Antibacterial Activity of Lawsonia inermis Leaf Extracts against Multidrug-resistant Pseudomonas aeruginosa from Infected Wounds

Background: Wound infection comprises numerous different organisms that have the ability to surface colonization of wounds. Multidrug-resistant Pseudomonas aeruginosa is one of the pathogenic bacteria associated with wound infections. Aim: This study isolated and identified multidrug-resistant Pseudomonas aeruginosa from infected wounds and determine the antibacterial activity of Lawsonia inermis leaf extracts against it. Design: This is a Clinical and laboratory-based study involving patients with defined cases of wound infections. Place and Duration of Study: This study was conducted in the Microbiology (Bacteriology) laboratory of Specialist Hospital, Bauchi, Nigeria, from February to November 2021. Methods: Twenty-eight (28) Pseudomonas aeruginosa isolates were recovered from 179 wound swabs using standard laboratory procedures and were screened for multidrug-resistant patterns according to the Kirby-Bauer disc diffusion method. Antibacterial efficacy of the aqueous, ethanolic, and methanolic leaf extracts of Lawsonia inermis was tested against the multidrug-resistant isolates using agar well diffusion techniques. The zone of inhibition was measured and the differences between means were statistically analyzed (p<0.05). Results: A total of twenty-eight (28) multidrug-resistant Pseudomonas aeruginosa were confirmed, showing resistance to Amoxicillin (64.3%), Ceftazidime (85.71%), and Cefotaxime (78.57%) but sensitivity to Imipenem (95.5%). The phytochemical screening revealed the presence of flavonoids, glycosides, saponins, steroids, and tannins among others. MDR P. aeruginosa was inhibited at varied concentrations of the extracts with the diameter mean zone of inhibition increasing as the concentration increased. The Methanol extracts showed the highest antibacterial activity against MDR P. aeruginosa with a mean zone of inhibition of 9.500±0.288mm at 400mg/ml. Conclusion: These results indicated that Lawsonia inermis leaf extracts possess antibacterial activities on Multidrug-resistant Pseudomonas aeruginosa which could be a good source for the production of plant-based antibacterial drugs., although somewhat less than the synthetic standard drugs (Imipenem) having a mean of 13.83±0.288mm.

Enumeration of Salmonella Species Isolated in Ready–to–Eat Fruits Vended in Bukuru Market, Jos South, Plateau State

Background: Despite control measures to curtailed salmonella fruit contamination over the years, pathogenic disease outbreaks caused by the ingestion of Salmonella contaminated fresh-cut-fruits pose a significant problem to human health by the consumption of fresh and minimally processed fruits. This study aimed to enumerate and determine the prevalence of Salmonella species isolated in ready-to-eat fruits vended in Bukuru Market Jos South, Plateau state. Methodology: A total of seventy-eight ready-to-eat vended fruit samples were purchased and cultured for the enumeration of bacterial isolates according to National Food Safety Standard for Microbiological Examination. Pulp pH value of each fruit was obtained by immersing litmus paper into the pulp and results recorded. Results: Of the 78 fruits specimen, 22 (28.2%) were Salmonella positive. The prevalence rates of salmonella isolated were found to be higher (22.7%) in both coconut and avocado followed by watermelon (18.2%) and sweetmelon (13.6%) as compared with other fruits in the study area. Lower rates of 4.5% were found in banana, pawpaw, and dates with a rise in apple with 9.1% respectively. Conclusion: The study showed a high p<0.05 (7.811) prevalence of pathogenic Salmonella species isolated in ready-to-eat fruits in the study area revealing that the spread of salmonella is not independent of fruits thereby suggestive of contamination made available by fruit vendors in this part of the world. Thus, epidemiological traceability and significant measures must be taken to check the safety of these vended products before consumption.

Challenges of contact tracing during COVID-19 pandemic response in a tertiary hospital in Northwestern Nigeria

Background: Contact tracing is a traditional pillar of infectious disease control, especially for illnesses involving direct transmission from person to person, such as COVID-19. Several challenges have arisen from COVID-19 contact tracing activities, particularly in low-resource settings. These include refusal of positive clients to disclose their close contacts, difficulties in conducting risk assessment for contacts traced, among others. Objectives: To explore the activities and identify challenges of contact tracing during COVID -19 pandemic response in a tertiary hospital in Northwestern Nigeria from May, 2020 to March, 2021. Methodology: Amixed method approach was done with quantitative secondary data analysis of COVID-19 contacts traced, and qualitative assessment through Key Informant Interviews (KII) of Ahmadu Bello University Teaching Hospital staff involved in COVID-19 outbreak response during the period. Results: Atotal of 2,249 clients were tested for COVID-19, of which 925 (41.1%) were healthcare workers. The identified challenges included problems with contact identification, delay in notification of results, refusal to disclose contacts by cases, contacts refusing to allow risk assessment, and health workers being overwhelmed by the task of contact tracing. Conclusion: Challenges identified include refusal of cases to disclose their contacts, overwhelming number of contacts, and delay in notification of results. There is need to institute contact tracing protocols to mandate cases to disclose their contacts, train more manpower to reduce the burden of contact tracing, and improve the notification of results.

COVID-19 Vaccine Hesitancy among Pregnant Women: A Facility-Based Cross-Sectional Study in Imphal, Manipur

Background: Vaccine hesitancy has been recognized as a public health issue which needs to be addressed urgently. Pregnant women with COVID-19 are at increased risk of adverse pregnancy outcomes. An assessment of the determinants of vaccine hesitancy will aid in the acceleration of vaccine administration among pregnant women. Objectives: The present study aimed to determine COVID-19 vaccine hesitancy among pregnant women in Imphal, Manipur and assess associated factors. Methods: A cross-sectional study was conducted among pregnant women attending Obstetrics and Gynecology Department of a Tertiary Care Institute in Imphal, Manipur during August 2021. One hundred and sixty-three pregnant women were interviewed using a structured questionnaire over phone calls. Univariate analysis was carried out using the Chi?square test and multivariable logistic regression was performed to determine the factors significantly associated with vaccine acceptance. Results: The mean age of the participants was 28.3 ± 5.5 years and majority, 102 (62.6%) were multigravida and 27 (16.6%) had comorbidities. Vaccine hesitancy was found in 127 (77.9%) participants. Logistic regression analysis indicated that awareness on COVID?19 vaccine eligibility (P = 0.002), disagreement of vaccine being unsafe during pregnancy (P = 0.005), and agreement on vaccine benefiting the baby (P = 0.003) were the significant predictors of vaccine acceptance. Conclusion: Nearly four out of every five pregnant women had COVID?19 vaccine hesitancy. Pregnant women should be informed about the benefits and encouraged to take COVID?19 vaccine.

Antibacterial Activity of Composite Mixture of Senna siamea Leaves and Tamarind Pulp Extracts on Multidrug Resistant Salmonella typhi

Background: For many years, antimicrobial chemotherapeutic approach have been challenged by drugs resistant bacteria such as Salmonella associated with gastrointestinal infections. To overcome these effects, several attempts by herbalists and traditional healers were in progress, using some plants parts to treat Typhoid fever in Nigeria. Aim: The aim of this work was to determine the antibacterial activity of Senna siamea leaves and Tamarindus indica fruit pulp against multidrug resistant Salmonella typhi. Methods: A total of 168 samples of stool and blood from patients with suspected cases of typhoid fever were collected and only three (3) Salmonella typhi isolates were recovered (from the 168 samples) by conventional microbiological techniques. The isolates were screened for multidrug resistant properties according to Kirby -Bauer disc diffusion method. Water and ethanol were used to extract phytochemical components from powdered leaves of Senna siamea and Tamarindus indica fruit pulp via percolation method. The extracts were tested for the antibacterial activity against the clinical isolates of Salmonella typhi. Results: All the isolates (100%) were resistant to Ampicillin, Amoxicillin, while two (66.7%) to Erythromycin and Tetracycline and sensitive (100%) to Streptomycin, Gentamycin, Nalidixic acid Ciprofloxacin, Cotrimoxazole, Augmentin and Chloramphenicol, The phytochemical screening o of both plants extracts showed the presence of alkaloids, terpenoids, flavonoids, saponins, tannins, carbohydrates and cardiac glycosides. The result shows that aqueous and ethanolic extracts of combined Tamarind and Senna siamea were more active (2.50µg/ml) against Salmonella typhi when compared to individual extracts. Conclusion: This study shows that aqueous and ethanol extracts of both plants exhibited activity on S. Typhi, hence, possess antimicrobial potentials that it can be used in treatment of typhoid.

Prevalence and correlates of psychological distress amongst healthcare workers during the COVID-19 pandemic: An online survey

Background: Understanding the mental health needs of healthcare workers during coronavirus disease 2019 (COVID-19) pandemic with a view of mitigating its impact on occupational functioning is vital. Aim: To determine the prevalence and correlates of psychological distress amongst healthcare workers. Setting: The study was carried out in Nigeria during COVID-19 pandemic. Methods: A cross-sectional quantitative study using a convenience sample was conducted amongst healthcare workers. The survey comprised of two Google formatted self-report questionnaires, a 12-item General Health Questionnaire and a questionnaire containing socio-demographic, work related and knowledge of COVID-19 variables. Questionnaires were distributed via closed professional WhatsApp platforms. Data were analysed using descriptive statistics, chi-square test and logistic regression. Results: There were 313 respondents and prevalence of psychological distress was 47.0%. Females were almost twice as likely to have psychological distress as males (OR = 1.92, 95% CI: 1.21­3.04, p = 0.006). Healthcare workers who had no contact with COVID-19 positive patients had an 87% reduced risk of psychological distress (OR = 0.13, 95%CI: 0.23­0.25, p = 0.018) compared with those who had contact with COVID-19 positive patients. Healthcare workers with poor knowledge of COVID-19 had a 44% reduced risk of psychological distress compared with those with good knowledge (OR = 0.56, 95% CI: 0.34­0.93, p = 0.025). Conclusion: Findings revealed that healthcare workers in Nigeria reported psychological distress during COVID-19 pandemic. Greater risk was amongst females and those who had contact with COVID-19 positive patients whilst poor knowledge was protective.

Effect of health education on long lasting insecticidal nets utilization among mothers of under five children in Yamaltu Deba Lga, Gombe State, Nigeria

Background: Malaria remains a major global public health challenge. It is the leading cause of death among children below the age of five years and constitutes 10% of the continent's disease burden. The objective of this study was to determine effect of health education on utilization of long lasting insecticidal nets (LLINs) among mothers of under five children in Yamaltu Deba LGA of Gombe state: Objective: This study was aimed at determining the effect of health education on LLINs utilization among mothers of under five children in Yamaltu Deba LGA of Gombe State. Method: The study was a community-based quasi-experimental intervention where 240 mothers of under five children were selected from two communities using a multi stage sampling technique. Health education was given in the study community and withheld in the control community. Data was collected from both communities before and after the intervention using an interviewer administered structured questionnaire. Data was analyzed using EPI-INFO 3.7.1 and Micro soft Excel software. Result obtained was presented using proportion, Chi-square test was used to assess the relationship between categorical variables and decision taken at p<0.05. Results: The mean ages of respondents in study and control communities were 28.9±6.2 and 27.9±6.7 years respectively. At pre-intervention, LLIN ownership was found to be 86.6% and 76.3% while its utilization was 45.4% and 38.1% in both communities. After health education intervention, (LLINs) improved significantly in study community from 42.9% to 89.9% compared with control community which increased from 33.9% to 60.9% and the difference was statistically significant(P=0.0001). Conclusion: This study concludes that health education significantly improved utilization. We recommended continuous health education on LLINs utilization in communities especially among mothers of under five children

Bacterial isolates associated with pelvic inflammatory disease among female patients attending some hospitals in Abuja, Nigeria

Background: Pelvic inflammatory disease refers to any infection in the female lower reproductive tract that spreads to the upper reproductive tract. The disease comprises a spectrum of inflammatory disorders of the upper female genital tract; including any combination of endometritis; salpingitis; tubo-ovarian abscess and pelvic peritonitis. PID is not a notifiable disease in most countries; so accurate statistics are not available. This situation is not in any way different here in Nigeria and more so in the Federal Capital Territory; Abuja where this research was conducted; there had never been any published report so far on PID. It therefore became pertinent that such studies be carried out to evaluate the bacterial organisms which may be associated with the disease in this part of Nigeria so that health care providers could take a better look at this affliction in women. Materials and Methods: Endocervical swabs totalling 100 were aseptically collected from patients with confirmed Pelvic Inflammatory Disease (PID); attending some hospitals in Abuja; Nigeria for detection of bacterial pathogens based on cultural and biochemical characterisation tests. Antibiogram was also conducted on the identified bacterial isolates. Results: Out of the 100 samples analysed; 43 yielded pure cultures of bacterial isolates; 2 yielded mixed cultures while no bacterial growths were recorded from the remaining 55 samples. Organisms encountered were Staphylococcus aureus (16); Escherichia coli (10); Streptococcus faecalis (8); Pseudomonas aeruginosa (4); Streptococcus pyogenes (3); Klebsiella pneumoniae (3); Proteus rettgeri (2) and Proteus mirabilis (1). The highest percentage occurrence of pathogenic isolates was observed in polygamous married patients (90). The age group most affected falls within the mean age 30.5 years (68) while the least affected group falls within the mean age 40.5 years (5). There was a significant difference in the acquisition of PID in relation to marital status (P 0.05). However there was no significant difference in the acquisition of the disease with respect to age (P 0.05). Antibiogram patterns of pathogenic isolates revealed varied resistance to most of the antibiotics employed. Cefotaxime (a new generation cephalosporin antibiotic) was established in this study as the best antimicrobial agent for treatment of PID due to Gram-positive and Gram-negative bacteria isolated from the women examined. Conclusion: In conclusion; Pelvic inflammatory disease is a major health problem in developed or developing countries of the world. PID is not a notifiable disease; as accurate statistics on disease prevalence are rarely available. There is therefore no doubt thousands of young women have salpingitis every year and their sheer number makes it an important health problem. PID hence can be said to be a very serious complication of sexually transmitted disease which should be critically and promptly handled by healthcare providers. The right type sample should be aseptically collected and be appropriately handled for laboratory investigation. Treatment of PID should be initiated as soon as the presumptive diagnosis has been made. Immediate administration of antibiotics has been effective in the long-term sequelae associated with PID; especially new generation antibiotics; such as cefotaxime as recorded in this study

Isolation and Elucidation of Pyrrolizidine alkaloids from tuber of Gynura pseudo-china (L.) DC.

Pyrrolizidine alkaloids (PAs) are produced by numerous plant species throughout the world. Numerous intoxications in animals and humans caused by the consumption of certain plants were attributed from the middle of this century to compounds of vegetable origin, the pyrrolizidine alkaloids. Daun dewa (Gynura pseudo-china (L.) DC.) is one of Indonesian medicinal plant which also a native plant of India, Thailand and China. The tuber of this plant is commonly used in Indonesian traditional medicine such as for treatments of uterine hemorrhages, dysentery, and inflamed wounds. Although its medicinal value, it is reported that leaves of this plant and other Gynura species content pyrrolizidine alkaloids (PAs). There are concern about the present of PAs in medicinal plants because of the toxicity of this compounds to human and animal. It is reported that PAs are hepatotoxic, pneumotoxic, genotoxic, neurotoxic, and cytotoxic. The purpose of this study is to study the PAs content of G. pseudochina tuber. The structures-were elucidated using spectral data of Infra Red, Liquid Chromatography-Mass Spectroscopy and a combination of one- and two dimensional 1H and 13C- Nuclear Magnetic Resonance spectroscopy. In this study, two pyrrolizidine alkaloids, senecionine (Compound 1) and senkirkine (Compound 2) were isolated from the tuber of G. pseudo-china. This results suggest that it should be a safety consideration in consuming this plant for traditional medicine because it is also contains PAs which are toxic compounds.

Acute salt poisoning due to different oral rehydration solution (ORS) packet sizes.

The packing and composition of ORS has undergone a change since its introduction. In India, some companies are manufacturing smaller pouches (4.2 g) to be dissolved in 200 ml of water. Therefore, out of confusion some prescribers routinely advise the patients to dissolve the standard formulation ORS pouch (21 g) in a glass (200 ml) of water. Two cases are discussed. First patient developed salt poisoning due to improper dilution and recovered after rapid correction. In the second patient improper reconstitution led to hypernatremia and death.

Determinants of Utilization of Maternity Services in Gidan Igwe; Sokoto; Nigeria

Background: The provision of antenatal care is regarded as the cornerstone of maternal and perinatal health care especially in developing nations and is expected to have a significant impact on achieving the fifth millennium development goal. The aim of this study was to assess the determinants of utilisation of maternity services in Gidan Igwe; Sokoto. Methods: The study was a cross-sectional descriptive one involving 300 women of child bearing age selected through a systematic sampling technique. Data was collected using a set of semi-structured interviewer and self administered questionnaires. Results: Majority; 214 (71.3) of the respondents had no formal education; visited a health facility for antenatal care during their last pregnancy; 218 (72.7) and had their last delivery at home; 190 (63.3). Of the 190 subjects that delivered at home; 165 (85) were assisted by Traditional birth attendants (TBAs). Education was statistically significantly associated with ANC attendance and hospital delivery (P=0.0012). Conclusion: Although; a high proportion of the respondents visited health facilities for ANC; only a few of them delivered in these facilities. There is need to increase public awareness on the use of antenatal care services and delivery by skilled attendants

Perception and Predictors of Insecticide-Treated Net Use in a Rural Northern Nigerian Community

"Background: Sub-Saharan Africa carries a high burden of malaria. Despite evidence of the effectiveness of insecticide treated nets (ITNs); utilization rates are still low. Methods: We assessed community perception of malaria and determinants of ITN use among 158 households in rural northern Nigeria using interviewer administered structured questionnaires. Results: Nearly all respondents 157(99.4) were familiar with the term ""malaria"" and attributed it to mosquito bite. Other mentioned causes of malaria included unclean environment (74); heat (7); overwork (1.9); and contaminated water (0.6). The symptoms mentioned included fever (95); headache (52.5); body weakness (41.1) and vomiting (25.9). Most respondents (84.0) were aware of ITNs but only 34.8used them. Willingness to buy at current market price; health workers as source of information and the use of mosquito coils were significant predictors of ITN use. Conclusion: High awareness of ITNs did not translate into its utilization. Public health education in malaria including free ITN use should be delivered by health workers."

Sleep habits and their consequences: a survey

Objective: To study the sleep habits and their consequences among the students of Shifa College of Medicine

Materials and Methods: A survey questionnaire consisting of a total of 50 questions was designed to analyze the sleep habits of the students of Shifa College of Medicine, Islamabad. Data were collected during March and April 2002. The answers were restricted to either YES or NO. A total of 120 questionnaires were then distributed to the students of the first four years in their respective classrooms, with an explanation of the aims and objectives of the study

Results: Responses were received from 112 students. The age range was between 18 and 23 years. Analysis revealed that on average the amount of sleep required per 24 hours of the respondents was 8 hours, however, the average amount of sleep that they actually got every day was on average 6 hours. There was an association between the quantity of caffeine ingested and its subsequent effects on the regularity of sleeping hours. Most of the students of Shifa College of Medicine are suffering from high levels of daytime sleepiness. Nearly half the class of second year admitted to being depressed and irritable [47% and 50% respectively]. A 37% said that their lifestyle and interpersonal relationships were affected

Conclusion: Our preliminary results show that disorders related to sleep are a significant problem. Caffiene ingestion affected sleep and there was high level of daytime sleepiness. Sleep difficulties resulted in irritability and affected lifestyle and interpersonal relationships