to obtain respondents opinion on the frequency of their observation of common errors in ultrasound reports. The commonest errors identified by respondents were conflicting report (3.73 + 0.62) and missed diagnosis (3.66 + 0.69). On a 4 point scale clinicians indicated that irrespective of the common errors, the ultrasound report was still helpful. The overall mean rating of the clinicians on the extent of common errors in ultrasound report is 2.77 + 0.29. The response indicates that ultrasound reports in the locality are associated with significant errors

Apoc impact assessment study: baseline prevalence and distribution of ocular Onchocerciasis in three ecological zones in Nigeria

During the APOC/WHO Impact Assessment studies in Nigeria held in 1998 and 1999, one thousand and sixty four randomly selected subjects underwent detailed eye examination in three selected sites namely, Cross River State (rain forest ecological zone), Taraba State (savanna ecological zone) and Kogi State (forest- savanna ecological zone). The general objective of the impact assessment studies was to evaluate the ophthalmological impact of onchocerciasis control (CDTI) in Nigeria, this paper highlights the public health significance of ocular onchocerciasis in three different ecological zones in Nigeria. The presence of ocular onchocerciasis was established in all the study sites, with a predominance of posterior segment manifestations, in the rain forest zone. A blindness prevalenc e of 2.4o/o was recorded in the study, with onchocerciasis being responsible for 13 out of the 43 (30.2%) bilaterally blind subjects identified. Onchocerciasis-induced blindness prevalence was relatively high in the rain forest and forest savanna zones of Cross River and Kogi States with Cross River State having the highest site-specific- prevalence (5/10) 50.0% of onchocercal blindness followed by Kogr with (5/12) 41.7%. Taraba site recorded only 27.3% (3121). Other conditions identified included glaucoma, optic nerve disease and cataract rates of which were also found to be high among the population (6.90/o,6.5 % and8.9oh respectively). Anterior segment onchocercal lesions, punctate and sclerosing keratitis were the predominant features of the infection in Taraba site (14.1o/o and 6.3% respectively), a savanna zone while posterior segment lesions were much more common in the forest zone of Cross-River site. Visual field measurements reflected the predominant posterior segment disease. The need to sustain the present efforts aimed at controlling onchocerciasis through mass ivermectin distribution is fuither highlighted. Integration of other Eye Care Programme for the conffol of glaucoma and cataract, into the community directed treatment initiative of APOC for onchocerciasis control should also be strongly considered, in order to drastically reduce the prevalence and incidence of ocular morbidity and blindness, in Nigeria, especially in the onchocerciasis endemic areas.