Student's Journal of Health Research Africa
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Isolation and identification of pathogenic bacteria present in wastewater effluents discharged into Lake Victoria at Mukuuba landing site, Wakiso district, Uganda. A cross-sectional study.
Get PDFBackground
Wastewater effluents discharged into Lake Victoria often contain pathogenic bacteria that threaten aquatic ecosystems and public health. This study aimed to isolate and identify the pathogenic bacteria present in wastewater effluents discharged into Lake Victoria at Mukuuba Landing Site, Wakiso District, Uganda.
Methodology
The study employed a descriptive, cross-sectional, laboratory-based design and quantitative methods. A total of 30 wastewater effluent samples, purposively selected, were described using standardized microbiological techniques. Microsoft Excel 2016 was used to analyze data.
Results
Citrobacter freundii was the most frequently isolated organism (75%), followed by Enterococcus faecalis (64.29%). Staphylococcus aureus and Escherichia coli accounted for 17.86%, while Klebsiella pneumoniae (10.71%) and Proteus mirabilis (7.14%) were the least amount isolated. 70% of isolates were Gram-negative rods consistent with enterics from fecal contaminant (pink bacilli in histological image). The remaining 30% were Gram-positive cocci (purple clusters or chains), suggestive of Staphylococcus and Enterococcus species, respectively.
Conclusion
Contamination of effluent water has the potential for serious public health risks, and there is a significant risk contribution from these bacteria in wastewater effluents.
Recommendation
There should be an ideal surveillance of environmental health programs at a national level, by the Ministry of Health, to put in place the appropriate action for public health in risk zones
Assessment of medication adherence among type 2 diabetes mellitus patients: A cross-sectional study.
Get PDFBackground
Medication adherence is a critical component in the management of type 2 diabetes mellitus (T2DM), directly influencing glycemic control and the risk of complications. However, adherence remains suboptimal in many settings, particularly in low- and middle-income countries, such as India.
Objective
To assess the level of medication adherence among T2DM patients attending a tertiary care hospital in South Odisha and identify key socio-demographic and clinical factors associated with adherence.
Methods
A cross-sectional observational study was conducted from August to October 2023 at MKCG Medical College and Hospital, Berhampur, involving 81 adult patients with type 2 diabetes mellitus (T2DM) who had been on pharmacotherapy for at least six months. Data were collected using a structured case record form and the Morisky Medication Adherence Scale (MMAS-8). Patients scoring ≥6 on MMAS-8 were categorized as adherent, and those scoring <6 as non-adherent. Associations between adherence and various factors were analyzed using chi-square tests and odds ratios.
Results
Among 81 patients, 57 were male (70.4%) and 24 were female (29.6%), with a mean age of 51.07 ± 11.08 years. Overall, 29.6% were adherent while 70.4% were non-adherent. Significant associations with adherence were observed for younger age <60 years (OR 5.09; 95% CI 1.32–19.6; p=0.008), literacy (OR 3.35; 95% CI 1.19–9.42; p=0.02), working lifestyle (OR 3.67; 95% CI 1.21–11.12; p=0.02), regular exercise (OR 2.97; 95% CI 1.02–8.63; p=0.04), and simpler therapy (≤2 drugs) (OR 6.69; 95% CI 1.66–26.9; p=0.002). Gender and treatment duration showed no significant association.
Conclusion
Medication adherence among T2DM patients in this setting was alarmingly low. Key determinants included age, education, lifestyle, physical activity, and complexity of therapy.
Recommendation
Interventions focusing on health literacy, lifestyle counseling, and simplified pharmacotherapy are urgently needed to improve adherence and outcomes in diabetes care
Comparative efficacy of oral fexofenadine hydrochloride and intranasal fluticasone furoate in patients with moderate to severe allergic rhinitis: A prospective randomized comparative study.
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Allergic rhinitis (AR) is a prevalent chronic condition with a significant impact on quality of life. Pharmacotherapy with non-sedating antihistamines and intranasal corticosteroids remains the mainstay, though comparative evidence in Indian settings is limited. This study aimed to evaluate and compare the clinical efficacy of oral fexofenadine hydrochloride and intranasal fluticasone furoate in patients with moderate to severe AR.
Methods
A prospective comparative study was conducted on 100 patients aged 16–55 years presenting with moderate to severe AR at a tertiary care centre. Participants were randomized into two equal groups: oral fexofenadine 120 mg once daily (Group OF) and intranasal fluticasone furoate spray, one puff daily (Group NF). Baseline demographic characteristics, symptom scores, and visual analogue scale (VAS) ratings were recorded. Patients were followed up weekly for four weeks.
Results
Baseline demographic and clinical characteristics were comparable between groups (Table 1). Both groups demonstrated significant reduction in total symptom scores after 4 weeks (p < 0.001), with mean post-treatment scores of 1.16 ± 3.36 in Group OF and 1.90 ± 3.85 in Group NF (Table 2). Severity distribution showed that most patients shifted from severe to moderate categories without intergroup difference (Table 3). However, fluticasone produced greater improvement in nasal obstruction, sneezing, and nasal discharge compared with fexofenadine (Table 4). VAS scores confirmed the superior efficacy of intranasal fluticasone in reducing overall symptom burden (Table 5).
Conclusion
Both oral fexofenadine and intranasal fluticasone furoate are effective in alleviating symptoms of moderate to severe AR. Fluticasone demonstrated superior improvement in nasal symptoms and VAS reduction, suggesting it may be preferred as first-line therapy.
Recommendations
For patients with prominent nasal obstruction or persistent AR, intranasal corticosteroids should be prioritized. Antihistamines may be considered when systemic symptoms or patient preference for oral therapy exist
Estimation of lipid profile in patients with pulmonary tuberculosis: A cross-sectional observational study.
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A significant worldwide health concern is pulmonary tuberculosis (TB) with well-documented effects on host metabolism. Lipid disturbances, particularly hypocholesterolemia and reduced HDL cholesterol, are common in TB and may reflect both nutritional status and disease severity. Understanding these changes can aid in clinical management and nutritional intervention.
Methods
In this resaecrh study was carried on 101 confirmed pulmonary TB patients. Data on demographics, BMI, lifestyle habits, and radiological severity were recorded. Various lipid parameters were measured. Statistical analysis included t-tests, ANOVA, and Pearson correlation, with significance level at p<0.05.
Results
The mean age was 51.73 years, with 64.4% male participants. Most patients had a normal BMI, but 16.8% were underweight. Mean lipid values were: total cholesterol 156.68 mg/dL, triglycerides 137.24 mg/dL, HDL cholesterol 34.54 mg/dL, LDL cholesterol 99.38 mg/dL, and VLDL cholesterol 12.53 mg/dL. BMI correlated positively with total cholesterol and LDL cholesterol, whereas disease severity correlated negatively with HDL cholesterol. Smoking showed no significant impact on cholesterol levels.
Conclusion
Pulmonary tuberculosis is associated with marked lipid abnormalities, particularly hypocholesterolemia and low HDL cholesterol, more pronounced in underweight individuals and those with severe disease. Lipid monitoring may serve as an adjunctive marker for disease assessment and prognosis.
Recommendation
Routine lipid profile testing should be considered in TB patients, with timely nutritional support aimed at correcting hypolipidemia to enhance recovery and treatment outcomes
Study of cytological findings of lymphocytic thyroiditis and its correlation with anti-thyroid peroxidase (anti-TPO) antibody levels and thyroid-stimulating hormone (TSH) levels: A retrospective observational study.
Get PDFIntroduction: Lymphocytic thyroiditis is an autoimmune thyroid disorder marked by diffuse lymphocytic infiltration of the thyroid gland. It is the second most common thyroid pathology encountered on fine-needle aspiration cytology (FNAC), predominantly affecting women. The disorder presents with variable thyroid functional states, including hypothyroidism, euthyroidism, and hyperthyroidism.
Objective: To evaluate the cytological spectrum of lymphocytic thyroiditis and to correlate cytological grades with serum Anti-thyroid peroxidase (anti-TPO) antibody titers and thyroid-stimulating hormone (TSH) levels.
Materials and methods: A retrospective study was carried out over 30 months (2021–2023), including 44 FNAC-confirmed cases of lymphocytic thyroiditis. Cytological grading was performed using the system proposed by Bhatia et al., and correlation with Anti-TPO antibody levels and TSH values was assessed. Both parameters were measured using ADVIA Centaur XP immunoassay analyser employing chemiluminescent technology. Data were analysed with SPSS software, and statistical significance was set at p < 0.05.
Results: Of the 44 cases, 39 were females (88.63%), with the 21–30 years age group being most commonly affected (29.5 %). Cytological grading revealed Grade I in 18 cases (40.9%), Grade II in 17 cases (38.63%), and Grade III in 9 cases (20.45%). Elevated Anti-TPO antibody levels were observed in 11 cases overall, with the highest frequency in Grade III (88.88%). Raised TSH levels were detected in 13 patients, more frequently in Grade II (58.82%). Correlation between cytological grades and biochemical markers was statistically significant (p < 0.05).
Conclusion: Cytological grading in conjunction with biochemical evaluation provides a comprehensive assessment of lymphocytic thyroiditis, facilitating early diagnosis and appropriate management.
Recommendations: Routine integration of FNAC grading with Anti-TPO and TSH estimation is recommended for timely diagnosis, monitoring, and individualized patient management
A prospective observational study on postoperative complications following urological, general surgical, and gynecological procedures in pelvic surgeries.
Get PDFBackground:Pelvic surgeries involving urological, general surgical, and gynecological procedures are highly complex and associated with considerable postoperative morbidity. To evaluate the incidence, spectrum, and predictors of postoperative complications in patients undergoing pelvic surgeries involving urological, general surgical, and gynecological procedures.
Methods:
This prospective observational study included 100 consecutive patients. Surgical interventions comprised urological procedures (bladder repair, ureteric reimplantation, vesicovaginal fistula repair), general surgical operations (sigmoid volvulus, sigmoid perforation, acute intestinal obstruction, obstructed femoral hernia, pelvic trauma), and gynecological procedures (hysterectomy, ovarian torsion, ectopic pregnancy). Postoperative complications within 30 days were classified using the Clavien–Dindo system, and predictors were analyzed using multivariable logistic regression.
Results:
The median age was 56 years (IQR: 46–65), with 62% males and 41% ASA class ≥III. Colorectal resection with urological reconstruction was most frequent (54%), followed by cystectomy with diversion (18%), complex fistula repairs (16%), pelvic exenterations (12%), and gynecological surgeries (10%). Open surgery was performed in 58% of cases, while 42% underwent minimally invasive approaches. The median operative time was 310 minutes (IQR: 250–380), with blood loss ≥500 mL in 35%. Overall, 38% developed complications, and 14% had major events (Clavien–Dindo III–V). The most common complications were surgical-site infection (16%), postoperative ileus (14%), and urinary leak (9%). Independent predictors included operative time ≥240 minutes (OR 2.62), blood loss ≥500 mL (OR 3.06), and ASA class ≥III (OR 2.28).
Conclusions:
Pelvic surgeries involving multidisciplinary teams carry a high incidence of postoperative morbidity. Surgical-site infection, ileus, and urinary leak were the most frequent complications, and prolonged operative time, higher blood loss, and greater ASA class were significant predictors.
Recommendations:
Preoperative optimization of high-risk patients, multidisciplinary planning, meticulous hemostasis, preference for minimally invasive approaches, and integration of enhanced recovery after surgery protocols are essential to reduce complications and improve outcomes
Microbial Profiles and Antimicrobial Susceptibility Patterns in Diabetic Patients Attending at a Hospital in Durban
Get PDFIntroductionDiabetes Mellitus is a group of metabolic disorders characterized by hyperglycaemia in the absence of treatment. Defects in insulin secretion, insulin action, or both accompany the heterogeneous etiopathology. The association between diabetes mellitus and various bacterial infections is proportionally increasing and further adds to morbidity linked to diabetes mellitus. The interplay between hyperglycaemia and impaired immune response makes diabetic patients more susceptible to a range of infections. This study examined the microbial profiles and antimicrobial susceptibility patterns observed in diabetic patients attending a public hospital in Durban, KwaZulu-Natal, South Africa.
Methodology:A retrospective, cross-sectional study was conducted using laboratory records of 150 diabetic patients at a public hospital in Durban, KwaZulu-Natal, South Africa. Diabetic patients were identified using HbA1C results exceeding 7%. Results from microbiological analyses and antimicrobial susceptibility testing were used for the study to determine the type and frequencies of isolated microorganisms and their antimicrobial susceptibility patterns.
Results:Escherichia coli was the most frequently isolated microorganism (27.3), followed by Staphylococcus spp (23.3%), Klebsiella pneumoniae (19%), and Enterobacter faecalis (11%). Antimicrobial patterns varied among the isolates, emphasizing the importance of effective and targeted therapeutic approaches, which ultimately enhance clinical outcomes and reduce infections associated with diabetes mellitus.
ConclusionThis study provides insight into the microbial profiles commonly found in diabetic patients and highlights their antimicrobial susceptibility patterns. Early detection of these bacterial infections is of critical importance to enable timeous treatment and avoid further infection-associated complications in diabetic patients
Role of anti-DFS70 antibodies in ruling out connective tissue disorders in Antinuclear Antibody (ANA) positive patients: A Cross-Sectional Study.
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Proteins are the target of Antinuclear Antibodies (ANAs), and the cell nucleus is where most nucleic acid antigens are found. The initial step in laboratory diagnosis for AARD is ANA detection. It is still difficult to comprehend the processes that underlie the production of ANAs in AARD and other chronic diseases of inflammatory.
Objectives
The purpose of conducting this study was to ascertain if isolated anti-DFS70 antibody positivity may be utilized to accurately rule out connective tissue disorders and to assess the value of diagnostics of anti-DFS70 antibodies in those individuals who are ANA-positive.
Materials and Methods
It was a cross-sectional, observational study. The study was carried out in the All-India Institute of Medical Sciences (AIIMS), Patna, Bihar, India. The study was conducted for 13 months. A total of 111 patients were enrolled.
Results
The average age of participants in the group of CTD was 40.1 ± 11.5 years, and CTD group age of participants 37.6 ± 12.6 years. Among all, 82 (73.9%) participants were female, and 29 (26.1%) participants were male. Isolated anti-DFS70 was seen in 16 patients, among them no participant had CTD, and all were non-CTD participants 16 (100%). Anti-DFS70 positive disease specific ENA was observed in 02 participants, and all the patients had CTD.
Conclusion
This study has revealed that isolated anti-DFS70 antibody positivity is quite specific for ruling out connective tissue disorders.
Recommendation
Routine testing for anti-DFS70 antibodies should be included in the diagnostic workup of ANA-positive patients to help effectively distinguish non-CTD cases and prevent unnecessary investigations
Materiovigilance in surgical care: A cross-sectional KAP study among surgeons.
Get PDFBackground:
Surgical devices and instruments play a vital role in patient safety and clinical outcomes. Materiovigilance, the systematic monitoring of adverse events and risks associated with medical devices, is essential in ensuring safer surgical practice.
Objective:
To assess the knowledge, attitudes, and practices (KAP) of surgeons regarding materiovigilance in surgical care.
Methods:
A cross-sectional, questionnaire-based study was conducted among practicing surgeons from various specialties in Navi Mumbai. The survey explored knowledge of materiovigilance, reporting practices, barriers to reporting, and attitudes towards medical device safety.
Results:
A total of 149 surgeons participated. About 67.8% correctly identified India’s Materiovigilance Programme (MvPI), and 75.2% were aware that all healthcare professionals can report device-related adverse events. While 69.1% acknowledged that surgical devices may cause adverse events, 85.2% felt reporting was a surgeon’s responsibility, and 80.5% supported making it mandatory. Nearly half (48.3%) had encountered a device-related adverse event, but only 25.5% reported it. Notably, 80.5% had never received formal training on adverse event reporting.
Conclusion:
Awareness regarding materiovigilance among surgeons was suboptimal. Strengthening training, creating user-friendly reporting platforms, and integrating materiovigilance into surgical practice are crucial for improving patient safety.
Recommendation:
Regular training programs on materiovigilance, simplified and accessible reporting systems, and mandatory integration of device safety reporting into routine surgical practice are recommended to enhance reporting compliance and patient safety
Paperless partogram as a bedside tool for the prevention of prolonged labour: A prospective observational study.
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Prolonged and obstructed labor, occurring in roughly 5% of deliveries, is a major cause of maternal and perinatal complications. Continuous monitoring of labor, timely recognition of deviations, and appropriate intervention are vital in reducing adverse outcomes. A more straightforward way to monitor the course of labor, the paperless partogram aids physicians in deciding the appropriate time for intervention and indicating when referral to higher centers with cesarean facilities is necessary. This study evaluated its effectiveness in preventing prolonged labor.
Materials and Methods:
A prospective study was carried out among 318 primigravida women with uncomplicated singleton pregnancies in cephalic presentation who presented in spontaneous active labor at the Department of Obstetrics and Gynecology, VSS Institute of Medical Science and Research, Burla. Alert ETD (anticipated time of delivery) and Action ETD parameters were used to track labor.
Results:
The mean age of participants was 24.6 ± 3.2 years. Most belonged to rural areas (68%) and the lower socioeconomic class (61%). Twenty-two percent of women crossed the Alert ETD, while only 1% exceeded the Action ETD. The mean duration of the active phase of labor was 4.9 hours. The incidence of prolonged labor was 8%, with 7 forceps and 20 cesarean deliveries.
Conclusion:
The paperless partogram was found to be a simple, reliable, and effective tool for managing labor. Its use minimized the occurrence of prolonged labor and contributed to a reduction in maternal and neonatal complications as well as cesarean section rates.
Recommendation:
It should be incorporated into routine obstetric care, especially in low-resource settings