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Demographic characteristics, clinical presentation and in-hospital outcome among patients with Covid-19 in a Nigerian tertiary hospital
No full textBackgroundWe described the demographic/clinical characteristics and in-hospital outcome of patients with COVID-19 at the University of Nigeria Teaching Hospital (UNTH) during the first wave to inform evidence-based responses during subsequent waves in Africa. MethodologyWe conducted retrospective cohort analyses of adult patients ≥18 years with PCR or GeneXpert-confirmed SARS-CoV-2 infection. Data was extracted from patients’ medical records from 1st May to 30th September 2020. Based on disease severity, patients were either hospitalized (82) or managed at home (90). Logistic regression and cox-proportional hazard models were used to determine predictors of severe COVID-19 disease and in-hospital mortality, respectively. ResultsOf 172 cases, 113 (65.7%) were males, and the mean age was 45 ± 19 years. The majority were urban dwellers (72.1%), 19.8% had a positive history of contact with a confirmed/suspected case, 15.7% were healthcare workers while 68 (39.5%) had co-morbidities. Symptomatic patients comprised 73.3% of cases. Fever (p=0.02) and breathlessness (p=0.03) were commoner in males while diarrhoea (p<0.01) was predominant in females. On multivariate analysis, severe COVID-19 was predicted by the presence of co-morbidity (AOR= 14.44, 95% C.I= 4.79- 43.58, p <0.001)and prior antibiotic/antimalarial use (AOR= 6.35, 95% C.I= 2.24- 18.05, p =0.001) while being a non-healthcare worker (AOR= 0.18, 95% C.I= 0.04-0.78, p=0.02) was protective. However, none of the variables assessed predicted in-hospital mortality.Conclusion Our findings underscore the contributions of demographic variables in COVID-19 transmission and gender differences in clinical presentation. Underlying comorbidity likewise prior antimicrobial use increased the likelihood of severe COVID-19. The absence of mortality predictors in our study may be related to the relatively small number of deaths. Further studies are recommended to unravel the predominance of severe disease in healthcare workers
Evaluation of Steroid Therapy in COVID‑19 Patients; in the Right Dose at the Right Time to the Right Patients
No full textBackground: Although there is still no universally accepted treatment agent, steroids have been administered chronologically at every dose and at every stage of the COVID-19 pandemic.
Aim: We aimed to evaluate the clinical efficacy of high‑dose steroid therapy and its effect on mortality in COVID‑19 patients with severe pneumonia, severe Acute Respiratory Distress Syndrome (ARDS), and septic shock.
Patients and Methods: Patients with severe pneumonia, septic shock, and ARDS due to COVID-19 who were followed up in the intensive care unit were retrospectively reviewed.
Results: The study population was divided into two groups; the methylprednisolone pulse group (MP) (n = 55) and the dexamethasone group (Dex) (n = 39). When the values before and after treatment were compared; there was a statistically significant increase in the neutrophil/ lymphocyte ratio after treatment in the MP group (p = 0.006). Although it was not statistically significant in the MP group, There was a numerical increase in D-dimer levels (p = 0.28). Thromboembolic complications developed in 2 patients in the MP group. The mortality outcomes of the groups were statistically similar (p = 0.943).
Conclusion: We recommend steroids use in the condition that it is indicated in the critically ill group with the poor general condition. Since there is no significant difference between high‑dose pulse steroid treatment and standard treatment doses, we think that the risk of complications should not be taken into account and high doses should not be used
Knowledge, Attitude, and Practices Regarding Proton Pump Inhibitors among Community Pharmacists and Pharmacy Students
No full textBackground: There are concerns about inappropriate use and insufficient knowledge of proton pump inhibitors (PPIs) use among medical staff.
Aims: This study was designed to examine pharmacy students’ and community pharmacists’ knowledge, attitude, and practices toward PPIs and their relationship with specific sociodemographic characteristics.
Subjects and Methods: This descriptive study was conducted on the pharmacy students (first and last year) at Eastern Mediterranean University and community pharmacists in North Cyprus Data were collected by a validated questionnaire, which assessed knowledge, attitude, and practices regarding PPI use. Students were included without sampling in a volunteer-based manner. Registered community pharmacists were selected randomly.
Results: First-year pharmacy students (n = 77) showed significantly lower knowledge levels than last- year students (12.00 vs. 13.65; P < 0.001); however, there was no significant difference between last‑year students (n = 111) and community pharmacists (n = 59). First‑year pharmacy students were significantly less aware of PPIs’ “dosage and administration” than the other two groups. Last-year students and community pharmacists exhibited significantly higher attitude scores regarding PPI use (24.7 and 24.6 vs. 22.7; P < 0.001). Omeprazole was found to be the most preferred PPI among the three studied populations. Community pharmacists used PPIs mainly to treat acid reflux. Gender, nationality, and pharmacy education program type did not influence pharmacy students’ knowledge, attitude, or practices.
Conclusions: There was not a significant difference regarding knowledge and attitude between the last-year pharmacy students and community pharmacists. The practices of community pharmacists were significantly different from the pharmacy students. It was concluded that certain essential topics regarding PPI use should be emphasized in pharmacy education and during pharmacy practice. Further, it is essentially important for community pharmacists to continue their education through training programs after graduation to enhance their knowledge of PPI use
Sexual Experiences of Infertile Women: A Qualitative Study
No full textBackground: It is suggested that stress related to infertility causes marriage conflicts and decreases in the frequency of sexual intercourse.
Aim: This study aimed to explore the experiences of the sexuality of infertile women.
Patients and Methods: A phenomenological design was used in this study. We conducted face-to-face, semistructured, in-depth interviews with 11 infertile women. The interviews were audio-recorded, and a thematic approach was used to assess the data.
Results: The average age of the women was 33.05 ± 3.40 years, and their age of first sexual intercourse was 23.0 ± 2.8 years and all of them are legally married. The durations of experiencing the problem of infertility were as follows; 3-5 years in 33%, 6-10 years in 27%, and 11 years and above in 38%. According to interpretative phenomenological analysis, two main themes emerge. Two main themes were determined: Perception of Sexuality and Sexual Problems. The results show that infertile women have a higher risk for sexual dysfunction than fertile women.
Conclusion: These findings suggest that the diagnosis of infertility is an important factor in assessing the differences in the sexual satisfaction of women. In infertility counseling, health professionals must explain the gender differences. Also, infertile couples must encourage to share each other’s feelings and this may help couples to cope with the communication problems they may experience.  
Evaluation of the Efficacy of Using Gnri and Mis as a Predictor of Mortality in Elderly Hemodialysis Patients
No full textBackground: Malnutrition is one of the most common geriatric syndromes in hemodialysis (HD) patients. Although there is no gold standard for evaluating nutritional status in HD patients, the Subjective Global Assessment (SGA), Geriatric Nutritional Risk Index (GNRI), and Malnutrition‑Inflammation Score (MIS) are widely used in clinical settings.
Aim: To examine the efficacy of using Geriatric Nutritional Risk Index (GNRI) and Malnutrition‑Inflammation Score (MIS) as a predictor of mortality in elderly hemodialysis patients.
Subjects and Methods: A retrospective cohort study was carried out in Malatya Training and Research Hospital’s Hemodialysis Unit between July 2018 and August 2022. Two hundred seventy-four elderly hemodialysis patients were included in the study. Demographic characteristics, laboratory parameters, and anthropometric measurements of the patients were reviewed. Statistical analyses were performed using the Statistical Package for the Social Sciences (SPSS) version 16.0 software (SPSS Inc., Chicago, IL, USA). Logistic regression analysis was performed to identify independent predictors of mortality.
Results: The mean age of 83 patients who died was 70.00 ± 8.39 years and 47 (56.6%) of these patients were male. All-cause death occurred in 69 (71.1%) of 97 patients with an MIS of ≥6. All‑cause death occurred in 24 (54.5%) of 44 patients with a GNRI score of <91.2. Accordingly, MIS (P < 0.001, OR = 1.376 [0.163–0.392]), GNRI (P = 0.001, OR = −0.431 [1.189–1.990]), and age (P = 0.021, OR = 0.109 [0.818–0.984]) were found to be independent predictors of all-cause mortality.
Conclusions: GNRI and MIS are important predictors of increased risk of mortality from all causes in elderly HD patients. 
Utilisation of village health workers’ services for tuberculosis screening in Lesotho
No full textBackground: Village health workers (VHWs) play an essential role because they extend the capacity of primary healthcare, particularly for developing countries. In Lesotho, VHWs are part of the primary healthcare connecting the community with clinics in their respective villages. They contribute to the prevention of the spread of tuberculosis (TB) within their catchment areas by encouraging communities to partake in TB screening. This study aimed at identifying factors associated with the utilisation of VHWs’ service to undertake TB screenings in Lesotho.
Methods: This study emanates from the main study that used a cross-sectional descriptive design. A total of 19 health service areas (HSAs) comprised 17 catchment areas and two clinics, each randomly selected from the District Health Management Team (DHMT) and the Lesotho Flying Doctors Service (LFDS), respectively. A total of 2928 individual household members aged 15 and above were included in the study. Data analysis included descriptive andinferential statistics.
Results: There were more female than male respondents, with a majority (77%) below 65 years of age. Tuberculosis knowledge of respondents was mostly on the TB symptoms and curability of TB, but they were less knowledgeable about the causes of TB. The use of VHWs’ services for TB screening was very low (23.3%).
Conclusion: The study revealed that while respondents were to some extent knowledgeable about TB, their utilisation of VHWs’ services for TB screening varied with education level, having worked in South Africa and the household size at α = 0.01. 
Health Care Delivery System in Uganda: a review
No full textThis paper provides insights into Uganda’s health care delivery system and highlights its strengths, weaknesses, opportunities, and threats. Uganda’s health care system consists of both public and private health care providers. Uganda has around 6,940 health facilities, of which 45% are government-owned, 15% are private not-for-profit, and 40% are private for profit. In 2019, the health worker population ratio was 1.87 per 1,000 population, which is still lower than the WHO ratio of 2.5 per 1,000 population. The total health expenditure was UGX 5,309 billion, equivalent to US 51 for the financial year 2015/16, which is still low compared to the WHO recommended minimum level of US$84.
The SWOT analysis shows that Uganda’s health delivery system boasts of having clear policies and plans, provision of free health care in public facilities and the existence of active international health agencies and Non-governmental organisations. However, the system is still fragmented with a very poor referral system, high out-of-pocket expenditure, low public spending, and inequitable distribution of health facilities across the country. Although considerable progress has been made in achieving health-related targets, several issues still require attention. There is need for a comprehensive redefinition of the health service delivery system, enhanced investment in health infrastructure with a focus on reducing inequalities; and establishment of a national health insurance scheme
Glycyrrhizinate attenuates exosome induced endothelial cell proliferation and permeability through p38 pathway
No full textPurpose: To investigate the mechanism of action involved in the treatment of severe burn injury with glycyrrhizinate (DG). Methods: Exosomes were purified from sera of patients with burn injury using an ultra-high-speed centrifuge, and verified by western blot. Cell proliferation and permeability were assessed using cell counting kit (CCK)-8, transepithelial-transendothelial electrical resistance (TEER), and Fluorescein Isothiocyanate (FITC) dextran assays, while immunoblotting was used for assay of the levels of p38, occluding, and zonula occludens 1 (ZO-1). Results: Serum-derived exosomes (serum-exo) significantly suppressed cell proliferation while causing hyperpermeability in HUVECs (p < 0.001). Furthermore, DG alleviated the hyperpermeability and inhibition of cell proliferation caused by serum-exo (p < 0.001). In addition, the upregulation of p-P38 induced by serum-exo decreased upon DG treatment. Interestingly, the effect of DG was blocked by anisomycin, a specific p38 activator, indicating that p38 signaling pathway may contribute to the function of DG. Conclusion: Glycyrrhizinate attenuates serum-exo-induced cell proliferation and permeability alteration via p38 signaling pathway, thereby making it a potential agent for the management of severe burn injury
Effects of routine drug therapy in combination with health exercise training on pain and joint function in patients with rheumatoid arthritis: A meta analysis
No full textPurpose: To logically review the effect of conventional drug therapy in combination with healthy exercise training on pain and joint function in patients with rheumatoid arthritis (RA). Methods: A search on case-control trials was conducted in PubMed, EMBASE, ScienceDirect, Cochrane Library, China National Knowledge Infrastructure (CNKI), China VIP database, Wanfang database and China Biomedical Literature Database (CBM) online database from January 2005 to May 2022. A separate extraction of the data was conducted by two researchers. A meta-analysis of the data was undertaken using RevMan5.3 statistical software as a tool for assessing the bias risk of each contained article. Results: A total of 7 clinical controlled studies with 483 samples were obtained. Based on the meta-analysis, the study group was significantly lower (p < 0.05) on the Visual Analogue Scale (VAS) score, Joint Tenderness Count (JTC), Joint Swelling Number (JSN), Morning Stiffness Time (MST) and DAS28 score. However, it was significantly higher (p < 0.05) on the average grip strength of both hands, Health Assessment Questionnaire (HAQ) and patients' general assessment (PGA). Conclusion: Routine drug therapy, in combination with healthy exercise training significantly reduces the degree of pain, relieves joint symptoms, and improves quality of life in patients with RA
Ethnobotanical Studies of Professor Afolayan Wildlife Park, Ondo State, Nigeria: A Rich Resource for medicinal plants against common ailments Ondo State, Nigeria
No full textEthnobotanical study of Professor Afolayan Wildlife Park was carried out to identify and document medicinal plants and their uses. Medicinal plants have been observed to be very effective in the treatment of ailments that defy orthodox medicine. In this study, common plants used were classified based on their families, parts used and the medicinal uses. Some of the plant families were briefly discussed and the plants local names provided. According to field survey, 40 plants were identified consisting of 20 families in the Park. The dominant families were Leguminosae (15.0%) and Sterculiaceae (12.5%) while the least dominant families include Caricaceae, Meliaceae, Loganiaceae, Poaceae and Verbenaceae. The medicinal uses of the plants varied, and the commonly used plant parts are leaves, bark, seeds, fruits and the whole plant which are used to treat ailments like malaria, stomach aches and diarrhoea. This study shows the high medicinal potentials of Professor Afolayan Wildlife Park, therefore the need for sustainable use and conservation of the Park