Periodontal Diseases in Adult and Elderly Nigerians: A National Survey.

BACKGROUND: Periodontitis has been shown to have links with general health and increase the risk of complications of some systemic diseases now showing a rising prevalence with age. The rising proportion of the elderly globally, and a high prevalence of periodontal disease among older adults may significantly impact the need for oral health care services in the near future. This national survey was carried out to highlight the trend of periodontal diseases among adult and elderly Nigerians and make evidence-based recommendations for good management outcomes. MATERIALS AND METHODS: A national cross-sectional survey of periodontal diseases (using the CPITN Index) among adult (35-44-year-old) and elderly (65-74-year-old) Nigerians selected by multistage sampling method. RESULTS: Periodontal disease is prevalent among adults (96.5%) and elderly (97.6%) Nigerians, with the zonal prevalence approximating the national prevalence. Gingivitis is the prevalent periodontal disease type in these age groups, with a national prevalence of 86.8%, 67.6% respectively, and more in the South than the North for both adults (90.7%, 83%) and elderly (75.7%, 59.7%), respectively (p<0.005). Destructive Periodontitis prevalence in adult and elderly Nigerians is 9.5%, 29.9%, respectively (p<0.05), with the North being more affected than South for both adults (13.4%, 5.6%) and elderly (37%, 22.7%), respectively (p<0.05). There is also a significant rise in the occurrence of destructive periodontitis with age, nationally and in all the zones (p<0.05). CONCLUSION: There is a high prevalence of periodontal diseases in adult and elderly Nigerians. The outcome of the management of periodontal diseases in adults and the elderly is inter-dependent on best practices in both oral and general health care service provision.

CONTEXTE: La parodontite a été liée à la santé générale et à l'augmentation du risque de complications de certaines maladies systémiques, montrant maintenant une prévalence croissante avec l'âge. La proportion croissante de personnes âgées dans le monde et une prévalence élevée des maladies parodontales chez les personnes âgées pourraient avoir un impact significatif sur le besoin de services de santé bucco-dentaire dans un avenir proche. Cette enquête nationale a été réalisée pour mettre en évidence la tendance des maladies parodontales chez les adultes et les personnes âgées nigérianes et formuler des recommandations fondées sur des preuves pour de bons résultats en matière de gestion. MATÉRIEL ET MÉTHODES: Une enquête nationale transversale sur les maladies parodontales (utilisant l'indice CPITN) parmi les adultes (35-44 ans) et les personnes âgées (65-74 ans) nigérianes sélectionnées par méthode d'échantillonnage à plusieurs niveaux. RÉSULTATS: Les maladies parodontales sont prévalentes chez les adultes (96,5 %) et les personnes âgées (97,6 %) nigérianes, la prévalence zonale approchant la prévalence nationale. La gingivite est le type de maladie parodontale prédominant dans ces groupes d'âge, avec une prévalence nationale de 86,8 %, 67,6 % respectivement, et plus dans le Sud que dans le Nord pour les adultes (90,7 %, 83 %) et les personnes âgées (75,7 %, 59,7 %), respectivement (p<0,005). La prévalence de la parodontite destructrice chez les adultes et les personnes âgées nigérianes est de 9,5 %, 29,9 %, respectivement (p<0,05), le Nord étant plus touché que le Sud pour les adultes (13,4 %, 5,6 %) et les personnes âgées (37 %, 22,7 %), respectivement (p<0,05). On observe également une augmentation significative de l'occurrence de la parodontite destructive avec l'âge, nationalement et dans toutes les zones (p<0,05). CONCLUSION: Il existe une prévalence élevée des maladies parodontales chez les adultes et les personnes âgées nigérianes. Les résultats de la gestion des maladies parodontales chez les adultes et les personnes âgées dépendent des meilleures pratiques dans la prestation de services de santé bucco-dentaire et générale. MOTS CLÉS: Prévalence, Gingivite, Parodontite, Nationale, Enquête.

Endemic status of urogenital schistosomiasis and the efficacy of a single-dose praziquantel treatment in unmapped rural farming communities in Oyo East Local Government Area, Oyo State, Nigeria.

BACKGROUND: Schistosomiasis is endemic in Nigeria, and the treatment is largely concentrated on children enrolled in schools. Consequently, the coverage of non-enrolled school-aged children is often neglected. Ajagba and Awosan are two communities in Nigeria that have never had any control intervention. Hence, this survey was designed to determine the endemicity of urogenital schistosomiasis and to evaluate the efficacy of a single-dose praziquantel in the communities. METHODS: Urine sample (10 mL) of each participant from Ajagba and Awosan communities was filtered through 12µm polycarbonate filter. The filter was placed on a microscope slide, and stained with a drop of 1% Lugol iodine solution. The stained slides were examined under the microscope and the numbers of S. haematobium eggs were counted. Water contact sites were searched for snail hosts and the snails collected were shed for Schistosoma cercariae. Data were analyzed using SPSS version 24.0 and the significance level was set at 95%. RESULTS: The overall prevalence of infection in the Ajagba community was 45.6% with a mean intensity of 61.1 ± 144.5 eggs/10 mL of urine, while the prevalence of infection in the Awosan community was 5.7% with a mean intensity of 1.4 ± 6.8 eggs/10 mL of urine. The school-aged children had a prevalence and mean intensity of infection of 73.1% and 111.6 ± 177.9 eggs/10 mL of urine, respectively. Following treatment, women had a higher egg reduction rate than men (p = 0.0283). Bulinus globosus were found in Ajagba but not in Awosan, with 5.7% shedding Schistosoma spp, cercariae. CONCLUSION: Urogenital schistosomiasis was hyperendemic in the Ajagba community, and hypoendemic in the Awosan community. The presence of Bulinus globosus supported the transmission of the schistosomiasis in the Ajagba community. Communities where schistosomiasis is still actively transmitted in Nigeria should be identified for effective intervention through the MDA programs.

Association of maternal insulin resistance with neonatal insulin resistance and body composition/size: a prospective cohort study in a sub-Saharan African population.

PURPOSE: We prospectively evaluated the association of the insulin resistance of third-trimester Nigerian pregnant women with their newborn infants' insulin resistance and birth size. Pregnancy-associated insulin resistance (IR), often assessed with homeostatic model assessment of IR (HOMA-IR), is associated, especially among women with gestational diabetes (GDM), with abnormal neonatal birth size and body composition, predisposing the baby to metabolic disorders like diabetes and obesity. The associations of maternal IR with neonatal IR, birth size and body composition are less studied in nondiabetic pregnant women, especially in sub-Saharan settings like Nigeria. METHODS: We originally recruited 401 third trimester, nondiabetic pregnant women to a prospective cohort study, followed up until birth. Blood samples of mothers and babies were obtained, respectively, at recruitment and within 24 hours postbirth for fasting serum glucose (FSG) and insulin (FSI) assays, and HOMA-IR was calculated as [(FSI × FSG)/22.5)]. RESULTS: Complete data for 150 mother-baby dyads was analysed: the mothers, with a mean (standard deviation [SD]) age of 31.6 (4.5) years, had live births at a mean (SD) gestational age of 39.2 weeks. The proportions of infants with wasting, stunting, impaired fetal growth (either wasting or stunted), small-for-gestation-age, large-for-gestational-age, low birthweight, and macrosomia were 4.2% (95% confidence interval, 1.1-10.3), 19.7% (12.9-28.0), 23.1% (15.8-31.8), 10.1% (5.3-17.0), 12.6% (7.2-19.9), 0.8% (0.02-4.5), and 5.0% (1.8-10.5), respectively. Maternal HOMA-IR was not associated with neonatal HOMA-IR (p=0.837), birth weight (p=0.416) or body composition measured with weight-length ratio (p=0.524), but birth weight was independently predicted by maternal weight (p=0.006), body mass index (p=0.001), and parity (p=0.012). CONCLUSION: In this nondiabetic/non-GDM cohort, maternal HOMA-IR was not associated with neonatal IR, body size or body composition. Larger studies are required to confirm these findings, with addi-tional inclusion of mothers with hyperglycaemia for comparison.

Molecular characterization of non-aureus staphylococci and Mammaliicoccus from Hipposideros bats in Southwest Nigeria.

Bats are not only ecologically valuable mammals but also reservoirs of zoonotic pathogens. Their vast population, ability to fly, and inhabit diverse ecological niches could play some role in the spread of antibiotic resistance. This study investigated non-aureus staphylococci and Mammaliicoccus colonization in the Hipposideros bats at Obafemi Awolowo University, Ile-Ife, Nigeria. Pharyngeal samples (n = 23) of the insectivorous bats were analyzed, and the presumptive non-aureus staphylococcal and Mammaliicoccus isolates were confirmed by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS). The isolates were characterized based on antibiotic susceptibility testing and whole-genome sequencing (WGS). Six bacterial genomes were assembled, and three species were identified, including Mammaliicoccus sciuri (n = 4), Staphylococcus gallinarum (n = 1), and Staphylococcus nepalensis (n = 1). All the isolates were resistant to clindamycin, while the M. sciuri and S. gallinarum isolates were also resistant to fusidic acid. WGS analysis revealed that the M. sciuri and S. gallinarum isolates were mecA-positive. In addition, the M. sciuri isolates possessed some virulence (icaA, icaB, icaC, and sspA) genes. Multi-locus sequence typing identified two new M. sciuri sequence types (STs) 233 and ST234. The identification of these new STs in a migratory mammal deserves close monitoring because previously known ST57, ST60, and ST65 sharing ack (8), ftsZ (13), glpK (14), gmk (6), and tpiA (10) alleles with ST233 and ST234 have been linked to mastitis in animals. Moreover, the broad host range of M. sciuri could facilitate the dispersal of antibiotic resistance genes. This study provides evidence of the importance of including migratory animals in monitoring the development and spread of antibiotic resistance.

Reviewing 3D convolutional neural network approaches for medical image segmentation.

Background: Convolutional neural networks (CNNs) assume pivotal roles in aiding clinicians in diagnosis and treatment decisions. The rapid evolution of imaging technology has established three-dimensional (3D) CNNs as a formidable framework for delineating organs and anomalies in medical images. The prominence of 3D CNN frameworks is steadily growing within medical image segmentation and classification. Thus, our proposition entails a comprehensive review, encapsulating diverse 3D CNN algorithms for the segmentation of medical image anomalies and organs. Methods: This study systematically presents an exhaustive review of recent 3D CNN methodologies. Rigorous screening of abstracts and titles were carried out to establish their relevance. Research papers disseminated across academic repositories were meticulously chosen, analyzed, and appraised against specific criteria. Insights into the realm of anomalies and organ segmentation were derived, encompassing details such as network architecture and achieved accuracies. Results: This paper offers an all-encompassing analysis, unveiling the prevailing trends in 3D CNN segmentation. In-depth elucidations encompass essential insights, constraints, observations, and avenues for future exploration. A discerning examination indicates the preponderance of the encoder-decoder network in segmentation tasks. The encoder-decoder framework affords a coherent methodology for the segmentation of medical images. Conclusion: The findings of this study are poised to find application in clinical diagnosis and therapeutic interventions. Despite inherent limitations, CNN algorithms showcase commendable accuracy levels, solidifying their potential in medical image segmentation and classification endeavors.

National health insurance scheme improves access and optimization of antimicrobial use in the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria.

BACKGROUND: Nigeria instituted the National Health Insurance Scheme (NHIS) for universal health coverage. This study compared the NHIS and out-of-pocket (OOP) antibiotic prescribing with the World Health Organization (WHO) optimal values. METHODS: A total of 2190 prescription forms from the NHIS and OOP were included in this study conducted at Obafemi Awolowo University Teaching Hospitals Complex, Nigeria from January 2021 to December 2022 and analysed using WHO drug prescribing guidelines. RESULTS: The average number of drugs per encounter was higher in the NHIS prescribing (χ2=58.956, p=0.00) than in OOP prescribing. The percentage of encounters with an antibiotic prescribed is higher in NHIS prescribing (χ2=46.034, p=0.000) than in OOP prescribing. The percentage of parenteral antibiotic prescribing is higher in OOP prescribing (χ2=25.413, p=0.000) than in NHIS prescribing. The percentage of antibiotic prescribed from the National Essential Medicine List is higher in NHIS prescribing (χ2=8.227, p=0.000) as well as the antibiotics prescribed from the Access category of the WHO Access, Watch and Reserve (AWaRe) Classification of antibiotics (χ2=23.946, p=0.000) when compared with OOP prescribing. CONCLUSIONS: Prescribing indicators show better performances with NHIS antibiotic prescribing and are closer to the WHO-recommended optimal values than in OPP prescribing. Hence NHIS prescribing can be an easy target for hospital antibiotic stewardship intervention for optimal antibiotic prescribing.

Physicochemical Characterization of Woody Lignocellulosic Biomass and Charcoal for Bio-energy Heat Generation.

Biomass and its interactions for heat generation have received little attention. In this study, the woody biomass materials were Prosopis africana (PA), Harungana madascariences (HM), Vitrllaria paradoxa (VP), and Afzelia africana (AA). The composition (extractives, carbohydrate, and lignin) of the biomass was determined. The biomass was converted to charcoal in a traditional kiln. A thermo-kinetic examination of the charcoal samples was carried out. The kinetic parameters and potential reaction mechanisms involved in the decomposition process were both obtained using the integral (Flynn-Wall Ozawa) isoconversional methods in conjunction with the Coats-Redfern approach. The activation energy profiles for the charcoal samples in oxidizing atmospheres were 548 kJ/mol for AA, 274 kJ/mol for VP, 548 kJ/mol for PA, and 274 kJ/mol for HM. All charcoal samples underwent comprehensive, multi-step, complex reaction pathways for thermal degradation. The charcoal samples exhibit not only great potential for biochemical extraction but also for bioenergy applications. The significant amount of combustion characteristics in the raw biomass and charcoal samples indicates that each type of wood charcoal produced has more fixed carbon, less ash, and less volatile matter, all of which are desirable for the thermo-chemical conversion of biomass for the production of heat.

Impact of Lung Disease on COVID-19 Health Outcomes in People Living With HIV.

Introduction COVID-19 most commonly causes pulmonary/lung infection, and these pulmonary diseases can complicate HIV infection. Underlying pulmonary diseases in people living with HIV (PLWH) could affect health outcomes if infected with COVID-19. Therefore, this study was designed to determine the impact of pulmonary diseases on the health outcomes of PLWH that were infected with COVID-19. Materials and methods We conducted a retrospective study to assess the impact of superimposed COVID-19 infection on pre-existing lung pathologies in patients living with human immunodeficiency virus (HIV) infection using data from the Minnesota Fairview network from January 1, 2020 to December 31, 2022. Ordinal logistic regressions were used to determine the effect of lung comorbidities on COVID-19 severity, COVID-19-specific mortality, and all-cause mortality, adjusting for patient age and gender.  Results Two hundred sixteen PLWH tested positive for COVID-19. 24.54% of these patients had one or more pulmonary diseases, including asthma, chronic obstructive pulmonary disease (COPD), and other lung diseases (interstitial lung diseases and pulmonary hypertension). The severity of COVID-19 outcomes was evaluated by the ranking of patients' medical records of testing positive, admitted to the hospital, being admitted to the ICU, and death. COVID-19-specific and all-cause mortality were evaluated separately. PLWH with underlying asthma or COPD was not associated with increased all-cause or COVID-19-specific mortality. Interstitial lung disease or pulmonary hypertension was significantly associated with poor health outcomes for COVID-19-specific mortality and all-cause mortality (Fisher's Exact p-value <0.001), with ICU admissions accounting for the most impact. Using the multivariate models, interstitial lung disease and pulmonary hypertension was significantly associated with an increased risk of more severe COVID-19 outcomes and COVID-19-specific mortality (OR=6.6153, CI=2.5944, 17.0795, p-value < 0.001). Interstitial lung disease and pulmonary hypertension were also significantly associated with an increased risk of more severe COVID-19 outcomes and all-cause mortality (OR=​​5.0885, CI=2.0590, 12.5542, p-value < 0.001). Conclusions To mitigate the poor outcomes associated with interstitial lung diseases and pulmonary hypertension in PLWH due to COVID-19, healthcare providers must educate their patients about safety measures against the COVID-19 vaccine. They can also encourage the COVID-19 vaccine uptake among their eligible patients.

The Trend of Cefepime-Induced Neurotoxicity: A Systematic Review.

There has been increased use of cefepime due to concerns about the nephrotoxic effects of the combined use of vancomycin and Zosyn. However, cefepime is associated with neurotoxicity. We conducted a systematic review using online data to explore the trend of cefepime-induced neurotoxicity over the last 10 years. Forty-six articles met our inclusion criteria, including 73 cases of cefepime-induced neurotoxicity. We noticed a steady increase in the reports of cefepime-induced neurotoxicity, from one case in 2013 to 11 cases in 2022. Individuals aged 65 and older accounted for most cefepime-induced neurotoxicity cases (52%). The top three indications for cefepime administration included bone and joint infections (25%), urinary tract infections (22.7%), and pneumonia (22.7%). Most patients with renal impairment have never had a renal adjustment of their cefepime dosage (either 2 g 12 hours a day or 2 g eight hours a day). Most cases of cefepime-induced neurotoxicity occurred between days two and five (n=29, 71%), while most resolution occurred between days one and five (n=29, 85%). While cefepime continues to be a popularly used and effective antibiotic against gram-negative bacteria like Pseudomonas aeruginosa, its dosage needs to be adjusted in patients with renal impairment to avoid neurotoxicity.

Prevalence of Complete Edentulism in Adults and Older Nigerian Population.

INTRODUCTION: The prevalence of complete edentulism varies from country to country and from one region to another region, and making comparisons between national data challenging because of the impact of lifestyle, socio-economic and educational factors. There is no reported national data for Nigeria. AIMS AND OBJECTIVES: The study was to determine the prevalence of complete edentulism among adult (35-44 years) and older (65-74 years) Nigerians, being part of a national oral health survey of Nigerians conducted in 2014. METHODOLOGY: The study was a cross-sectional survey of oral diseases, specifically dental caries, periodontal diseases, dental trauma, and tooth loss, among adult and older Nigerian populations using a multi-stage stratified sampling technique for all 36 states and the FCT, and clinical examination in field situations using daylight settings, with findings collected using data entry forms (WHO 1997). Ethical approvals were obtained from the FMOH, SMOH and SMLGCA. Data was analysed using SPSS-11 and nominal variables compared using chi-square. A p-value of 0.05 was considered significant. RESULTS: A total of 5,038 adults and 4,658 older Nigerians were examined, of which 4(0.08%) and 84 (1.8%), respectively had complete edentulism. Among the adults, it was reported exclusively in Northern Nigeria; whereas among the older population, 66(2.8%) and 18(0.8%) participants in Northern and Southern Nigeria respectively, were reported to be edentulous (p<0.05). 45 cases (4.7%) of edentulism in older Nigerians were reported from the North West geopolitical zone alone. Edentulism is higher in the older population than the adult population in both Northern and Southern regions (p<0.05). Socio-demographic variation was significant in the North, with a higher prevalence in the rural localities among the older population (p<0.05). CONCLUSION: The study showed that there are variations in the prevalence of edentulism in Nigeria, reflecting lower prevalence in comparison with global trends. National prevalence values did not reflect variations along geographical and socio-political divide.

INTRODUCTION: La prévalence de l'édentation complète varie d'un pays à l'autre et d'une région à l'autre, ce qui rend les comparaisons entre les données nationales difficiles en raison de l'impact des facteurs liés au mode de vie, à la situation socio- économique et à l'éducation. Il n'existe pas de données nationales pour le Nigéria. BUTS ET OBJECTIFS: L'étude visait à déterminer la prévalence de l'édentation complète chez les Nigérians adultes (35-44 ans) et plus âgés (65-74 ans), dans le cadre d'une enquête nationale sur la santé bucco-dentaire des Nigérians menée en 2014. MÉTHODOLOGIES: L'étude était une enquête transversale sur les maladies bucco-dentaires, en particulier les caries dentaires, les maladies parodontales, les traumatismes dentaires et la perte de dents, parmi les populations nigérianes adultes et âgées, en utilisant une technique d'échantillonnage stratifiée à plusieurs niveaux pour les 36 États et le FCT, et un examen clinique dans des situations de terrain utilisant des environnements de lumière du jour, avec des résultats recueillis à l'aide de formulaires de saisie de données (OMS 1997). Les autorisations éthiques ont été obtenues auprès de la FMOH, de la SMOH et de la SMLGCA. Les données ont été analysées à l'aide du logiciel SPSS -11 et les variables nominales ont été comparées à l'aide du chi-carré. Une valeur p de 0,05 a été considérée comme significative. RÉSULTATS: Au total, 5 038 adultes et 4 658 Nigérians âgés ont été examinés, dont 4 (0,08 %) et 84 (1,8 %), respectivement, souffraient d'édentation complète. Chez les adultes, l'édentation a été signalée exclusivement dans le nord du Nigeria, tandis que chez les personnes âgées, 66 (2,8 %) et 18 (0,8 %) participants du nord et du sud du Nigeria respectivement ont été déclarés édentés (p<0,05). 45 cas (4,7%) d'édentulisme chez des Nigérians âgés ont été signalés dans la seule zone géopolitique du Nord-Ouest. L'édentulisme est plus élevé dans la population âgée que dans la population adulte, tant dans les régions du Nord que du Sud (p<0,05). Les variations sociodémographiques étaient significatives dans le Nord, avec une prévalence plus élevée dans les localités rurales parmi la population âgée (p<0,05). CONCLUSION: L'étude a montré qu'il existe des variations dans la prévalence de l'édentation au Nigéria, reflétant une prévalence plus faible par rapport aux tendances mondiales. Les valeurs de prévalence nationale ne reflètent pas les variations géographiques et sociopolitiques. Mots-clés: Édentulisme, Prévalence, Adultes, Personnes âgées, Nigérians.

The Inhibitory Effects of Hydroxytyrosol, α-Tocopherol and Ascorbyl Palmitate on Lipid Peroxidation in Deep-Fat Fried Seafood.

This study aimed to investigate the inhibitory effects of hydroxytyrosol, α-tocopherol and ascorbyl palmitate on lipid peroxidation in squid, hoki and prawn during deep-fat frying and refrigerated storage. Fatty acid analysis using gas chromatography (GC) showed that the seafood had a high omega-3 polyunsaturated fatty acid (n-3 PUFAs) content, including docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). The total content of n-3 fatty acids in their lipids was 46% (squid), 36% (hoki) and 33% (prawn), although they all had low lipid contents. The oxidation stability test results showed that deep-fat frying significantly increased the peroxide value (POV), p-anisidine value (p-AV) and the value of thiobarbituric acid reactive substances (TBARS) in squid, hoki and prawn lipids. Meanwhile, antioxidants delayed the lipid oxidation in fried seafood and sunflower oil (SFO) used for frying, albeit in different ways. The least effective of all the antioxidants was α-tocopherol, as the POV, p-AV and TBARS values obtained with this antioxidant were significantly higher. Ascorbyl palmitate was better than α-tocopherol but was not as effective as hydroxytyrosol in suppressing lipid oxidation in the frying medium (SFO) and in the seafood. However, unlike the ascorbyl palmitate-treated oil, hydroxytyrosol-treated oil could not be used for multiple deep-fat frying of seafood. Hydroxytyrosol appeared to be absorbed in the seafood during multiple frying, thus leaving a low concentration in the SFO and making it susceptible to oxidation.

Cost-effectiveness of expanded hepatitis A vaccination among adults with diagnosed HIV, United States.

Hepatitis A virus can cause severe and prolonged illness in persons with HIV (PWH). In July 2020, the Advisory Committee on Immunization Practices (ACIP) expanded its recommendation for hepatitis A vaccination to include all PWH aged ≥1 year. We used a decision analytic model to estimate the value of vaccinating a cohort of adult PWH aged ≥20 years with diagnosed HIV in the United States using a limited societal perspective. The model compared 3 scenarios over an analytic horizon of 1 year: no vaccination, current vaccine coverage, and full vaccination. We incorporated the direct medical costs and nonmedical costs (i.e., public health costs and productivity loss). We estimated the total number of infections averted, cost to vaccinate, and incremental cost per case averted. Full implementation of the ACIP recommendation resulted in 775 to 812 fewer adult cases of hepatitis A in 1 year compared with the observed vaccination coverage. The incremental cost-effectiveness ratio for the full vaccination scenario was $48,000 for the 2-dose single-antigen hepatitis A vaccine and $130,000 for the 3-dose combination hepatitis A and hepatitis B vaccine per case averted, compared with the observed vaccination scenario. Depending on type of vaccine, full hepatitis A vaccination of PWH could lead to ≥80% reduction in the number of cases and $48,000 to $130,000 in additional cost per case averted. Data on hepatitis A health outcomes and costs specific to PWH are needed to better understand the longer-term costs and benefits of the 2020 ACIP recommendation.

Infective Endocarditis-Induced Lung Injury Mimicking Acute Vanishing Lung Syndrome.

Infective endocarditis is the infection of the endocardial surface of the heart valve. The right-sided endocarditis can be complicated by pulmonary injury. The pulmonary complications of infective endocarditis include pulmonary embolism, empyema, pleural effusion, lung abscess, and, in rare cases, pneumothorax. We present a case of bilateral pneumatoceles mimicking vanishing lung syndrome, a very rare pulmonary complication of right-sided infective endocarditis.

Health and Wellbeing amidst a Prolonged Pandemic: Implications for Physicians and Patients.

Health is wealth, so goes the popular maxim. The 46th West African College of Physicians Annual General and Scientific Meeting focuses on Health and Wellbeing Amidst a Prolonged Pandemic. Health and wellbeing are closely related components critical to healthy living and cannot be considered independent of each other. While health is a state of total wellbeing; wellbeing is intricately linked with happiness and satisfaction in life. The COVID- 19 pandemic has significantly impacted the health and well-being of nations all over the world. In the wake of the pandemic came the COVID-19 recession which brought a crash in the global economy, reduction in productivity, rise in unemployment, massive layoffs, collapse of businesses and manufacturing industries, disruptions in transportation and much more. These harsh economic realities have placed a huge strain on global mental health resulting in physical, mental and social disorders. The workload of the average physician and other health care workers increased tremendously resulting in burnout and psychological stress with a consequent increase in the incidence of psychological disorders including anxiety, depression, suicide and suicidal ideation amongst others. The lack of preparedness for the pandemic and the inequality in strength of healthcare systems across the world prolonged the pandemic and its adverse consequences on health and wellbeing of the populace. Promotion of health and well-being of health care professionals and the populace at large is essential for the growth of any economy and is an essential consideration for stakeholders involved in disease prevention and health promotion.

La santé est une richesse, dit la maxime populaire. La 46e réunion générale annuelle et scientifique du Collège des médecins d'Afrique de l'Ouest a pour thème la santé et le bien-être dans un contexte de pandémie prolongée. La santé et le bien-être sont des éléments étroitement liés et essentiels à une vie saine et ne peuvent être considérés comme indépendants l'un de l'autre. Alors que la santé est un état de bien-être total, le bien-être est intimement lié au bonheur et à la satisfaction dans la vie. La pandémie de COVID- 19 a eu un impact considérable sur la santé et le bien-être des nations du monde entier. Dans le sillage de la pandémie, la récession du COVID-19 a entraîné un effondrement de l'économie mondiale, une réduction de la productivité, une hausse du chômage, des licenciements massifs, l'effondrement des entreprises et des industries manufacturières, des perturbations dans les transports, etc. Ces dures réalités économiques ont exercé une pression énorme sur la santé mentale mondiale, entraînant des troubles physiques, mentaux et sociaux. La charge de travail du médecin moyen et des autres travailleurs de la santé a considérablement augmenté, entraînant un épuisement professionnel et un stress psychologique, avec pour conséquence une augmentation de l'incidence des troubles psychologiques, dont l'anxiété, la dépression, le suicide et les idées suicidaires, entre autres. Le manque de préparation à la pandémie et l'inégalité des systèmes de santé dans le monde ont prolongé la pandémie et ses conséquences négatives sur la santé et le bien-être de la population. La promotion de la santé et du bien-être des professionnels de la santé et de la population en général est essentielle à la croissance de toute économie et constitue une considération essentielle pour les acteurs impliqués dans la prévention des maladies et la promotion de la santé. Mots clés: Santé, Bien-être, Pandémie de COVID-19, Santé mentale, Prevention des maladies.

Awareness of the Malaria Vaccine in India.

BACKGROUND: Malaria remains a serious public health problem in India. According to the World Health Organization (WHO), as per the 2021 report, India accounts for 83% of malaria cases in Southeast Asia. Various interventions have been implemented to control malaria's burden in India. In October 2021, the WHO approved the RTS,S/AS01 (RTS,S) malaria vaccine for administration in four scheduled doses in children five months of age to reduce the burden and severity of malaria. The objectives of this study were to assess public awareness about the vaccine among residents of India and determine any associations with demographic characteristics. METHODS: The study was a web-based, cross-sectional survey. The survey questionnaire was sent out electronically using Qualtrics® (Provo, UT) and remained active for 12 weeks (December 2021 to March 2022). The questionnaire was self-administered anonymously, using a link that was shared with people across India through social media platforms. A total of 2,371 respondents above 18 years of age and current residents of India participated in the study. The chi-square test was used to examine the association between awareness about the vaccine and demographic characteristics. A p-value of <0.05 was used to describe a statistically significant association. RESULTS: Most participants (71.95%) had heard about the malaria vaccine, and 68.75% favored making it a required childhood vaccine. Similarly, 67.27% indicated that they would encourage caregivers to get their children/wards vaccinated. Age, gender, educational status, residence, and caregiver status were associated with the awareness regarding the malaria vaccine (p < 0.05). Males, participants between 18 and 24 years old, and caregivers of children aged five years or less were more likely to be aware of the vaccine. Participants with higher education and residing in urban localities had more awareness of the vaccine. CONCLUSION: The malaria vaccine has the potential to eradicate malaria in India, especially if included in the immunization schedule for children. However, it is critical that health policymakers target populations that are less aware of information on any intended rollout of the malaria vaccine to ensure rapid uptake toward the goal of eliminating malaria from India.

A Comprehensive Review of Cross-Linked Gels as Vehicles for Drug Delivery to Treat Central Nervous System Disorders.

Gels are attractive candidates for drug delivery because they are easily producible while offering sustained and/or controlled drug release through various mechanisms by releasing the therapeutic agent at the site of action or absorption. Gels can be classified based on various characteristics including the nature of solvents used during preparation and the method of cross-linking. The development of novel gel systems for local or systemic drug delivery in a sustained, controlled, and targetable manner has been at the epitome of recent advances in drug delivery systems. Cross-linked gels can be modified by altering their polymer composition and content for pharmaceutical and biomedical applications. These modifications have resulted in the development of stimuli-responsive and functionalized dosage forms that offer many advantages for effective dosing of drugs for Central Nervous System (CNS) conditions. In this review, the literature concerning recent advances in cross-linked gels for drug delivery to the CNS are explored. Injectable and non-injectable formulations intended for the treatment of diseases of the CNS together with the impact of recent advances in cross-linked gels on studies involving CNS drug delivery are discussed.

Community Advocacy and Capacity Building of Community Health Workers on Rheumatic Heart Disease in Osun State, Nigeria.

Rheumatic heart disease (RHD) is one of the leading causes of cardiovascular diseases in the world. The study aimed to assess awareness and capacity building on the diagnosis and prevention of RHD among Community Health Workers (CHWs) Nigeria. It was an interventional study, where 300 CHWs from public Primary Health Care (PHC) facilities were selected pre-assessed on the diagnosis and prevention of RHD before their training on RHD. Also, a post-test evaluation was done to reassess the CHWs awareness on RHD. Data were analyzed and RHD knowledge was scored and graded. Results showed, at pre-test evaluation, that 49% of the CHWs had good knowledge, 49.7% had fair knowledge while 4.1% had poor knowledge on the diagnosis and prevention of RHD, while post-test evaluation revealed that 100% of the CHWs had good knowledge. Awareness of the CHWs about the diagnosis and prevention of RHD was fair in the pre-test and improved after the training with all the CHWs having good knowledge. This showed the training was impactful. Intermittent assessment of the awareness and simultaneous training of the CHWs on RHD may be scaled up into a significant and effective measure in the armamentarium of community prevention of the disease.

La cardiopathie rhumatismale est l'une des principales causes de maladies cardiovasculaires dans le monde. L'étude visait à évaluer la sensibilisation et le renforcement des capacités sur le diagnostic et la prévention de la cardiopathie rhumatismale chez les agents de santé communautaire (ASC). au Nigeria. Il s'agissait d'une étude interventionnelle, dans le cadre de laquelle 300 ASC des établissements publics de soins de santé primaires (PHC) ont été sélectionnés et pré-évalués sur le diagnostic et la prévention des RHD avant leur formation sur les RHD.. De plus, une évaluation post-test a été réalisée pour réévaluer la connaissance des ASC sur la RHD. Les données ont été analysées et les connaissances sur la RHD ont été notées et évaluées. Les résultats ont montré, lors de l'évaluation du pré-test, que 49% des ASC avaient une bonne connaissance, 49,7 % une connaissance moyenne et 4,1 % une mauvaise connaissance du diagnostic et de la prévention de RHD, tandis que l'évaluation du post-test a révélé que 100% des ASC avaient de bonnes connaissances. La connaissance des ASC sur le diagnostic et la prévention de la RHD était moyenne dans le pré-test et s'est améliorée après la formation, tous les ASC ayant de bonnes connaissances. Cela montre que la formation a eu un impact. L' évaluation intermittente de la sensibilisation et la formation simultanée des ASC sur la RHD peut devenir une mesure significative et efficace dans l'arsenal de prévention communautaire de la maladie. Mots-clés: Cardiopathie rhumatismale, Agents de santé communautaire, service de santé, prévention.

An Unusual Presentation of Clostridioides Difficile Colitis in a Patient on Opioids.

Clostridioides difficile colitis is an inflammation of the colon due to toxins produced by a gram-positive bacterium called Clostridioides difficile (also known as Clostridium difficile). Clostridioides difficile colitis is associated with an increased risk of morbidity and mortality in elderly patients. The infection develops because of the disruption of the microbiome that usually suppresses the overgrowth of Clostridioides difficile. Testing for Clostridium difficile infection is routinely recommended in patients with at least three loose bowel movements in a day. We present an unusual case of a 74-year-old woman on chronic opioids who presented with a three-day history of lower abdominal pain, constipation, hematochezia, with no diarrhea. Radiologic imaging showed evidence of colitis, and the patient was found to have Clostridium difficile colitis.

Seaweed Phenolics as Natural Antioxidants, Aquafeed Additives, Veterinary Treatments and Cross-Linkers for Microencapsulation.

Driven by consumer demand and government policies, synthetic additives in aquafeed require substitution with sustainable and natural alternatives. Seaweeds have been shown to be a sustainable marine source of novel bioactive phenolic compounds that can be used in food, animal and aqua feeds, or microencapsulation applications. For example, phlorotannins are a structurally unique polymeric phenolic group exclusively found in brown seaweed that act through multiple antioxidant mechanisms. Seaweed phenolics show high affinities for binding proteins via covalent and non-covalent bonds and can have specific bioactivities due to their structures and associated physicochemical properties. Their ability to act as protein cross-linkers means they can be used to enhance the rheological and mechanical properties of food-grade delivery systems, such as microencapsulation, which is a new area of investigation illustrating the versatility of seaweed phenolics. Here we review how seaweed phenolics can be used in a range of applications, with reference to their bioactivity and structural properties.

Availability Bias and the COVID-19 Pandemic: A Case Study of Legionella Pneumonia.

Cognitive biases, such as the availability heuristic or availability bias, can inadvertently affect patient outcomes. These biases may be magnified during times of heightened awareness of a particular disease. Failure to identify cognitive biases when managing patients during the coronavirus disease 2019 (COVID-19) pandemic can delay the institution of the right treatment option and result in poor health outcomes. We present a case of delayed diagnosis of Legionella pneumonia due to COVID-19-related availability bias. We discuss some methods to mitigate the effects of this bias and the importance of challenging trainees to recognize these pitfalls in medical training.