Detection and Quantification of Gastrointestinal Parasites among Inmates of Social Welfare Homes and Low Socio-economic Areas in Metropolitan Port Harcourt

Background: Detection and quantification of gastrointestinal parasitic infections (GIPIs) causing public health problems among poorer layers of the society are still one of the Neglected Tropical Diseases (NTDs) in developing countries. Objective: The aim of the study was to detect gastrointestinal parasites among inmates of Social Welfare Homes and Low Socioeconomic Areas in Metropolitan Port Harcourt. Methods: A cross-sectional survey was carried out for the evaluation of all the 1500 participants for GIPs among residents of social welfare homes and low socioeconomic areas in Rivers State, Nigeria for a period of one year (July 2019- June 2020). Stool samples were collected from each participant for isolation of GIPs in stool sample. Formol-ether concentration methods and Modified Ziehl-Neelson Staining techniques was used for the isolation and identification of gastrointestinal parasites. Descriptive and Chi square statistical analysis was applied. Results: Out of 1500, 1,381 (92.1%) participants showed negative report, while 119(7.9%) participants were positive for GIPs. Females account for 839 (55.9%) while males were 661 (44.1%). Positivity in males accounted for 9.8% (65/661) and the females had 6.4% (54/839). Age group with high prevalence occurred among 11-15yrs (13.5%)/340. Both variables were statistically significant (p<0.05). Seasonal distribution of GIPs was high during the wet season (p<0.05). Overall, A. lumbricoides was the most predominant gastrointestinal parasites, accounting for 35.3% of the total identified. Others were as follows; T. Trichiura 26.1%, hookworm 21.9%, C. sinensis and S. mansoni 2.5%, tapeworm 1.7%, while H. nana and H. diminuta had 0.8% each. Co-infection of A. lumbricoides + hookworm and hookworm + T. Trichiura recorded 4.2% each. Protozoa species were not identified. Risk factor of the use of toilet papers was found to be statistically significant (p<0.05) among others. Conclusion: We recommend that knowledge of epidemiology and transmission routes of C. sinensis and H. diminuta needs to be improved and effective health education on personal hygiene and mass treatment should be sustainable to control the spread of gastrointestinal parasites.

Work-related psychological distress among teachers in southwest Nigeria: a rural and urban comparison

Background: The jobs of teachers involve high demand and low control, which predisposes them to psychological distress. Differences in the basic infrastructure in rural and urban areas may influence the psychological health status of teachers. Objectives: We assessed the prevalence of psychological distress and associated work-related factors among secondary school teachers in rural and urban areas of southwest Nigeria. Methods: A cross-sectional analytical study design was utilised. Teachers from rural (n = 578) and urban (n = 596) areas were selected using multistage sampling. Sociodemographic and occupational characteristics were recorded, and the 12-item General Health Questionnaire (GHQ-12) was used to assess psychological distress, using a cut-off score of ≥ 3 to indicate distress. Data were analysed using SPSS version 23. Chi-square analysis was used to test for differences between categorical variables and Student's t-test was used to check for differences in means. Logistic regression analysis was conducted to determine predictors of psychological distress. Statistical significance was set at 5%. Results: Rural-based teachers were significantly younger than those in urban locations (p = 0.013), had fewer mean years of work experience (p = 0.043), taught larger class sizes (p < 0.000), had more financial dependants (p = 0.001), and spent less time at work each day (p < 0.000). More rural- than urban-based teachers had other jobs in addition to teaching (p = 0.023). Overall, 38.1% of the teachers were psychologically distressed: 42.7% in rural and 33.6% in urban schools (p = 0.001). Factors associated with psychological distress were being married (p = 0.007), teaching in a public school (p = 0.007), and teaching > 5 subjects (p < 0.001). The adjusted odds of psychological distress were higher in teachers in rural schools (AOR 1.30, 95% CI 1.02­1.67), and in public schools (AOR 1.58, 95% CI 1.19­2.11). The adjusted odds increased by 19% for every additional subject taught, and by 2% for every hour spent teaching. Conclusion: Teachers in rural schools had more psychological distress than those in urban ones. Distress was associated with both individual and workrelated characteristics. Teachers' work conditions in rural schools need to be improved to provide an incentive for them to work and remain in remote

Intestinal Parasites and Salmonella typhi Infection among Food-handlers in Port Harcourt Metropolis, Nigeria

Background: Intestinal parasites andSalmonellainfections are of main public health concerns in Nigeria and the world, especially in developing countries where access to safe water and hygienic food handling practices by food handlers is a challenge. Consequently, food-handlers play a major role in the transmission of these types of foodborne diseases.Objective: This study was to determine the preponderance of intestinal parasites and Salmonella typhiamong food-handlers in selected areas in Port Harcourt.Materials and Methods: A total of 480 food-handlers (195 males and 285 females) of various educational levels were sampled. Stool samples were collected and analyses were carried out using direct smear examination and formol-ether concentration technique -adopted for nvestigation of intestinal parasites and deoxycholate citrate agar and Salmonella-Shigella agar for the cultivation of Salmonella typhi.Results:Of 480 food-handlers examined, comprisesof 195(40.6%) males and 285(59.4%) females,-majority (85.4%) were young adults aged 20-40 years. 47.9% of them -had education above secondary educational level. The preponderance of intestinal parasites was 48(10.0%) and implicated were Ascaris lumbricoides(41.7%), hookworm (33.3%) and Trichuris trichiura(25.0%). No intestinal protozoa were identified. Prevalence of 30(6.3%) was recorded for Salmonella typhi.Conclusion:Prevalence of Intestinal Parasites and S.typhi infection is relatively low among food handlers in Port Harcourt, but indicates the important role food handlers play in the transmission of the infection. Therefore, awareness should be step-up forthe food handlers to avoid escalation of these infections

Evaluation of lumbo-sacral epidural anaesthesia or analgesia with lidocaine-acepromazine combination in dogs undergoing cystotomy

Background:Epidural anaesthesia is one of the most frequently used regional anesthetic techniques recommended for surgical procedures caudal to the umbilicus in dogs. However, the use of lignocaine alone for epidural regional analgesia has been discovered to have shorter duration of analgesia and prolong onset of action, hence there is need to explore combinations of agents that will overcome this challenge. This study aimed to evaluate the anaesthetic/analgesic effect of cranial epidural anaesthesia in dogs undergoing cystotomy using Lignocaine in combination with acepromazine at the dose rates of 7 mg/kg and 0.05 mg/kg respectively.Methods:Eight apparently healthy matured, male and female dogs were used for the experiment. The onset and duration of analgesia was determined. The pulse rates, respiratory rates, mean arterial blood pressure, rectal temperature, complete blood count and the oxygen saturation level were determined at baseline, intra operative and post-operative.Results:There were no significant differences in all the parameters measured before and after the epidural administration of the agents. The onset of anaesthesia was rapid and the duration of anaesthesia was sufficient enough for the procedure to be carried out. However, there was significant difference in PCV, Hb and total RBC count between the baseline and other timing intervals. There were no significant differences in leucocytic and cardiopulmonary parameters between the baseline and other timing intervals.Conclusions:The epidural administration of lignocaine and acepromazine combination at the doses indicated can produced sufficientepidural anaesthesia with rapid onset for the purpose of cystotomy in dogs without major systemic influence on hemodynamic and cardiopulmonary changes

Incidence of Septicemia in Children Attending University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria

Introduction: Septicemia is an invasive infection where chemical substances released into the bloodstream causes morbidity and mortality in neonates. The developing countries carries major burden of the problem and Nigeria is not exceptional.Objective: The study was carried out to determine age/sex-related prevalence, causative agents and antimicrobial sensitivity pattern of neonatal septicemia in children at University of Port Harcourt Teaching Hospital, Nigeria.Methods: This retrospective study was carried out in the pediatric department for a period of twelve months. Blood culture test using thioglycollate broth and tryptone soya broth for isolation of microorganisms was adopted. Antimicrobial sensitivity pattern was done with disc diffusion method. The data was analyzed using descriptive statistics and Chi square for significance.Results:A total of 598 children were examined, of which 394(67.9%) children showed negative blood cultures, while 204(34.1%) children had positive bacterial cultures and 2 children (0.3%) were positive for Candida albicans. Overall, Klebsiellaspp. was the most common pathogen, accounting for (37.8%) of the total isolates, which is followed by Staphylococcus aureus(28.4%), Escherichia coli(11.8%), unclassified Coliforms (8.3%), Pseudomonasspp. (4.9%), Proteusspp. (3.4%), Enterococcusspp. (2.9%) and coagulase-negative Staphylococcus(CONS) (2.5%) respectively. Early onset neonatal sepsis (EONNS) had Klebsiella spp as the most prevalent causative agent while Staphylococcus aureus was prevalent among the late onset neonatal sepsis (LONNS). Klebsiella spp. was susceptible to spafloxacin(87.0%) followed by ofloxacin (82.0%), amoxycillin-clavulanic acid (79.0%) and ceftazidime (65.0%) among the Gram negative organisms. In the category of Gram positive organisms, Staphylococcus aureus was highly sensitive to ofloxacin (81.0%) followed by spafloxacin (79.0%) and amoxicillin-clavulanic acid (71.0%). Conclusion: The study showed Klebsiellaspp. and Staphylococcus aureus were the prevalent bacterial organisms of septicemia in children in University of Port Harcourt Teaching Hospital. Early diagnosis with use of appropriate antimicrobial treatment will effect intervention for management of the children

Prevalence and pattern of hypertension among elderly in Osun state, Nigeria

Background: Hypertension is a major public health challenge worldwide. It is acknowledged as an important risk factor for cardiovascular morbidity and mortality, particularly among the elderly. This study aimed to investigate the prevalence and pattern of hypertension among the elderly in Osun state, Nigeria.Methods: A descriptive cross-sectional design was used. The study involved 425 respondents aged 60 years and above selected randomly in five local government areas in Osun state. The blood pressure was measured (using a standardized Accoson® type pneumatic mercury sphygmomanometer); weight and height of the respondents were checked and recorded in mmHg, Kg and meters respectively. Data were presented using descriptive statistics, charts and frequency distribution table. Statistical association between categorical variables was assessed using Chi-square method at 5% level of significance.Results: Prevalence of hypertension among elderly was 44.7%. Among other factors, respondents’ body mass index BMI was found significantly associated with hypertension, p=0.009. However, prevalence of hypertension was higher for respondents that were; rural dwellers, female, not living with spouse, without viable source of income and engaging in little or no physical activity compared to their counterparts. Respondent’s BMI and sex were also found to be statistically significantly associated, p=0.011.Conclusions: Prevalence of hypertension was high among the elderly in this study. Health interventions aimed at reducing the diseases should encourage increased physical activities and incorporate financial empowerment schemes particularly for elderly women in rural settings.

Parenting styles and socio-demographic dynamics associated with mental health of in-school adolescents in Ibadan, south-west Nigeria

Background: Positive parenting and enabling socio-demography, engenders good conduct in adolescence. Balanced parental demandingness and emotional responsiveness, deployed by authoritative parents, supports adolescents' mental health. Parental emotional responsiveness deters peer-pressured risky behaviours; while parental negligence, permissiveness, or demandingness encourages mental health problems. This is especially in the context of unfavourable socio-demographic setting.Aim: We aimed to evaluate parenting styles and socio-demographic factors associated with adolescents' mental health.Method: A cross-sectional multistage study was conducted with 286 in-school adolescents in Ibadan, Nigeria. Data were collected with questionnaires. The questionnaires evaluated socio-demography, mental health, and perceived parenting styles using the Strength and Difficulty Questionnaire (SDQ) and Scale of Parenting Styles (SPS) questionnaires. Data analysis was conducted using SPSS 21.Results: Some of the adolescents in this study, experienced peer problems (4.9%), conduct problems (9.4%), hyperactivity problems (0.7%), emotional problems (14.3%), and they lacked pro-social behaviours (11.1%). In comparison to adolescents who perceived fathers as authoritative, adolescents who perceived fathers as less demanding experienced emotional (p = 0.01) and peer (p = 0.02) problems. Perceived maternal negligence and authoritarian parenting was associated with more peer problems (1.5±2.3 and 1.3±2.2) in comparison to perceived maternal authoritative style (0.6±1.5). Most adolescents from lower social class experienced conduct (88.8%; p = 0.07) and emotional problems (73.2%; p = 0.20).Conclusion: Competent parenting style and socio-economic resources supports resilience to mental health problems in adolescents

Glycemic control and its impact on oxidative stress biomarkers in type 2 diabetic patients treated with metformin: a cross-sectional analysis / Controle glicêmico e seu impacto em biomarcadores de estresse oxidativo em pacientes diabéticos tipo 2 tratados com metformina: uma análise transversal

AIMS: Evidence shows that diabetic patients may be predisposed to oxidative stress owing to increased glyco-oxidation and lipid peroxidation processes in consequence of chronic hyperglycemia. However, there is dearth of information whether glycemic control positively affects the antioxidant defense system in type 2 diabetes mellitus (T2DM). We investigated the potential association between glycemic control and oxidative stress biomarkers in controlled and uncontrolled diabetic states. METHODS: After obtaining ethical clearance, we included patients receiving metformin with glycated hemoglobin A1c ˂7.0% (glycemic control); newly diagnosed T2DM patients without glycemic control with hemoglobin A1c ˃7.0%; and apparently healthy normoglycemic individuals. The following biomarkers were determined: fasting glycemia level, malondialdehyde, glutathione peroxidase activity, catalase activity, total antioxidant capacity and total cholesterol level. The comparisons between the groups were made by ANOVA. RESULTS: The participants were 260 in number: 80 with controlled diabetes, 80 uncontrolled and 100 controls. All participants were between 40 and 71 years old. Fasting glycemia level and hemoglobin A1c showed significant reductions (p<0.05) in controlled T2DM against the uncontrolled T2DM group, all the same both were significantly higher (p<0.05) against the controls. Likewise, malondialdehyde levels showed significant elevations (p<0.05) correspondingly in both uncontrolled and controlled T2DM against the controls, accompanied with significant reductions (p<0.05) in the antioxidative enzyme activities (glutathione peroxidase activity and catalase activity) and total antioxidant capacity levels against the controls. In addition, total cholesterol was significantly reduced (p<0.05) in controlled T2DM against both uncontrolled T2DM and controls, respectively. There were significant correlations between hemoglobin A1c and oxidative stress biomarkers (p<0.05). CONCLUSION: There was no remarkable difference in oxidative stress states between glycemic controlled and uncontrolled T2DM, despite differences in their fasting glycemia and glycated hemoglobin levels. Our data, therefore, suggest that chronic hyperglycemia and possibly anti-diabetic medication may both equally associate with oxidative stress.

OBJETIVOS: Evidências mostram que pacientes diabéticos podem estar predispostos ao estresse oxidativo devido ao aumento dos processos de oxidação da glicose e peroxidação lipídica em consequência da hiperglicemia crônica. No entanto, há escassez de informações se o controle glicêmico afeta positivamente o sistema de defesa antioxidante no diabetes mellitus tipo 2. Esse estudo investiga a possível associação entre controle glicêmico e biomarcadores de estresse oxidativo em estados glicêmicos controlados e não controlados. MÉTODOS: Após a liberação da comissão de ética, o estudo incluiu pacientes em uso de medicação hipoglicemiante (metformina) com hemoglobina glicosilada A1c ˂7,0% (diabetes controlado), pacientes recém-diagnosticados com diabetes mellitus tipo 2 sem controle glicêmico e com hemoglobina A1c ˃7,0% e indivíduos normoglicêmicos aparentemente saudáveis. Foram determinados os seguintes biomarcadores: glicemia de jejum, malonaldeído, atividade da glutationa peroxidase, atividade de catalase, capacidade antioxidante total e nível de colesterol total. A comparação entre os grupos foi feita pela ANOVA. RESULTADOS: Foram incluídos 260 participantes: 80 com diabetes controlada, 80 não controlada e 100 controles. Todos os participantes tinham entre 40 e 71 anos. A glicemia de jejum e a hemoglobina glicosilada foram significativamente menores (p<0,05) nos diabéticos controlados comparado aos não controlados, e todos os diabéticos apresentaram valores significativamente maiores (p<0,05) que os controles. Da mesma forma, os níveis de malonaldeído foram significativamente maiores (p<0,05) nos diabéticos (controlados e não controlados), assim como valores das atividades antioxidantes (glutationa peroxidase e catalase) e nos níveis de capacidade antioxidante foram significativamente menores (p<0,05) frente aos controles. Além disso, o colesterol total foi significativamente menor (p<0,05) nos diabéticos controlados quando comparados aos não controlados e controles, respectivamente. Houve correlações significativas entre a hemoglobina glicosilada e do estresse oxidativo (p<0,05). CONCLUSÃO: Não houve diferença significativa nos estados de estresse oxidativo entre os diabéticos controlados e não controlados, apesar das diferenças nos níveis de glicose plasmática e hemoglobina glicosilada. Nossos dados, portanto, sugerem que a hiperglicemia crônica e, possivelmente, a medicação antidiabética pode associar-se igualmente ao estresse oxidativo.

No Association between Urogenital Schistosomiasis and HIV Infection among Children in Ore Community, Southwestern Nigeria

Aim: To determine if there was any association between urogenital schistosomiasis and HIV infection among children in Ore Community, Southwestern Nigeria. Methodology: Urine samples were collected from 438 children and examined microscopically for ova of Schistosoma haematobium. A sample of 3 ml of blood was drawn from each participant for HIV test. Antibodies to HIV were determined using Determine HIV1/2 kit, Unigold kit and enzyme linked immunosorbent assay (ELISA). Results: The overall prevalence of S. haematobium infection was 30.1% while that of HIV infection was 0.9%. None of the 132 S. haematobium infected children had HIV infection while 1.3% of the 306 children negative for S. haematobium were positive for HIV test. Conclusion: This study did not identify an association between urogenital schistosomiasis and HIV infection among children in Ore, Southwestern Nigeria. Therefore, urogenital schistosomiasis may not play a significant role in the spread of HIV infection in a locality where HIV prevalence is low.

Lubricating effects of cocoa butter and coconut oil in conventional paracetamol tablets

Background: Due to chemical instability of some Active Pharmaceutical Ingredients often caused by magnesium stearate and its impurities, it is expedient to research into some other materials especially of natural origin, which would probably exhibit better lubricating activity, chemically inactive, less bioactive and less prohibitive.Objective: This work is designed to examine the lubricating properties of cocoa butter and coconut oil as alternative lubricants in comparison with conventional lubricant - magnesium stearate at different concentrations in paracetamol tablets. Materials and Methods: Cocoa butter was extracted from the seeds of Theobroma cacao and coconut oil from the meat of matured coconuts harvested from the coconuts palm (Cocos nucifera).Physicochemical evaluation was carried out on the extracted oils. Thirteen different formulations were prepared using different lubricants; magnesium stearate, cocoa butter and coconut oil at 0 ­ 4 %w/w concentrations. The prepared granules were evaluated for various pre-compression characteristics (bulk density, tapped density, angle of repose, Hausner's quotient and Carr's index) and post-compression characteristics (weight variation, friability, hardness, disintegration and dissolution times).Results: Most of the values obtained from the evaluation of pre- and post- compression characteristics correlate with the pharmacopoeial limits. The values of disintegration time were observed to increase as the lubricant concentration increased but no direct relationship with dissolution time. Tablet hardness values decreased while friability increased as the lubricant concentration increased for all the batches. From the study, cocoa butter and coconut oil at 2 ­ 4 % exhibited effective lubricating effect in the formulation of paracetamol tablet with respect to their values of weight variation, friability, hardness, disintegration and dissolution times.Conclusion: Cocoa butter and coconut oil could be employed as good alternative lubricants to the conventional ones in pharmaceutical tablet formulation

Cardiovascular Risk Profile of Post-Menopausal Women in a Semi-Urban Community in Nigeria.

Aims: Menopause is associated with a myriad of chronic health risks. This study assessed the Cardiovascular Disease (CVD) risk profile of post-menopausal women from a semi-urban community in Nigeria. Study Design: Cross-sectional study Place and Duration of Study: Ife Central Local Government, Ile - Ife, Nigeria Methodology: One hundred and twenty menopausal women aged 55 years and older participated in this study. The respondents were recruited using a multistage sampling technique. The Framingham Heart Study Questionnaire was used to assess CVD risk level. Risk scores were classified as low (0-19), medium (20-29) and high risk (40+). Socio-Economic Status (SES) was assessed using a validated questionnaire while cardiovascular and anthropometric parameters were measured following standard procedures. Data were analyzed using descriptive and inferential statistics. Alpha level was set at 0.05. Results: The mean age, weight and Body Mass Index (BMI) of respondents were 64.9±8.4 years, 73.4±15.2kg and 27.3±5.4kg/m² respectively. A majority, 84(70.0%) of the respondents had high blood pressure, 77(64.2%) had over five years duration of onset of menopause while 13(10.8%) had high cardiovascular risk. Half of the respondents, 64(53.3%) were in the low SES class. High CVD risk was higher among individuals with over five years of menopause. Pearson Product Moment Correlation revealed significant relationship between CVD risk and each of age (r = 0.507; P = 0.01), body weight (r = 0.257; P = 0.01), onset time of menopause (0.359; P = 0.01), blood pressure status (r = 0.665; P = 0.01), occupation (r = 0.330; P = 0.01) and SES (r = 0.406; P = 0.01) among post-menopausal women. Conclusion: Prevalence of CVD risk was high among Nigerian post-menopausal women in a semi-urban community. Age, body weight, years of onset menopause, blood pressure, occupation and socio-economic status level had significant relationship with high cardiovascular disease risk.

Surface activity as basis for pharmaceutical applications of hydrocolloids: A review.

Hydrocolloids are polymeric substances with mild to moderate surface activity. They are widely used as excipients in drug delivery systems where they serve various purposes such as suspending, emulsifying, wetting, foaming, solubilizing, stabilizing and bioadhesive agents as well as permeation enhancers. The surface activity and pharmaceutical applications of some hydrocolloids were reviewed in this study. The review showed that most natural hydrocolloids are characterized by higher critical micelle concentrations (CMC) compared to semisynthetic and synthetic ones. Cashew and khaya gums (exudates gums) with hydrophile – lipophile balance (HLB) values in the range of 15 - 18 possess solubilizing property. Dispersions of afzelia and prosopis gums (seed gums) have higher viscosity compared to acacia gum and may produce more stable disperse systems. Semisynthetic and synthetic hydrocolloids like sodium carboxyl methylcellulose and polyvinylpyrrolidone are characterized by low CMC and exhibit very high surface elasticity at concentrations above CMC thus exhibiting high bioadhesive strength. Therefore, surface activity is the basis for most pharmaceutical applications of hydrocolloids and the application of individual hydrocolloid depends on its adsorption power, CMC, HLB value and bioadhesive strength.

Influence of Some Starch Mucilages on Compression Behaviour and Quality Parameters of Paracetamol Tablets.

Aims: To evaluate the effect of mucilages of natural and pregelatinized forms of trifoliate yams, rice and official corn starch binders on a paracetamol tablet formulation. Methodology: Natural starches from two trifoliate yam varieties, and rice were isolated and pregelatinized. Both starch forms were then incorporated into a paracetamol tablet formulation as binders. The influence of the binders on compaction of granules and quality of tablets was assessed. Particle, bulk and tapped densities were measured for all the batches of the prepared paracetamol granules. The Heckel and Kawakita plots from which mean yield pressure, Py and another pressure term Pk, which indicates the pressure required to reduce the volume of the granule bed by 50%, were derived respectively. Both were employed to assess the compaction behaviour of the granules. Quality of the compressed tablets was studied using tensile strength, friability, disintegration time and dissolution properties as evaluation parameters. Results: Pregelatinized starch mucilages generally show lower values of both Py and Pk than natural starch mucilages. Increased concentration of starch mucilage binder also yielded lower values of both Py and Pk. Tablets containing natural starches exhibited higher Tensile strength and lower friability than those formulated with pregelatinized starch binders. Generally, Disintegration time (Dt) and the time taken for 80 % paracetamol to be released (t80) were higher for formulations containing natural starch binders than those containing pregelatinized binders The drug dissolution rate constants k1 and k2, were higher for formulations containing pregelatinized binders. Conclusion: The results obtained are suggestive of the fact that the use of mucilage of pregelatinized starch (rather than natural starch), as well as increase in concentration of the material, would yield formulations with faster onset of plastic deformation as well as higher total plastic deformation. The experimental starches compared well with the standard official corn starch and may thus be developed as substitutes in some tablet formulations.

Integrating Cervical Cancer Screening with HIV Care in a District Hospital in Abuja; Nigeria

Human immunodeficiency virus positive (HIV+) women have a higher risk of developing invasive cervical cancer compared with uninfected women. This study aims to document programmatic experience of integrating cervical cancer screening using Visual Inspection and Acetic Acid (VIA) into HIV care as well as to describe patients' characteristics associated with positive VIA findings amongst HIV+ women. Materials and Methods: A cross-sectional study analysed routine service data collected at the antiretroviral therapy (ART) and cervical cancer screening services. Our program integrated screening for cervical cancer using VIA technique to HIV care and treatment services through a combination of stakeholder engagement; capacity building for health workers; creating a bi-directional referral between HIV and reproductive health (RH) services and provider initiated counselling and screening for cervical cancer. Information on patients' baseline and clinical characteristics were captured using an electronic medical records system and then exported to Statistical Package for the Social Sciences (SPSS). Logistic regression model was used to estimate factors that influence VIA results. Results: A total of 834 HIV+ women were offered VIA screening between April 2010 and April 2011; and 805 (96.5) accepted it. Complete data was available for 802 (96.2) women. The mean age at screening and first sexual contact were 32.0 (SD 6.6) and 18.8 (SD 3.5) years; respectively. VIA was positive in 52 (6.5) women while 199 (24.8) women while 199 (24.8) had a sexually transmitted infection (STI). Of the 199 who had a STI; eight (4.0) had genital ulcer syndrome; 30 (15.1) had lower abdominal pain syndrome and 161 (80.9) had vaginal discharge syndrome. Presence of lower abdominal pain syndrome was found to be a significant predictor of a positive VIA result ( P = 0.001). Women with lower abdominal pain syndrome appeared to be more likely (OR 47.9; 95 CI: 4.8-480.4; P = 0.001) to have a positive VIA result. Conclusion: The high burden of both HIV and cervical cancer in developing countries makes it a necessity for integrating services that offer early detection and treatment for both diseases. The findings from our study suggest that integrating VIA screening into the package of care offered to HIV+ women is feasible and acceptable

Comparison of the Average of Five Readings with Averages from Fewer Readings for Automated Oscillometric Blood Pressure Measurement in an Outpatient Clinic

BACKGROUND AND OBJECTIVES: The optimal number of consecutive measurements for obtaining an average blood pressure (BP) reading in clinical practice is yet undefined by research. This study aimed to compare readings obtained from an average of 5 with averages of 2, 3, and 4, sequential measurements. SUBJECTS AND METHODS: Using an automated oscillometric device (BpTRU), BP measurement was conducted on 410 consenting adults attending a general outpatients clinic. Comparison of an average of 5 readings with averages of 2, 3, and 4 readings involved evaluation of correlations, Bland-Altman analysis, comparison of means and distribution of readings, and determination of the proportion of differences between compared readings which were clinically non-significant. RESULTS: 397 (96.8%) sets of complete BP readings were suitable for analysis. Clinically non-significant differences ( or =140 mm Hg and or =90 mm Hg for systolic and diastolic readings, respectively. Strong positive correlations were found between 5 average readings and each of 2, 3, and 4 average readings, respectively. CONCLUSION: An average of 5 readings may be excessive for routine BP measurement using this device at outpatient clinics.

Perception of Foreign Students on Food Safety and Hygiene Practices among Food Handlers in Malaysian Restaurants: Public Health Perspective

Influx of foreign students in Malaysia calls for a study on safety of food in Malaysia restaurants as perceived by them. This study aims to investigate perception of foreign students regarding food safety and personal hygiene practice of food handlers in Malaysia restaurants. A six sections Likert scale questionnaire was used. A total of 350 questionnaires were distributed during this study between March 2011 and March 2012 to the international students from 26 countries of the world in various public and private institutions of higher learning in Klang Valley, Malaysia. Among the distributed questionnaires, only 155 were correctly filled, retrieved and analyzed. Ninety-one respondents (59%) were male while 63 (41%) were females. A total of 107 (69%) were undergraduates and 29 (19%) were postgraduate students. One hundred and thirty-nine (90%) respondents were local or foreign restaurants. Eleven respondents (7%) did not patronize any of the restaurants. Among factors influencing choice of restaurants are closeness to residence, price of food and quality of food were the most important factors 62 (38%). Twenty-seven (28%) eat in restaurants because of the similarity of the food to that of their home country. Of the most preferred food, Nasi ayam, 89 (57%) top the list, next was Nasi goreng ayam, 14 (14%) and African food, 23 (15%). Nasi lemak was the least food preferred 3 (2%). A total of 104 (67%) respondents were of the opinion that handlers kept short nails, 91 (59%) do not pick nose, 108 (55%) stated that food handlers cough or sneeze while handling food. Ninety-eight respondents (64%) also stated that serving of food with unprotected hands were observed. The result of this study showed that although food handlers are aware of the need for personal hygiene, more awareness needs to be created.

Survey of low vision among students attending schools for the blind in Nigeria: a descriptive and interventional study

The aim of this study is to determine the prevalence of low vision among students attending all the schools for the blind in Oyo State, Nigeria. The study set out to determine the proportion of students with low vision/severe visual impairment after best correction, to determine the causes of the low vision, to document the associated pathologies, to determine the types of treatment and visual aid devices required, and to provide the visual aids needed to the students in the schools. All schools students for the blind in Oyo State were evaluated between August 2007 and January 2008. All the students underwent a thorough ophthalmic examination that included measurement of visual acuity, retinoscopy and subjective refraction, tests for visual aids where indicated, and a structured questionnaire was administered. A total of 86 students were included in the study and the mean age was 19.4 +/- 8.19 years. Twenty six [30%] were under 16 years of age. The most common cause of blindness was bilateral measles keratopathy/vitamin A deficiency [VAD] in 25 students [29.1%]. The most common site affected was the cornea in 25 students [29.1%], the lens in 23 [26.7%], and the retina/optic nerve in 16 [18.6%]. Preventable blindness was mainly from measles keratopathy/ VAD [29.1%]. Eleven students benefited from refraction and correction with visual aids; two having severe visual impairment [SVI], and nine having visual impairment [VI] after correction. The prevalence of low vision in the schools for the blind in Oyo State is 2.3%, while the prevalence of visual impairment is 10.5%. These results suggest that preventable and treatable ocular conditions are the source of significant childhood blindness in Oyo State

Disintegrant activities of natural and pregelatinized trifoliate yams, rice and corn starches in paracetamol tablets.

Natural and pregelatinized starches from white and yellow trifoliate yams and rice were comparatively studied with official corn starch, in a paracetamol tablet formulation to assess their relative effectiveness as disintegrants. Disintegration time (Dt) and the (crushing strength/friability)/disintegration time ratio (Cs/Fr)/Dt were employed as assessment parameters. Generally, the rankings of (Cs/Fr)/Dt for the natural and pregelatinized starch disintegrants were white T. yam > corn > yellow T. yam > rice; and white T. yam > yellow T. yam > corn > rice, respectively. Pregelatinized starches produced better combined disintegrant properties of (Cs/Fr)/Dt than natural starches. Tablets formulated with official corn starch disintegrant exhibited the lowest disintegration time values, but generally all the tablets containing the experimental starches also passed the official disintegration time test, and can therefore be used as alternative disintegrants in tablets.

Synergistic effect of menthol on in-vitro antibacterial activity of Garcinia kola against Gram positive Bacteria: A preliminary study.

In vitro antibacterial activity of aqueous and ethanol extracts of Garcina kola seeds and synergistic effect of menthol was investigated against selected Gram positive bacteria using agar diffusion method. The following bacteria were used as test microorganisms Staphylococcus aureus, Streptococcus pneumoniae, Staphylococcus epidermidis and Micrococcus luteus. Results obtained showed that only S. epidermidis was susceptible to aqueous extract while the remaining organisms did not show any susceptibility. It was also observed that S. pneumoniae did not show any susceptibility to ethanol extract. The Minimum Inhibitory Concentration (MIC) ranged between 25mg/ml and 200mg/ml. M. luteus showed the highest zone of inhibition (24mm). The least zone of inhibition (10mm) was observed in S. aureus and S. epidermidis. A different result was obtained when the organisms was tested with combinations of ethanol, aqueous and menthol. S. aureus, S. epidermidis and M. luteus became susceptible to ethanol extract when menthol was added likewise S. aureus and M .luteus became susceptible to aqueous extract with 5mm and 8mm as MIC respectively. Further study is required to ascertain the phytochemicals present in this plant seeds.

Determinants of young people's sexual behaviour concerning HIV and AIDS in the practice population of a university health centre in Lagos, Nigeria

Background: AIDS has been a scourge of universities in Africa for a long time. This study was launched at ground-level to fight the dreaded disease by concentrating on young people and to counter the ignorance that surrounds the disease even in numerous African universities. This study of the student community was carried out by family doctors at the University Health Department to determine the prevalence of the determinants of young people's reproductive health behaviour. Objectives: This study is aimed at determining young people's sexual behaviour concerning HIV and AIDS in the practice population of a university in Lagos, Nigeria. Method: Self-administered 63-item questionnaires were distributed amongst 2000 randomly selected students of the University of Lagos, Lagos, Nigeria in September 2005, using a semistructured form of the Comprehensive Youth Survey questionnaire, developed by FOCUS (led by Pathfinder International, Futures Group International and Tulane University School of Public Health. Results: The age distribution of the respondents was designated in the age groups of 15-19 years (15.8%), 20-24 years (60.1%), 25-29 years (19.6%), 30-34 years (2.8%). Demographics of note were that 88.3% of the fathers of the respondents were literate and that 94.5% of the fathers earned more than one US $ per day. The majority of the respondents (99.1%) indicated adherence to one religious faith or the other and 58.8% believed definitely that religion shaped their attitudes about sexual intercourse and sexuality. More than half (64.0%) denied having had sex at all in the three months preceding the study. Furthermore, 68.8% affirmed that it was common amongst friends of their age to use condoms. A significant number of respondents (65.5%) thought that their friends have drunken alcohol. Almost all of the respondents (94.3%) had a positive perception of their family. Conclusion: The Programming for HIV and AIDS Reduction on university campuses in Africa should be conducted comprehensively rather than monothematically and should, take into consideration the five thematic areas of behaviour change communication amongst young people concerning their reproductive health