Efficacy of Hexetidine, Thymol and Hydrogen Peroxide-Containing Oral Antiseptics in Reducing Sars-Cov-2 Virus in the Oral Cavity: A Pilot Study.

BACKGROUND: Studies have demonstrated the role of sputum as a site of severe acute respiratory syndrome-coronavirus-2 (SARSCoV-2) transmission. However, there is limited literature on the virucidal efficacy of oral antiseptics against SARS-CoV-2 virus. This study investigated the virucidal efficacy of three oral-antiseptics compared to a placebo-control in the sputum of SARS-CoV-2 infected individuals. METHODOLOGY: A pilot study of adults with SARS-CoV-2 positive results, as determined by reverse transcription-polymerase chain reaction (RT-PCR) of <7 days. The oral antiseptics investigated were: Hexetidine (0.1% w/v); Thymol (0.063% w/v) and H2O2(1.5%) compared to de-mineralized sterile water (Placebo-control). The primary outcome measure was the proportion of negative RT-PCR results at 15-mins, 30-mins, 1-hour, 2-hours and 4-hours After Oral antiseptics Interventions (AOI) compared to the placebo-control. Statistical analysis was done using STATA 15.0 software with p-values of <0.05 considered statistically significant. RESULTS: Data from a total of 66 participants that were RT-PCR SARS-CoV-2 positive at baseline (0-min) was analysed. At 15-mins AOI, the highest proportion of negativation from sputum samples was observed in the Hexedine group, with 69.2% of the baseline PCR positive cases converting to negative compared to 46.7% in the placebo-control group. In addition, H2O2 demonstrated efficacy at 2-hours AOI compared to placebo-control (62.5% vs 37.5% respectively) and other oral-antiseptics. Across all time-points, the oral-antiseptic groups compared to the placebo-control group, there was no statistically significant difference in the proportion of sputum samples which converted to a negative status (p>0.05). CONCLUSION: The findings in this study suggest there was no significant difference in the proportion of participants who converted to a negative sputum status across the treatment groups at various time points. Future studies could compare the cycle threshold (ct) viral titre values of sputum samples to determine quantitative differences.

CONTEXTE: Des études ont démontré le rôle des expectorations comme un site de transmission du syndrome respiratoire aigu sévère-coronavirus- 2 (SRAS-CoV-2). Cependant, il existe peu de documentation sur l'efficacité virucide des antiseptiques oraux contre le virus du SRASCoV-2. Cette étude a examiné l'efficacité virucide de trois antiseptiques oraux par rapport à un contrôle placebo dans les expectorations de personnes infectées par le SRAS-CoV-2. MÉTHODOLOGIE: Une étude pilote menée auprès d'adultes dont les résultats sont positifs pour le SRAS-CoV-2, tels que déterminés par la réaction en chaîne de la polymérase par transcription inverse (RT-PCR) pendant 7 jours. Les antiseptiques oraux étudiés étaient : Hexetidine (0,1% p/v) ; Thymol (0,063% p/v) et H2O2 (1,5%) par rapport à l'eau stérile déminéralisée (Placebo-contrôle). Le principal critère d'évaluation était la proportion de résultats RT-PCR négatifs 15 minutes, 30 minutes, 1 heure, 2 heures et 4 heures après les interventions antiseptiques orales (AOI) par rapport au contrôle placebo. L'analyse statistique a été réalisée à l'aide du logiciel STATA 15.0, les valeurs p de <0,05 étant considérées comme statistiquement significatives. RÉSULTATS: Les données d'un total de 66 participants qui étaient positifs à la RT-PCR SARS-CoV-2 au départ (0 minute) ont été analysées. Au bout de 15 minutes, la plus forte proportion de négativation des échantillons d'expectoration a été observée dans le groupe Hexedine, 69,2 % des cas positifs au départ par PCR devenant négatifs, contre 46,7 % dans le groupe témoin placebo. En outre, l'H2O2 a démontré son efficacité à 2 heures après l'apparition de la maladie par rapport au groupe placebo (62,5 % contre 37,5 % respectivement) et aux autres antiseptiques oraux. Pour tous les points temporels, les groupes d'antiseptiques oraux comparés au groupe placebo n'ont pas présenté de différence statistiquement significative dans la proportion d'échantillons d'expectoration qui sont devenus négatifs (p>0,05). CONCLUSION: Les résultats de cette étude suggèrent qu'il n'y a pas de différence significative dans la proportion de participants qui sont passés à un statut négatif d'expectoration dans les groupes de traitement à différents moments. Les études futures pourraient comparer les valeurs du titre viral au seuil de cycle (ct) des échantillons d'expectoration afin de déterminer les différences quantitatives. MOTS CLÉS: SRAS-CoV-2, antiseptiques oraux, hexétidine, peroxyde d'hydrogène.

Cervical cancer: community perception and preventive practices in an urban neighborhood of lagos (Nigeria).

Background. Cervical cancer prevention in developing countries is suboptimal compared with the developed world where there are fewer deaths and improved survival rates. This study describes the perception and preventive practices on cervical cancer by residents of an urban neighborhood of Lagos, Nigeria. Methods. A descriptive cross-sectional study was conducted on 317 consecutively recruited consenting participants at a medical outreach using a pretested, interviewer-administered, semistructured questionnaire. Data analysis was done using statistical package for social sciences version 19. Tests of significance were performed using 95% confidence interval with level of significance set at P < 0.05. Results. The majority of respondents were within 30-49 years of age (46.7%) and female (62.1%) and 70.3% had secondary level education and above. About 37.2% of respondents had heard about cervical cancer with 84.5% of the participants willing to attend a cervical cancer health education program. Among the female respondents, 4.1% had received the HPV vaccine, while 5.1% had undergone a Pap test. Awareness about cervical cancer was significantly higher with increasing age in the total population (P < 0.05). Conclusion. There is a need to improve awareness of at-risk groups and the menfolk about cervical cancer based on the immense benefit of male involvement in reproductive health matters.

The perception of caregivers attending a Nigerian teaching hospital on teething.

BACKGROUND: in November 2008. There was a national tragedy which recorded about eighty four Nigerian infant deaths due to the consumption of adulterated teething syrup- 'my pikin' administered to children by mothers to prevent 'teething problems". This could have been prevented if they had been well informed about the teething process. OBJECTIVE: to determine the knowledge, understanding and beliefs of caregivers attending LASUTH immunization clinic about teething. METHODS: An interviewer administered questionnaire was used to collect data from 260 caregivers of children aged 4-36 months attending the immunization clinic in LASUTH over a six weeks period. The questionnaire assessed their knowledge, understanding, beliefs about teething and the teething experience in their wards. RESULTS: The mean age of the respondents was 30.4 5.3years. Fifty seven percent had tertiary education. However, none of the caregivers obtained information about teething from the dentist. There was an association between educational level and attitude to teething (p=0.002) as well as their understanding of the teething process (p=0.0009). Gum irritation was the most reported symptom observed in this study. Many of the caregivers had erroneous beliefs regarding the systemic symptoms such as fever, diarrhoea and vomiting which they attributed to teething. CONCLUSION: Many of the caregivers studied still had erroneous beliefs regarding teething. Thus there is a need to disseminate the right information about teething to care givers in this environment in order to discourage the use of the term "teething" for a serious childhood illness that might require prompt medical attention.

Widespread endometriosis mimicking ovarian malignancy: a case report.

A 26 year old Nigerian nulliparous woman who presented in the medical emergency unit of a teaching hospital was referred after two weeks of management to the gynecology casualty with a diagnosis of malignant left ovarian cyst, because of the ascites, massive haemorrhagic pleural effusion, a left ovarian mass and an elevated C-125 marker. However, exploratory laparotomy, cytologic and histological examination of the pleural fluid and biopsied specimens revealed endometriosis. We present a case of intra and extra-pelvic endometriosis which simulated a malignant ovarian lesion and was histologically confirmed by cytology of the haemorrhagic pleural effusion and biopsy of the ovarian mass and peritoneal deposits obtained at laparotomy. This is to draw the attention of clinicians to endometriosis as a cause of pleural effusion, ascites and groin swelling which can simulate ovarian cancer.

The future of trauma care in a developing country: interest of medical students and interns in surgery and surgical specialties.

BACKGROUND: Attracting the best medical graduates to trauma-related specialties is pivotal for excellent injury management in future, especially with the rising global incidence of injuries. We sought to explore the interest of Nigerian medical students and interns in Orthopaedics, Cardiothoracic, Neurological, Burns and Plastic and General Surgery specialties. METHODS: A cross-sectional study was conducted using a self-administered questionnaire to assess interest in selected trauma-related specialties among 177 senior medical students and interns at the Lagos State University Teaching Hospital and Lagos University Teaching Hospital in Lagos, Nigeria. Stratified random sampling method was employed and Chi-square test was performed in data analysis using SPSS v15.0 statistical package. RESULTS: Majority (80%) showed interest in post-graduate specialization. Surgery topped the list of specialties chosen by participants while 55% were likely to choose one of the selected trauma-related specialties. Exposure to positive role models, male gender and being single were significantly associated with interest in trauma-related future career. Opportunities for career fulfilment, carrying out difficult procedures, research and discovery, intellectual challenges during practice, use of modern technology, financial remuneration of specialists, patient outcomes and previous theatre experience had significant positive influence on participants who had strong interest in trauma-related specialty. Lifestyle issues like workload, call schedules, stress and duration of residency, training conditions and facilities and time commitment to practice had negative influence on choice of specialty. CONCLUSION: Interest of medical students and interns in trauma-related specialties may be sustained and enhanced by practicing surgeons through mentoring and by serving as role models. Training programs in surgery should be revisited and made less stressful while lifestyle issues need to be made more favourable.

The need to incorporate routine cervical cancer counselling and screening in the management of HIV positive women in Nigeria.

OBJECTIVE: The study aimed to assess the awareness and utilization of the Pap smear among HIV positive women in Lagos, Nigeria. MATERIALS AND METHODS: A descriptive cross sectional survey of women attending the anti-retroviral clinic of the Lagos State University Teaching Hospital, Ikeja, Lagos State, Nigeria was carried out between 1st September and 30th November 2009 using a pre-tested questionnaire. Data were analysed using the Epi-info 3.5 statistical software of the Centre for Disease Control and Prevention, Atlanta USA. RESULTS: None of the 300 respondents reported having received any form of counselling about cervical cancer and screening during the post HIV test counseling. Seventy six (25.3%) of them had heard of cervical cancer; Forty eight (16%) were aware of the Pap smear and only 15 (31.3%) of these (5% of the total number of respondents) have ever done the test before. The majority (69.7%) of those who had not been screened despite knowledge of the Pap smear, gave non- recommendation by their doctor as the main reason for not doing the test. CONCLUSION: Cervical cancer counseling and screening is not part of the routine management of HIV positive women in Lagos, Nigeria. There is need to address this deficiency with appropriate guidelines.

Hepatitis C virus co infection in HIV positive patients.

BACKGROUND: Hepatitis C virus (HCV) co infection is reported common in HIV positive individuals and also responsible for increasing morbidity and mortality among them. OBJECTIVE: This study was undertaken to determine the prevalence of antibodies to HCV (anti- HCV) among HIV positive patients. METHODS: This cross sectional study was carried out among HIV positive patients and HIV negative blood donors. HIV infection was diagnosed in patients using Determine HIV- 1/2 rapid kits and Elisa based immunocombfirm, while Dialab Elisa kits were used for screening blood donors for HIV and also assaying anti HCV in all subjects. RESULTS: Anti-HCV was detected in 14.7% of patients and 1.1% of HIV negative blood donors. HIV/HCV co-infection rate was highest in the 30-39 years age group (P > 0.05). CONCLUSION: Findings demonstrate a high prevalence with 13 fold higher risk of HCV co infection among HIV-positive patients.

Seroprevalence of Toxoplasma gondii antibodies amongst pregnant women at the Lagos State University Teaching Hospital, Nigeria.

BACKGROUND: Toxoplasma gondii (T.gondii), an obligate intracellular parasite found in many species throughout the world, causes a variety of clinical syndromes in humans and animals. It is also associated with morbidity and mortality in pregnancy. Hence the need to determine the seroprevalence of antibody to toxoplasmosis gondii amongst pregnant women. SUBJECTS AND METHODS: A cross- sectional study was carried out using patients attending the ante-natal clinic of Lagos State University Teaching Hospital Ikeja. All consenting newly registered ante-natal patients were recruited consecutively into the study within a time frame of six weeks during which a total of 179 pregnant participants were recruited. Literate participants filled self administered questionnaires whilst the non-literate participants were interviewed by research assistants. Five milliliters of blood was collected from each participant after obtaining patient's consent. Sera were assayed for antitoxoplasmosis IgG antibody by enzyme linked immunosorbent assay. (ELISA.) RESULTS: A total of 179 pregnant women were studied. Almost 50.8% were between the ages of 25-30 years, 70.8% of the patients studied, had tertiary education. An assessment of the patients' status to anti-toxoplasmosis IgG showed 40.8% were positive while 59.2% were negative. Pet-keeping was a practice amongst only 6.1% of patients whilst 90.5% did not keep pets. Out of those who kept pets, 63.6% were positive while 39.5% were negative. Amongst those who did not keep pets, 39.5% were positive while 60.5% were negative. This difference was not statistically significant. (P=0.261) CONCLUSION: It appears that seroprevalence of toxoplasmosis IgG antibody amongst the pregnant women in this study population is high. Therefore, it is valuable to follow up the IgMantibody status of their off springs as its presence indicates recent exposure.