GLP-1/GIP Agonist as an Intriguing and Ultimate Remedy for Combating Alzheimer's Disease through its Supporting DPP4 Inhibitors: A Review.

BACKGROUND: Alzheimer's disease (AD) is a widespread neurological illness in the elderly, which impacted about 50 million people globally in 2020. Type 2 diabetes has been identified as a risk factor. Insulin and incretins are substances that have various impacts on neurodegenerative processes. Preclinical research has shown that GLP-1 receptor agonists decrease neuroinflammation, tau phosphorylation, amyloid deposition, synaptic function, and memory formation. Phase 2 and 3 studies are now occurring in Alzheimer's disease populations. In this article, we present a detailed assessment of the therapeutic potential of GLP-1 analogues and DPP4 inhibitors in Alzheimer's disease. AIM: This study aimed to gain insight into how GLP-1 analogues and associated antagonists of DPP4 safeguard against AD. METHODS: This study uses terms from search engines, such as Scopus, PubMed, and Google Scholar, to explore the role, function, and treatment options of the GLP-1 analogue for AD. RESULTS: The review suggested that GLP-1 analogues may be useful for treating AD because they have been linked to anti-inflammatory, neurotrophic, and neuroprotective characteristics. Throughout this review, we discuss the underlying causes of AD and how GLP signaling functions. CONCLUSION: With a focus on AD, the molecular and pharmacological effects of a few GLP-1/GIP analogs, both synthetic and natural, as well as DPP4 inhibitors, have been mentioned, which are in the preclinical and clinical studies. This has been demonstrated to improve cognitive function in Alzheimer's patients.

An exploratory diagnosis and proposed index of technological change and sustainable industrial development in selected OECD member countries.

Industrial development has resulted in economic progress and the well-being of the society. At the same time, the impact of the industrial complex has disrupted the environment and resulted in climate change related impacts. The purpose of this study was to carry out an exploratory diagnosis and propose a technological change and sustainable industrial development index at the international level. Therefore, a network study was conducted to identify the main nodes and thematic clusters associated with cleaner production. A patent analysis was applied to technologies related three selected/relevant areas of cleaner production, i.e. carbon footprint, wastewater treatment, and renewable energy. Additionally, based on factor analysis, an index including different indicators related to scientific, technological, economic, environmental, and social issues was developed and proposed in this study.

Advances in amelioration of air pollution using plants and associated microbes: An outlook on phytoremediation and other plant-based technologies.

Globally, air pollution is an unfortunate aftermath of rapid industrialization and urbanization. Although the best strategy is to prevent air pollution, it is not always feasible. This makes it imperative to devise and implement techniques that can clean the air continuously. Plants and microbes have a natural potential to transform or degrade pollutants. Hence, strategies that use this potential of living biomass to remediate air pollution seem to be promising. The simplest future trend can be planting suitable plant-microbe species capable of removing air pollutants like SO2, CO2, CO, NOX and particulate matter (PM) along roadsides and inside the buildings. Established wastewater treatment strategies such as microbial fuel cells (MFC) and constructed wetlands (CW) can be suitably modified to ameliorate air pollution. Green architecture involving green walls and green roofs is facile and aesthetic, providing urban ecosystem services. Certain microbe-based bioreactors such as bioscrubbers and biofilters may be useful in small confined spaces. Several generative models have been developed to assist with planning and managing green spaces in urban locales. The physiological limitations of using living organisms can be circumvent by applying biotechnology and transgenics to improve their potential. This review provides a comprehensive update on not just the plants and associated microbes for the mitigation of air pollution, but also lists the technologies that are available and/or can be modified and used for air pollution control. The article also gives a detailed analysis of this topic in the form of strengths-weaknesses-opportunities-challenges (SWOC). The strategies mentioned in this review would help to attain corporate Environmental Social and Governance (ESG) and Sustainable Development Goals (SDGs), while reducing carbon footprint in the urban scenario. The review aims to emphasise that urbanization is possible while tackling air pollution using facile, green techniques involving plants and associated microbes.

Volume-targeted ventilation.

Despite strong evidence of important benefits of volume-targeted ventilation, many high-risk extremely preterm infants continue to receive traditional pressure-controlled ventilation in the United States and elesewhere. Reluctance to abandon one's comfort zone, lack of suitable equipment and a lack of understanding of the subtleties of volume-targeted ventilation appear to contribute to the relatively slow uptake of volume-targeted ventilation. This review will underscore the benefits of using tidal volume as the primary control variable, to improve clinicians' understanding of the way volume-targeted ventilation interacts with the awake, breathing infant and to provide information about evidence-based tidal volume targets in various circmstances. Focus on underlying lung pathophysiology, individualized ventilator settings and tidal volume targets are essential to successful use of this approach thereby improving important clinical outcomes.

Telemedicine Service Adoption During the COVID-19 Pandemic: Physicians' Experience from Nigeria.

Introduction: Telemedicine practice experiences during the COVID-19 pandemic have not been well documented in resource-constrained settings, such as Nigeria. We set out to assess knowledge, attitude, and factors associated with telemedicine practice during the COVID-19 lockdown, as well as physician experiences in Kano, Nigeria. Methods: We employed a mixed-methods approach, utilizing structured questionnaires administered to 246 physicians, followed by in-depth interviews with a purposive subsample of 20 individuals. The data were analyzed using logistic regression and the framework approach. Results: Overall, 65.0% of the respondents demonstrated moderate to good knowledge of telemedicine. Before COVID, only 47.6% (n = 117) reported practicing telemedicine, compared with 77.2% (n = 190) during the COVID lockdown (p < 0.05). Factors associated with telemedicine practice included having at least 5 years of work experience, working in pediatrics, undergoing senior residency training, receiving formal telemedicine training, possessing good knowledge of telemedicine, and having a positive attitude toward it. The odds of engaging in telemedicine practice were four times higher (adjusted odds ratio = 4.10, 95% confidence interval: 1.79-9.40) for those who practiced it before the pandemic. Challenges identified included knowledge and skill gaps, slow internet connectivity, unstable electricity, and inadequate equipment. Conclusion: To enhance telemedicine practice in resource-limited settings, it is important to focus on strengthening information and communication infrastructure, providing comprehensive clinician training, implementing careful patient selection processes, and improving practice guidelines.

Arsenic Exposure and Amyloid Precursor Protein Processing: A Focus on Alzheimer's Disease.

BACKGROUND: Arsenic is present in above permissible safe limits in groundwater, soil, and food, in various areas of the world. This is increasing exposure to humankind and affecting health in various ways. Alternation in cognition is one among them. Epidemiological research has reflected the impact of arsenic exposure on children in the form of diminished cognition. AIMS: Considering this fact, the present study reviewed the impact of arsenic on amyloid precursor protein, which is known to cause one of the commonest cognitive disorders such as Alzheimer's disease. METHODS: The present study reviews the arsenic role in the generation of amyloid-beta from its precursor that leads to Alzheimer's disease through the published article from Pubmed and Scopus. DESCRIPTION: According to the findings, regular, long-term exposure to arsenic beginning in infancy changes numerous arsenic level-regulating regions in the rat brain, which are related to cognitive impairments. Arsenic also affects the BBB clearance route by increasing RAGE expression. Arsenic triggers the proamyloidogenic pathway by increasing APP expression and subsequently, its processing by ß-secretase and presenilin. Arsenic also affects mitochondrial dynamics, DNA repair pathway and epigenetic changes. The mechanism behind all these changes is explained in the present review article. CONCLUSION: A raised level of arsenic exposure affects the amyloid precursor protein, a factor for the early precipitation of Alzheimer's disease.

Curriculum Development: Postgraduate Diploma in Health Systems Management.

BACKGROUND: Postgraduate diploma in health systems management (PDHSM) curriculum was designed and developed to equip medical doctors with the knowledge, skills, and attitudes required to manage health systems and resources for quality patient care and safety. OBJECTIVES: Describe processes and steps to design and develop a new curriculum using the development of PDHSM as a guide by identifying learning needs; using the six-step approach to curriculum development; incorporating quality assurance and quality enhancement frameworks; and identifying evaluation methods. METHODOLOGY: Four (4) subject content experts in health policy, planning, and management and experienced public health physicians at the National Postgraduate Medical College of Nigeria deliberated, determined, and compiled learning needs that were incorporated into the design and development of the new curriculum for PDHSM. The learning needs, informal data on key learning issues in health system management and specific challenges in the context and operational environment were analyzed. Triangulation of information from these different perspectives and opinions was aligned with medical doctors' educational needs to acquire competency in managing health systems. The derived instructional needs, assessment methods, and resources were incorporated into the design, development, and evaluation of the PDHSM curriculum. The outline of the curriculum was developed using the curriculum matrix table. RESULTS: The contents of the developed curriculum in PDHSM include the purpose, organization of the programme, educational experience, and evaluation of the curriculum. The curriculum was structured into modules. Each module has intended learning outcomes (ILOs) of major subject areas of HSM and teaching and learning activities that outline methods of instruction and assessments. The Indicative contents of each module are topics of each subject area of the PDHSM. The assessment formats in the curriculum included both formative and summative assessment methods and types. The resources required for instructional and assessment activities were identified. The evaluation methods of the curriculum will be through reviews of assessment results and performance evaluation of students, tutors, and the PDHSM programme. CONCLUSION: The educational needs of medical doctors to function as managers in the health systems determine the development of intended learning outcomes, teaching and learning activities, indicative contents, resources required, and evaluation of the PDHSM curriculum. Quality assurance and quality enhancement should be part of curriculum design and development.

CONTEXTE: Le programme du diplôme de troisième cycle en gestion des systèmes de santé (PDHSM) est conçu et développé pour doter les médecins des connaissances, des compétences et des attitudes nécessaires pour gérer les systèmes et les ressources de santé en vue d'assurer la qualité des soins et la sécurité des patients. OBJECTIFS: Décrire les processus et les étapes de la conception et du développement d'un nouveau programme en s'inspirant du développement du PDHSM, en identifiant les besoins d'apprentissage, en utilisant l'approche en six étapes du développement du programme, en incorporant les cadres d'assurance et d'amélioration de la qualité, et en identifiant les méthodes d'évaluation. MÉTHODOLOGIE: Quatre (4) experts en politique, planification et gestion de la santé et des médecins expérimentés en santé publique du National Postgraduate Medical College of Nigeria ont délibéré, déterminé et compilé les besoins d'apprentissage qui ont été incorporés dans la conception et le développement du nouveau programme d'études pour le PDHSM. Les besoins d'apprentissage, les données informelles sur les questions clés de l'apprentissage dans la gestion des systèmes de santé et les défis spécifiques dans le contexte et l'environnement opérationnel ont été analysés. La triangulation des informations provenant de ces différentes perspectives et opinions a été alignée sur les besoins éducatifs des médecins pour acquérir des compétences en matière de gestion des systèmes de santé. Les besoins pédagogiques, les méthodes d'évaluation et les ressources qui en découlent ont été intégrés dans la conception, le développement et l'évaluation du programme d'études du PDHSM. Les grandes lignes du programme ont été élaborées à l'aide du tableau matriciel du programme. RÉSULTATS: Le contenu du programme d'études élaboré pour le PDHSM comprend l'objectif, l'organisation du programme, l'expérience éducative et l'évaluation du programme d'études. Le programme a été structuré en modules. Chaque module comporte des objectifs d'apprentissage (OIT) dans les principaux domaines de la gestion des systèmes de santé, ainsi que des activités d'enseignement et d'apprentissage qui décrivent les méthodes d'instruction et d'évaluation. Le contenu indicatif de chaque module correspond aux thèmes de chaque domaine du PDHSM. Les formats d'évaluation du programme comprennent des méthodes et des types d'évaluation formative et sommative. Les ressources nécessaires aux activités d'enseignement et d'évaluation ont été identifiées. Les méthodes d'évaluation du programme d'études seront basées sur l'examen des résultats des évaluations et sur l'évaluation des performances des étudiants, des tuteurs et du programme de PDHSM. CONCLUSION: Les besoins éducatifs des médecins en tant que gestionnaires des systèmes de santé déterminent le développement des résultats d'apprentissage prévus, des activités d'enseignement et d'apprentissage, des contenus indicatifs, des ressources nécessaires et de l'évaluation du programme d'études du PDHSM. L'assurance et l'amélioration de la qualité devraient faire partie de la conception et du développement du programme. Mots-clés: Curriculum, Conception, Développement, Évaluation, Assurance qualité.

An Analysis of the Effect of Stroke on Health-Related Quality of Life of Older Adults With Coronary Heart Disease Who Take Aspirin.

OBJECTIVE: The aim of this study was to examine the impact of coronary heart disease (CHD) on health-related quality of life (HRQoL) among individuals taking aspirin, as well as to explore the potential association between stroke and CHD on HRQoL. METHOD: A total of 17,106 respondents aged 50 years and above who reported using aspirin on "some days" or "daily" were included in the analysis. Among them, 4,036 individuals had a history of coronary heart disease. We utilized the Chi-square test to assess the proportion of individuals with CHD who reported poor self-rated health and experienced poor HRQoL in four domains: physical health, mental health, physical and mental health combined, and the number of days limited by poor health. Logistic regression was employed to investigate the interaction between stroke and CHD concerning the quality of life. RESULT: Among adults aged 50 years and above using aspirin, those with CHD tended to be older (68.7 years ± 0.37 vs 66.6 ± 0.24), had a higher proportion of male respondents (60.0% vs 45.1%), and were mostly of white ethnicity (77.4% vs 76.2%). The group with CHD reported significantly poorer self-rated health compared to those without CHD (52.1% vs 25.6%, p<0.001), along with a higher prevalence of poor physical health (55.3% vs 42.7%, p<0.001) and poor mental health (50.2% vs 40.4%, p = 0.033) in comparison to aspirin users without CHD. However, there was no statistically significant association between stroke and CHD concerning the impact on all domains of quality of life (p>0.05). CONCLUSION: Our findings indicate that individuals aged 50 years and above with CHD who are using aspirin experience a lower quality of life in both the physical and mental health domains when compared to their counterparts without CHD. Furthermore, there was no significant interaction between stroke and CHD in relation to the impact on HRQoL in this study.

Nigeria healthcare worker SARS-CoV-2 serology study: Results from a prospective, longitudinal cohort.

Healthcare workers, both globally and in Nigeria, have an increased risk for SARS-CoV-2 infection compared with the general population due to higher risk contacts, including occupational exposures. In addition, primary healthcare workers represent an important group for estimating prior infection to SARS-CoV-2 because they work at the first point-of-contact for most patients yet have not been included in prior COVID-19 seroepidemiology research in Nigeria. We sought to evaluate baseline seroprevalence, rates of seroconversion (IgG- to IgG+) and seroreversion (IgG+ to IgG-), change in IgG concentration at 3- and 6-month follow-up, and factors associated with seropositivity. From June 2020 to December 2020, we conducted a longitudinal seroepidemiology study among frontline health care workers in Nigeria using a validated dried blood spot assay. Among 525 participants, mean (SD) age was 39.1 (9.7) years, 61.0% were female, and 45.1% were community health workers. The six-month follow-up rate was 93.5%. Seropositivity rates increased from 31% (95% CI: 27%, 35%) at baseline to 45% (95% CI: 40%, 49%) at 3-month follow-up, and 70% (95% CI: 66%, 74%) at 6-month follow-up. There was a corresponding increase in IgG levels from baseline (median = 0.18 ug/mL) to 3-month (median = 0.35 ug/mL) and 6-month follow-up (median = 0.59 ug/mL, Ptrend < .0001). A minority of participants reported symptoms from February 2020 until baseline (12.2%) or during 3-month (6.6%) or 6-month (7.5%) follow-up. only 1 participant was hospitalized. This study demonstrated high baseline, 3-month and 6-month follow-up prevalence of IgG antibodies to SARS-CoV-2 during the first two waves of the COVID-19 pandemic in Nigeria among a cohort of unvaccinated frontline healthcare workers, including primary healthcare workers despite low symptomatology. These results may have implications in state- and national-level disease pandemic modeling. Trial registration: NCT04158154.

The use of Traditional Medicines for Sexual Enhancement in Northern Nigeria.

BACKGROUND: There is a paucity of information on the use of traditional medicine TM to improve sexual performance. This study aims to assess the prevalence and self-reported adverse effects associated with the use of TM as a sexual enhancer in northern Nigeria. METHODS: The study was a cross-sectional design among adults aged 18 years and above, who are residing in northern Nigeria. A mixed-mode approach was utilized using face-to-face interviews and an online survey. For the online survey, a link to the questionnaire was shared on the social media platforms of the targeted participants. RESULTS: A total of 794 eligible participants completed the survey over the six weeks. Of this number, 508 reported ever using TM for sexual enhancement, with a prevalence of 64% (95% CI: 60.5, 67.3). About 30 (3.8%) reported daily use, 49 (4.9%) weekly, 65 (8.2%) monthly and 473 (59.6%) as when needed. Islamic medicine was the most frequently implicated TM. Most respondents obtained it TM practitioners 213 (26.8%). Participants 164 (20.7%) reported experiencing side effects, mostly headaches 59 (35.9%), and 31 (3.9%) were severe (required hospitalization). Predictors of TM use for sexual enhancement were found to be gender, marital status, number of wives, ethnicity, educational level, and lifestyle. CONCLUSION: The use of TM for sexual enhancement is common among the adult population in northern Nigeria. One out of five of the users reported an adverse event. Therefore, there is a need for improved awareness of the safe use of the TM in the community, especially among females, those with multiple wives, a low education level, and poor lifestyles.

Factors Associated With Residents' Responsive Behaviors Toward Staff in Long-Term Care Homes: A Systematic Review.

BACKGROUND AND OBJECTIVES: When staff experience responsive behaviors from residents, this can lead to decreased quality of work life and lower quality of care in long-term care homes. We synthesized research on factors associated with resident responsive behaviors directed toward care staff and characteristics of interventions to reduce the behaviors. RESEARCH DESIGN AND METHODS: We conducted a mixed-methods systematic review with quantitative and qualitative research. We searched 12 bibliographic databases and "gray" literature, using 2 keywords (long-term care, responsive behaviors) and their synonyms. Pairs of reviewers independently completed screening, data extraction, and risk of bias assessment. We developed a coding scheme using the ecological model as an organizing structure and prepared narrative summaries for each factor. RESULTS: From 86 included studies (57 quantitative, 28 qualitative, 1 mixed methods), multiple factors emerged, such as staff training background (individual level), staff approaches to care (interpersonal level), leadership and staffing resources (institutional level), and racism and patriarchy (societal level). Quantitative and qualitative results each provided key insights, such as qualitative results pertaining to leadership responses to reports of behaviors, and quantitative findings on the impact of staff approaches to care on behaviors. Effects of interventions (n = 14) to reduce the behaviors were inconclusive. DISCUSSION AND IMPLICATIONS: We identified the need for an enhanced understanding of the interrelationships among factors associated with resident responsive behaviors toward staff and processes leading to the behaviors. To address these gaps and to inform theory-based effective interventions for preventing or mitigating responsive behaviors, we suggest intervention studies with systematic process evaluations.

Effects of COVID-19 era on a subtropical river basin in Bangladesh: Heavy metal(loid)s distribution, sources and probable human health risks.

The COVID-19 era has profoundly affected everyday human life, the environment, and freshwater ecosystems worldwide. Despite the numerous influences, a strict COVID-19 lockdown might improve the surface water quality and thus provide an unprecedented opportunity to restore the degraded freshwater resource. Therefore, we intend to investigate the spatiotemporal water quality, sources, and preliminary health risks of heavy metal(loid)s in the Karatoya River basin (KRB), a tropical urban river in Bangladesh. Seventy water samples were collected from 35 stations in KRB in 2019 and 2022 during the dry season. The results showed that the concentrations of Ni, Cu, Zn, Pb, Cd, and Cr were significantly reduced by 89.3-99.7 % during the post-lockdown period (p < 0.05). However, pH, Fe, Mn, and As concentrations increased due to the rise of urban waste and the usage of disinfectants during the post-lockdown phase. In the post-lockdown phase, the heavy metal pollution index, heavy metal evaluation index, and Nemerow's pollution index values lessened by 8.58 %, 42.86 %, and 22.86 %, respectively. Besides, the irrigation water quality indices also improved by 59 %-62 %. The total hazard index values increased by 24 % (children) and 22 % (adults) due to the rise in Mn and As concentrations during the lockdown. In comparison, total carcinogenic risk values were reduced by 54 % (children) and 53 % (adults) in the post-lockdown. We found no significant changes in river flow, rainfall, or land cover near the river from the pre to post-lockdown phase. The results of semivariogram models have demonstrated that most attributes have weak spatial dependence, indicating restricted industrial and agricultural effluents during the lockdown, significantly improving river water quality. Our study confirms that the lockdown provides a unique opportunity for the remarkable improvement of degraded freshwater resources. Long-term management policies and regular monitoring should reduce river pollution and clean surface water.

Improving the antecedents of non-compliance to safety regulations toward an optimized self-regulated construction environment in Nigeria.

The construction industry has been plagued with safety challenges, resulting in a wide occurrence of devastating accidents and fatalities. As previous studies have attributed the persistent safety challenges in Nigeria to non-compliance to safety regulations, this study builds on the existing literature by assessing the antecedents of non-compliance to safety regulations amongst construction workers. To achieve this, the study pursued two main objectives which involved the assessment of workers' safety attitude and workers' safety behavior as the antecedents of safety regulation compliance. A quantitative research approach was adopted using a questionnaire to elicit responses from randomly selected respondents. Data collected were analyzed using both descriptive and inferential statistics. Findings from the study showed relatively low levels of safety attitude and behavior amongst construction workers, which limit their ability to be comply to instituted safety regulations. Thus, improving the attitude and behavior of construction workers toward better compliance was recommended.

Assessment of Seasonal Radon Concentration in Dwellings and Soils in Selected Areas in Ga East, Greater Accra Region of Ghana.

Seasonal radon levels have been studied in dwellings and soils in selected areas in Ga East, Greater Accra Region of Ghana using LR-115-type II (SSNTDs). This study was conducted to determine the seasonal correlation between soil and dwelling radon concentrations. Detectors were exposed from January to March and April to June, for dry and wet seasons, respectively. Overall, indoor radon was 133.4 ± 6.7 Bqm-3 and 72.1 ± 3.6 Bqm -3 for wet and dry seasons. The estimated annual effective dose to the lung received by the occupants at Paraku Estate, Dome, and Kwabenya was 6.9 ± 0.4, 7.2 ± 0.5, and 9.8 ± 0.8 mSvy-1 for the wet season and 3.8 ± 0.2, 4.3 ± 0.2, and 4.6 ± 0.3 mSvy-1 for the dry season. On average, the soil radon concentration was found to be 0.96 ± 0.07 kBqm-3 and 2.24 ± 0.01 kBqm-3 for wet and dry seasons. To determine the correlation between soil and dwelling radon, a positive Pearson correlation coefficient value R = (0.74) and R = (0.66) was obtained representing the dry and wet seasons. To test the statistical significance between soil and dwelling radon, P < 0.05 was obtained, indicating a statically significant relationship between the two.

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria - A multi-facility study of 34 tertiary hospitals.

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.

Correlative Ultrasound Evaluation of Anterior Abdominal Wall Subcutaneous Tissue Thickness in Type 2 Diabetic and Non-Diabetic Adults.

BACKGROUND: Subcutaneous fat accumulation complicating diabetes mellitus (DM) has long been recognised, even as its clinical significance remains controversial. Ultrasound is safe and accurate in assessing soft tissue dimensions. Reports on ultrasound evaluation of anterior abdominal wall subcutaneous fat in diabetic and apparently healthy normoglycaemic subjects are scanty in the Nigerian environment. AIMS AND OBJECTIVES: To sonographically assess and compare the mean anterior abdominal wall subcutaneous tissue thickness (AAST) in adult diabetic subjects and apparently healthy, normoglycaemic subjects and correlate the values with age, gender, body mass index (BMI), waist circumference (WC), waist to hip ratio (WHR) and glycated hemoglobin (Hb1c). MATERIALS AND METHODS: The AAST in 150 adult diabetic subjects and equal numbers of age, and sex matched apparently healthy individuals was assessed with a SONOACE X4 ultrasound scanner. (Medison Inc, SOUTH KOREA), using a l inear array transducer of frequency 7. 5MHz10MHz.Measurements were taken in the midline at two points; 2cm above and below the umbilicus. Anthropometric parameters such as BMI, WC, WHR, were recorded. RESULTS: Adult diabetic subjects had significantly higher AAST values, compared to age and BMI matched male and female apparently healthy controls respectively. (2.7±0.9cm vs 2.2 ± 0.9cm (below the umbilicus; p=0.001), and 2.1 ± 0.8cm vs 1.6 ± 0.8cm (above the umbilicus; p = 0.001). Below the umbilicus, AAST correlated positively with WHR, BM1 and disease duration among diabetic patients. CONCLUSION: AAST is significantly increased in diabetic subjects compared to controls, and can be a useful guide in the management of obesity in these patients. There is correlation of AAST below the umbilicus with BMI and waist circumference.

CONTEXTE: Accumulation de graisse sous-cutanée compliquant le sucré (DM) est reconnu depuis longtemps, même s'il est linique l'importance est restée controversée. L'échographie est sûre et précise dans l'évaluation des dimensions des tissus mous. Rapports sur l'évaluation échographique de graisse sous-cutanée de la paroi abdominale antérieure chez le diabétique et apparemment les sujets normogl ycémiques en bonne sant é sont rares au Ni géri a environnement. BUTS ET OBJECTIFS: Évaluer et comparer par échographie l'épaisseur moyenne du tissu sous-cutané de la paroi abdominale antérieure(AAST) chez les sujets diabétiques adultes et apparemment en bonne santé, normoglycémique sujets et corréler les valeurs avec l'âge, le sexe,indice de masse corporelle (IMC), tour de taille (WC), taille à hanchesrapport (WHR) et hémoglobine glyquée (Hb1c). MATÉRIAUX ET MÉTHODES: L'AAST chez 150 diabétiques adultes sujets et nombre égal d'âge et de sexe apparié apparemment en bonne santé ont été évalués à l'aide d'un échographe SONOACEX4.(Medison Inc, CORÉE DU SUD), en utilisant un transducteur linéaire defréquence 7.5 MHz-10 MHz.Des mesures ont été prises dans la ligne médianeen deux points; 2cm au-dessus et au-dessous de l'ombilic. Anthropométrique des paramètres tels que l'IMC, WC, WHR, ont été enregistrés. RÉSULTATS: Les sujets diabétiques adultes avaient un AAST plus élevé valeurs, par rapport à l'âge et à l'IMC appari és hommes et femmes apparemment cont rôl es sai ns respectivement. (2.7±0.9 cm vs 2.2 ± 0.9 cm (sous leombilic; p=0.001), et 2.1 ± 0.8cm contre 1.6 ± 0.8cm (au-dessus de laombilic; p = 0.001). Sous l'ombilic, AAST corrélépositivement avec WHR, BM1 et durée de la maladie chez les diabétiques patient. CONCLUSION: AAST est significativement augmenté chez lessujets diabétiques par rapport aux contrôles, et peut être un guide utile dans la gestion d' obésité chez ces patients. Il y a une corrélation de l'AAST sous l'ombilic avec IMC et tour de taille. Mots-clés: Paroi abdominale antérieure, diabète, obésité, tissus mous,ultrason.

Triple-negative Breast Cancer (TNBC) and Its Luminal Androgen Receptor (LAR) Subtype: A Clinicopathologic Review of Cases in a University Hospital in Northwestern Nigeria.

BACKGROUND: Breast cancer (BC) is a common malignancy; the most frequent in Nigeria. BC characteristically exhibits great biologic diversity. Amongst its variants, the triple-negative subtype is also characterized by heterogeneity (thus making it a study in diversity within diversity) and also by some unique clinicopathologic features including clinical aggressiveness, lack of response to current targeted therapies, and tendency to cluster amongst young premenopausal women especially in populations of women of African ancestry. AIMS: The objective of this study was to conduct a retrospective clinicopathologic survey of all breast carcinomas to profile the triple-negative breast cancers (TNBCs) amongst them and illustrate their immunohistochemical pattern of luminal androgen receptors (LARs) expression. PATIENTS AND METHODS: All the cases entered into the departmental records as breast carcinomas over the study period were extracted including patients' request cards, hematoxylin and eosin-stained slides, and paraffin-embedded tissue blocks of those diagnosed as triple-negative cancers. These were immunohistochemically stained using a monoclonal antibody for androgen receptor (AR). The whole data were analyzed and presented in tabular formats. RESULTS: A total of 660 breast carcinomas of which 89 (13.48%) cases were identified as TNBCs with a mean age of occurrence of 42.89 ± 11.88 years. Most TNBCs (95.5%) were carcinoma no special type and 61.8% had low or intermediate histologic grading. LAR expression was noted in 11.24% of the TNBCs. CONCLUSION: Triple-negative cancer in this study shares some of the known characteristics but also portrays some divergence from the commonly described features.

HIV self-testing and repeat testing in pregnancy and postpartum in Northern Nigeria.

OBJECTIVE: Incident HIV infections in pregnant and breastfeeding mothers pose significant challenges to prevention of mother-to-child HIV transmission efforts in sub-Saharan Africa. We identified the predictors of willingness to self-test for HIV when retesting in pregnancy and postpartum among antenatal clients in a tertiary hospital in Northern Nigeria. METHODS: Structured and validated questionnaires were administered to a cross section of antenatal attendees (n = 370) in March 2021. Willingness to self-test and adjusted odds ratios of potential predictors were generated from logistic regression models. RESULTS: Of the 317 respondents who agreed to repeat HIV test during pregnancy, 29.3% (n = 93) were willing to self-test. Similarly, of those (n = 350) willing to retest after delivery, 27.4% (n = 96) were willing to self-test. Willingness to self-test during pregnancy was higher among respondents who were multiparous (2-4 births) (adjusted odds ratio, aOR = 2.40, 95% confidence interval CI, 1.14-6.43), employed (aOR = 1.49, 95% CI, 1.13-4.53) and those with at least secondary education (aOR = 2.96, 95% CI, 1.43-11.47). In contrast, willingness to self-test was lower among those who were unaware of the husband's HIV status (aOR = 0.05, 95% CI, 0.02-0.13). Willingness to self-test after delivery was higher among respondents who were married (aOR = 15.41, 95% CI, 3.04-78.2), multiparous (aOR = 2.01, 95% CI, 1.27-5.63), employed (aOR = 1.59, 95% CI, 1.08-2.35) and had at least to secondary education (aOR = 6.12, 95% CI, 1.36-27.47). In contrast, willingness to self-test postpartum was lower among those who booked late (≥29 weeks) (aOR = 0.11, 95% CI, 0.022-0.52), those who were unaware of the risk of HIV transmission during breastfeeding (aOR = 0.29, 95% CI, 0.12-0.68) and participants who were unaware of the husband's HIV status (aOR = 0.076, 95% CI, 0.03-0.19). CONCLUSION: Willingness to self-test for HIV in pregnancy and postpartum was low in this population and was influenced by risk perception, socio-demographic and obstetric attributes. Communication interventions and training of potential mentor mothers among early adopters could improve self-testing in this group and similar settings.

Effect of the COVID-19 pandemic on blood donations and transfusions in Nigeria ­ A multi-facility study of 34 tertiary hospitals

Background: The coronavirus disease 2019 (COVID-19) pandemic affected blood supplies globally. Mobile blood drive campaigns halted, and voluntary blood donations reduced, challenging available blood supplies. Furthermore, fears of virus transmission led to deferrals of elective surgeries and non-urgent clinical procedures with noticeable declines in blood donations and transfusions. Aims: We aimed to assess the effect of the COVID-19 pandemic on the number of blood donations and transfusions across the country by blood product type across various hospital departments. Materials and Methods: A retrospective descriptive study was conducted to determine the impact of the COVID-19 pandemic on blood services in 34 tertiary hospitals in Nigeria, comparing January to July 2019 (pre-COVID-19) to January to July 2020 (peri-COVID-19). Data were collected from the country's web-based software District Health Information System, Version 2 (DHIS2). Results: A 17.1% decline in numbers of blood donations was observed over the study period, especially in April 2020 (44.3%), a 21.7% decline in numbers of blood transfusions, especially in April 2020 (44.3%). The largest declines in transfusion were noted in surgery department for fresh frozen plasma (80.1%) [p = 0.012] and accident and emergency department transfusion of platelets (78.3%) [p = 0.005]. The least decline of statistical significance was observed in internal medicine transfusions of whole blood (19.6%) [p = 0.011]. Conclusions: The COVID-19 pandemic significantly affected the numbers of blood donations and transfusions in Nigeria. Strengthening blood services to provide various blood components and secure safe blood supplies during public health emergencies is therefore critical.