Sars-Cov-2 Infection Screening Using Two Serological Testing Methods.

The challenges associated with adequate deployment of nucleic acid amplification tests (NAATs) in developing countries underscores the important role of simple but sensitive and specific serological testing kits in COVID-19 diagnosis. Presently, there are a number of point-of-care tests for Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) screening. However, the reliability of these test kits is poorly documented and hence, needs to be ascertained. This study was therefore designed to determine the sensitivity and specificity of two serological test kits for COVID-19 screening with the view to providing necessary information on the suitability of their deployment as routine test kits for SARS-CoV-2 in Nigeria. Forty-seven (47) asymptomatic adults who had been tested for SARS-CoV-2 with the real-time reverse-transcriptase polymerase-chain reaction (RT-PCR) were enrolled into this study. Blood samples were obtained for qualitative determination of serum IgM and IgG antibodies to the S-antigen of SARS-CoV-2 using a commercially available IgM and IgG Rapid Diagnostic Test (RDT) and enzyme linked immunosorbent assay (ELISA). The association between the test kits (ELISA and RDT) and PCR in diagnosing COVID-19 was determined using the Fisher's Exact test at P<0.05. The sensitivity and specificity of the test kits were determined using ROC while the Positive Predictive Value (PPV), Negative Predictive Value (NPV), Positive Likelihood Ratio (PLR), Negative Likelihood Ratio (NLR), Diagnostic Odds Ratio (DOR) and accuracy were calculated as appropriate. Twenty-eight (59.6%) of the study participants had positive PCR result. ELISA and RDT identified 20 (42.6%) and 13 (27.7%) participants respectively as having anti- SARS COV-2 specific antibodies. ELISA had a better sensitivity performance, NPV, PLR, DOR and accuracy than the RDT while the RDT had a better specificity performance than ELISA. The proportion of participants with anti-SARS-CoV-2 IgM antibody identified using ELISA was significantly higher compared with RDT. In contrast, the proportion of participants with positive anti- SARS COV-2 IgG antibody identified using RDT was significantly higher compared with ELISA. ELISA has a better sensitivity for detecting anti-SARS-CoV-2 Spike-protein specific antibodies than the RDT. However, combination of RDT and ELISA for the detection of anti-SARS-COV-2 antibodies might be useful for population COVID-19 screening.

LARVICIDAL POTENTIAL AND MOSQUITO REPELLENT ACTIVITY OF CASSIA MIMOSOIDES EXTRACTS.

This study aims to investigate larvicidal activities of extracts of Cassia mimosoides leaves and pods as a potential agent in vector control of malaria and to evaluate repellent effect against Anopheles gambiae mosquito of the extract formulated in an aqueous cream base. Petroleum spirit, ethanol, water and dichloromethane extracts were tested against third and fourth instar Anopheles gambiae larvae. The petroleum extract was formulated in an aqueous cream base and repellency determined using N-N-diethyl-m-toluamide (DEET) as control. Phytochemical analysis showed the presence of saponins, tannins, anthraquinones, steroids, and flavonoids but absence of cardiac glycosides and alkaloids in powdered C. mimosoides. A dose related response was observed in the mortality rate of the extracts, with 2 mg/ml petroleum ether and dichloromethane extracts achieving 100 % mortality. Larvicidal activity of extracts based on LC50 values was petroleum ether > dichloromethane > ethanol > water. The formulated petroleum ether extract cream had a characteristic odor, hard and smooth texture, skin feeling of smoothness, ease of application by rubbing, easy removal using soap and water, non-irritating effect on skin and an acceptable pH value. The cream containing 2%-6% (w/w) extract and control achieved 100% repellency against mosquitoes after an exposure time of 5 minutes. There was a linear relationship between percent concentration of plant extract in the cream samples and repellent activity. These results suggest that crude extracts of C. mimosoides can be developed as eco-friendly larvicide and mosquito repellent and encourage further effort to investigate the bioactive compounds in the extracts.

Acceptance and perception of Nigerian patients to medical photography.

The aim of the study was to determine the acceptance and perception of Nigerian patients to medical photography. A self-administered questionnaire was distributed among Nigerian patients attending oral and maxillofacial surgery and plastic surgery clinics of 3 tertiary health institutions. Information requested included patients' opinion about consent process, capturing equipment, distribution and accessibility of medical photographs. The use of non-identifiable medical photographs was more acceptable than identifiable to respondents for all purposes (P = 0.003). Most respondents were favourably disposed to photographs being taken for inclusion in the case note, but opposed to identifiable photographs being used for other purposes most especially in medical websites and medical journals. Female respondents preferred non-identifiable medical photographs to identifiable ones (P = 0.001). Most respondents (78%) indicated that their consent be sought for each of the outline needs for medical photography. Half of the respondents indicated that identifiable photographs may have a negative effect on their persons; and the most commonly mentioned effects were social stigmatization, bad publicity and emotional/psychological effects. Most of the respondents preferred the use of hospital-owned camera to personal camera/personal camera-phone for their medical photographs. Most respondents (67.8%) indicated that they would like to be informed about the use of their photographs on every occasion, and 74% indicated that they would like to be informed of the specific journal in which their medical photographs are to be published. In conclusion, non-identifiable rather than identifiable medical photography is acceptable to most patients in the studied Nigerian environment. The use of personal camera/personal camera-phone should be discouraged as its acceptance by respondents is very low. Judicious use of medical photography is therefore advocated to avoid breach of principle of privacy and confidentiality in medical practice.

Nigerian dentists' knowledge of the current guidelines for preventing infective endocarditis.

OBJECTIVE: This study assessed Nigerian dentists' knowledge of current guidelines for the prevention of infective endocarditis. MATERIAL AND METHODS: A self-administered questionnaire surveyed a cross-section of Nigerian dentists gathering information on respondent demographics, awareness of the American Heart Association current guidelines on preventing infective endocarditis and sources of knowledge regarding that guidance. Respondents indicated: a) whether or not they would prescribe antibiotics before dental treatment in 10 cardiac conditions, b) if antibiotic prophylaxis was reasonable before 10 dental procedures in an endocarditis high-risk patient, and c) a prescription for oral antibiotics for an endocarditis high-risk non-allergic adult about to undergo a dental procedure. RESULTS: Respondents numbered 173 and 41% were aware of the guidelines. Most commonly the sources of this knowledge were undergraduate/postgraduate education. Overall, the correct responses for the 10 cardiac conditions was very low (33%), ranging from 94% for prosthetic heart valves (94.2%) down to 4% for previous coronary artery bypass (3.5%). For clearly invasive procedures, 80% to 96% of respondents indicated that a prophylactic antibiotic was reasonable. For clearly non-invasive procedures, 89% to 92% indicated that antibiotics were not reasonable. Correct antimicrobial agent, dose and timing of administration were prescribed by 89%, 9%, and 57% respectively. CONCLUSIONS: A low level of knowledge of the current guidelines was found among Nigerian dentists. Although, most prescribed the correct antimicrobial agent, the numbers prescribing correct dose and time of administration were quite low. Therefore, attempts should be made to teach the current guidelines in Nigerian undergraduate/postgraduate dental education.

A survey of facial nerve dissection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria.

OBJECTIVE: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear, Nose, and Throat (ENT) Surgeons. MATERIALS AND METHODS: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear, Nose, and Throat Surgeons in Nigeria, on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy, limited superficial parotidectomy, and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. RESULT: About half (47.5%) of them routinely used the antegrade technique, while only a few (12.5%) used the retrograde technique. A large number of them (40%), however, used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60%) and limited superficial parotidectomy (62%). However, the retrograde approach was the technique of choice by most of them (47%) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. CONCLUSIONS: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated.

Use of information and communication technology among dental students and registrars at the faculty of dental sciences, University of Lagos.

The aim of this study was to investigate the use of information technology amongst dental students, dental nursing students and resident doctors in training at the faculty of dental Surgery University of Lagos. A structured questionnaire was distributed to 58 clinical dental students in 4 th and 5 th years of training in the 2010/2011 academic year, 36 dental nursing students and 63 resident doctors undergoing specialist training. All participants have access to the computers, 2.5% within the University and 31% at home and internet cafes and about 50% have the basic skills required. A significant difference was observed between the resident doctors and clinical dental students (P = 0.003), between resident doctors and dental nursing students (P = 0.0001) when the use of computer for study was compared. Over 95% of participants have access to internet and about 50% of them use the internet for their studies. A significant difference (P = 0.005) was observed between clinical dental students and dental nursing students that use the internet and word processing. The resident doctors used the computers for multimedia and MedLine search tools more than clinical dental students (P = 0.004) and dental nursing students (0.0006). The findings of the study show that dental students and resident doctors in training have the requisite knowledge to operate the computer for use in their study and personal activities.

A survey of facial nerve dessection techniques in benign parotid surgery among maxillofacial and ear, nose, and throat surgeons in Nigeria

Objective: The aim of the present study is to identify the facial nerve dissection technique routinely used during parotidectomy for benign parotid tumors by Nigerian Oral and Maxillofacial (OMF) and Ear; Nose; and Throat (ENT) Surgeons. Materials and Methods: A questionnaire-based study was conducted among Oral and Maxillofacial and Ear; Nose; and Throat Surgeons in Nigeria; on their experience with antegrade and retrograde facial nerve dissection techniques in parotid surgery. The respondents were asked to indicate their choice of dissection techniques in revision parotidectomy; limited superficial parotidectomy; and in obese patients with large tumors. They were also asked to indicate if they routinely used perioperative facial nerve monitoring devices in parotid surgery for benign tumors. Result: About half (47.5) of them routinely used the antegrade technique; while only a few (12.5) used the retrograde technique. A large number of them (40); however; used a combination of antegrade and retrograde routinely. Technical ease was the main reason for the choice of technique. The antegrade technique was the technique of choice by most respondents for revision parotidectomy (60) and limited superficial parotidectomy (62). However; the retrograde approach was the technique of choice by most of them (47) in case of parotidectomy in obese patients with large tumors. The routine use of perioperative facial nerve monitoring devices is an uncommon practice among OMF and ENT surgeons in Nigeria. Conclusions: The antegrade approach for facial nerve dissection is the most common technique used in parotid surgery by Nigerian OMF and ENT surgeons. Nigerian surgeons need to consider the retrograde approach in selected cases of parotid surgery especially for localized tumors that are amenable to limited superficial parotidectomy. Inclusion of perioperative facial nerve monitoring devices is also advocated

Oral cancer education in dental schools: knowledge and experience of Nigerian undergraduate students.

The objective of this study was to determine the knowledge and experiences of clinical dental students of the College of Medicine, University of Lagos, Nigeria related to the management and prevention of oral malignancy and premalignancy. A self-administered questionnaire was distributed to all clinical dental students. Most of the students (87.7 percent; n=57) had witnessed at least a patient with oral malignancy, while 61.5 percent (n=40) had witnessed or examined a patient with oral premalignancy. While 61.5 percent of the students had observed biopsies of malignant and premalignant lesions, only 13.8 percent (n=9) had ever performed one under supervision. All the respondents believed that oral malignancy is always or sometimes associated with pain, and most of the students were more familiar with the late signs of oral malignancy than the early signs. Almost two-thirds (64.6 percent) of the respondents believed that oral screening programs were effective for early diagnosis and management of oral malignancies. This study revealed a need for a more structured teaching program with increased emphasis on the early signs and symptoms of oral malignancies and involvement of the students in the examination and biopsies of malignant and premalignant lesions.

The choice of antibiotic in open fractures in a teaching hospital in a developing country.

Open fracture wounds may be contaminated, and the use of an appropriate antibiotic in the early stages of management reduces the risk of osteomyelitis developing. Environmental factors influence both the type of micro-organisms that are isolated from these wounds and the antibiotics that are chosen to manage the wounds. Before this study, the choice of antibiotic in the management of open fractures in our hospital was based on tradition and 'best guess' antibiotics. In a prospective study of 52 open fractures seen in the accident and emergency unit of University College Hospital, Ibadan, between January and June 2000, the positive bacterial culture yield was more than 70%. Staphylococcus aureus was the commonest microbial isolate, accounting for 37.5% of total isolates. The antibiotic sensitivity pattern revealed high efficacies for pefloxacin, ciprofloxacin and ceftriaxone against the isolated micro-organisms. In comparative costs, these antibiotics are cheaper than the combination of the 'best guess' antibiotics that were used previously. On the strength of this finding, we have suggested a change in the antibiotic policy of the hospital with regard to the antibiotic regimen to be used to complement the surgical management of open fractures.

Management of chronic osteomyelitis in a developing country using ceftriaxone-PMMA beads: an initial study.

Chronic osteomyelitis is a debilitating disease that is fairly common in developing countries. Various operative techniques have been adopted in the management of this disease but there have been few reports of their use in Africa. In this report, we present our experience of the use of a modified two-staged Belfast operation in patients with chronic osteomyelitis in Ibadan, Nigeria. An important modification of the procedure was the substitution of gentamicin beads (Septopal) with ceftriaxone-polymethylmethacrylate (PMMA) beads at the saucerised segment of bone at the first stage. Thirty-four patients with chronic osteomyelitis had the two-stage Belfast operation in 35 long bones; of these, 32 patients had ceftriaxone-PMMA antibiotic beads inserted at the saucerised segment of bone at the first stage, while the other two patients had gentamicin beads inserted. One of the two patients who had gentamicin beads had a residual collection of pus at second stage surgery but, following a repeat debridement, the cavity was rid of infection. There was recurrence of infection in three patients (8.6%) who had a suction drain inserted at the first stage and in six patients (17.1%) who had no suction drain at the first stage. The locally produced ceftriaxone-PMMA beads were found to be as efficient as the commercially available gentamicin beads in eluting antibiotics locally, thereby eliminating the residual infection in the bone cavities after the first stage. Another important outcome was a fourfold saving in cost in choosing to use ceftriaxone-PMMA beads rather than gentamicin beads.

Microbial isolates in open fractures seen in the accident and emergency unit of a teaching hospital in a developing country.

In this prospective study, superficial and deep swabs of all open fractures seen at the accident and emergency unit of our hospital between January and June 2000 were taken (before wound debridement was done or anitibiotics commenced). Routine microscopy, culture and sensitivities for aerobic and anaerobic organisms were carried out on these specimens. The organisms were cultured and identified using standard techniques and the antibiotic sensitivity testing was carried out using the disc diffusion method of Stokes. Within six hours of injury, single-organism isolates were commonly found whilst after 48 hours a mixed or poly-microbial organism load were isolated. In 90% of the positive isolates, the organisms isolated form the superficial and the deep swabs were the same. The antibiotic sensitivity pattern of all the isolates shows that pefloxacin, ciprofloxacin and ceftriaxone were more effective compared to cefuroxime and amoxycillin which had substantial resistance to most of the isolates. 41 fractures were followed to union and 4 (9.7%) developed osteomyelitis.

Microbial isolates in chronic osteomyelitis--a guide to management.

Between August 1995 and December 1999, sixty patients with chronic osteomyelitis had the effluent from the discharging sinuses and bone biopsies cultured aerobically and anaerobically. 47 positive isolates were obtained and the organism commonly isolated both in the single- and two-organism isolates was Staphylococcus aureus. The sensitivity patterns of these isolates were carried out with the available antibiotic discs. 30 per cent of the organisms isolated were sensitive to ceftriaxone (Rocephine) and gentamycin.

Ceftriaxone-PMMA beads--a slow release preparation?

The use of various drug delivery systems to achieve high levels of the desired antibiotic(s) at the site of infection has become commonplace in orthopaedic and trauma units the world over. One of these techniques uses the implantation of antibiotic-impregnated beads at operation sites. Commercial antibiotic beads such as the gentamicin bead are available but expensive, especially for patients in developing countries. We have shown that ceftriaxone-polymethylmethacrylate beads can be produced locally and at low cost in a resource-poor environment. We have also shown that such beads elute the antibiotic (ceftriaxone) effectively in vitro, achieving similar or better activity when measured by zones of inhibition against various bacteria species compared with standard antibiotic discs. This technique offers a cost-effective method of treating chronic bone infections in resource-poor settings.