Efficacy of silver nanoparticles against multidrug resistant clinical Staphylococcus aureus isolates from Nigeria.

Multidrug resistant (MDR) S. aureus infections continue to account for excess mortality in hospital and community settings and constitute a rising global health problem. However, data on the efficacy and mechanism of actions of alternative solutions like silver nanoparticles in developing countries are lacking. This study investigated anti-staphylococcal activity of silver nanoparticles (AgNP) against local strains from Nigeria. A total 119 clinical isolates of S. aureus from five Nigerian laboratories categorized as MRSA (n = 52) and MSSA (n = 67) by PCR were studied. The MIC of AgNP produced by chemical reduction method and characterized by surface plasmon resonance absorbance and size equivalence by scanning electron microscopy was determined by microbroth dilution method. Its effect on protease activity and plasmids were also investigated. Baseline characteristics of the isolates revealed MDR phenotype of the isolates, carriage of diverse plasmids (15-32 kb) among the MDR MSSA, and mean extracellular protease activity of 24.8-55.7 U/mL. The chemically synthesized AgNP had a peak absorbance at 400 nm with a size equivalence of 4.58 nm. The MICs of AgNP against the isolates were 4.7 µg/mL and 4.9 µg/mL, respectively, for MRSA and MSSA (P > 0.05). The bactericidal effect of AgNP at 2.5-5 µg/mL on the MSSA and MRSA isolates was observed at 2.7-5.5 h post exposure in vitro. Further analysis revealed plasmid eviction in the MDR MSSA isolates exposed to 5 µg/mL AgNP and dose-dependent reduction in extracellular protease activity by 84.6-93.1%. Hemolysis of human erythrocytes by AgNP was not observed at the MIC range. Conclusion: This study revealed safety and efficacy of AgNP against clinical MDR S. aureus isolates from Nigeria, using plasmid eviction and protease inhibition as mechanisms of action.

Assessment of women's attitude to and perception of transvaginal sonography in Nigeria.

PURPOSE: To assess the attitude to and perception of transvaginal sonography (TVS) among Nigerian women of mixed educational status in order to ascertain factors that may prevent them from submitting to TVS when recommended. METHODS: A Cross-sectional survey was adopted for the study. Subjects were enrolled from one missionary, one government and eight private hospitals. The instruments for data collection were visual analogue scale (VAS), to ascertain patients' pain/discomfort experience, and a researcher-developed semi-structured questionnaire. The level of pain/discomfort on the VAS was categorized into four on a scale of 100. The categories were: 0-5 (no pain), 6-40 (mild pain), 41-74 (moderate pain), and 75-100 (severe pain). RESULTS: The majority (50.6%) of the respondents who attained secondary education had positive attitude to TVS. The majority majority of the respondents (63.1%) preferred female sonographers. A majority of the respondents (54.1%) perceived TVS as not embarrassing, 78% did not consider it stressful, 96.9% reported that the sonographers were professional, 46.7% felt that a chaperon was needed, 98.4% reported there was enough privacy and 84.7% reported they needed prior information. Most of the respondents (82%) were willing to consent to TVS in future, 90.5% reported no pain, 8.6% reported mild pain/discomfort and 0.9% reported moderate pain. CONCLUSIONS: Majority of our respondents had a positive attitude to TVS and were willing to consent to TVS in future, hence it was acceptable to them. It was however observed that acceptability increased with increasing education.

REFERENCE VALUES OF FETAL PEAK SYSTOLIC BLOOD FLOW VELOCITY IN THE MIDDLE CEREBRAL ARTERY AT 12-41 WEEKS OF GESTATION IN JOS, NORTH CENTRAL NIGERIA.

OBJECTIVES: The objectives of this prospective cross sectional study are (i) to establish new reference values of peak systolic blood flow velocity measurement in the fetal middle cerebral artery (MCA-PSV) following validated methodological guidelines (ii) to correlat peak systolic velocity with gestational age and (iii) to establish regression prediction model of MCA-PSV for our population. PATIENTS AND METHODS: Cross-sectional data were obtained from 480 low risk pregnant women and cross validated by 120 high risk pregnant women between 12 and 41 weeks' gestation. Reference ranges for MCA-PSV were constructed and for each measurement linear regression models were fitted separately to the mean and standard deviations (SD) as a function of gestational age. A comparison was made between the reference ranges produced in our study and those of Caucasians. RESULTS: Tables of mean values of peak systolic velocity and percentile with regression equations of MCA-PSV are resented, with suggested limits of 2.5th as lower borderline and 97.5th values representing the upper borderline of normal. Foetal middle cerebral artery peak systolic velocity demonstrated simple continues increase and strong positive correlation with gestational age. Calculated values of z were higher than critical values for PSV of subjects and Caucasian values; p < 0.05 CONCLUSIONS: We have constructed reference ranges for MCA-PSV of gestation 1,241 week period and because the methodological flaws of published study have been eliminated, cross validated by a control group including larger sample size drawn from our population we therefore consider this to be useful for clinical practice.

Awareness of information, expectations and experiences among women for obstetric sonography in a south east Nigeria population.

BACKGROUND: The role of obstetric sonography in the development of diagnostic ultrasound technology has remained invaluable in obstetric and gynaecological investigation. OBJECTIVES: This work investigated the awareness of information, expectations and experiences of pregnant women coming for obstetric sonography. METHODS: One hundred and ten (110) pregnant women in Anambra State of Nigeria were prospectively studied during prenatal ultrasound scan. RESULTS: The mean age of the studied population was 30.5 +/- 14.5 years. Majority (85%) of the subjects were already aware of obstetric ultrasound scan. Most of the subjects were between the ages of 26-35. 73% got their information from antenatal centre. Over 20% were interested in the lies and presentation of their foetus. During the scan, about 69% subjects interested with the sonographers, and more than half of the population (51%) saw their babies. CONCLUSION: The role of prenatal a-sonography in obstetric care should be promoted by creating awareness campaign in antenatal centres, and initiating mother/sonographers interaction are necessary.