Application of acoustic spectroscopy and neural networks to on-line size measurement of pharmaceutical nanocrystals.

Acoustic spectroscopy and neural networks (NNs) are applied to on-line real-time measurement of particle size distribution (PSD) during wet milling of pharmaceutical nanocrystals. A method for modeling the relationship between acoustic attenuation spectra and PSD is proposed that is based on NNs and principal component analysis (PCA). PCA reduces the dimensions of both the spectra and the PSD; then, a neural network model of 2 × 2 × 2 (input, hidden, output layer nodes) with only eight connection weights is built. Compared with previous instrument models that could require as many as 14 physical properties, the current approach does not need any prior knowledge of the system's properties. In addition, the time taken to complete a PSD measurement is reduced from minutes to seconds and it always generates a single solution, rather than possible multiple PSD solutions as in early methods. Application to hydrotalcite nanomilling found good agreement between the on-line measurements and off-line analysis.

Accuracy of ultrasound estimation of fetal weight at term: A comparison of shepard and hadlock methods.

Background: Ultrasound measurement provides a noninvasive means of obtaining information about fetal weight and may help in necessary preparations at and after delivery. Although some ultrasound methods include only one or two fetal indices, others, to improve accuracy, incorporate either three or all the four fetal indices. The aim of this report is to assess the accuracy of two different methods for fetal weight estimation. Materials and Methods: This was a prospective study of 170 consecutive pregnant women at term. Ultrasound was used to estimate fetal weight by the Shepard and Hadlock methods, and the actual birth weight (ABW) was determined at birth. The ultrasound-estimated fetal weights (EFWs) and ABW were analyzed. Results: The women were aged 21-42 years (mean 31.3 ± 7 years). The EFW using the Shepard method was 1.9 kg-5.0 kg (mean 3.6 ± 0.5 kg) and 1.8 kg-4.4 kg (mean 3.3 ± 0.4 kg) for Hadlock method, and ABW was 2.0 kg-4.5 kg (mean 3.4 ± 0.5 kg). The mean EFW using the Shepard method was significantly higher than that of ABW (P < 0.001). The Shepard method significantly overestimated macrosomia compared to that by the ABW. There was no significant difference in microsomia rate between the two methods and ABW. Conclusion: The Hadlock method was more accurate at estimating fetal weight compared to the Shepard method and is recommended for the ultrasound estimation of fetal weight in our setting and similar settings.

Résumé Contexte: La mesure par ultrasons fournit un moyen non invasif d'obtenir des informations sur le poids du fœtus et peut aider à préparations nécessaires à et après l'accouchement. Bien que certaines méthodes d'échographie n'incluent qu'un ou deux indices fœtaux, d'autres, pour améliorer précision, incorporent trois ou tous les quatre indices fœtaux. Le but de ce rapport est d'évaluer l'exactitude de deux méthodes différentes pour estimation du poids fœtal. Matériels et méthodes: Il s'agissait d'une étude prospective de 170 femmes enceintes consécutives à terme. Ultrason a été utilisé pour estimer le poids fœtal par les méthodes Shepard et Hadlock, et le poids réel à la naissance (ABW) a été déterminé à la naissance. le les poids fœtaux estimés par échographie (EFW) et ABW ont été analysés. Résultats: Les femmes étaient âgées de 21 à 42 ans (moyenne 31,3 ± 7 ans). le EFW utilisant la méthode Shepard était de 1,9 kg à 5,0 kg (moyenne 3,6 ± 0,5 kg) et de 1,8 kg à 4,4 kg (moyenne 3,3 ± 0,4 kg) pour la méthode Hadlock, et ABW était de 2,0 kg à 4,5 kg (moyenne 3,4 ± 0,5 kg). L'EFW moyen en utilisant la méthode Shepard était significativement plus élevé que celui d'ABW (P < 0,001). le La méthode Shepard surestimait significativement la macrosomie par rapport à celle de l'ABW. Il n'y avait pas de différence significative dans la microsomie taux entre les deux méthodes et ABW. Conclusion: La méthode Hadlock était plus précise pour estimer le poids fœtal par rapport à la La méthode de Shepard est recommandée pour l'estimation échographique du poids fœtal dans notre contexte et dans des contextes similaires. Mots-clés: Précision, poids de naissance, poids fœtal, Hadlock, Shepard, échographie.

Assessing community engagement in Nigeria polio eradication initiative: application of the Consolidated Framework for Implementation Research.

OBJECTIVE: This study employed the Consolidated Framework for Implementation Research (CFIR) to assess factors that enhanced or impeded the implementation of community engagement strategies using the Nigerian polio programme as a point of reference. DESIGN: This study was a part of a larger descriptive cross-sectional survey. The CFIR was used to design the instrument which was administered through face-to-face and phone interviews as well as a web-based data collection platform, Qualtrics. SETTING: The study took place in at least one State from each of the six geopolitical zones in Nigeria (Nasarawa, Borno, Kano, Sokoto, Anambra, Bayelsa, Lagos, Ondo and Oyo States as well as the Federal Capital Territory). PARTICIPANTS: The respondents included programme managers, policy-makers, researchers and frontline field implementers affiliated with the Global Polio Eradication Initiative (PEI) core partner organisations, the three tiers of the government health parastatals (local, state and federal levels) and academic/research institutions. RESULTS: Data for this study were obtained from 364 respondents who reported participation in community engagement activities in Nigeria's PEI. Majority (68.4%) had less than 10 years' experience in PEI, 57.4% were involved at the local government level and 46.9% were team supervisors. Almost half (45.0%) of the participants identified the process of conducting the PEI program and social environment (56.0%) as the most important internal and external contributor to implementing community engagement activities in the community, respectively. The economic environment (35.7%) was the most frequently reported challenge among the external challenges to implementing community engagement activities. CONCLUSION: Community engagement strategies were largely affected by the factors relating to the process of conducting the polio programme, the economic environment and the social context. Therefore, community engagement implementers should focus on these key areas and channel resources to reduce obstacles to achieve community engagement goals.

Intima-media thickness of the common carotid arteries as a marker of retinopathy and nephropathy in sickle cell disease.

PURPOSE: This study was conducted to test the hypothesis that the carotid intima-media thickness (CIMT) is higher in patients with sickle cell disease (SCD) than in the normal population, and to determine the relationships of the CIMT with central retinal artery (CRA) and renal artery Doppler indices. METHODS: Forty-four confirmed steady-state SCD patients aged 16 years and above were recruited consecutively. The Doppler velocimetric indices of their right renal artery and both CRAs were obtained. The CIMT was also measured on each side via B-mode ultrasonography. The subjects were categorized by age and sex. Mean and median values for each group were determined. The Spearman correlation test was used to quantify the relationships between CIMT and the Doppler parameters. RESULTS: The participants had a median age of 24.50 years (interquartile range, 12.50 to 36.50 years). Twenty-three were men (52.3%) and 21 were women (47.7%). The median CIMT was 0.70 mm (IQR, 0.50 to 0.90 mm). Significant correlations with the CIMT were found for the CRA peak systolic velocity (r=0.312, P=0.003), the renal artery resistivity index (RI) (r=0.284, P=0.007), and the renal artery pulsatility index (PI) (r=0.273, P=0.010). There was no significant relationship between the CIMT and the CRA end-diastolic velocity, CRA RI, or CRA PI. CONCLUSION: CIMT in SCD patients was higher than in the previously reported age groups of the reference populations. In addition, the CIMT was significantly correlated with the CRA peak systolic velocity, the renal artery RI, and the renal artery PI.

Intima-media thickness of the common carotid arteries as a marker of retinopathy and nephropathy in sickle cell disease

Purpose@#This study was conducted to test the hypothesis that the carotid intima-media thickness (CIMT) is higher in patients with sickle cell disease (SCD) than in the normal population, and to determine the relationships of the CIMT with central retinal artery (CRA) and renal artery Doppler indices. @*Methods@#Forty-four confirmed steady-state SCD patients aged 16 years and above were recruited consecutively. The Doppler velocimetric indices of their right renal artery and both CRAs were obtained. The CIMT was also measured on each side via B-mode ultrasonography. The subjects were categorized by age and sex. Mean and median values for each group were determined. The Spearman correlation test was used to quantify the relationships between CIMT and the Doppler parameters. @*Results@#The participants had a median age of 24.50 years (interquartile range, 12.50 to 36.50 years). Twenty-three were men (52.3%) and 21 were women (47.7%). The median CIMT was 0.70 mm (IQR, 0.50 to 0.90 mm). Significant correlations with the CIMT were found for the CRA peak systolic velocity (r=0.312, P=0.003), the renal artery resistivity index (RI) (r=0.284, P=0.007), and the renal artery pulsatility index (PI) (r=0.273, P=0.010). There was no significant relationship between the CIMT and the CRA end-diastolic velocity, CRA RI, or CRA PI. @*Conclusion@#CIMT in SCD patients was higher than in the previously reported age groups of the reference populations. In addition, the CIMT was significantly correlated with the CRA peak systolic velocity, the renal artery RI, and the renal artery PI.

Clomiphene citrate ameliorated lead acetate-induced reproductive toxicity in male Wistar rats.

OBJECTIVE: The current study investigated the effects of clomiphene citrate on the hypothalamic-pituitary-testicular axis, steroidogenesis, sperm parameters, and testicular antioxidant enzyme activity of male Wistar rats submitted to lead acetate (Pb)-induced reproductive toxicity. METHODS: Twenty adult male Wistar rats were divided into four groups of equal size as follows: Control; Clomid (0.35 mg/kg); Pb (10 mg/kg); and Clomid + Pb. Serum levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone, testicular 17-ß hydroxysteroid dehydrogenase (17-ß HSD) activity, androgen receptors, catalase activity, superoxide dismutase (SOD), malondialdehyde (MDA), sperm motility, viability, counts and morphology were estimated after oral administration of Clomid and/or lead acetate for 35 consecutive days. Data were analyzed using ANOVA at p<0.05. RESULTS: Lead acetate significantly decreased (p<0.05) serum LH and testosterone levels, testicular 17ß-HSD activity, androgen receptor expression, sperm motility, viability, counts, catalase activity, and SOD when compared with controls. Abnormal sperm morphology and MDA were significantly increased (p<0.05) in the Pb group compared with controls. Clomid co-administrated with lead acetate significantly increased (p<0.05) serum LH, testosterone levels, testicular 17ß-HSD, androgen receptor expression, sperm motility and viability when compared with the group given lead acetate. CONCLUSIONS: The present study suggests that clomiphene citrate may stimulate testicular testosterone synthesis, sperm motility and viability via luteinizing hormone in a context of lead acetate-induced reproductive toxicity.

Urban-rural differences in immunisation status and associated demographic factors among children 12-59 months in a southwestern state, Nigeria.

Vaccine preventable diseases (VPDs) are a leading course of child under-five mortality in sub-Saharan Africa. A target of 95% immunization coverage is necessary for the sustained control of VPDs. This study aims to determine the immunization status and its associated demo-graphic factors among children 12-59 months old in Akinyele Local Government area (LGA), Oyo State, Nigeria. A community-based cross-sectional study was carried out in one urban and one rural ward of Akinyele LGA. Fourhundred and forty-four (449) Under-five children were selected by multistage sampling technique. Data were collected from caregivers using interviewer administered questionnaires. Odds ratios at 95% CIand Chi square at 5% significant level were computed to identify the factors associated with non or partial immunisation. Multiple logistics regression at 5% significance level was done to determine the socio-demographic determinants of immunisation status. Overall, 449 children aged 12-59 months were surveyed of which 213(47.4%) were males and 236(52.6%) were from urban area. Overall, 365(81.3%) was fully immunized, 75(16.7%) was partially immunized and 9(2.0%) had never been immunized. Predictors of a child being partially or un-immunised were being in the fourth wealth quintile (AOR 7.9; 95%CI: 2.7-18.0), poorest wealth quintile (AOR 14.5; 95%CI 4.2-20.5), having a mother with no education (AOR 6.4; 95%CI: 2.9-14.1) and a mother that practiced Islam (AOR: 2.2; 95%CI: 1.3-3.7). Immunisation coverage was somewhat high but still suboptimal among the study population. Strategies that improve female literacy and those that target religious institutions may be effective in improving immunisation uptake.

Single-shot lamina thoracic paravertebral block with ketofol for modified radical mastectomy.

We describe the use of single-shot lamina thoracic paravertebral block (TPVB) with sedation for a 56-year-old female patient who had modified radical mastectomy with axillary clearance. Two years ago, she suffered vocal cord palsy post thyroidectomy, which was managed with tracheostomy. The tracheostomy tube was removed 8 months later, leaving the patient with persistent hoarseness of voice and left vocal cord palsy. She declined general anesthesia and consented for TPVB. The surgery lasted 95 minutes and was successfully completed with TPVB. Her vital signs were stable during the operation. She had low pain scores, minimal opioid use, early alimentation, and no postoperative nausea and vomiting and was discharged early. We present the anesthetic management of this case in our setting, where TPVB under ultrasound guidance and modern drug-delivery systems for sedation are unavailable.

An overview of disease surveillance and notification system in Nigeria and the roles of clinicians in disease outbreak prevention and control.

While outbreaks of infectious diseases have long presented a public health challenge, especially in developing countries like Nigeria; within recent years, the frequency of such outbreaks has risen tremendously. Furthermore, with the recent outbreaks of emerging and re-emerging infectious diseases such as Ebola virus disease and other epidemic prone diseases in Nigeria demanding immediate public health action, there is a need to strengthen the existing notifiable disease surveillance and notification system with increased clinicians' involvement in timely reporting of notifiable diseases to designated public health authorities for prompt public health action. Hence, this paper provides the opportunity to increase awareness among clinicians on the importance of immediate reporting of notifiable diseases and intensify engagement of clinicians in disease notification activities by describing various notifiable diseases in Nigeria using their surveillance case definition, outlines the reporting channel for notifying these diseases and highlights the roles of clinicians in the current disease surveillance and notification network for early disease outbreak detection and public health response in Nigeria.

Failed Obstetric Spinal Anesthesia in a Nigerian Teaching Hospital: Incidence and Risk Factors.

BACKGROUND: In a retrospective survey, we found 1% cases with complete and partial failure of spinal anesthesia for cesarean delivery between 2008 and 2010, which we attributed to underreporting because of the study design. In this prospective study, we determined the incidence of failed spinal anesthesia and identified the factors that increased its risk. METHODS: This prospective, observational study consisted of all spinal anesthetics administered for cesarean delivery surgery from January 2011 to December 2013. Our definition of failure covered complete (preoperative) failure to achieve a pain-free operative condition and pain during surgery (intraoperative failure). RESULTS: Of a total of 3568 cesarean deliveries, there were 3239 (90.8%) spinal blocks, and the overall failure was 294 (9.1%). These were rescued by conversion to general anesthesia (22.8%) and repeating spinal (23.1%) and IV analgesic supplementation (54.1%). Analysis by logistic regression model indicated that factors associated with failure were the level of experience of the anesthesia provider as shown by senior registrar (adjusted risk ratio [RR], 1.4; 95% confidence interval [CI], 1.0-1.9), >1 lumbar puncture attempt (adjusted RR, 1.5; 95% CI, 1.1-1.9), and use of the L4/L5 interspace (adjusted RR, 1.7; 95% CI, 1.4-2.0). CONCLUSIONS: The rate of failed spinal anesthesia from this study was high. The independent predictors of failure were multiple lumbar puncture attempts, use of the L4/L5 interspace, and the level of experience of the anesthesia provider. It is imperative to develop clear guidelines to standardize our obstetric spinal anesthetic practice as well as the management of failures.

Total anti-oxidant capacity, flavonoid, phenolic acid and polyphenol content in ten selected species of Zingiberaceae rhizomes.

BACKGROUND: Natural products such as herbs, fruits, spices, beverages, vegetables are becoming more popular among scientific community and consumers because of their potential to arrest the effect of free radicals in human system. This study determined the total antioxidant capacity of ten selected species of Zingiberaceae (Ginger) used as spices and for medicinal purposes in Southeast Asia. MATERIALS AND METHODS: Methanol was used as the extraction solvent, 2,2 - diphenyl-1-picrylhydrazil (DPPH) for free radical scavenging activity and ferric reducing antioxidant power (FRAP) assays. Phenolic compounds were measured using Total flavonoid, Phenolic acid and Polyphenols content assay to evaluate the quality of the antioxidant capacity of the rhizomes and vitamin C as positive control. RESULTS: The results obtained revealed that Curcuma longa and Zingiber officinale had the highest free radical scavenging capacity of 270.07mg/TE/g DW and 266.95mg/TE/g DW and FRAP assay, Curcuma longa and Zingiber officinale also gave the highest ferric reducing power of 231.73mg/TE/g DW and 176.26mg/TE/g DW respectively. For Phenolic compounds, Curcuma longa and Curcuma xanthorrhiza gave the highest values of flavonoid (741.36mg/NGN/g DW and 220.53mg/NGN/g DW), phenolic acid (42.71mg/GAE/g DW and 22.03mg/GAE/g DW) and polyphenols (39.38mg/GAE/g DW and 38.01mg/GAE/g DW) respectively. Significant and positive linear correlations were found between Total antioxidant capacity and Phenolic compounds (R = 0.65 - 0.96). CONCLUSION: This study provides evidence that extracts of Zingiberaceae (Ginger) rhizomes are a potential source of natural antioxidants and could serve as basis for future drugs and food supplements.

Epidemiology of measles in Southwest Nigeria: an analysis of measles case-based surveillance data from 2007 to 2012.

BACKGROUND: In Nigeria, a system of measles case-based surveillance with laboratory confirmation of suspected cases was introduced in 2005 as one of the strategies for the control of measles morbidity and mortality. In this report, we provide an epidemiological distribution of confirmed cases of measles reported from the southwest of the country between 2007 and 2012, and predict the expected number of cases for the ensuing years. METHODS: A descriptive analysis of persons and place and time of confirmed measles cases (laboratory and epidemiological link) reported in the case-based surveillance data was carried out. Using an additive time series model, we predicted the expected number of cases to the year 2015, assuming that current interventional efforts were sustained. RESULTS: From the 10 187 suspected cases investigated during the time period, 1631 (16.0%) cases of measles were confirmed. The annual incidence rose from <1 case per million in 2007 to 23 cases per million in 2011. Cases were confirmed from all six states within the zone and most (97.4%) were in individuals aged less than 20 years. Seasonal variation existed with peaks of infection in the first and second quarters of the year. There was an increasing trend in the number of expected cases based on projections. CONCLUSIONS: Case-based surveillance provided an insight into understanding the epidemiology of measles infection in Southwest Nigeria. There is a need to work out alternate strategies for control of measles and to strengthen the surveillance system.

Breaking bad news to a prospective cross-sectional sample of patients' relatives in a nigerian neurosurgical service.

OBJECTIVES: Breaking of medical bad news is anecdotally deemed culturally unacceptable, even intolerable, to native Africans. We explored this hypothesis among a cohort of relatives of patients who had difficult neurosurgical diagnoses in an indigenous practice. MATERIALS AND METHODS: A semi-structured, interviewer-administered questionnaire was used in a cross-sectional survey among a consecutive cohort of surrogates/relatives of concerned patients. Their opinion and preferences regarding the full disclosure of the grave neurosurgical diagnoses, and prognoses, of their wards were analyzed. RESULTS: A total of 114 patients' relatives, 83 (72.8%) females, were sampled. They were mainly young adults, mean age 40.2 (SD 14.2) years; 57% had only basic literacy education; but the majority, 97%, declared themselves to have serious religious commitments. Ninety nine percent of the study participants deemed it desirable that either they or the patients concerned be told the bad news; 80.7% felt that this is best done with both patients and relations in attendance; 3.5% felt only the patients need be told. These preferences are similar to those expressed by the patients themselves in an earlier study. But a nearly significant greater proportion of patients' relatives (15 vs 5%, p = 0.06) would rather be the only ones to be told the patients' bad news. CONCLUSION: This data-driven study showed that contrary to anecdotal belief about them, a cohort of native Nigerian-African surrogates of neurosurgical patients was well disposed to receiving, and appeared able to handle well, the full disclosure of difficult medical diagnostic/prognostic information.

Pattern of condom use among clients at a Nigerian HIV Counseling and Testing Centre.

BACKGROUND: Studies in Nigeria have shown that the main route of HIV transmission is sexual intercourse and that effective condom use protects people against infection. The objective of this study was to determine the pattern of condom use among clients of a friendly HIV Counseling and Testing (HCT) Centre in Osogbo southwestern Nigeria. METHODS: This was a review of the HCT Centre records from 2006 to 2010 retrieving socio-demographic information, sexual behaviour, condom use and result of HIV testing. Data obtained were analyzed using descriptive and inferential statistics. RESULTS: One thousand nine hundred and twenty-one client records were reviewed. The mean age of the study population was 35.4 (SD 10.5) years. The majority (53%) of the respondents were females, 232 (12%) were HIV positive, and 38.2% had multiple sexual partners. Only heterosexual vaginal sex was reported among the clients. Overall 45.2% of the clients did not use a condom in their last sexual act. Factors identified to be significantly associated with non-use of condoms were; younger age, having had higher education and positive HIV status. CONCLUSION: Unprotected heterosexual intercourse was common among the study population, indicating a need to step up HIV preventive programme through behavioural change communication strategy.

Mothers' awareness of anorectal malformations: a pointer to delayed diagnosis in a developing country.

INTRODUCTION: Delay in the presentation of babies with anorectal malformations (ARMs) to the pediatric surgeon accounts for a major cause of morbidity and mortality in developing countries. In countries lacking proper guidelines for screening and newborn physical examination, a lot of responsibility is placed on parents and caregivers; with mothers often being the first to note abnormalities in their babies. The aim of the study was to assess the awareness of mothers about ARM and their knowledge about normal or abnormal appearance of the anus. MATERIALS AND METHODS: A descriptive cross-sectional study involving mothers attending immunization clinics at two hospitals in a developing country was conducted using a structured interviewer administered questionnaire. Data were obtained on sociodemographic characteristics, awareness of ARM, and knowledge of appearance of the anus by requesting mothers to identify if three pictures of the perineum were normal or abnormal. RESULTS: A total of 365 mothers participated in the study with age ranging from 17 to 42 years. Only 71 (19.5%) mothers had ever heard about ARM. A picture of a girl with ARM and rectoperineal fistula was correctly identified by 66 (18.1%) and that of a boy with ARM and rectoperineal fistula by 71 (19.5%) mothers. A higher proportion (25.0%) of the mothers who were older than 30 years were aware of ARM than those younger than 30 years (16.0%), (p = 0.035). Participants with tertiary education were more likely to be aware of ARM than those with 12th grade or less education (31.1 vs. 6.9%, p < 0.001). Skilled workers were also more likely to be aware of ARM than unskilled workers and artisans (41.1 vs. 8.1%, p < 0.001). The predominant technique of "checking" the anus by the mothers was "inspection of their baby's perineum." CONCLUSION: Level of awareness of ARMs was low among women interviewed. Educational intervention targeting young mothers from low socioeconomic class is suggested.

Representativeness of suspected measles cases reported in a southern district of Nigeria.

OBJECTIVE: To compare the characteristics of suspected measles cases at the health facilities and to determine the representativeness of the data. METHODS: We visited 25 hospitals in the Aniocha Local Government Area (LGA) of Delta State, Nigeria, from which information on reportable diseases was collected. In particular, the suspected measles cases in their registries between January 1, 2007, and June 30, 2008, were reviewed. We compared the characteristics, including age, sex, location, and month of reporting, of the suspected cases with the LGA surveillance records. RESULTS: In the LGA records, 10% cases involved individuals older than 14 years, compared with 20% in the same age group in the health facility records. Based on geographic location, 53% of the measles cases among the hospital records came from a single location, in contrast to only 30% of the cases among the LGA records. An analysis considering time revealed that 30% of the cases in the LGA records occurred in August 2007, whereas 20% of hospital cases were reported in February and May 2008 combined. CONCLUSIONS: The two record types differed considerably in all of the characteristics used in this comparison.

Representativeness of suspected measles cases reported in a southern district of Nigeria

OBJECTIVE@#To compare the characteristics of suspected measles cases at the health facilities and to determine the representativeness of the data.@*METHODS@#We visited 25 hospitals in the Aniocha Local Government Area (LGA) of Delta State, Nigeria, from which information on reportable diseases was collected. In particular, the suspected measles cases in their registries between January 1, 2007, and June 30, 2008, were reviewed. We compared the characteristics, including age, sex, location, and month of reporting, of the suspected cases with the LGA surveillance records.@*RESULTS@#In the LGA records, 10% cases involved individuals older than 14 years, compared with 20% in the same age group in the health facility records. Based on geographic location, 53% of the measles cases among the hospital records came from a single location, in contrast to only 30% of the cases among the LGA records. An analysis considering time revealed that 30% of the cases in the LGA records occurred in August 2007, whereas 20% of hospital cases were reported in February and May 2008 combined.@*CONCLUSIONS@#The two record types differed considerably in all of the characteristics used in this comparison.

Hematoxicity of amodiaquine in sprague-dawley rats.

OBJECTIVE: The use of amodiaquine (AQ) and its associated toxic effect has been a major public health concern since cases of life-threatening agranulocytosis and hepatic toxicity were reported during its prophylactic use. The objective of this study was to evaluate the hematological safety profile of AQ therapy. MATERIALS AND METHODS: Sprague-Dawley rats were randomly distributed into four groups (n=5). Group 1 was the control, while groups 2, 3, and 4 received AQ treatment for 14 days at varying doses of 5 mg/kgBW, 10 mg/kgBW, and 15 mg/kgBW daily, respectively. RESULTS: Following treatment, hematological variables were comparable in all groups (P>0.05). CONCLUSION: This study provides evidence to support the use of AQ in the treatment of uncomplicated malaria. However, to prevent emergence of local drug resistance, it should be used as part of a combination therapy. Monitoring for adverse effects is suggested.

Treatment outcomes among pulmonary tuberculosis patients at treatment centers in Ibadan, Nigeria.

OBJECTIVE: To assess treatment outcomes and determinants of outcome among tuberculosis patients. DESIGN: A longitudinal study design involving a cohort of sputum smear-positive pulmonary tuberculosis patients at initiation of therapy, who were followed up to the end of treatment at eighth month. SETTING: Tuberculosis treatment centers in Ibadan, Nigeria. RESULTS: A total of 1,254 patients were followed up with a mean age of 35.0+/-3.3 years. The percentages of patients with treatment outcomes assessed in the study were as follows: cure (76.6%), failure (8.1%), default (6.6%), transferred out (4.8%), and death (1.9%). The cure rate varied significantly between treatment centers from 40 to 94.4% (P<0.05). The treatment centers located within the specialist health centers at Jericho and the University College Hospital had 50 and 75% cure rates, respectively.The mean age of cured patients was 31.2+/3.1 years which was significantly lower than the mean age of those with poor treatment outcomes (36.7+/3.5 years; P<0.05). Males had a higher risk of a poor treatment outcome (RR=1.8; 95% CI: 1.02-1.94) than females. Also, patients with a poor knowledge of tuberculosis had a higher risk of having a poor treatment outcome (RR=1.35; 95% CI: 1.25-1.62) compared to those with knowledge. CONCLUSION: Variations in health center treatment outcomes and poor knowledge of tuberculosis among patients suggest that poor program implementation quality may be a major modifiable determinant of treatment outcomes in our environment.

Awareness and attitude of health workers at a Nigerian HIV treatment clinic toward HIV/AIDS and HAART adherence.

OBJECTIVE: To assess the awareness and attitude of antiretroviral clinic workers to HIV/AIDS and highly active antiretroviral therapy (HAART). METHODS: A descriptive cross-sectional study design using a self-administered questionnaire was used. RESULTS: Of the 43 staff, 39 (92.5%) completed the questionnaire. Their mean age was 35.1 + 7.6 years. There were 19 (48.7%) males and 20 (51.7%) females. The majority (87.2%) had tertiary education. More than three fifths (61.5%) were married. There were 20 (51.3%) professional staff and 19 (48.7%) support staff. Only 28.2% of staff members had ever received on-the-job training in HIV/AIDS care. None of the adherence counselors had ever received any training in HIV/AIDS care and HAART adherence counseling. Despite this lack of training, this majority of the clinic staff had good knowledge about and a positive attitude to HIV/AIDS and HAART adherence. CONCLUSION: Adherence counselors and support staff required on-the-job training for optimum job performance.