Assessment of workhour feeding practices, healthy behaviour score and body mass index of physicians in Northern Nigeria: a cross-sectional multi-centre study.

Background: The increasing prevalence of obesity and overweight among health workers calls for an appraisal of their lifestyle. This study assessed medical practitioners' workhour feeding and lifestyle practices and explored the relationship between these practices and their body mass index (BMI). Methods: The survey involved 321 medical practitioners selected from 9 northern Nigeria hospitals in 2021. Data collected included biodata, medication history, workhour feeding characteristics, lifestyle behaviours, blood pressure, height, and weight measurements. Data were analyzed using Epi info software (version 7). Results: Most respondents were male (70.7%). Their mean age was 38 ± 7.4 years. During their last workhours, 84.1% had lunch, and 46.4% took sugary drinks. Usually, 41.7% source their lunch from the hospital canteen, and 18.7% patronize their canteen at least weekly. Most reported healthy behaviour towards alcohol consumption (99.7%), fruit and vegetable consumption (54.8%) and smoking (98.4%). However, only 22.4% were physically active. Their mean healthy behaviour score and BMI were 2.8 ± 0.7 and 26.1 ± 4.6 kg/m2, respectively. The obesity and overweight rates were 18.4% and 37.7%, respectively. Their source of lunch during workhours, age, sex, years of practice, employment duration, marital status, job category, systolic blood pressure, anti-hypertensive, and antidiabetic medication use were significantly associated with mean BMI. However, only antihypertensive medication use, being married, inadequate fruit/vegetable consumption and workhour sugary drinks consumption predicted obesity. The predictors of overweight/obese were years of practice (< 10 y) and use of antihypertensive medications. Conclusions: Obesity and overweight rates were high. Most were physically inactive. Workhour sugary drink consumption predicted obesity. Effective workplace and community interventions to improve practitioners' lifestyle behaviour and curtail obesity and overweight are needed.

Isolation, characterization and anti-inflammatory activity of compounds from the Vernonia amygdalina.

The need to explore the abundance of natural products cannot be overemphasized particularly in the management of various disease conditions. In traditional medical practice, Vernonia amygdalina has been widely adopted in the management of various inflammatory disorders. The objective of this investigation was to isolate the bioactive principles from the stem-bark and root of V. amygdalina and assess the anti-inflammatory (in vitro) activity of both the crude extracts and the isolated compounds. Following extraction with the methanol, the extract was subjected to gravity column chromatography and the resultant fractions was further purified to obtained pure compounds. The structural elucidation of the compounds were based on data obtained from 1H to 13C nuclear magnetic resonance (NMR) spectroscopies as well as fourier transform infrared (FT-IR). Using diclofenac as a control drug, the albumin denaturation assay was used to determine the in vitro anti-inflammatory activity of the extracts and isolates. Three distinct compounds characterized are vernoamyoside D, luteolin-7-α-o-glucuronide, and vernotolaside, a new glycoside. When compared to diclofenac, which has an IC50 of 167.8 µg/mL, luteolin-7-α-o-glucuronide, vernoamyoside D, and vernotolaside all showed significant inhibitions with respective IC50 values 549.8, 379.5, and 201.7 µg/mL. Vernotolaside is reported for the first time from the root. The assertion that the plant is used in traditional medicine for the management of inflammatory disorder is somewhat validated by the confirmation of the existence of the compounds with the biochemical actions. Further validation of the isolated compounds would be required in animal studies.

Exploring Factors and Impact of Blockchain Technology in the Food Supply Chains: An Exploratory Study.

Blockchain technology (BCT) has been proven to have the potential to transform food supply chains (FSCs) based on its potential benefits. BCT promises to improve food supply chain processes. Despite its several benefits, little is known about the factors that drive blockchain adoption within the food supply chain and the impact of blockchain technology on the food supply chain, as empirical evidence is scarce. This study, therefore, explores factors, impacts and challenges of blockchain adoption in the FSC. The study adopts an exploratory qualitative interview approach. The data consist of Twenty-one interviews which were analyzed using thematic analysis techniques in NVivo (v12), resulting in identifying nine factors classified under three broad categories (Technology-complexity, compatibility, cost; Organization-organization size, knowledge; Environment-government support, competitive pressure, standardization, and compliance) as the most significant factors driving blockchain adoption in the FSC. In addition, five impacts were identified (visibility, performance, efficiency, trust, and value creation) to blockchain technology adoption. This study also identifies significant challenges of blockchain technology (interoperability, privacy, infrastructure conditions, and lack of knowledge). Based on the findings, the study developed a conceptual framework for blockchain adoption in food supply chains. The study adds to the corpus of knowledge by illuminating the adoption of blockchain technology and its effects on food supply chains and by giving the industry evidence-based guidance for developing its blockchain plans. The study provides full insights and awareness of blockchain adoption challenges among executives, supply chain organizations, and governmental agencies.

Probing environmental sustainability pathways in G7 economies: the role of energy transition, technological innovation, and demographic mobility.

Global warming remains the most devastating environmental issue embattling the global economies, with significant contributions emanating from CO2 emissions. The continued rise in the level of greenhouse gas (GHG) emissions serves as a compelling force which constitutes the core of discussion at the recent COP26 prompting nations to commit to the net-zero emission target. The current research presents the first empirical investigation on the roles of technological advancement, demographic mobility, and energy transition in G7 pathways to environmental sustainability captured by CO2 emissions per capita (PCCO2) from 2000 to 2019. The study considers the additional impacts of structural change and resource abundance. The empirical backings are subjected to pre-estimation tests consisting of cross-sectional dependence, second-generation stationarity, and panel cointegration tests. The model estimation is based on cross-sectional augmented autoregressive distributed lag, dynamic common correlated effects mean group, and augmented mean group for the main analysis and robustness checks. The findings reveal the existence of EKC based on the direct and indirect effects of the components of economic growth. The indicators of demographic mobility differ in the direction of influence on PCCO2. For instance, while rural population growth negatively influences PCCO2 in the short-run alone, urban population growth increases PCCO2 in the short-run and long-run periods. Nonrenewable energy, information computer technology (ICT) imports, and mobile cellular subscriptions serve as positive predictors of PCCO2, while ICT exports and renewable energy moderate the surge in PCCO2. Policy implications that enhance environmental sustainability are suggested following the empirical verifications.

On energy transition-led sustainable environment in COP26 era: policy implications from tourism, transportation services, and technological innovations for Gulf countries.

The present generation is witnessing the most devastating effects of global warming far beyond what was evident in the pre-industrial era. To forestall further ecosystem destruction, nations are working assiduously toward achieving sustainable global environment in decades to come, specifically by 2050. This ambitious goal prompts the convergence of countries in the last climate conference tagged COP26 which provides the roadmap to global sustainability. The resolutions of COP26 motivate the present study to assess the energy transition-led sustainable environment in Gulf countries, considering tourism, transport services, and technological innovation. The study employs annual data from 2005 to 2019 by relying on advanced second-generation estimators comprising cross-sectional ARDL (CS-ARDL), common correlated effects mean group (CCEMG), and augmented mean group (AMG). The study conducts robustness checks using quantile regression (QR) and quantile plots (QP). The results reveal that nonrenewable energy, tourism, and transport services hinder sustainable environment due to their inducing impacts on carbon emissions. Renewable energy and technological innovations promote sustainable environment by moderating the surge in carbon emissions. The QR results reveal that the regressors' effects are not one-off. For instance, the moderating effects of renewable energy correspond to increasing levels of the quantiles. In contrast, nonrenewable energy posits the opposite, thus confirming the energy transition-led sustainable environment hypothesis in the Gulf countries. Policy implications that drive sustainable environment are suggested based on the findings.

Knowledge, attitude, and practices of patients and caregivers attending a Northern Nigerian family medicine clinic regarding the use of face mask during COVID-19 pandemic: a hospital-based cross-sectional study.

Introduction: facemask use is well recognized as an effective public health strategy for preventing COVID-19. However, facemask can only provide enough protection if people recognize its importance and learn how to use it properly. The objective of the study was to assess the knowledge, attitudes, and practices (KAP) of patients or caregivers regarding the use of facemasks as a COVID-19 preventive measure and identifies the factors associated with its practice. Methods: a cross-sectional study where 480 patients or caregivers attending the Family Medicine Clinic were systematically selected over four weeks. A self-administered questionnaire was used to collect data on KAP regarding facemasks use. Student t-test and analysis of variance (ANOVA) were used to examine the relationship between the socio-demographic characteristics and KAP. Pearson's correlation coefficient was used to determine the relationship between knowledge, attitudes and practices. A p-value ≤ 0.05 was considered statistically significant. Results: about 82% of the respondents knew the correct steps of wearing a facemask, but with low positive attitudes. Further analyses showed that respondents were more likely to wear a facemask at clinics and public places than at home. There was a moderately strong correlation between knowledge and practices but weak correlations between attitude and knowledge, and attitude and practices of facemask use. Conclusion: the study revealed good knowledge and practices but low attitudes towards facemask use. Therefore, public health programmes or interventions on facemask usage as a COVID-19 preventive measure, should address the attitudinal problems and also involve the family and community leaders to enhance compliance.

Durability Performance of Self-Compacting Concrete Containing Crumb Rubber, Fly Ash and Calcium Carbide Waste.

Waste tire disposal continues to pose a threat to the environment due to its non-biodegradable nature. Therefore, some means of managing waste tires include grinding them to crumb rubber (CR) sizes and using them as a partial replacement to fine aggregate in concrete. However, the use of CR has a series of advantages, but its major disadvantage is strength reduction. This leads to the utilization of calcium carbide waste (CCW) to mitigate the negative effect of CR in self-compacting concrete (SCC). This study investigates the durability properties of SCC containing CR modified using fly ash and CCW. The durability properties considered are water absorption, acid attack, salt resistance, and elevated temperature of the mixes. The experiment was conducted for mixes with no-fly ash content and their replica mixes containing fly ash to replace 40% of the cement. In the mixes, CR was used to partially replace fine aggregate in proportions of 0%, 10%, and 20% by volume, and CCW was used as a partial replacement to cement at 0%, 5%, and 10% by volume. The results indicate that the mixes containing fly ash had higher resistance to acid (H2SO4) and salt (MgSO4), with up to 23% resistance observed when compared to the mix containing no fly ash. In addition, resistance to acid attack decreased with the increase in the replacement of fine aggregate with CR. The same principle applied to the salt attack scenario, although the rate was more rapid with the acid than the salt. The results obtained from heating indicate that the weight loss was reduced slightly with the increase in CCW, and was increased with the increase in CR and temperature. Similarly, the compressive strength was observed to slightly increase at room temperature (27 °C) and the greatest loss in compressive strength was observed between the temperature of 300 and 400 °C. However, highest water absorption, of 2.83%, was observed in the mix containing 20% CR, and 0% CCW, while the lowest water absorption, of 1.68%, was found in the mix with 0% CR, 40% fly ash, and 10% CCW. In conclusion, fly ash is recommended for concrete structures immersed in water, acid, or salt in sulphate- and magnesium-prone areas; conversely, fly ash and CR reduce the resistance of SCC to heat beyond 200 °C.

Practice patterns in the management of amblyopia among optometrists in Ghana.

Despite internationally recognized guidelines, amblyopia management varies among eye care professionals worldwide. Hence, we sought to investigate the practice patterns of amblyopia management and the factors associated with the decision to treat amblyopia among optometrists in Ghana. A cross-sectional survey was conducted among registered optometrists in Ghana from January 2020 to October 2020. Data collection was done through the administration of online questionnaires via e-mail (google form). The structured questionnaires included demographic information, mode, and scope of practice, diagnostic criteria, examination procedures, treatment modalities, and prognosis. A p value of less than 0.05 was deemed statistically significant. The mean (±SD) age of all the 168 respondents was 32.6 (±6.1) years (range: 24-50 years). The majority of the optometrists (64.9%) treated amblyopia in their practice; with the most prevalent being refractive amblyopia (68.2%), followed by strabismic amblyopia (27.1%), then form-deprivation amblyopia (4.7%). Most (76.1%) amblyopic patients presented with symptomatic squinting. The most common ocular and medical history was anisometropia (90.0%), and the most common diagnostic procedures were patient history, visual acuity, and refraction. Optical correction (88.3%) was mainly prescribed for amblyopia treatment, followed by patching (58.5%). Nearly half of the respondent (45.0%) reported good prognosis after amblyopia treatment. After statistical adjustment, female optometrists were significantly associated with decreased odds of treating amblyopia (AOR = 0.36, p = .004). Refractive amblyopia is the main type of amblyopia managed by optometrists in Ghana. Hence, optical correction is the primary treatment regime. Current amblyopia management practice among optometrists adhere to recommended guidelines and our findings demonstrate uniformity in the standard of care.

Properties of Low-Cost WPCs Made from Alien Invasive Trees and rLDPE for Interior Use in Social Housing.

Low-cost wood-plastic composites (WPCs) were developed from invasive trees and recycled low-density polyethylene. The aim was to produce affordable building materials for low-cost social housing in South Africa. Both raw materials are regarded as waste materials, and the subsequent product development adds value to the resources, while simultaneously reducing the waste stream. The production costs were minimised by utilising the entire biomass of Acacia saligna salvaged from clearing operations without any prior processing, and low-grade recycled low-density polyethylene to make WPCs without any additives. Different biomass/plastic ratios, particle sizes, and press settings were evaluated to determine the optimum processing parameters to obtain WPCs with adequate properties. The water absorption, dimensional stability, modulus of rupture, modulus of elasticity, tensile strength, and tensile moduli were improved at longer press times and higher temperatures for all blending ratios. This has been attributed to the crystallisation of the lignocellulose and thermally induced cross-linking in the polyethylene. An increased biomass ratio and particle size were positively correlated with water absorption and thickness swelling and inversely related with MOR, tensile strength, and density due to an incomplete encapsulation of the biomass by the plastic matrix. This study demonstrates the feasibility of utilising low-grade recycled polyethylene and the whole-tree biomass of A. saligna, without the need for pre-processing and the addition of expensive modifiers, to produce WPCs with properties that satisfy the minimum requirements for interior cladding or ceiling material.

Job satisfaction and its associated factors among optometrists in Ghana: a cross-sectional study.

BACKGROUND: Job satisfaction describes an employee's motivation and/or feeling of satisfaction towards his/her work. Globally, healthcare professionals' turnover and retention play a critical role in the delivery of essential health services. In Ghana, however, little has been done to ascertain job satisfaction levels among human resources for eye-health. The objective of this study therefore was to assess job satisfaction and its associated factors among optometrists in Ghana. METHODS: A cross-sectional survey was conducted among 304 registered and licensed optometrists of the Ghana Optometric Association between September 2018 and June 2019. A validated, well-structured questionnaire was used to elicit information on socio-demographic characteristics of participants and measures on job satisfaction. Scores from a five-point Likert scale was employed to examine job satisfaction and its associated factors. Linear regression analyses were used to evaluate the association between overall job satisfaction and its associated factors using Rasch logit scores. RESULTS: A total of 214 optometrists gave valid responses to the questionnaires used for the final analysis. The mean (± SD) score of the overall perception of job satisfaction among optometrists was 3.36 (± 1.00), with 74.3% of them being satisfied with their jobs. After statistical adjustment, Good work-life balance (Unstandardized co-efficient (ß) = 0.288, p = 0.001), Salary (ß = 0.222, p < 0.0005), Supervision (ß = 0.117, p = 0.044), and Continuing Education Opportunities (ß = 0.138, p = 0.017) were all significantly associated with higher levels of overall job satisfaction. CONCLUSIONS: Most optometrists were satisfied with their jobs. Effective strategic planning and management of human resources for eye-health in Ghana are essential in the development of quality eye-health systems and the provision of high-quality eyecare services.

Prevalence and predictors of clinic appointment non-adherence among adults with poorly controlled hypertension in a primary care setting.

Objectives: To assess the prevalence and predictors of non-adherence to clinic appointments in adult patients with poorly controlled hypertension. Design: A descriptive cross-sectional study. Setting: A primary care setting (family medicine clinic) overseen by family physicians in Kano, Nigeria. Participants: Two hundred and thirty-four randomly selected patients, aged ≥ 18 years with a diagnosis of hypertension, who had been on treatment for ≥1 year and had a current blood pressure of ≥140/90 mmHg were included. Main outcome measures: Non-adherence to clinic appointment among participants. Results: Participants' mean age was 55±12.2 years (range: 23-85 years); they were predominantly females (163, 69.7%). Sixty (25.6%) participants were non-adherent to clinic-appointments. Being employed (OR [Odds ratio] =2.92, 95%CI [confident interval] =1.52-5.65, P=0.002), inability of participants or their children to pay the medical bills (OR=2.92,95%CI=1.42-6.00, P=0.004), and systolic blood pressure (SBP) of <160mmHg (OR=0.43, 95%CI=0.22-0.86, P=0.018) were predictors of clinic appointment non-adherence. Conclusions: The prevalence of non-adherence to clinic appointments was high. Being employed, patients or their children's inability to pay medical bills, and higher SBP were predictors of non-adherence to clinic appointments. Therefore, more studies are needed on effective interventions to reduce non-adherence to clinic appointments in this setting.

Assessment of bacteriological quality and physico-chemical parameters of domestic water sources in Samaru community, Zaria, Northwest Nigeria.

The quality of water supply is assessed by its physico-chemical and bacteriological properties. This study was carried-out with the aim of determining the contamination level of domestic water sources of Samaru community, Zaria, Northcentral Nigeria in order to observed the trend of change in quality of these water sources, if any. This was with a view to safeguard the public health of the riparian users against a possible outbreak of water borne diseases. Water samples were collected and analyzed for bacteriological and physicochemical quality using standard procedures. The results showed that the mean values recorded for physico-chemical parameters among the domestic water sources were within stipulated limits of WHO for safe drinking water except for chloride mean value of 314 ± 142.4 mg/L recorded in borehole water. The total heterotrophic bacterial counts recorded in tap, borehole, well, reservoir and river water samples (3.67 × 106 ± 1.25 × 106, 5.67 × 106 ± 8.49 × 105, 2.60 × 107 ± 6.09 × 106, 5.07 × 106 ± 1.59 × 106 and 6.02 × 107 ± 3.69 × 106) exceeded the WHO permissible limits for drinking water (<500 cfu/ml). High abundance of isolated bacteria genus such as Enterobacter, proteus, Escherichia, Salmonella and Shigella were recorded in well, river and reservoir water systems. There was a strong positive correlation between the total bacteria count and physico-chemical parameters, which suggested that the parameters influenced bacterial growth. The occurrence of these bacterial geniuses in the water sources are considered capable to cause potential health consequences for the consumers. Therefore, proper purification and treatment of domestic water sources of the Samaru community should be ensured before being used by the riparian users.

Group B Streptococcus Colonization, Antibiotic Susceptibility, and Serotype Distribution among Saudi Pregnant Women.

BACKGROUND: Group B Streptococcus (GBS) comprises the normal flora of the female urogenital tract and can be transferred to neonates during delivery, causing invasive diseases. This study was performed to investigate the colonization rate, antibiotic susceptibility, and serotype of GBS among Saudi pregnant women. MATERIALS AND METHODS: In this cross-sectional study, vagino-rectal swabs from 400 pregnant women were collected over a period of one year. Identification of GBS isolates and determination of their antibiotic susceptibility were performed using the Microscan Walk Away system. The isolates were then typed using both latex agglutination and capsular gene-based multiplex polymerase chain reaction assays. RESULTS: Sixty (15.0%) subjects were colonized by GBS, with serotype Ia as the dominant type (30.0%) followed by serotype III and V (25.0%, each). Only 43 (71.7%) isolates were typed by latex agglutination, whereas the remaining isolates were not typable or were non-specifically typed as compared to the genotyping assay, which revealed the specific type of each GBS isolate. The highest resistance rates were observed for erythromycin and clindamycin (16.7%, each), which were mainly restricted to the prevalent serotypes. CONCLUSION: This study is the first to report the distribution of GBS serotypes based on molecular genotyping in Saudi Arabia. GBS colonization was evident among pregnant women, and resistance to erythromycin and clindamycin was predominant among serotypes Ia, III, and V. Molecular genotyping using capsular gene-based multiplex PCR provided reliable typing of the investigated GBS isolates in terms of sensitivity and specificity as compared to conventional serotyping using latex agglutination.

Group B Streptococcus Colonization, Antibiotic Susceptibility, and Serotype Distribution among Saudi Pregnant Women / 감염과화학요법

Background@#Group B Streptococcus (GBS) comprises the normal flora of the female urogenital tract and can be transferred to neonates during delivery, causing invasive diseases.This study was performed to investigate the colonization rate, antibiotic susceptibility, and serotype of GBS among Saudi pregnant women. @*Materials and Methods@#In this cross-sectional study, vagino-rectal swabs from 400 pregnant women were collected over a period of one year. Identification of GBS isolates and determination of their antibiotic susceptibility were performed using the Microscan Walk Away system. The isolates were then typed using both latex agglutination and capsular genebased multiplex polymerase chain reaction assays. @*Results@#Sixty (15.0%) subjects were colonized by GBS, with serotype Ia as the dominant type (30.0%) followed by serotype III and V (25.0%, each). Only 43 (71.7%) isolates were typed by latex agglutination, whereas the remaining isolates were not typable or were non-specifically typed as compared to the genotyping assay, which revealed the specific type of each GBS isolate. The highest resistance rates were observed for erythromycin and clindamycin (16.7%, each), which were mainly restricted to the prevalent serotypes. @*Conclusion@#This study is the first to report the distribution of GBS serotypes based on molecular genotyping in Saudi Arabia. GBS colonization was evident among pregnant women, and resistance to erythromycin and clindamycin was predominant among serotypes Ia, III, and V. Molecular genotyping using capsular gene-based multiplex PCR provided reliable typing of the investigated GBS isolates in terms of sensitivity and specificity as compared to conventional serotyping using latex agglutination.

Review: DNA Barcoding and Chromatography Fingerprints for the Authentication of Botanicals in Herbal Medicinal Products.

In the last two decades, there has been a tremendous increase in the global use of herbal medicinal products (HMPs) due to their claimed health benefits. This has led to increase in their demand and consequently, also, resulted in massive adulteration. This is due to the fact that most of the traditional methods cannot identify closely related species in a process product form. Therefore the urgent need for simple and rapid identification methods resulted in the discovery of a novel technique. DNA barcoding is a process that uses short DNA sequence from the standard genome for species identification. This technique is reliable and is not affected by external factors such as climates, age, or plant part. The difficulties in isolation of DNA of high quality in addition to other factors are among the challenges encountered using the DNA barcoding in the authentication of HMP. These limitations indicated that using DNA barcoding alone may ineffectively authenticate the HMP. Therefore, the combination of DNA barcoding with chromatographic fingerprint, a popular and generally accepted technique for the assessment and quality control of HMP, will offer an efficient solution to effectively evaluate the authenticity and quality consistency of HMP. Detailed and quality information about the main composition of the HMPs will help to ascertain their efficacy and safety as these are very important for quality control.

Antidiabetic potential of some less commonly used plants in traditional medicinal systems of India and Nigeria.

The incidence of diabetes mellitus continue to rise annually all over the world with India and Nigeria having recorded cases of 65.1 and 3.9 million respectively in 2013 and expected to increase by a large amount in 2035. Hyperglycemia is a pre-condition for the development of diabetic complications and is accompanied by an increase in the production of free radicals. The present available treatment option for diabetes like sulfonylurea, metformin and alpha-glucosidase are restricted by their limited actions, secondary failure rates, and side-effects; and unaffordable to the majority of the population. Hence, the need to screen for more medicinal plants with antidiabetic ability due to the fact that plants are; biodegradable, safe and cheap with fewer side-effects. In this review article, we have presented the current status of diabetes in India and Nigeria and the role of some less commonly used medicinal plants from both countries that have antidiabetic potential.

The association between tricuspid regurgitation velocity and 5-year survival in a North West London population of patients with sickle cell disease in the United Kingdom.

Raised tricuspid regurgitant velocity (TRV) occurs in approximately 30% of adults with sickle cell disease (SCD), and has been shown to be an independent risk factor for death. TRV was assessed in 164 SCD patients who were subsequently followed up for survival. Raised pulmonary pressures were defined as a TRV jet ≥2.5 m/s on echocardiography. Elevated TRV was present in 29.1% of patients and it was associated with increased age and left atrial diameter. There were 15 deaths (9.1%) over a median of 68.1 months follow up; seven patients had increased TRV, and eight patients had a TRV<2.5 m/s. Higher TRV values were associated with a greater than 4-fold increased risk of death (Hazard Ratio: 4.48, 99% confidence interval 1.01-19.8), although we found a lower overall mortality rate than has been reported in previous studies. TRV was not an independent risk factor for death. We have confirmed the association between raised TRV and mortality in a UK SCD population whose disease severity appears to be less than that reported in previous studies. Further prospective studies are needed to more clearly characterize which patient factors modify survival in SCD patients with raised TRV.

Prevalence of Anemia and Immunological Markers in HIV-Infected Patients on Highly Active Antiretroviral Therapy in Northeastern Nigeria.

BACKGROUND: There are conflicting reports on the impact of highly active antiretroviral therapy (HAART) in resolving hematological complications. Whereas some studies have reported improvements in hemoglobin and other hematological parameters resulting in reduction in morbidity and mortality of HIV patients, others have reported no improvement in hematocrit values of HAART-treated HIV patients compared with HAART-naïve patients. OBJECTIVE: This current study was designed to assess the impact of HAART in resolving immunological and hematological complications in HIV patients by comparatively analyzing the results (immunological and hematological) of HAART-naive patients and those on HAART in our environment. METHODS: A total of 500 patients participated, consisting of 315 HAART-naive (119 males and 196 females) patients and 185 HAART-experienced (67 males and 118 females) patients. Hemoglobin (Hb), CD4+ T-cell count, total white blood count (WBC), lymphocyte percentage, plateletes, and plasma HIV RNA were determined. RESULTS: HAART-experienced patients were older than their HAART-naive counterparts. In HAART-naive patients, the incidence of anemia (packed cell volume [PCV] <30%) was 57.5%, leukopenia (WBC < 2.5), 6.1%, and thrombocytopenia < 150, 9.6%; it was, significantly higher compared with their counterparts on HAART (24.3%, 1.7%, and 1.2%, respectively). The use of HAART was not associated with severe anemia. Of HAART-naive patients, 57.5% had a CD4 count < 200 cells/µL in comparison with 20.4% of HAART-experienced patients (P < 0.001). The mean viral load log10 was significantly higher in HAART-naive than in HAART-experienced patients (P < 0.001). Total lymphocyte count < 1.0 was a significant predictor of

Private medical providers' knowledge and practices concerning medical abortion in Nigeria.

To investigate the knowledge and practices regarding medical abortion and postabortion care in northern Nigeria among private physicians--the principal providers of such services in the area--122 doctors operating separate clinics in five states--Bauchi, Borno, Kaduna, Niger, and Taraba--were interviewed by means of a structured questionnaire. The results showed that 22 percent of the doctors reported that they terminate unwanted pregnancies, whereas nearly all reported that they manage complications of unsafe abortion. Manual vacuum aspiration and dilatation and curettage performed singly or in combination were the most common methods of abortion and postabortion care reported by the doctors. Only one doctor reported exclusive use of medical abortion in the first trimester, and three reported its exclusive use in the second trimester. Only 35 percent of the doctors listed misoprostol as a drug that they knew could be used for abortion and postabortion care, and only 12 percent listed mifepristone. By contrast, 49 percent listed inappropriate or dangerous drugs for use in abortion provision in the first and second trimesters of pregnancy. We conclude that private practitioners in northern Nigeria have limited knowledge of medical abortion and postabortion care, and that a capacity-building program on the subject should be instituted for them.