Prevalence of chronic kidney disease in a Nigerian family practice population

Background: Chronic kidney disease (CKD) is a global public health problem, with a greater burden and prohibitive cost of care particularly in developing countries. This study determined the prevalence of chronic kidney disease and identified its associated risk factors in patients attending the Family Practice Clinic, Wesley Guild Hospital, Ilesa, Nigeria. Method: Consecutive newly-registered patients who attended the Family Practice Clinic of Wesley Guild Hospital, Ilesa from August 2005 to January 2006 were recruited and studied. Relevant data were collected by using an interviewer-administered questionnaire, and determining the spot urinary ACR (albumin-creatinine ratio) of the subjects by using Microalbustix™ reagent strips and using their serum creatinine concentration. The glomerular filtration rate (GFR) of each subject was estimated using the Modification of Diet in Renal Disease (MDRD) formula. A repeat urine test was done three months after the initial screening to identify subjects with persistent microalbuminuria. Results: The age of the study subjects ranged from 20 to 74 years, with a mean age of 50.52 + 13.03 years. There were 68 males and 182 females in the sample population, showing a male to female ratio of 1:2.7. One hundred and thirteen of the 250 subjects (45.2%) were found to have pathologic albuminuria at the initial screening, while 31 (12.4%) had persistent albuminuria three months later. Also, 51 subjects (20.4%) had estimated low GFR at the initial screening and 26 (10.4%) had persistent low GFR three months later. Significant risk factors for CKD in the study subjects were increasing age, elevated blood pressure, history of diabetes mellitus (DM), habitual intake of analgesics and herbs, and an abnormal waist to hip ratio(p < 0.05). The association between persistent abnormal ACR and low GFR did not reach statistical significance (p = 0.053). Habitual analgesic intake (p = 0.002) and age group (p = 0.0027) were true predictors of CKD among the study subjects. Conclusions: The prevalence of CKD in the study population was high and its association with modifiable risk factors was demonstrated. Family physicians have a unique opportunity to identify and address these factors in their patients. Routine screening for CKD in family practice clinics is indicated to reduce the burden of renal disease in the population

Sexual behaviour of in-school adolescents in Ibadan, South-West Nigeria

This study was a crossectional survey conducted among 716 senior secondary school adolescents in Ibadan from March to August 2005. The result of 695 that was analyzed revealed that the mean age of 15±2.6years. 28.3% of the respondents had previous sexual exposure with higher proportions being male (p=0.00043). Majorities' first sexual exposure was unplanned. Family settings and educational level do not have significant influence on the previous sexual exposure. The methods of sexual activity were mainly through vagina route while some had also practiced oral and anal sex. Most of those that are sexually exposed had more than one partner. About half of the respondents learn about sex from their friends while others through their parents and media. We conclude that in-school adolescents practiced unsafe sexual activity and they are therefore predisposed to STI/HIV and other reproductive health risks. (Afr J Reprod Health 2008; 12[2]:89-97)

Comparative evaluation of haemoglobin estimation amongst pregnant women in Ibadan: Hemocue ­ B Haemoglobin analyzer versus haemiglobincyanide (Standard) method as the gold standard

This was a comparative crossectional study that was conducted among 557 antenatal women at the University College Hospital, Ibadan, Nigeria between 1st April and 30th May 2006. The study compared the accuracy of haemoglobin estimation using an automated HemoCue B analyzer kit with a standard laboratory method(haemogloincyanide) as the gold standard. The result showed a positive correlation of HaemoCue haemoglobin results when compared with the standard methods (Pearson's correlation coefficient = 0.892; p value = 0.000). We concluded that the use of the automated HemoCue kit for haemoglobin estimation gives an objective assessment which overcomes the challenge of extra skilled manpower or power outages in rural areas thereby enhancing access to quality of care in resource poor countries. (Afr J Reprod Health 2008; 12[2]:153-159)

Physicians and AIDS Care: Does Knowledge Influence their Attitude and Comfort in Rendering Care?

Adequate knowledge; positive attitude; and feeling of comfort are important factors in providing compassionate care to patients. The purpose of this study was to assess physicians' knowledge; attitude and global comfort in caring for patients with AIDS (PWA); to determine the sociodemographic variables that could influence physicians' attitude and global comfort; and to identify any relationship between their knowledge; attitude and comfort. Consultants and residents (N=211) in two Nigerian teaching hospitals were surveyed using a two-part questionnaire. Part I elicited sociodemographic and previous AIDS encounter information; and Part II assessed knowledge; attitude and global comfort with AIDS patients care. Nigerian physicians showed satisfactory knowledge; but they harbored negative attitude and low level of comfort in caring for PWA. Previous AIDS care experience; age and being a consultant or a senior resident influenced attitude; while male gender and knowing someone with AIDS influenced global comfort. Knowledge is weakly but positively associated with attitude; while attitude is modestly associated with comfort. The study reinforced the need for an ongoing education focused on experiential learning; and professional socialization in order to influence physicians' attitude and enhance their feeling of comfort when caring for PWA

Fourteen days oral administration of therapeutic dosage of some antibiotics reduced serum testosterone in male rats

Fourteen days oral administration of therapeutic dose of Ampicillin (4mg/100g/day); Cloxacillin (6mg/100g/day) and Tetracycline (12mg/100g/day) separately to healthy adult male albino rats significantly reduced their serum testosterone level as assessed by enzyme immunoassay. The control group received equal volume of the vehicle (Normal saline) throughout the period of the treatment. A significant reduction (P0 .05) in testicular and epididymal weight was also produced by Cloxacillin; Cloxacillin and Tetracycline respectively. Ampicillin administration on the other hand significantly reduced (P0 .05) prostrate gland weight. After subjecting the treated animals to a recovery period ranging from 1-2 weeks; during which the drug administration was discontinued; all the animals recovered fully from the antifertility effect of these antibiotics on the serum testosterone level by the end of the second week. A significant recovery in the epididymal; testicular and prostrate gland weight was also recorded in the Cloxacillin and Tetracycline; Cloxacillin; and Ampicillin treated animals respectively. The result suggests that the reversible antifertility effects of these antibiotics were produced via the disruption of testosterone hormone production process. This was also accompanied by reduction in the weight of some of the male reproductive organs

Fourteen Days Oral Administration of Therapeutic Dosage of some Antibiotics Reduced Serum Testosterone in Male Rats

Fourteen days oral administration of therapeutic dose of Ampicillin (4mg/100g/day); Cloxacillin (6mg/100g/day) and Tetracycline (12mg/100g/day) separately to healthy adult male albino rats significantly reduced their serum testosterone level as assessed by enzyme immunoassay. The control group received equal volume of the vehicle (Normal saline) throughout the period of the treatment. A significant reduction (P0 .05) in testicular and epididymal weight was also produced by Cloxacillin; Cloxacillin and Tetracycline respectively. Ampicillin administration on the other hand significantly reduced (P0 .05) prostrate gland weight. After subjecting the treated animals to a recovery period ranging from 1-2 weeks; during which the drug administration was discontinued; all the animals recovered fully from the antifertility effect of these antibiotics on the serum testosterone level by the end of the second week. A significant recovery in the epididymal; testicular and prostrate gland weight was also recorded in the Cloxacillin and Tetracycline; Cloxacillin; and Ampicillin treated animals respectively. The result suggests that the reversible antifertility effects of these antibiotics were produced via the disruption of testosterone hormone production process. This was also accompanied by reduction in the weight of some of the male reproductive organs

Estado del arte de la participacion en salud ocupacional de los trabajadores en Colombia desde 1976 / State of Art of teh occupational health workers participation in Colombia since 1976

Tradicionalmente la persona encargada de la salud ocupacional, se siente responsable de controlar los factores de riesgo a los cuales está expuesto el trabajador quien asume un papel pasivo. Aun cuando este tipo de intervención es necesaria, se requieren cambios de actitud del trabajador y la organización laboral, que contribuyan al empoderamiento del trabajador respecto a su salud. Para esto son esenciales los procesos participativos. Por lo anterior se considera importante realizar una recapitulación crítica de la participación en salud de los trabajadores, conscientes de la necesidad de un cambio en los procesos participativos, que los involucren como sujetos activos en la determinación de procesos que promuevan, mejoren y conserven su salud, pues son ellos los que poseen la vivencia y conocimiento acerca de las condiciones de trabajo y las repercusiones en ella. Con este estado del arte, se busca recopilar la información existente, teniendo en cuenta los antecedentes históricos, tanto de la participación comunitaria como la de los trabajadores; un marco de referencia que contempla la conceptualización de la participación; las formas y tipos de participación; la intervención de la educación como proceso de participación; la participación vista como un derecho y deber; los modelos de participación; el marco constitucional y legal y los actores sociales en nuestro contexto. Finalmente, en una fase reflexiva - crítica de la documentación se pretende analizar los fenómenos hallados, con el fin de develar como se presentan y los intereses y las tendencias de los mismos. Como último aporte se elabora una base de datos de la participación, útil para próximas investigaciones relacionadas con el tema

Receptores solubles para interferón / Soluble interferon receptors

En el desarrollo del trabajo se detectó la presencia de receptor pra interferón gamma (R-IFN gamma) soluble en el plasma de individuos sanos, infectados con el virus de la inmunodeficiencia humana (VIH), con cáncer y trastornos autoinmunes (artritis reumatoidea) y en el sobrenadante de cultivos celulares (Colo 205, Raji). Se observó la presencia de especies moleculares de 84, 56, 51 y menores de 30 kDa en la preparación proveniente de plasma. Se purificó el receptor de membrana para interferón (IFN) gamma en leucocitos y plaquetas humanos. Fueron detectados especies moleculares de 84 y 51 kDa en ambos. Productos degradativos con unión específica al IFN gamma y fueron detectados en 27 y 13 kDa, en condiciones reductoras, en la preparación de receptos de membrana para leucocitos. Fue encontrada la actividad que une IFN *-2 de forma específica en el plasma y en el sobrenadante de cultivos celulares (Hep-2, Daudi)