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Towards characterization of Female Genital Mutilation (FGM) in rural Nigeria
Get PDFBackground: Female genital mutilation (FGM) is a public health
challenge and seems to be secretly practiced in some rural communities,
despite the ban in Nigeria. Objectives: The study aimed to identify the
activities that are involved in FGM, type(s) of FGM practiced and the
knowledge of health implications of FGM among rural community members
in Ebonyi State, Nigeria. Methods: We employed exploratory design using
qualitative technique. In-depth interviews were conducted with 44 adult
(18 years and older) volunteers in four rural communities in Ebonyi
State, Nigeria. After thematic analysis using NVivo 11 Pro software,
eight sub-themes emerged, among which are: types of FGM practiced,
seasons for FGM, FGM by health workers and community leaders,
punishment for refusing FGM and knowledge of health implications of
FGM. Results: Findings show that FGM is more like a process than just
an act, and type most practiced in the study area is Type 1.
Circumcisers are health workers and women leaders. Knowledge of health
implications of FGM was found to be low among those interviewed.
Conclusion: Based on the findings, we concluded that FGM is still
practiced in some rural communities in Nigeria, maybe because of poor
knowledge of health implications of FGM
Comparison of breastfeeding self-efficacy and breastfeeding success of obese and normal-weight mothers in the early period
Get PDFBackground: Body mass index (BMI) of overweight and obese women is a
risk factor for breast milk secretion. Aim: This study was conducted in
a descriptive and comparative way in order to identify the relation
between the breastfeeding success and self-efficacy of obese and
non-obese mothers during postnatal period and to make a comparison
between the obese and non-obese group. Methods: The study sample
consisted of 113 obese and 111 non-obese mothers that met the study
criteria who were hospitalized at the postnatal service of Health
Education and Research Hospital in Ankara, September 2014-February
2015. Result: The mean BMI of obese women prior to the pregnancy was
31.41\ub12.4 while it was 22.25\ub12.8 for the non-obese women. As
the BSS scores increase among both the obese and non-obese mothers, the
LATCH breastfeeding success score averages increase as well (p<0.05,
r:0.613). Conclusion: In the light of the data of, to increase the
breastfeeding success among obese mothers, it is suggested that the
perception of self-efficacy is enhanced, and additional consultation is
provided on breastfeeding starting from the antenatal period. The
trainings given to mothers by the midwife and nurse are supported with
home visits especially in the obese women in the postnatal period in
order for them to breastfeeding
Association analysis of vitamin D receptor gene polymorphisms in North England population with Type 2 diabetes mellitus
Get PDFBackground: Numerous diabetes susceptibility loci, include a region
consisting vitamin D receptor gene found in chromosome 12q, have been
known using genome wide screens. Aim: The aim of present study is to
probe the relationship between polymorphism of vitamin D receptor gene
(single nucleotide polymorphisms) and type 2 diabetes mellitus (T2DM).
Five hundred T2DM patients and 200 healthy subjects with normal HbA1c(
64 5.0 %), fasting blood sugar ( 64 120 mg/dL) and random
blood sugar ( 64 140 mg/dL) were enrolled. Metholodgy: The
genotypes were found by polymerase chain reaction restriction fragment
length polymorphism and DNA sequencing. Results: revealed that no
considerable differences in frequencies of genotype and allele of the
Bsm I and Fok I polymorphisms between healthy and patients in the North
England (For Fok I: OR = 1.11, 95% CI: 0.72\u20131.12; for Bsm I: OR =
1.35, 95% CI: 0.79\u20131.98). Conclusion: It is recommended that both
following polymorphisms of vitamin D receptor gene may not considerably
add to the progression of T2DM in the North England
Uric acid lowering improves insulin sensitivity and lowers blood pressure: a meta-analysis of randomized parallel-controlled clinical trials
Get PDFObjectives: This meta-analysis aimed to investigate whether uric acid
lowering treatment can improve \u3b2-cell function and insulin
sensitivity. Methods: PubMed, Cochrane Library, EMBASE and China
Biology Medicine were searched up to March 1, 2020. Randomized
controlled clinical trials of urate lowering therapy in hyperuricemia
patients were included in meta-analysis. Effect size was estimated as
mean difference with 95% confidence interval (CI). Results: Our search
yielded 7 eligible trials with 503 participants. This meta-analysis
showed that uric acid-lowering therapy decreased fasting insulin -1.43
\u3bcIU/ml (weighted mean differences (WMD, 95% CI -2.78 to -0.09),
homeostasis model assessment of insulin resistance -0.65 (WMD, 95% CI
-1.05 to -0.24), systolic blood pressure -2.45 mm Hg (WMD, 95%CI -4.57
to -0.33) and diastolic blood pressure -3.41 mm Hg (WMD, 95%CI -3.87 to
-2.95). However, the treatment had no significant effect on fasting
plasma glucose (WMD -0.19 mmol/L, 95%CI -0.42 to 0.05), homeostasis
model assessment of \u3b2-cell function index (WMD -0.02, 95%CI -0.28
to 0.24), total cholesterol (WMD 0.18 mg/dl; 95%CI, -1.39 to 1.75) and
triglyceride (WMD 3.15 mg/dl, 95% CI -9.83 to 16.14). Conclusion: Uric
acid-lowering therapies might improve insulin sensitivity and lower
blood pressure, but had no significant effect on HOMA-\u3b2 and serum
lipids
Risk factors for hazardous drinking in university students from South Africa and Belgium: a cross-cultural comparison study
Get PDFBackground: Previous studies have associated certain risk factors with
hazardous drinking in students. However, big cultural and geographical
differences exist regarding alcohol use. Objectives: To determine
whether or not there was a difference in hazardous drinking between
Belgian and South African university students and to establish the risk
factors that contribute to hazardous drinking in university students
(calculated using the AUDIT-C) from a developing country (South Africa)
and a developed country (Belgium). Methods: An online survey assessing
hazardous drinking among university students in South Africa
(University of KwaZulu-Natal, UKZN) and Belgium (University of Antwerp,
UoA) was conducted, using the shortened version of the Alcohol Use
Disorder Identification Test (AUDIT-C). Risk factors in males and
females for hazardous drinking were explored using multivariate
logistic regression analysis. Results: In total, 499 students were
included in the study (250 UoA and 249 UKZN students). A significant
higher amount of male (94.8%) as well as female (92.4%) UoA students
drank alcohol in the last year compared to the male (66.2%) and female
(67.8%) UKZN students (p<0.001). Additionally, a significant higher
amount of UoA students were hazardous drinkers, compared to the UKZN
students (p<0.001). Multivaiate analysis showed that male UoA
students were almost 6 times more likely to be hazardous drinkers than
male UKZN students (OR=5.611, p=0.005). Female UoA students were more
than twice as likely to be hazardous drinkers than female UKZN students
(OR=2.371, p=0.016). Conclusion: This study found a significant
difference in hazardous drinking between Belgian and South African
university students
Isolated acute pseudobulbar palsy with infarction of artery of percheron: case report and literature review
Get PDFIntroduction: Pseudobulbar palsy (PBP) is characterized by supranuclear
lesions in the corticobulbar pathway. Neoplasia, inflammatory,
demyelinating, and stroke are possible etiologies of this disorder.
Case report: We report an elderly female who presented with dysarthria.
She was dysarthric with a hypernasal voice, no apraxia or aphasia was
observed. Tongue movements were slow with limited amplitude. Her soft
palate dropped bilaterally; gag reflex was present. Also, she reported
swallowing difficulty and choking with her saliva. Bilateral vertical
and horizontal gaze were intact to either voluntary or oculocephalic
movements. A cranial CT scan was suggestive of artery of Percheron
(AOP) infarction. Brain magnetic resonance imaging showed hypersignal
on diffusion-weighted and T2-weighted images and hyposignal on apparent
diffusion coefficient in both thalami. CT angiography scan revealed an
AOP originating from the left posterior cerebral artery. The swallowing
study with a videofluoroscopic demonstrated oral and pharyngeal phases
with severe dysfunction. Conclusion: To the authors\u2019 knowledge,
there are two cases of individuals with artery of Percheron infarction
who developed PBP associated with other clinical syndromes. Still,
isolated PBP following infarction of Percheron\u2019s artery was not
reported. We hypothesized that the PBP may have occurred because of the
existence of vascular territory variations in the perforating arteries
that arise from the AOP
Phenotypic and genotypic detection of extended spectrum \u3b2-lactamases among Escherichia coli and Klebsiella pneumoniae isolates from type 2 diabetic patients with urinary tract infections
Get PDFBackground: T2DM patients are more likely to have UTIs caused by
resistant organisms such as ESBLs producing bacteria. Challenging
reliable identification and prompt characterization of in-vitro
susceptibilities of these bacteria are the first steps of deciding the
appropriate antimicrobial therapy for UTIs caused by them. Objectives:
To isolate and identify E. coli and K. pneumoniae from urine of T2DM
patients with UTIs, to determine antibiotic resistance pattern among
isolates, and to identify ESBLs production phenotypically and
genotypically. Material and method: All samples were cultured on
Cystine-Lactose-Electrolyte-Deficient Agar medium (CLED) by using
calibrated loop. Growth of 100 colonies or more, i.e. 105 colony
forming units (CFU)/mL urine was considered as significant bacteriuria.
Isolation and identification were done according to standard method.
All isolates were tested for antibiotic susceptibility testing by the
disc diffusion method according to CLSI guidelines. Phenotypic
detection of ESBLs was done by double-disk synergy test. Genotypic
detection of blaTEM, blaSHV and blaCTX-M genes by using PCR. Results:
Results of this study showed that E. coli and K. pneumoniae were the
dominant bacterial isolates, they constituted 103 (91.2%) out of 113
urine isolates. E. coli (58. 4%) K. pneumoniae (32.7%), Enterococcus
spp. (4.4%), Proteus spp. (2.7%) and Pseudomonas spp. (1.8%). About 25
(24.3%) out of 103 E. coli and K. pneumoniae isolates were ESBLs
positive by DDST, and 22 (88.0%) out of them had ESBLs encoding genes
by conventional PCR. The most common gene detected was blaTEM (59.1%),
followed by blaSHV (27.3%). CTX-M had not been detected in any of
testes isolates. Conclusion: blaTEM and blaSHV genes were detected in
22 out of 25 ESBLs producing E. coli and K. pneumoniae isolates
phenotypically detected by DDST. blaTEM was found to be the predominant
gene (59.1%), while blaCTX-Mene was not detected in any of tested
isolates
Brucellosis and its associated risk factors to humans and domestic ruminants in Kagera Ecosystem, Tanzania
Get PDFBackground: Brucellosis is an important disease for both veterinary and
public health. A study was conducted to understand the seroprevalence
of brucellosis and its associated risk factors in pastoral areas of
Kagera, Tanzania. Methods: Sera from 156 patients with malaria-like
symptoms were analyzed using the commercial rapid agglutination test
(specific for B.abortus and B.melitensis detection) and Fluorescence
Polarization Assay (FPA). Sera from 426 cattle, 206 goats and 197 sheep
were analyzed using Rose Bengal Plate (RBPT) and Competitive ELISA
(c-ELISA) tests. Results: In humans, overall brucellosis, B. abortus,
and B. melitensis sero-prevalences were 7.7% (95%CI: 3.8-12.2%), 1.9%
(95% CI: 0.4-4.5%), and 5.8 % (95%CI: 2.6-10.6%), respectively. At
animal level, seropositivity was 5.9% (95%CI: 4.0-8.6%), 2.5% (95%CI:
0.8-5.7%) and 0.5% (95%CI: 0.01-2.8%) in cattle, goats and sheep,
respectively. At herd level, seropositivity was 18.2% (95%CI:
12.0-25.8%) in cattle and 6.9% (95%CI: 2.2-15.3%) in small ruminants.
Brucellosis was associated with assisting in parturition without
wearing protective gears (OR= 5.6; p= 0.02) in humans, herds of 50-200
animals (OR= 4.2, p= 0.01) and cattle (OR=3.5; p=0.01). The knowledge
of brucellosis among pastoralists (OR=0.1; p<0.01) was a protective
factor. Conclusion: Brucella infections could be occurring in
pastoralists and domestic ruminants in Kagera. Community health
education is necessary for the control of brucellosis in Tanzania
Community pharmacists\u2019 management of self-limiting infections: a simulation study in Akwa Ibom State, South-South Nigeria
Get PDFBackground: Inappropriate use of antibiotics, especially for treatment
of self-limiting infections remains one of the major drivers of
antibiotic resistance (ABR). Community pharmacists can contribute to
reducing ABR by ensuring antibiotics are dispensed only when necessary.
Objective: To assess community pharmacists\u2019 management of
self-limiting infections. Methods: A purposive sample of 75 pharmacies
participated in the study. Each pharmacy was visited by an investigator
and a trained simulated patient who mimicked symptoms of common cold
and acute diarrhoea, respectively. Interactions between the simulated
patient and pharmacist were recorded by the investigator in a data
collection form after each visit. Descriptive statistical analysis was
carried out. Ethics approval was obtained from the state Ministry of
Health Research Ethics Committee. Results: For common cold, 68% (51/75)
of pharmacists recommended an antibiotic. Azithromycin,
amoxicillin/clavulanic acid, and sulphamethoxazole/trimethoprim (43%,
24%, 20%, respectively) were the most frequently dispensed agents. For
acute diarrhoea, 72% (54/75) of pharmacists dispensed one antibiotic,
while 15% dispensed more than one antibiotic. The most frequently
dispensed agent was metronidazole (82%), which was dispensed in
addition to amoxicillin or tetracycline among pharmacists who dispensed
more than one agent. In both infection scenarios, advice on dispensed
antibiotics was ofered in 73% and 87% of the interactions,
respectively. Conclusion: This study shows high rate of inappropriate
antibiotics dispensing among community pharmacists. There is need for
improved awareness of antibiotic resistance through continuing
education and training of community pharmacists. Furthermore, the
inclusion of antibiotic resistance and stewardship in undergraduate
pharmacy curriculum is needed
Detection of hepatitis C virus among HIV patients in Port Harcourt, Rivers State
Get PDFBackground: Hepatitis C virus (HCV) a major human pathogen infecting
millions of individuals worldwide, thereby increasing the risks for
chronic liver diseases and has been discovered that HIV/HCV co-infected
patients have a greater risk. Objective: To determine the prevalence of
HCV infection among HIV infected people in Port Harcourt, Rivers State.
Methodology: The patients were from the ages of 18 and above attending
the antiretroviral clinic for over 6 months. The mean age of the
participants was 36.91\ub18.38. Data were gotten from the 550
patients using a modified questionnaire and 5mls of blood samples were
collected through venepuncture into EDTA bottles and spun at 3000rpm
for 10 minutes separating the plasma from the whole blood. The CD4+
count was gotten from the patients\u2019 file and the samples kept at
-700C till analized. HCV antibody was detected using a commercially
available third generation kit manufactured by Melsin Medical Co and
statistical analysis was done using a Stata version 16. P value was
determined using ANOVA Result: Total number positive to the HCV
antibody was 24(4.4%) of which 8(33.3%) were males, while 16(66.7%)
were females. Prevalence (29.2%) was among patients in the 31\u201335
age range. The CD4+ count ranged from 22-864 cells/\u3bcl with a mean
value of 303.08\ub1194. Conclusion: From this study HIV/HCV
co-infection occurs among HIV infected people in Port Harcourt. The
CD4+ count was discovered to be low and was not age, nor gender
dependent. HIV infected people should therefore be routinely screened
for HCV