Morbidity pattern of underfives with moderate acute malnutrition in southern Nigeria

Background:Moderate acute malnutrition (MAM) is a leading cause of childhood morbidity and mortality globally. The morbidity pattern of underfives with this condition is yet to be described. Objective: To describe the morbidity pattern of underfives with MAM.Method: Across sectional study was conducted in two Primary Health Centres in Uruan Local Government Area of Akwa Ibom State. Caregivers'brought children aged 6- 59 months to the health facilities following community mobilization. Eligible children were recruited into the study after obtaining parental consent. Avalidated proforma was used to obtain the biodata and symptoms of common illnesses in the children. Ageneral physical examination, anthropometric measurements and systemic examination were performed. Results: Atotal of 162 children were recruited into the study. Their mean (±SD) age was 20.4 ± 13.0 months. Over 70% of them were 6 - 23 months of age. Their mean (±SD) length/height was 77.3 ± 29.6 cm, mean (±SD) weight was 8.3 ± 3.4 kg and mean (±SD) mid upper arm circumference was 12.4 ± 4.5 cm. The main symptoms noted in the children were; fever 99 (61.1%), cough 84 (51.9%), weight loss 81 (50.0%), diarrhoea 40 (24.7%) and vomiting 40 (24.7%) while pallor 77 (47.5%), lymphadenopathy 56 (34.6%), hair changes 49 (30.2%), skin changes 27 (16.6%) were the main signs in them.Conclusion: The main symptomatology of underfives with MAM were fever, cough and weight loss

Burnout Among Doctors and Nurses at The University of Uyo Teaching Hospital, South-South, Nigeria: A Comparative Study

BACKGROUND: Burnout remains a crucial occupational health challenge to healthcare professionals given its immediate and remote harmful effects. Doctors and nurses are highly susceptible to burnout due to the essence and demands of their services. The study aimed to determine and compare the prevalence of burnout among doctors and nurses working at the University of Uyo Teaching Hospital, Southern Nigeria. MATERIALS AND METHODS: A comparative, cross-sectional study of 553 doctors and nurses was conducted using a stratified random sampling technique. A pretested, self-administered MBI - Human Services Survey for Medical Personnel - MBI-HSS (MP) was used for data collection and analysis using IBM Statistical Product and Service Solutions (SPSS) software version 23. The Chi-square and Fisher's exact tests were applied with a statistical significance level set at α<0.05. RESULTS: The mean ages for doctors and nurses were 37.1 ± 5.3 and 39.0 ± 9.2 respectively (p=0.003). Burnout prevalence among doctors was 9.7% compared to 5.5% among nurses (p =0.062). Out of 553 respondents, 247 (46.7%) had high emotional exhaustion (EE), 70 (12.7%) had high depersonalization (DP), and 342 (61.9%) had low personal accomplishments (PA). Furthermore, 132 (47.3%) doctors had high EE, 43 (15.4%) had high DP and 159 (57%) had low PA. While 115 (42%) nurses had high EE, 27 (9.9%) had high DP and 183 (66.8%) had a low PA (p=0.041). Excessive workload (p=0.042) and lengthy years in a workplace position (p=0.002) were significantly associated with burnout among doctors compared to family size (p=0.045) and workplace support or community (p=0.005) among nurses. CONCLUSION: The study found burnout prevalence to be higher among doctors than nurses. Work-related factors contributed significantly to burnout development. Recreating and/or modifying workplace environments is essential to mitigating the adverse effects of burnout among healthcare workers.

CONTEXTE: Le burnout demeure un défi crucial pour la santé au travail des professionnels de la santé compte tenu de ses effets immédiats et à distance. Les médecins et les infirmières sont hautement susceptibles au burnout en raison de la nature et des exigences de leurs services. L'étude visait à établir et à comparer la prévalence du burnout parmi les médecins et les infirmières travaillant à l'Hôpital Universitaire de Uyo, dans le sud du Nigéria. MATÉRIEL ET MÉTHODES: Une étude comparative et transversale a été menée auprès de 553 médecins et infirmières à l'aide d'une technique d'échantillonnage aléatoire stratifié. Une enquête préalablement testée, auto-administrée, l'Inventaire d'épuisement professionnel humain pour le personnel médical (MBI-HSS [MP]), a été utilisée pour la collecte et l'analyse des données à l'aide du logiciel IBM Statistical Product and Service Solutions (SPSS) version 23. Les tests du Chi carré et de Fisher ont été appliqués avec un seuil de signification statistique fixé à α<0,05. RÉSULTATS: Les âges moyens des médecins et des infirmières étaient de 37,1 ± 5,3 et 39,0 ± 9,2 respectivement (p = 0,003). La prévalence de l'épuisement professionnel parmi les médecins était de 9,7 % par rapport à 5,5 % parmi les infirmières (p = 0,062). Sur les 553 répondants, 247 (46,7 %) présentaient un épuisement émotionnel élevé (EE), 70 (12,7 %) présentaient une dépersonnalisation élevée (DP) et 342 (61,9 %) présentaient un faible accomplissement personnel (PA). De plus, 132 (47,3 %) médecins avaient un EE élevé, 43 (15,4 %) avaient une DP élevée et 159 (57 %) avaient un PA faible. Tandis que 115 (42 %) infirmières avaient un EE élevé, 27 (9,9 %) avaient une DP élevée et 183 (66,8 %) avaient un PA faible (p = 0,041). Une charge de travail excessive (p = 0,042) et de nombreuses années passées à un poste de travail (p = 0,002) étaient significativement associées à l'épuisement professionnel parmi les médecins, par rapport à la taille de la famille (p = 0,045) et au soutien au travail ou à la communauté (p = 0,005) parmi les infirmières. CONCLUSION: L'étude a révélé une prévalence plus élevée du burnout parmi les médecins que parmi les infirmières. Les facteurs liés au travail ont contribué de manière significative au développement du burnout. Recréer et/ ou modifier les environnements de travail est essentiel pour atténuer les effets néfastes du burnout chez les travailleurs de la santé Mots-clés: épuisement professionnel, épuisement émotionnel, dépersonnalisation, accomplissement personnel, médecins, infirmières, hôpital Universitaire, Uyo, Nigéria.

Effect of Health Education on the Knowledge of Cervical Cancer and Uptake of Papanicolaou Smear Test among Teachers in Uyo, Akwa Ibom State Nigeria: An Interventional Study.

BACKGROUND: Evidence exists that the uptake of cervical cancer screening is low in Nigeria despite the availability of effective tools. This study determined the effect of health education on the knowledge of cervical cancer and uptake of Papanicolaou (Pap) smear test among teachers in public secondary schools in Uyo, Nigeria. METHODS: This was an interventional study among public secondary school teachers in Uyo, Akwa Ibom State, Nigeria. It entailed a baseline survey, administration of health education sessions on cervical cancer and its screening tests to the intervention group and a post-intervention evaluation. Data was captured using a semi-structured questionnaire and analyzed with Stata software Version 10. RESULTS: There were 185 respondents each in the interventional and control groups. The mean ages of the teachers were 38.7 ± 8.1 years and 37.1 ± 7.7 years respectively. Post-intervention, knowledge of cervical cancer symptoms increased from 10.1% to 66.5% in the intervention group compared to an increase from 7.0% to 12.0% in the control group (p< 0.001). Similarly, risk factor knowledge improved from 6.1% to 59.5% in the intervention group compared to 4.9% to 7.2% in the control group (p< 0.001). Also, the uptake of the Pap smear test increased from 11.9% to 22.2% in the intervention group (p = 0.01) compared to an increase from 4.9% to 7.0% in the control group (p=0.379). CONCLUSION: Health education brought about a significant increase in the knowledge of cervical cancer symptoms/risk factors and uptake of Pap smear test and should therefore, be encouraged among teachers in secondary schools.

CONTEXTE: Il est prouvé que le dépistage du cancer du col de l'utérus est peu pratiqué au Nigeria malgré la disponibilité d'outils efficaces. Cette étude a déterminé l'effet de l'éducation sanitaire sur la connaissance du cancer du col de l'utérus et le recours au test de Papanicolaou (Pap) chez les enseignants des écoles secondaires publiques d'Uyo, au Nigeria. MÉTHODES: Il s'agissait d'une étude interventionnelle parmi les enseignants des écoles secondaires publiques d'Uyo, Etat d'Akwa Ibom, Nigeria. Elle comportait une enquête de base, l'administration de séances d'éducation sanitaire sur le cancer du col de l'utérus et ses tests de dépistage au groupe d'intervention et une évaluation postintervention. Les données ont été recueillies à l'aide d'un questionnaire semi-structuré et analysées avec le logiciel Stata version 10. RÉSULTATS: Il y avait 185 répondants dans les groupes d'intervention et de contrôle. L'âge moyen des enseignants était respectivement de 38,7 ± 8,1 ans et 37,1 ± 7,7 ans. Après l'intervention, la connaissance des symptômes du cancer du col de l'utérus a augmenté de 10,1% à 66,5% dans le groupe d'intervention par rapport à une augmentation de 7,0% à 12,0% dans le groupe de contrôle (p< 0,001). De même, la connaissance des facteurs de risque s'est améliorée de 6,1 % à 59,5 % dans le groupe d'intervention, contre 4,9 % à 7,2 % dans le groupe témoin (p< 0,001). De même, le recours au test de Papanicolaou a augmenté de 11,9% à 22,2% dans le groupe d'intervention (p = 0,01) par rapport à une augmentation de 4,9% à 7,0% dans le groupe de contrôle (p=0,379). CONCLUSION: L'éducation à la santé a entraîné une augmentation significative de la connaissance des symptômes/facteurs de risque du cancer du col de l'utérus et du recours au test de Papanicolaou et devrait donc être encouragée parmi les enseignants des écoles secondaires. Mots clés: Cancer du col de l'utérus, symptômes, facteurs de risque, recours au test de Papanicolaou, enseignant.

Cultural adaptation and psychometric evaluation of the Yoruba version of the Health Literacy Questionnaire.

Background: Health literacy is an important multidimensional concept of public health concern and a determinant of health outcomes and access to healthcare which requires robust measurement. The objective of this study was to culturally adapt and establish the psychometric properties of the Yoruba version of the Health Literacy Questionnaire. Methods: A cross-sectional survey of Nigeria Yoruba speaking adults was conducted with the Health Literacy Questionnaire following its translation and adaptation. Data were subject to psychometric evaluation (confirmatory factor analysis, composite reliability, Cronbach's alpha, intra class correlation) and association with sociodemographic variables. Results: A total of 258 adults with mean age 26.7 years participated in the study. The easiest scale to score highly was 'Actively managing my health' and hardest was 'Ability to find good health information' and 'Navigating the healthcare system'. Six one-factor models fitted well without correlated residuals but the other three had a good fit after model modification. Composite reliability and Cronbach's α of ≥ 0.7 were observed for all scales, suggesting good internal consistency of the scales. Test-retest reliability of the Yoruba translation of the Health Literacy Questionnaire was moderate to good in all scales, intra class correlation ranging from 0.66 to 0.76. Conclusion: The Health Literacy Questionnaire was successfully translated and culturally adapted and demonstrated good content and construct validity and high composite reliability. The Yoruba translation of the Health Literacy Questionnaire has the potential of being a useful clinical tool for the assessment of health literacy, especially among Yoruba speaking community of Nigeria. Thereby helping to improve the health outcomes through access to healthcare.

Translation and psychometric evaluation of the Yoruba version of the STarT Back tool among persons with long-term non-specific low-back pain.

Conclusion: The Y-SBT have acceptable psychometric properties. It is recommended for use among Yoruba speaking patients with LBP. Background: Translating questionnaires into local languages is essential as it aids easy accessibility and understanding of such questionnaires by patients and their health caregivers. The STarT Back Tool (SBT), validated tool used to classify subgroups of persons with Low-Back Pain, has few translated versions. We translated the STarT Back Tool into the Yoruba language and established its psychometric properties among patients with long-term non-specific Low-Back Pain. Methods: Following the Lenz protocol, the SBT was successfully cross-culturally adapted into the Yoruba language. One hundred consenting patients (mean age = 57.0±11.43 years, 55% females) took part in the validation phase, while 53 of them participated in the test-retest phase. Psychometric indices of the Y-SBT assessed showed internal consistency, intraclass correlation coefficient (ICC), ceiling and floor effects and divergent validity. Results: The sub- and total Cronbach's α score for Y-SBT was 0.704 and 0.857, respectively. The test-retest reliability of the sub- and total scores of the Y-SBT yielded an ICC of 0.82 (95% CI: 0.74 - 0.87) and 0.89 (95% CI: 0.84 - 0.93), respectively. The divergent validity for sub- and total-scores of the Y-SBT based on Quadruple Visual Analogue Scale score for on-going pain was r = 0.374 (p = 0.001) and r = 0.432 (p = 0.001), respectively. The Y-SBT had no ceiling or floor effects.

Food Hygiene Knowledge and Practice among Food Vendors in Uyo, Nigeria.

BACKGROUND: The role of food vendors in food hygiene and safety is an important one which, if neglected, could lead to outbreaks of food borne illnesses, currently major causes of morbidity and mortality, especially in sub-Saharan Africa and East Asia. OBJECTIVE: The aim of this study was to assess the food hygiene knowledge and practices of food vendors in Uyo, Nigeria. METHODS: This was a descriptive cross-sectional study. Data were collected using a pre-tested semi-structured questionnaire and analyzed with SPSS version 20. RESULTS: A total of 125 respondents participated in the study. The mean age was 31.99 ± 10.51 years, with a male: female ratio of 1:1.04. Thirty-six (28.8%) respondents had good food hygiene knowledge (>75% of maximum scores) which was significantly associated with tertiary level of education and female sex (p<0.05). Only 11 (8.8%) however had good practice (>75% of maximum scores). Tertiary education, working less than 6 hours daily and food hygiene training were significantly associated with good practice scores (p<0.05). The relationship between food hygiene knowledge and practice was statistically significant (p=0.00). There were also statistically significant associations between having good knowledge of food hygiene and use of apron, hair covering, observing good sanitary conditions, water supply, waste disposal and protection of food from flies (p<0.05). CONCLUSION: A link existed between having good level of knowledge and the hygiene practices of the respondents. Food vendors should therefore be adequately trained to equip them to offer sufficiently hygienic services, thus ensuring food safety among the consumers.

Latent Tuberculosis in a Paediatric Health Worker: A Case Report.

BACKGROUND: Latent Tuberculosis (LTBI) affects approximately a third of the world population. Paediatric health workers caring for adolescent Tuberculosis (TB) patients in high TB endemic regions are particularly susceptible as they are exposed to TB in the community and in the work place. However, there is a paucity of reports on LTBI in paediatric health workers. OBJECTIVES: To identify the factors that could have resulted in latent TB in a paediatric health worker Methods/Results: We present a case of a 38-year old female paediatrician who was diagnosed with LTBI by a positive QuantiFERON-TB gold test during the routine new entry immigrant screening for tuberculosis on arrival in the United Kingdom for postgraduate studies. She was treated with three months course of Rifampicin and Isoniazid (plus pyridoxine). CONCLUSION: Latent TB infection may have been acquired from her involvement in the management of adolescents with adult type TB without the use of personal protective equipment. In this case, routine systematic screening of an at risk individual helped to eliminate TB infection. RECOMMENDATION: Paediatric health workers should use personal protective equipment when managing childhood TB and should also be routinely screened for latent TB.

Forms and determinants of sexual abuse among female child hawkers in Uyo, Nigeria

Background: Female hawkers are exposed to numerous hazards including sexual abuse. This study aimed at assessing the prevalence, forms and determinants of sexual abuse among female child hawkers in Uyo, Nigeria. Methods: This was a cross-sectional descriptive study carried out among female child hawkers in Uyo, Nigeria. Data was collected using an interviewer-administered structured questionnaire and was analyzed with IBM SPSS Statistics 20.0 software. Level of significance was set at 0.05. Result: A total of 172 respondents participated in the study. The mean age was 12.9±2.3 years. School dropout rate was 11.6% among respondents. Commonest reasons for hawking included family support (66.8%), feeding (22.1%) and generating school fees (11.1%). Prevalence of any form of sexual abuse was 76.2%. Forms of sexual abuse reported included verbal abuse (54.1%), inappropriate touching (56.4%), kissing (14.5%), intercourse due to enticement (18.0%) and rape (12.2%). The commonest reason for sexual act among those enticed was monetary gains, (64.5%). Consequences of sexual abuse included STI (13.5%), pregnancy (5.8%) and abortion (5.8%) respectively. Predictors of any form of sexual abuse included being aged 14-17 years (OR =14.70, 95%CI=2.05-105.14, p=0.007), being a dropout (OR=7.37, 95%CI=2.21-24.59, p=0.001) and being from social class V (OR=23.44, 95%CI=1.13-401.67, p=0.031). Conclusion: There was high prevalence of sexual abuse ranging from inappropriate touching to rape. Predictors of sexual abuse included age, being a dropout and of low socio economic class. Enlightenment campaigns on risks of female child hawking, establishment of skill acquisition centres and free education to secondary level are advocated

Forms and determinants of sexual abuse among female child hawkers in Uyo, Nigeria

Background: Female hawkers are exposed to numerous hazards including sexual abuse. This study aimed at assessing the prevalence, forms and determinants of sexual abuse among female child hawkers in Uyo, Nigeria. Methods: This was a cross-sectional descriptive study carried out among female child hawkers in Uyo, Nigeria. Data was collected using an interviewer-administered structured questionnaire and was analyzed with IBM SPSS Statistics 20.0 software. Level of significance was set at 0.05. Result: A total of 172 respondents participated in the study. The mean age was 12.9±2.3 years. School dropout rate was 11.6% among respondents. Commonest reasons for hawking included family support (66.8%), feeding (22.1%) and generating school fees (11.1%). Prevalence of any form of sexual abuse was 76.2%. Forms of sexual abuse reported included verbal abuse (54.1%), inappropriate touching (56.4%), kissing (14.5%), intercourse due to enticement (18.0%) and rape (12.2%). The commonest reason for sexual act among those enticed was monetary gains, (64.5%). Consequences of sexual abuse included STI (13.5%), pregnancy (5.8%) and abortion (5.8%) respectively. Predictors of any form of sexual abuse included being aged 14-17 years (OR =14.70, 95%CI=2.05-105.14, p=0.007), being a dropout (OR=7.37, 95%CI=2.21-24.59, p=0.001) and being from social class V (OR=23.44, 95%CI=1.13-401.67, p=0.031). Conclusion: There was high prevalence of sexual abuse ranging from inappropriate touching to rape. Predictors of sexual abuse included age, being a dropout and of low socio economic class. Enlightenment campaigns on risks of female child hawking, establishment of skill acquisition centres and free education to secondary level are advocated

Occupational health problems and work practices of hairdressers in Uyo, Akwa Ibom State, Nigeria

There are several million hairdressers worldwide who are chronically exposed to various chemicals used in hairdressing business. This study aimed at determining the occupational health problems and work practices of hairdressers in Uyo, Nigeria. This was a cross-sectional descriptive study carried out in March 2017.The study participants consisted of all consenting hairdressers in Uyo metropolis, Nigeria who had been working for at least 6 months prior to the study. Data obtained was analyzed using STATA 12.1 software. Level of significance was set at 5%. A total of 429 hairdressers participated in the study. The mean age of respondents was 28.5 �7.5 years. Majority, (88.3%) were females and 63.9% were single. Ninety percent had at least secondary education, while 47.6% had worked for > 3years. Health problems reported included back pain 61.5%, tiredness 57.1%, Itching/ redness of hands 43.1%, eye itching 26.1%, catarrh 22.8% and hearing difficulty 17.7%. Injuries included needle pricks 59.0% and cuts 46.9%. Standing for > 8 hours was reported by 33% of respondents. Use of any personal protective equipment (PPE) was 67.6%. The most commonly used was glove 42.7%. Awareness about PPE increased with respondent's level of education (p<0.05).Hand lesions were significantly less among those who used gloves as 95.6% had no chemical burns and rashes, 95.1% experienced no dryness and 63.4% had no itching/redness (p<0.05). The respondents reported several health problems. Work practices included poor use of PPE and prolonged standing. Regular workplace safety training, shift duty and use of ergonomically suitable chairs are advocated for hairdressers

Effect of health education on the riding habits of commercial motorcyclists in Uyo, southern Nigeria.

BACKGROUND: The increasing number of motorcyclists in Nigeria has led to a rise in poor road safety practices leading to increased rate of accidents. This study was conducted to implement and evaluate the effect of safety education on riding habits of motorcyclists in Uyo, Nigeria. METHODS: The intervention study was conducted among commercial motorcyclists in Uyo with controls from another town in Akwa Ibom State. Baseline information was collected from both groups on their riding habits. Motorcyclists in Uyo were educated on appropriate road safety practices. Data was collected from both groups three months later and analysed using the Statistical Package for Social Sciences version 11. RESULTS: A total of 200 respondents participated in the study, 100 per group. At 3 months post-intervention, those riding when tired reduced in the intervention group from 69% at baseline to 42% (p < 0.05), while in the control group it increased from 74% to 79%. Furthermore, those who rested during riding hours increased from 30% at baseline to 93% (p < 0.05) in the intervention group, while it reduced from 40% to 36% in the control group. Those riding within speed limit in the intervention group increased from 37.5% at baseline to 56.6% (p < 0.05), while in the control group, it remained the same. Use of psycho-active substances reduced in the intervention group, though the changes were not statistically significant at p < 0.05. CONCLUSION: Safety education improved many riding habits of motorcyclists in the intervention group. Road safety education is recommended for all motorcyclists to ensure safer road use.

Social Impact of HIV/AIDS on Clients Attending a Teaching Hospital in Southern Nigeria

People living with human immunodeficiency virus and acquired immune deficiency syndrome (PLWHA) face numerous social challenges. The objectives of this study were to assess the level of self-disclosure of status by PLWHA; to describe the level and patterns of stigma and discrimination; if any; experienced by the PLWHA and to assess the effect of sero-positivity on the attitude of friends; family members; health workers; colleagues and community. This was a cross-sectional descriptive study carried out among PLWHA attending the University of Uyo Teaching Hospital; Uyo; Southern Nigeria. Information was obtained using an interviewer-administered semi-structured questionnaire; which was analysed using the Epi 6 software. A total of 331 respondents were interviewed. A majority; 256 (77.3); of the respondents were within the age range of 25-44 years. A total of 121 (36.6) PLWHA were single and 151 (46.6) were married; while the rest were widowed; divorced or separated. A majority; 129 (85.4); of the married respondents disclosed their status to their spouses and 65 (50.4) were supportive. Apart from spouses; disclosure to mothers (39.9) was highest. Most clients (57.7) did not disclose their status to people outside their immediate families for fear of stigmatization. Up to 111 (80.4) of the respondents working for others did not disclose their status to their employers. Among those whose status was known; discrimination was reported to be highest among friends (23.2) and at the workplace (20.2). Attitudes such as hostility (14.5); withdrawal (11.7) and neglect (6.8) were reported from the private hospitals. Apart from disclosure to spouses; the level of disclosure to others was very low. Those whose status was known mainly received acceptance from their families but faced discriminatory attitudes such as hostility; neglect and withdrawal from friends; colleagues and hospital workers. There is a need for more enlightenment campaigns on HIV/AIDS by stakeholders to reduce stigma and discrimination and ensure adequate integration of PLWHA into the society

Effect of safety education on knowledge of and compliance with road safety signs among commercial motorcyclists in Uyo, Southern Nigeria.

OBJECTIVE: Compliance with road safety signs is important in the reduction of motorcycle accidents. The aim of this study was to implement health education intervention and assess its impact on the knowledge of and compliance with road safety signs among commercial motorcyclists in Uyo, Southern Nigeria. METHOD: This was an intervention study among motorcyclists in Uyo, Southern Nigeria, with a control group from a similar town. The instrument of data collection was a semi-structured interviewer administered questionnaire. Subjects were selected through multistage sampling method. Baseline data on compliance to road safety signs was collected from both groups. Motorcyclists in the intervention group were given education on the importance of compliance to road safety signs. Data was subsequently collected from both groups 3 months post intervention and analysed using the Statistical Package for the Social Sciences version 11. RESULT: A total of 200 respondents participated in the study, 100 from each group. Following intervention, respondents with good knowledge score increased from 21% at baseline to 82% at 3 months post intervention in the intervention group (p<0.05) and from 19% to 21% in the control group. Compliance score in the intervention group increased from 15% to 70% (p<0.05) and from 12% to 18% in the control group. CONCLUSION: A significant increase in compliance to road safety signs was recorded among motorcyclists in the intervention group after safety education. All motorcyclists should therefore be given education on road safety signs as this will improve compliance and lead to safer road use among them.

Effects of ultraviolet radiation (type B) on wound exudates, appearance and depth description.

Purulent exudate is one of the clinical signs of decubitus ulcers; and it is indicative of infection. The greatest challenge is the decreasing sensitivity of infective micro-organisms to antibiotics. There appears to be paucity of data on the effect of Ultraviolet radiation on wound exudates and appearance. The main purpose of this study was to determine the effect of ultraviolet radiation (Type B) on wound exudates and appearance of decubitus ulcers. Ten (10) bed-ridden subjects with ascertained bilateral sore from unrelieved pressure in their lower extremities consented to participate in the study. The decubitus ulcers were treated with traditional saline-wet-to-moist (WM) wound dressing. The decubitus ulcers on the left lower extremities were the experimental limbs and were exposed to ultraviolet radiation as adjunct while the right lower limbs served as control and received only the saline-wet-to-moist (WM) wound dressing. The frequency of treatment was 3 times per week for 6 weeks. The type of exudates produced, amount of exudates, wound appearance and depth description were scored on a 5-point likert scale. The data was analyzed using descriptive statistics and non-parametric inferential statistics (Kruska-Wallis test). The result of the Kruskal Wallis test showed that there was significant improvement in the type of exudates produced by the decubitus ulcers of the experimental (left) limbs (X{2} = 33.71, p < 0.00) when compared with the control limbs. Similarly, there was significant reduction in the amount of exudates produced by the decubitus ulcers of the experimental limbs (X{2} = 30.58, p < 0.00) when compared with that of the control. Also, there was significant improvement in the appearance of the decubitus ulcers (X{2} = 33.01, p< 0.00) and depth description of the experimental (left) limbs compared to that of the control (right). This study concluded that Ultraviolet radiation (Type B) can significantly improve the appearance of decubitus ulcers. Also, it can significantly reduce the amount of purulent exudates and can hasten skin replacement of decubitus ulcers.

The use of VP16 and cisplatin in the treatment of Merkel cell carcinoma.

A 70-year-old male with regionally recurrent Merkel cell cancer obtained a complete remission with three cycles of VP16 and cisplatin. His response was consolidated with local radiation therapy. Two additional patients have been reported to have responded to the same combination. Chemotherapy consisting of either cyclophosphamide, vincristine, and doxorubicin or VP16 and cisplatin should be considered in locally recurrent Merkel cell cancer.

Transbronchial mucus transfer of bronchogenic carcinoma.

The metastatic transfer of cells from a primary bronchogenic carcinoma to other portions of the lung as a result of mucus embolization and inoculation has been demonstrated. Histologic observations indicate tumor implantation and survival in peripheral bronchioles. In these regions mucosal dysplasia and carcinoma-in-situ changes which characteristically accompany a primary lesion are notably absent. Morphologic changes associated with acute bronchitis and focally denuded bronchial mucosa may be implicated.