Intake of Fruits and Vegetables as Self Prescribed Weight Reducing and DASH Diets among Obese-Hypertensive Individuals Attending Irrua Specialist Teaching Hospital Irrua, Edo State, Nigeria

Background: Five servings of fruits and vegetables each day, along with relatively unprocessed whole grains or legumes with each meal, are essential for reducing the risk of obesity, hypertension and other related non communicable diseases. While being low or relatively low in calories, fruits and vegetables include a large amount of dietary fiber and a range of micronutrients, antioxidants and phytochemicals which are all essential for health. Aims: To investigate the intake of fruits and vegetables as self prescribed weight reducing and DASH (Dietary Approach to Stop Hypertension) diets among obese - hypertensive individuals attending Irrua Specialist Teaching Hospital Irrua, Edo State. Methods: A descriptive cross sectional study design was used with a sample size of 440 obese hypertensive individuals (with body mass index of = or > 30Kg/m2 and blood pressure of = or > 140/90mmHg). Questionnaires, personal interviews and anthropometric measurements were used to collect data using purposive sampling technique. Data collected were analyzed using Statistical Package for the Social Sciences (IBM SPSS) 22 Version. Results: A total of 440 respondents were used in the study and data were elicited from all of this number giving a 100% response rate. A total of 242 (55.0%) and 215 (48.9%) of the respondents consumed fruits and vegetables only one to two days per week with only 36 (8.2%) and 26 (5.9%) consuming fruits and vegetables every day. Conclusion: It can be concluded based on the key findings of this study that there is statistically significant mean difference in fruits and vegetables consumption amongst obese - hypertensive individuals attending Irrua Specialist Teaching Hospital, Edo State, Nigeria (p<0.05).

Microbiological Evaluation of Fresh Catfish (Clarias gariepinus) Obtained from Selected Markets and Ponds in Minna Metropolis

This research aimed at evaluating the microbiological quality of fresh catfish (Clarias gariepinus) sold in three different markets and ponds in Minna metropolis. The total plate counts from Bosso pond are 2.7 × 102 cfu/mL and 3.8 × 102 cfu/mL (satisfactory) for skin and gills respectively. Kure pond includes total plate counts of 4.7 × 103 cfu/mL and 3.3 × 102 cfu/mL (satisfactory) for skin and gills respectively while Mobil pond had total plate counts of 2.5 × 103 cfu/mL and 2.5 × 102 cfu/mL on skin and gills respectively. The total coliforms counts from Bosso pond are 3.8 × 102 cfu/mL and 3.0 × 101 cfu/mL (satisfactory) for skin and gills respectively. Kure pond includes total coliforms counts of 2.4 × 102 cfu/mL and 2.6 × 102 cfu/mL (satisfactory) for skin and gills respectively while Mobil pond had total coliforms counts of 4.6 × 103 cfu/mL and 3.2 × 104 cfu/mL on skin and gills respectively. The coliforms count of fresh catfish (Clarias gariepinus) obtained from three markets locations are total coliforms counts from Bosso market are 5.6 × 104 cfu/mL and 4.0 × 105 cfu/mL (Unsatisfactory) for skin and gills respectively. Kure market includes total coliforms counts of 1.6 × 103 cfu/mL and 7.2 × 103 cfu/mL (satisfactory) for skin and gills respectively while Mobil market had total coliforms counts of 6.0 × 104 cfu/mL and 4.8 × 104 cfu/mL (Marginal) on skin and gills respectively. The fungal count of fresh catfish (Clarias gariepinus) obtained from three markets locations are Bosso market 1.3 × 102 cfu/mL and 1.5 × 101 cfu/mL (satisfactory) for skin and gills respectively. Kure market 2.0 × 103 cfu/mL and 1.0 × 102 cfu/mL (satisfactory) for skin and gills respectively while Mobil market had total fungal counts of 1.7 × 104 cfu/mL and 1.7 × 102 cfu/mL on skin and gills respectively. The following bacteria were isolated Escherichia coli, Bacillus substilis, Staphylococcus aureus, Pseudomonas species, Streptococcus species, Shigella species and Enterobacter species. The fungi isolated were Rhizopus spp and Aspergillus niger.

Prevalence and Pattern of Visual Impairment among Adult Population in Mangu Local Government Area of Plateau State, Nigeria

Aim: Visual impairment is a public health problem globally. This study aimed to determine the prevalence and pattern of visual impairment among adult population in Mangu Local Government Area (L.G.A), Plateau State, Nigeria.Study Design: A population-based descriptive cross-sectional survey of 802 adult population aged 18 years and above was conducted in Mangu L.G.A, Plateau State, Nigeria using a multi-stage cluster random sampling design.Methodology: Subjects were evaluated using a magnifying loupe, Snellen E chart, direct ophthalmoscope and torchlight. Vision status was defined using World Health Organization categories of visual impairment based on presenting visual acuity (VA).Results: Out of a total of 960 respondents enumerated for the study, 802 (83.5%) adults participated. Prevalence of blindness (presenting VA of less than 3/60 in the better eye) was 8.1%; prevalence of low vision (presenting VA of at least 3/60 but less than 6/18 in the better eye) was 27.6%; prevalence of overall visual impairment (presenting VA less than 6/18 in the better eye) was 35.7%. Prevalence of visual impairment was higher in males (40.8%) than in females (34.9%), although not statistically significant (p=0.098). Prevalence of blindness and impaired vision increased significantly with increasing age, from 21.7% at 20 - 39 years to 83.6% among those aged ?80 years (P < 0.001).Conclusion: Much can be done by individuals, governments and non-governmental organizations to reduce so much blindness and vision loss through cost-effective interventions such as wears of sunglasses and other preventive measures to prevent ultraviolet radiation effect on their eyes.

Effect of Pathyadi Churna with Masthu in Amajirna w.s.r to Dyspepsia- A Case Study

Amajirna is a common clinical condition that has symptoms such as - Yadhabhukta Avidagdha Udgara, Praseka, Utkleda, Gatra Gaurava, Akshikoota sotha. As per classics, the treatment of Amajirna includes Dipana and Pachana. Amajirna has resemblance with dyspepsia. Dyspepsia or indigestion is a common gastro-intestinal disorder with symptoms like nausea, bloating, early satiety, post prandial fullness, abdominal discomfort etc. There are various causes for the occurrence of dyspepsia including micro-organisms. The present case report is of a 41 years old male with onset of symptoms such as nausea, bloating, abdominal discomfort, early satiety, Yadhabhukta Avidagdha Udgara (burping with the same taste of food consumed), Praseka (excess salivation) and Utkleda (nausea) since one or two weeks in every month for the last 6 months. He was taking antacids while coming to the OPD, and got temporary relief. Gradually, even after taking his normal diet, the symptoms started to re-occur and effect of his medications lasted for only a few weeks. The patient was given Pathyadi Churna with Masthu as Anupana for 7 days. It was observed after the completion of treatment that all the symptoms disappeared after 7 days. Also, no reoccurrence for the next 4 months. This shows the Pathyadi Churna with Masthu has a significant effect in relieving the symptoms of dyspepsia/Amajirna.

Effect of Malted African Breadfruit (Treculia africana) Seed Flour Inclusion on In-vitro Glycemic Index, Starch and Protein Digestibility of Fibre Rich Snack Bars

The study was carried out to elucidate the suitability and utilization of malted African breadfruit (Treculia africana) seed flour in snack bars production. Malted African breadfruit seeds, maize and coconut were processed to flour and evaluated of their proximate composition, phytochemical composition and particle sizes. Six (6) products were developed from the flour blends in the respective ratio of 0:95:5 (T0), 20:75:5 (T20), 25:70:5 (T25), 30:65:5 (T30), 35:60:5 (T35) and 95:0:5 (T95). Soluble dietary fibre (SDF = 5.15 – 3.15%) decreased while insoluble (IDF = 7.23 – 19.23%) and total dietary fibre (TDF = 12.33 – 22.39%) increased significantly (p<0.05) with increasing malted African breadfruit inclusion. In vitro glycemic index (IVGI) and starch digestibility (IVSD) decreased significantly (p<0.05) from 57.30 – 45.65% and 57.48 – 31.44% respectively, with increasing substitution of malted African breadfruit seed flour. A negative correlation was observed between the TDF and IVGI content of the snack bars. In vitro protein digestibility ranged from 68.19 to 87.45%. With reference to standard classifications, the formulated malted African breadfruit seed based snack bars could be referred to as ‘high fibre’ and ‘low glycemic’ foods, and may have positive health benefit to the consumers, especially the diabetics and those interested in weight management.

Comparison of Outcome between the Implementation of Enhanced Recovery after Surgery Programme (ERAS) vs. Traditional Care, in Elective Abdominal Surgeries

ERAS has been responsible for reducing surgical stress, maintaining postoperative physiological function, and for enhancing mobilization after surgery. It has been ultimately shown to reduce the rates of morbidity, hastening recovery, and reducing the length of hospital stay. The objective of this study was to compare the outcome between the implementation of enhanced recovery after surgery program vs. traditional care in elective abdominal surgeries. METHODSThis retrospective study was carried out in the General Surgery Department of Government Medical College, Kottayam, Kerala. This is a tertiary care centre that caters to the needs of nearly five districts in the state. The hospital has excellent critical care and surgical facilities. Patients were grouped as ERAS and Non-ERAS. 78 patients were included in each group. A standard questionnaire was formulated. The clinical outcomes, functional recovery, and patient experience in ERAS and conventional methods of recovery after surgery were analyzed and compared. RESULTSDuration of hospital stay, complications, and costs incurred were found to be almost 60 % less as compared to the non-ERAS group and patient satisfaction was high in the ERAS group. By using ERAS, we have been able to reduce the duration of hospital stay by more than 30 % and the post-operative complications by up to 50 %. CONCLUSIONSThe ERAS programme has definite advantage over traditional methods in terms of hospital stay, treatment cost, complications, readmission rates and overall patient satisfaction. We have to analyse the avoidable factors leading to substandard care or any missed opportunities. Patient education must also be given utmost importance.

Algunos aspectos históricos de la Psiquiatría en la V Región de Valparaíso: 1940-1990 / Some historical aspects of Psychiatry in the 5th Region of Valparaíso: 1940-1990

Resumen: Se trata de dar a conocer las vicisitudes de la Psiquiatría y de algunos Psiquiatras en la V Región de Valparaíso, Chile, abarcando un período de 50 años, desde 1940 hasta 1990. Se quiere resaltar las características del ejercicio médico-psiquiátrico y del equipo de salud mental, en una época de cambios político-sociales que impactaban en el ejercicio médico y en especial en la psiquiatría, tomando en cuenta el origen y evolución del Hospital del Salvador de Valparaíso.

The aim is to share the struggles of Psychiatry and of some Psychiatrists in the V Region of Valparaíso, Chile, covering a period of 50 years, from 1940 to 1990. It is intended to highlight the characteristics of the medical-psychiatric practice and the influence of the mental health team, at a time of political-social changes that had an impact on medical practice and especially on psychiatry, taking into account the origin and evolution of the Hospital del Salvador de Valparaíso.

Gordon Dry Gin (Moringa Citrus Blend) Induce Adenomatous Hyperplasia in Female Sprague Dawley Rats

Objectives:This study aim to investigate the histopathological effects of binge consumed Gordon’s dry gin moringa citrus blend on the uterus of adult female dawley Sprague rats.Materials: Fifty female rats (weighing range;120±2.6g -250±3.5g) were divided into four groups(A, B and C &D).Group A,B,C(15 animals each)were orally administered with Gordon’s dry gin moringa citrus blend,43% ethanol, and 200mg/kg moringa extract, respectively, while Group D(5 animals) did not receive any treatment and was used as negative control. In groups A,B, and C, five animals were sacrificed on the 7th,14thand 21stday of administration, whereas animals of group D were sacrificed on day 21.The uterus of each rat was harvested, processed and stained with haematoxylin and eosin solution for histological analysis.Results:Results of the study revealed histological alterations in the uterus of treated animals. Such alterations include adenomatous hyperplasia and cystic hyperplasia.Conclusion:The oral administration of gordon’s dry gin moringa citrus and moringa extract at 200mg/kg induced cystic and adenomatous hyperplasia in rat uterus, inferring that both gordon dry gin and moringa might yield antifertility activity

The Enhancement Of Collagen Synthesis Process On Diabetic Wound By Merremia Mammosa (LOUR.) Extract Fraction

Objective: This research aimed to evaluate the effect of fractionation of Merremia mammosa Lour. (Mm (Lour.)) extract on diabetic wound healing by observing the collagen synthesis process and to search the most potent fraction. Methods: Wistar rats were divided into five groups (n=5), i.e., K-(negative control), K+(positive control), K1 (ethyl acetate fraction), K2 (water fraction), and K3 (n-hexane fraction). The Mm (Lour.) was extracted with ethanol 70%, then fractionated by using three solvents which have different polarity. The rats were adapted in 7 d, then induced into diabetic by streptozotocin dose 40 mg/kg body weight. The wound was made by Morton excision method. Treatment was given every two days and a skin biopsy was done on day 11. Analysis of collagen density was done by photomicrograph of histopathology preparations in Masson’s trichome stained by using trinocular microscope with 400x magnification in 6 fields of view, then processed by imageJ software and analyzed by appropriate statistic tool. Results: The results of this research showed that fractionation of Mm (Lour.) extract significantly enhanced diabetic wound healing based on macroscopic (percentage of wound healing) and collagen density with p-value<0.05 when compared with negative control, especially the water fraction (p=0.000). The follow-up post hoc analysis showed that there was no­ significant (p=0.989) or there was no meaningful difference in the group of water fraction when compared to positive control. Conclusion: Water fraction is the extract fraction of Mm (Lour.) which has the most significant influence on diabetic wound healing showed by enhancement of collagen synthesis.

The KAPP Study of Malaria and its Prevalence amongst Boarding School Students in Gboko Local Government Area of Benue State, Nigeria

Malaria is a life-threatening parasitic disease caused by a protozoan of the genus Plasmodium and is one of the most important parasitic diseases of man globally especially in sub-Saharan Africa. This research was done to assess malaria infection and its relationship with the knowledge, attitude, perception and prevention among students of boarding schools in Gboko Local Government Area. Five boarding schools within Gboko Local Government were selected for the study. A total of 370 students were sampled to represent the population. Malaria in the schools selected for this study was determined through malaria test via the examination of stained thick blood smears under the microscope. Structured questionnaires were administered to the participants to get information pertaining to their demography, knowledge, attitude, perception and preventive methods towards malaria. Thick blood films were stained using Romanowsky Field Stains. Chi-square was used for comparing infections and to determine the significant relationships at 95% level of significance. The results showed an overall prevalence of 20.8%. The prevalence of malaria was higher among female students (22.3%) than in male students (19.5%). Malaria was found most (10.8%) among students who use insecticide treated nets (ITNs). This study revealed that the knowledge and ownership of insecticide treated net (ITN) was high (86.2%) among the students. However, only 60.0% of the ITN owners actually use it. Thirteen percent of the students have phobia for the use of ITN while many students do not use the ITN for diverse perceived reasons. The treatment seeking behavior of the students showed that majority of the students (84.9%) access the school clinic when they have fever. This study has revealed that there are misconceptions on the knowledge of malaria among students and these are some of the factors leading to the risk and exposure of students to the bites of mosquitoes. The perceived beliefs on malaria in this study have no scientific basis and can easily be overcome through proper health education. Providing a mosquito free environment and promoting ITN usage as well as use of mosquito repellent cream among boarding school students may help achieve the desired protection against mosquito bites and subsequently prevent malaria.

Chirurgie foraine pédiatrique: organisation et prise en charge anesthésique

Introduction : La chirurgie foraine est une chirurgie de proximité aux populations présentant des difficultés d'accès aux soins. L'objectif des auteurs était d'évaluer l'approche d'interventions chirurgicales et le mode d'anesthésie proposée par les organisateurs pour apporter des soins de qualité et à moindre coût à des populations démunies. Patients et Méthodes : Il s'est agi d'une étude transversale et descriptive menée au cours d'une mission foraine réalisée au Centre Hospitalier Universitaire Départemental ­ Ouémé / Plateau du 30 Septembre au 06 Octobre 2018. Elle concernait les enfants de 0 à 15 ans, opérés durant la mission. L'équipe d'intervention était dirigée par 3 chirurgiens pédiatres et 2 Médecins anesthésistes. Etaient étudiées, les données épidémiologiques, les indications chirurgicales, la classification ASA, les techniques anesthésiques et les suites opératoires. Résultats : Parmi les 483 enfants ayant consulté, l'indication d'une intervention chirurgicale a été poséchez 348 (72,04%) enfants parmi lesquels 136 (39,08%) ont été opérés. Ces derniers avaient une moyenne d'âge de 6,10 ± 4,23 ans avec des extrêmes de 2 jours de vie à 15 ans. Il y avait une prédominance masculine (85,29%), avec une sex-ratio de 5,8. Les hernies de la paroi abdominale étaient prédominantes (60,93%). La rachianesthésie (47,06%) était la plus pratiquée. La majorité des enfants opérés était classée ASA1 et ASA2. La durée moyenne d'hospitalisation était 1,16 ± 0,47 jouret la mortalité péri-opératoire était nulle, avec une morbidité négligeable. Conclusion : Certains actes chirurgicaux chez l'enfant peuvent être exécutés dans le cadre d'une mission foraine. Mais leurréalisation nécessite une structure et une organisation permettant d'assurer la sécurité pour la prise en charge de ces malades

Knowledge and Attitude Regarding Premarital Screening for Sickle Cell Disease among Students of State School of Nursing Sokoto.

Background: Sickle cell disease is a condition in which an individual has inherited two abnormal hemoglobin genes at least one of which is hemoglobin S (HbS) and the resulting symptomatology or pathology is attributed to the sickling phenomenon. About 5% of the world’s population carries genes responsible for hemoglobinopathies and each year about 300 000 infants are born with major hemoglobin disorders including more than 200 000 cases of sickle-cell anemia in Africa. Sickle cell anemia is a very common disorder in Nigeria with birth rate of about 1 in 50 and about 150,000 children are born annually with sickle cell anemia in Nigeria alone. The study aimed to explore the knowledge and attitude of nursing students about premarital screening for sickle cell disease. Methods: A descriptive, cross-sectional study was conducted using self-administered semi-structured questionnaire among 176 students. Results: Majority of respondents knew sickle cell disease and also knew their genotype 97.6% and 71% respectively, although up to 9.1% selected blood group as their genotype. More than half of respondent (51.7%) said sickle cell disease can be transmitted through blood, 55.1% of respondent said they think government should prohibit marriage between incompatible couples with regard to sickle cell disease, Only about one third (34.1%) of respondent have good knowledge of SCD, and 34.3% of respondent have good knowledge of premarital screening for SCD, More than half (55.4%) of respondent have good attitude regarding premarital screening for SCD. Conclusion: The study shows that the respondent have poor knowledge of sickle cell disease and premarital screening though more than half of the respondent have good attitude towards premarital screening. The results of this study reflect the importance of health education as a keystone in improving knowledge and attitude towards premarital screening for sickle cell disease.

Liver Protein and Enzymes in HIV Infected Pregnant and Non-pregnant Women on Antiretroviral Therapy.

This in vivo study was carried out to investigate alterations in the levels of proteins and enzymes produced by the liver of HIV infected pregnant women and HIV infected non pregnant women under different antiretroviral therapy. Forty six human patients (Pregnant patient, n=21, Non pregnant patient, n=25) were recruited during this study from the PEPFAR (President Bush Emergency Plan for Aids Research) clinic in LUTH (Lagos University teaching Hospital), Lagos. The patients were between the ages of 29 – 34 years. All samples were analyzed for Albumin, Transferrin, Urea, Total protein, Total bilirubin, Creatinine and Cholinesterase. Along with it, liver enzymes – Alkaline phosphate, Alanine aminotransferases and Aspartate aminotransferases were also analyzed to confirm proper liver function for each patient. Result showed that total bilirubin and transferrin were statistically higher in the pregnant group while other liver proteins (Albumin, Urea and Total protein) were statistically lower in the pregnant group. Two liver enzymes, Creatinine and Cholinesterase, were statistically lower in the pregnant group. Though, other liver enzymes; aspartate aminotransferases and alanine aminotransferases were also lower in the pregnant group. No significant difference were noted when statistics were applied. Only alkaline phosphatase showed a non significant increase in the pregnant group. Findings in this study suggest that effective antiretroviral therapy stabilizes proteins and enzymes production in both HIV groups, however, slight alterations which were observed in the pregnant HIV group were due to physiological changes during pregnancy.

Extracts of Caesalpinia ferrea and Trichoderma sp. on the control of Colletotrichum sp. transmission in Sideroxylon obtusifolium seeds / Extratos de Caesalpinia ferrea e Trichoderma spp. no controle da tramissibilidade de Colletotrichum sp. em sementes de Sideroxylon obtusifolium (Sapotaceae)

ABSTRACT Recent research reports the importance of preserving plants in Brazilian semiarid regions, in this context, the scientific literature has reported different pharmacological studies from plant extracts with an antifungal potential, coming from forest species that can contribute as a control and management strategy in the transmission of phytopathogens. This study aimed to evaluate the effect of biotech treatments in controlling the transmission of Colletotrichum sp. in seeds of S. obtusifolium. In this study, 100 seeds were subjected to the following preventive treatments: fungicide Captan®, extract of Caesalpinia ferrea Mart. Ex. Tul., and biological control with Trichoderma spp. The biological control with Trichoderma spp. and the alternative control using C. ferrea extract provided a greater protection to seeds and seedlings of S. obtusifolium facing the transmissibility of Colletotrichum sp.The treatment based on plant extract is more efficient for this purpose only in large seeds and does not interfere on the germination percentage and speed. Therefore it is necessary to perform other studies with Trichoderma spp. and C. ferrea extract to test different doses of these products.

RESUMO Recentes pesquisas relatam a importância da preservação de plantas do semiárido brasileiro. Neste contexto, a literatura científica tem relatado diferentes estudos farmacológicos com extratos vegetais com potencial antifúngico proveniente de espécies florestais que podem contribuir como estratégia de controle e gerenciamento na transmissão de fitopatógenos. No presente estudo o objetivo foi avaliar o efeito de tratamentos biotecnológicos no controle da transmissibilidade de Colletotrichum sp. em sementes de S. obtusifolium. Neste estudo foram utilizadas 100 sementes submetidas aos seguintes tratamentos preventivos: fungicida Captan®, extrato de Caesalpinia ferrea Mart. Ex. Tul. e controle biológico com Trichoderma spp. O controle biológico com Trichoderma spp. e o alternativo com extrato de C. ferrea proporcionam maior proteção às sementes e plântulas S. obtusifolium quanto a transmissibilidade do Colletotrichum sp. O tratamento à base de extrato vegetal foi o mais eficiente para este fim, apenas em sementes de maior tamanho, por não interferir na porcentagem e velocidade de germinação. Portanto, faz-se necessário à realização de outros trabalhos com Trichoderma spp. e extrato de C. ferrea para testar doses diferentes desses produtos.

A Cross-Sectional Study of Socioeconomic Status and Cardiovascular Disease Risk among Participants in the Prospective Urban Rural Epidemiological (PURE) Study

Background. Cardiovascular diseases (CVDs) are a challenge to populations and health systems worldwide. It is projected that by 2020 about a third of all deaths globally will be caused by CVDs; and that they will become the single leading cause of death by 2030. Empirical evidence suggests that there is socioeconomic patterning in the distribution and prevalence of risk factors for CVD; but the exact nature of this relationship in South Africa remains unclear. Objective. To examine the association between socioeconomic status (SES) and risk factors for CVD in a cohort of adult South Africans living in rural and urban communities.Method. This was a cross-sectional analytical study of baseline data on a population-based cohort of 1 976 SA men and women aged 35 - 70 years who were part of the Cape Town arm of the Prospective Urban and Rural Epidemiology (PURE) Study.Results. We found a complex association between SES and CVD risk factors; its pattern differing between urban and rural participants. Marital status showed the most consistent association with CVD risk in both groups: widowed participants living in urban communities were more likely to be hypertensive as well as diabetic; while single participants in both locations were more likely to use alcohol and tobacco products. Level of education was the only SES variable that had no significant association with any CVD risk factor in either study group. All measured SES variables were significantly different between urban and rural participants (p0.05); with diabetes; obesity and alcohol use significantly more prevalent in urban than in rural participants (p0.05) while hypertension and tobacco use were not (p?0.05). Conclusions. In this cohort of South Africans; there were significant associations between SES and CVD risk; with marked differences in these associations between rural and urban locations. These findings highlight the need to consider SES and area of residence when designing interventions for CVD prevention and control

Caracterización del metabolismo óseo mineral en pacientes con enfermedad renal crónica en hemodiálisis en el Servicio de Salud Metropolitano Sur, Santiago de Chile / Bone mineral metabolism in patients with chronic kidney disease on dialysis in Southern Metropolitan Santiago

Background: Chronic Kidney Disease-Mineral and Bone Disorder (CKD-MBD) is a condition of dialysis patients associated with both morbidity and mortality. Management is based on clinical guidelines with goals that are hard to comply with. Aim: To describe and compare biochemical variables associated with this disorder in two different time periods. Material and Methods: Revision of medical records of 814 patients (49% females) dialyzed during 2009 and 1018 patients (48% females), dialyzed during 2012 in Southern Metropolitan Santiago. Information about serum calcium, phosphorus, parathyroid hormone (PTH) and albumin was retrieved. Results: Median PTH values in 2009 and 2012 were 222.5 and 353.5 pg/ml respectively (p < 0.05). The figures for serum calcium corrected by albumin were 9.0 and 8.5 mg/dl respectively (p < 0.05). The figures for phosphorus were 4.7 and 5.0 mg/dl respectively (p < 0.05). The Calcium x Phosphorus product was 41.4 and 42.5 mg²/dl² (p < 0.05). Of note, the proportion patients with serum calcium below recommended levels (< 8.4 mg/dl) increased from 16% to 40% from 2009 to 2012. The proportion of patients with biochemical variables within recommended ranges was lower in 2012 than in 2009. Conclusions: There was a low proportion of patients with bone metabolism parameters within ranges recommended by clinical guidelines. These parameters were worst in 2012.

Atuação da comissão de farmácia e terapêutica em um hospital de ensino / Performance of the pharmacy and therapeutics committee in ateaching hospital

Introdução: As atividades hospitalares caracterizam-se por um acentuado dinamismo em consequência do surgimento de novas tecnologias em saúde, tais como medicamentos. Uma unidade hospitalar, devido suas características de ensino, pesquisa e atendimentos de alta complexidade, possui maior concentração de diferentes tipos de tecnologias em saúde. O Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto –USP (HCFMRP-USP) é uma instituição hospitalar, de qualidade comprovada, inserido no SUS como referência terciária/quaternária e que conta com a Divisão de Assistência Farmacêutica (DAF) para desenvolvimento das ações de atenção a saúde. A DAF para auxílio da gestão de recursos, seleção e padronização de medicamentos adotou como estratégia a Comissão de Farmácia e Terapêutica (CFT). ACFT é uma instância colegiada, de caráter consultivo e deliberativo, estabelecida pela Organização Mundial de Saúde como ferramenta de estratégia para monitorar e promover a qualidade no uso do medicamento,porém estudos que sobre a atuação das CFTs no Brasil são incipientes. Desta forma, este estudo pretende apresentar a CFT do HCFMRP-USP. Objetivos: apresentar a composição, atribuições e metodologia de trabalho da CFT, bem como desenvolver uma análise crítica de seu atual funcionamento. Metodologia:Foi realizado estudo descritivo e exploratório com o objetivo de descrever o atual funcionamento da CFT do HCFMRP-USP. Foram buscadas portarias, regulamentações internas e foi realizada revisão bibliográfica sobre a CFT. Para Análise crítica do atual funcionamento, foi selecionado dentre os itens padronizados pela comissão aquele que se enquadrasse como pertencente a classificação A e V, após o cruzamento das curvas ABC e VEN, cujo item selecionado foi o medicamento Sevoflurano...

Introduction: The hospital activities are characterized by a highly dynamism as a result of new health technologies such as medicines. A hospital due its characteristics of teaching, research and high complexity care, has the highest concentration of different types of health technologies. The Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto – USP (HCFMRP-USP) is a hospital, with proven quality, inserted in the SUS as a tertiary/quaternary referral and has the Pharmaceutical Services Division (DAF) for development of actions of health care. To aid resource management, selection and standardization of drugs, DAF adopted the strategy of Pharmacy and Therapeutics Committee (CFT). The CFT is a collegial, consultative and deliberative body, established by the World Health Organization as a strategy tool to monitor and promote the quality in the use of medicine, but studies of CFTs are incipient in Brazil. Thus, this study aims to present the CFT of HCFMRP–USP. Objectives: To introduce the composition, responsibilities and working methods of CFT, as well as a critical analysis of its current operation. Methods: A descriptive study aimed to describe the current functioning of the CFT of HCFMRP-USP was performed. Ordinances, internal regulations were surveyed and a bibliographic review of the CFT was performed. To the critical analysis ofthe current operating, was selected by the committee from the standard one that would fit classification asbelonging to “A” and “V” items after the crossing of the curves ABC and VEN, whose selected item was the medicine Sevoflurane...

An Eight-Year Review of Morbidity and Mortality among Adult Patients with Tetanus at a Tertiary Hospital in Zaria, Northern Nigeria.

Background: Tetanus infection is a major cause of morbidity and mortality in many developing countries. The infection results from contamination of wound by Clostridium tetani in unimmunized individuals. The morbidity is mainly due to sustained skeletal muscle spasms from unopposed action of tetanospamin on excitatory neurons in the central nervous system. The clinical presentation and outcome depend on both patient and disease factors. Health education and immunization would contribute to prevention and eradication of the infection. This review studied morbidity and mortality patterns among adults treated for tetanus at a tertiary hospital in Zaria from January 2006 to December 2013. Materials and Methods: Medical records of adults admitted with the diagnosis of tetanus were retrieved and reviewed. Information on socio-demography, clinical presentation, complications, co morbidities and outcomes were obtained and analysed using the Statistical Package for Social Sciences version 17.0. Results: Forty-seven patients were admitted during the period, with an average of 6 patients per year. Male (70.2%): female (29.8%) ratio was 2.4: 1. Their ages ranged from 15 years to 65 years, the age group 20-39 years constituting 76.6% of the population. 51.2% were students. The lower limbs were portal of entry in 70.6% of cases, and 52.9% of the wounds were dirty. 82.4% of the patients were unimmunized and overall mortality was 40.4%. Predictors of mortality were short incubation period, short onset time, severe muscle spasms, non-immunization and presence of complications. Conclusion: Tetanus remains a major preventable disease among unimmunized and low income people. Therefore, immunization of people at risk would prevent tetanus infection and its associated complications.

Sero-negative Antibody Status in HIV-Infected Children Initiated on Early Anti-Retroviral Therapy in Jos, Nigeria.

Aim: To determine the association between the age at initiation of anti-retroviral therapy (ART) and the 18 month antibody status of human immunodeficiency virus (HIV)-infected children in Jos, Nigeria. Study Design: This was a retrospective cohort study. Place and Duration of Study: AIDS Prevention Initiative in Nigeria (APIN)-supported HIV clinic at Jos University Teaching Hospital, Jos, Nigeria between July 2008 and June 2012. Methods: We reviewed the clinical records of all children confirmed to be HIV-infected with 2 positive HIV deoxyribonucleic acid polymerase chain reaction (DNA PCR) results who were initiated on ART before 12 months of age. We studied the association between the age at initiation of ART and their antibody status at 18months of age. We also studied the association between the viral load and the antibody status. Result: Seventy-three HIV-infected children were initiated on ART at <12 months of age, 66 of these had antibody tests at 18-21 months of age. Nineteen (29%) of the 66 children were negative for rapid antibody test. Those that were initiated on ART at <6 months of age had 5 times the odds ratio of being rapid antibody test negative compared to those who were initiated at ≥6 months of age (AOR=5.23 (1.82-19.66), P=0.002). All the children with negative rapid antibody tests were virally suppressed while all those with detectable viral load were positive for rapid antibody tests. Conclusion: Antibody tests alone cannot be used to determine whether ART should be stopped in children where a definitive diagnosis does not exist. Improved access to affordable, technically simple DNA PCR testing is essential for the appropriate management of HIV-exposed infants in resource limited settings.

Erythropoietic Effects of Eremomastax polysperma Leaf Extracts on Female Prepubertal and Pubertal Wistar Rats.

This study assessed the erythropoietic effect of Eremomastax polysperma leaf extracts in female albino Wistar rats. Method: Twenty eight (28) female rats were divided into two major groups based on their weight and age. The duration of administration of E. polysperma extracts lasted for twenty one (21) days. This study was carried out in the Department of Biochemistry University of Calabar, between February and March 2013. A significant increase (P<0.05) in red blood cell count (RBC) (8.17±0.48, 6.46±0.37) and Haemoglobin (Hb) count (15.13±1.03, 13.27±0.7) was observed in the prepubertal group compared to the control, while packed cell volume (PCV) was significantly increased (P<0.05) in the pubertal group compared to the control (55.40±4.40, 48.63±2.33 respectively). This suggests that E. polysperma leaf extract can be used as a haematinic and a therapy for anaemic conditions.