bluuebunny/crossref_metadata_2025 huggingface dataset:
Oral health delivery in refugee camps in East Region of Cameroon
Authors: Michael Agbor , Bruno Kaptue , Tetu Acha-teku , Tambo Ernest , Mark Keboa , Sudeshni Naidoo
Published: October 2023

Background: Oral health care affects the quality of life and plays an essential role in the general health of vulnerable populations especially refugees. The purpose of the study was to evaluate the quality of oral health care delivery in the Gado-Badzeré refugee camp in the Eastern region of Cameroon.

Methods: We carried out a cross-sectional study between January and July 2020 using a structured questionnaire in French and translated orally to Fulfulde language.

Results: A total of 716 refugees from the Central African Republic with ages ranging from 6 to 81 years (29.3years ± 14.6 s.d), made up of 61.2% females, 378(52.8%) unemployed, 342(47.8%) married, 701(97.9%) Muslims, and 511(71.4 %) had no formal education participated. Oral health knowledge was significantly poor, 305 (42.6%) that consulted the health post for their oral health needs were not satisfied, 640(89.50%) had experienced toothache, 592(83.0%) needed restorative treatment, 709(99.0%) periodontal treatment and 215(30.0%) urgent needs like tooth extraction. There were no oral health facilities, no oral health personnel, no oral health outreach had ever been carried out in the camp, and oral pathologies were managed by nurses with medications.

Conclusion: The quality of oral health care delivery in this camp was very poor. There is an absence of oral health workforce and basic primary oral health care facilities. Oral health knowledge was very poor and the treatment needs the refugees was very high.

Keywords: Oral health care; periodontal diseases; refugees; refugee camps; Cameroon.
Socio-demographic and behavioural determinants of HIV prevalence among homosexual and bisexual men having sex with men (MSM) in India: Integrated bio-behavioural surveillance
Authors: Santhakumar Aridoss , K David Joseph , Nagaraj Jaganathasamy , Mathiyazhakan Malathi , Ganesh Balasubramanian , Manikandan Natesan , Padmapriya VM , Kumar Pradeep , Rajan Shobini , Elangovan Arumugam
Published: October 2023

Background: HIV prevalence among men who have sex with men (MSM) is 16.5 times higher than adult HIV prevalence. With a socio cultural context that demands marriage, a considerable proportion of MSM in India have female sexual partners and act as a bridge population. Stratified analysis of HIV risk factors among homosexual and bisexual MSM will be instrumental in identifying the high-risk MSM. We aim to identify the socio-demographic and behavioural factors associated with HIV risk among homosexual and bisexual MSM.

Methods: Overall, 23081 MSM were enrolled in the IBBS conducted across India between October 2014 and November 2015. Data and blood samples were collected. Chi-square test, univariate and multivariable logistic regression methods were used in data analysis.

Results: HIV prevalence was significantly higher among homosexual MSM than bisexual MSM. Older age, lesser education, being a sex worker, being married, living with a male or hijra partner, younger age at initiation of MSM behaviour, duration, injecting drugs, and having STI symptoms were associated with higher prevalence. The prevalence of new homosexual MSM was 11.4%. Nearly 75% of the bisexual MSM reported inconsistent condom usage with female partners.

Conclusion: Interventions for early identification of new MSM and advocacy for safe sex with alternative preventive techniques are recommended.

Keywords: HIV; Men who have sex with men; homosexual; bisexual; India.
Using artificial intelligence on dermatology conditions in Uganda: a case for diversity in training data sets for machine learning
Authors: Kamulegeya Louis , Bwanika John , Okello Mark , Rusoke Davis , Nassiwa Faith , Lubega William , Musinguzi Davis , Börve Alexander
Published: October 2023

Background: In pursuit of applying universal non-biased Artificial Intelligence (AI) in healthcare, it is essential that data from different geographies are represented.

Objective: To assess the diagnostic performance of an AI-powered dermatological algorithm called Skin Image Search on Fitzpatrick6 skin type (dark skin) dermatological conditions.

Methods: 123 dermatological images selected from a total of 173 images were retrospectively extracted from the electronic database of a Ugandan telehealth company, The Medical Concierge Group (TMCG) after getting their consent. Details of age, gender, and dermatological clinical diagnosis were analysed using R on R studio software to assess the diagnostic accuracy of the AI app along with disease diagnosis and body part. Predictability levels of the AI app were graded on a scale of 0 to 5, where 0- no prediction was made and 1-5 demonstrated a reduction incorrect diagnosis prediction rate of the AI.

Results: 76 (62%) of the dermatological images were from females and 47 (38%) from males. Overall diagnostic accuracy of the AI app on black dermatological conditions was low at 17% (21 out of 123 predictable images) compared to 69.9% performance on Caucasian skin type as reported from the training results. There were varying predictability levels correctness i.e., 1-8.9%, 2-2.4%, 3-2.4%, 4-1.6%, 5-1.6% with performance along individual diagnosis highest with dermatitis (80%).

Conclusion: There is need for diversity of image datasets used to train dermatology algorithms for AI applications to increase accuracy across skin types and geographies.

Keywords: Artificial intelligence; Dermatology; Fitzpatrick 6 skin type; Telehealth; Algorithms.
Aflatoxin exposure in a population of HIV patients at risk of hepatocellular carcinoma North-Central, Nigeria
Authors: Davwar Pantong , David Paul , Imoh Lucius , Duguru Mary , Zawaya Kefas , Tsok Yop , Sagay Atiene , Okeke Edith
Published: October 2023

Background: Aflatoxin B1causes damage to the DNA by the alkylation of bases and P53 mutation. Exposure to this mycotoxin is associated with the development of liver cancer. Measures to reduce grain and cereal contamination have been a focus however, the effects of these measures are still lagging behind and exposure continues to occur even in populations at risk of developing liver cancer.

Objective: To quantify aflatoxin B1 exposure in a population of HIV infected patients with and without HCC.

Method: This was a cross-sectional study among 196 patients with HIV and or HCC. We evaluated the exposure to aflatoxin B1 using the Aflatoxin M1 metabolite by ELISA on urine samples.

Results: A total of 196 participants consisting of 163 (83.2%) HIV positive and 28 (14.3%) HCC. Mean age is 46.64±10.8 years. The median aflatoxin (IQR) aflatoxin M1level is 177.3(112.5-272) pg/ml. Only 8(4.1%) of the participant had no exposure to aflatoxin B1. The median (IQR) aflatoxin for fibrosis score ≥ 13kpa (178.7(112.9-286.8) pg/ml) VS < 13kpa (173.5(107.9-250.4)), p = 0.046.

Conclusion: There is high prevalence of aflatoxin B1 exposure in this population. Concerted efforts must be put in place to mitigate exposure because of the potential effects of short- and long-term exposure to aflatoxin.

Keywords: Liver Cell Carcinoma; Aflatoxin B1; HIV.
Editor’s choice: Sexual reproductive health, child issues, NCDs, surgery, infections and health systems - a salad of sorts
Authors: K Tumwine James
Published: October 2023

NIL
Abdominal obesity, serum estradiol and cardiovascular risk among Nigerian postmenopausal women: a cross-sectional study
Authors: T Lewechi-Uke Omolara , O Ajayi Ikeoluwapo , O Akinyemi Joshua
Published: October 2023

Background: Rates of cardiovascular (CV) disease mortality is usually higher in men but this equalizes with that of women following menopause.

Objectives: This was to determine the contribution of abdominal obesity and estradiol to cardiovascular risk in postmenopausal women (PMW) as well as estimate their CV risk profile.

Methods: 271 consenting PMW were recruited consecutively into this cross-sectional hospital-based study. Data relating to their socio-demography, blood pressure and anthropometry was obtained and laboratory analysis of lipid profile and serum estradiol was done. Cardiovascular risk of participants was estimated using standardized calculators.

Results: Mean age of participants was 57.8±5.5 years. Significant correlation existed between each of triglyceride (Positive), High Density Lipoprotein (negative) and Waist-Hip-Ratio (WHR) (p=0.001 and 0.000 respectively). Hypertension and dyslipidaemia were significantly associated with WHR (p=0.01 and 0.031 respectively). Significant negative correlation existed between CV risk profile and serum estradiol (rs = -0.140, p = 0.028). Ten-unit increase in WHR was associated with two-fold risk of hypertension (OR> 1.73, C.I.= 1.13-2.66). A unit change in age was associated with 0.61 increase in TC.

Conclusion: Abdominal obesity and serum estradiol significantly influence cardio-metabolic risk. Newer risk calculator which incorporates factors peculiar to women such as serum E2 is hereby recommended.

Keywords: Cardiovascular risk; postmenopausal women; abdominal obesity.
A cross-sectional study of prevalence and predictors of risky sexual behavior among school-going adolescents in Mbarara municipality, Uganda
Authors: U Anyanwu Michael , Tamwesigire Imelda
Published: October 2023

Background: Adolescents in Sub-Saharan Africa are at a greater risk of experiencing the adverse consequences of risky sexual behavior such as unwanted pregnancy and school drop-out than adolescents from other regions.

Objectives: This study determined the prevalence and identified the demographic, school and social factors associated with risky sexual behavior among secondary school students in Uganda.

Methods: This was a quantitative cross-sectional study conducted in 12 secondary schools in Mbarara Municipality, Uganda. A self-reported questionnaire was used to estimate the prevalence and predictors of risky sexual behavior among the students.

Results: Out of the 910 students, 314 (34.6%) were sexually active and almost two in every ten adolescents had engaged in risky sexual behavior 171 (18.8%). About 27 (8.7%) had been pregnant or impregnated their sexual partner while 143 (45.6%) used condoms consistently. Risky sexual behavior was associated with age, gender of the student as well as alcohol consumption, smoking and substance use.

Conclusion: Most of the participants were not sexually active, however, among the sexually active students, more than half engaged in risky sexual behavior. This finding suggests the need to introduce comprehensive sex education with a focus on safe sex practices in secondary schools in Uganda.

Keywords: Prevalence; risk factors; sexual behavior.
Prevalence and factors associated with neonatal acute respiratory distress syndrome among neonates admitted to the neonatal intensive care units of Gurage zone public hospital, South West Ethiopia
Authors: Chekole Bogale , Tamene Fetene Terefe , Shegaw Geze Tenaw , Bitew Tefera Zewudie , Eyesus Fisha Alebel Gebre , Kassaw Amare , Belete Gelaw Walle , Fentahun Tamene Zeleke , Mira Yemsirach , Mulatu Tesfu , Deressa Derartu
Published: October 2023

Background: Respiratory distress syndrome (RDS) is the leading cause of respiratory failure and death of a neonate in today's world, especially in developing countries like Ethiopia.

Methods: We used an institutional-based cross-sectional study in the selected hospitals of the Gurage zone admitted from June 2019 to June 2021. The data were collected using a structured questionnaire. Data were entered into Epi data 3.1 and exported to SPSS version 25 for analysis.

Result: The prevalence of respiratory distress syndrome (RDS) in the study area was 45.1%. The odds of RDS in neonates from mothers with gestational age between 35 &37 were 3.99 times higher compared to term gestation. The odds of RDS among neonates with jaundice and sepsis are 4.33- and 1.92-times higher odds compared to their counterparts. The odds of RDS in neonates born via Caesarean section were 1.7 times higher compared with those delivered via spontaneous and instrumental delivery. RDS was also higher in neonates born to mothers <20 years of age and >=35 years old.

Conclusion: the prevalence of RDS in the study area was high. Thus, healthcare providers should act on those factors with appropriate follow-up for early detection of the problem and prevent the risk.

Keywords: Respiratory distress syndrome; neonate.
The road to a polio-free Uganda; contribution of the Expanded Program on Immunization Laboratory (EPI-LAB) at Uganda Virus Research Institute
Authors: B Nanteza Mary , Tushabe Phionah , Bukenya Henry , Namuwulya Prossy , Kabaliisa Theopista , Birungi Molly , Tibanagwa Mayi , Ampeire Immaculate , Kakooza Proscovia , Katushabe Edson , Bwogi Josephine , Bakamutumaho Barnabas , Nanyunja Miriam , R Byabamazima Charles
Published: October 2023

Background: The control of poliomyelitis in Uganda dates back as far as 1950 and acute flaccid paralysis (AFP) surveillance has since been used as a criterion for identifying wild polioviruses. Poliovirus isolation was initially pursued through collaborative research however, in 1993, the Expanded Program on Immunization Laboratory (EPI-LAB) was established as a member of the Global Poliovirus Laboratory Network (GPLN) and spearheaded this activity at Uganda Virus Research Institute.

Objectives: The aim of this report is to document the progress and impact of the EPI-LAB on poliovirus eradication in Uganda.

Methods: Poliovirus detection and identification were achieved fundamentally through tissue culture and intra-typic differentiation of the poliovirus based on the real-time reverse transcriptase polymerase chain reaction (rRT PCR). The data obtained was entered into the national AFP database and analysed using EpiInfoTM statistical software.

Results: Quantitative and qualitative detection of wild and Sabin polioviruses corresponded with the polio campaigns. The WHO target indicators for AFP surveillance were achieved essentially throughout the study period.

Conclusion: Virological tracking coupled with attaining standard AFP surveillance indicators has been pivotal in achieving and maintaining the national wild polio-free status. Laboratory surveillance remains key in informing the certification process of polio eradication.

Keywords: Poliovirus; eradication; acute flaccid paralysis; laboratory surveillance; Uganda.
Epidemiological and clinical characteristics of 66 Tunisian Sickle cell syndrome patients
Authors: Sahli Ahlem , Ouali Faida , Dabboubi Rym , Hadj Fredj Sondess , Meddeb Nabila , Mzoughi Naila , Messaoud Taieb
Published: October 2023

Introduction: Sickle cell syndrome (SCS) represent a real health problem. In this work, we propose to study the epidemiological and clinical features of 66 patients with SCS.

Methods: This is a retrospective descriptive cross-sectional study carried out on a population of 66 patients with SCS, (36 S/S, 18 S/β-thalassemia, seven S/C and five S/OArab), over a period of two years.

Results: The average age of our population is 15.5 years ± 8.4. 36 patients (55%) were born to a consanguineous marriage and 35 (53%) had siblings with SCS. The average baseline hemoglobin in our patients is 9.1g/dL±1.51. S/C patients have significantly higher baseline hemoglobin than S/S, S/β-thalassemia and S/OArab with p <0.05. Jaundice, mucosal skin pallor and hepatomegaly have been observed only in S/S, S/β-thalassemia and S/OArab patients. The persistence of splenomegaly is more frequent in S/C than in S/S, and in S/-thalassemia than in S/S. The most common acute complications were vaso-occlusive attacks (69.7%) and worsening of anemia (54.54%). The most common chronic complication was cholelithiasis (36.36%).

Conclusion: S/C patients present the best tolerated form and were the least affected by chronic complications and therefore can lead an almost normal life.

Keywords: Acute complications; chronic complications; sickle cell syndrome; steady state.
Imaging classification and BIRADS assessment of cystic breast lesions with pathologic correlates. a 5-year experience in Zaria, North West Nigeria
Authors: Adebanke Olarinoye-Akorede Sefiya , Lawal Suleiman , Zaria Ibrahim Mohammed
Published: October 2023

Background: Breast cysts encompass a variety of pathologies, both benign and malignant. Therefore, classifying cysts into different categories is needful to develop a management algorithm. This study aimed to describe and distinguish between simple, complicated and complex cysts; and compare the final BIRADS assessment with pathologic findings.

Materials and methods: A 5-year retrospective review of our ultrasound database identified two hundred and seventy patients with cystic breast lesions. They were divided into simple, complicated and complex cysts according to ultrasound characteristics based on shape, orientation, margin, wall thickness, internal features (echogenicity, septa, mass) posterior acoustic features, surrounding tissue vascularity. The final BIRADS assessment was correlated with histological findings.

Results: There were two hundred and sixty-six (98.5%) females and four (1.5%) males with a mean age 34.9 ± 11.8 years. The commonest presentation was a palpable mass, in 70% of the patients. There were 89 (33.0%) simple cysts, 61 (22.6%) complicated cysts and 120 (44.4%) complex cysts.

Conclusion: Majority of the breast cysts (83%) were benign with overall 17% incidence of malignancy. Complex cysts were the most frequent cyst type in our study, it is also the category most frequently associated with breast cancer, obviating the need for histology.

Keywords: Breasts; Cysts; BIRADS; ultrasound; pathology.
Cervical cancer awareness and risk factors among women residing in an urban slum in Lagos, Southwest Nigeria
Authors: Olubodun Tope , O Ogundele Oluwatoyin , A Salisu Zainab , O Odusolu Yetunde , U Caleb-Ugwuowo Ugonnaya
Published: October 2023

Background: Poor awareness of cervical cancer and high prevalence of its risk factors may be responsible for the large burdenof cervical cancer in low-income countries. This study assessed awareness of cervical cancer and prevalence of risk factorsamong women residing in a slum in Lagos, Nigeria.

Methods: This was a descriptive cross-sectional study carried out amongst 305 women of reproductive age (15-49 years) inIdi-Araba, a slum in Urban Lagos. Data were collected using interviewer administered questionnaires. Analysis was done withSPSS 20 software.

Results: Mean age of respondents was 33.5(9.0) years. Only 12.8% of the respondents had heard of cervical cancer. Ninety-fivepercent of respondents were sexually active and 56.2% had more than one lifetime sexual partner. Close to half (47.3%) ofrespondents had their first sexual intercourse before the age of 20. One in five (22.2%) had 5 or more children. Half of therespondents (54.8%) had had abnormal vaginal discharge.

Conclusion: Awareness of cervical cancer among the women was poor and prevalence of risk factors of cervical cancer washigh. Campaigns aimed at increasing awareness of cervical cancer, and screening should be carried out by governmental andcharitable organizations for women residing in slums.

Keywords: Cervical cancer; awareness; risk factors; slum; Nigeria.
Comparative genomics of spike, envelope, and nucleocapsid protein of severe acute respiratory syndrome coronavirus 2
Authors: Sohail Khan Sufyan , Ullah Anwar
Published: October 2023

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) upsurge sprang up in Wuhan, China, in late December 2019.

Objectives: Due to the exceptionally high mutation frequency, comparative genomics of viruses isolated throughout time and in various geographical locations are crucial. To better understand how SARS-CoV-2 heterogeneity has changed around the globe, this research was conducted.

Methods: Nucleotide and protein sequences of SARS-CoV-2, SARS-CoV, and bat SARS-like CoV were extracted from the NCBI Virus database. The Wuhan SARS-CoV-2 variant was used as a reference. Molecular Evolutionary Genetics Study performed the phylogenetic analysis, while the Genome Detective Coronavirus Typing Tool performed the mutational analysis.

Results: The evolutionary research has revealed that bats are the primary host for coronavirus evolution and the origin of the formation of SARS-CoV and SARS-CoV-2. Numerous mutations have been discovered in the spike, envelope, and nucleocapsid protein.

Conclusions: The current research findings may have an implication that facilitates the development of prospective immunization candidates/small pharmacological compounds targeting COVID-19.

Keywords: SARS-CoV-2; COVID-19; pandemic; comparative genomics; spike protein; envelope protein; nucleocapsid protein.
The practice of using repurposed medications as chemoprophylaxis for COVID-19 by healthcare workers in a tertiary hospital in Southern Nigeria
Authors: B Udoette Sylvanus , E Onukak Asukwo , A Umoh Victor , A Akpabio Akpabio
Published: October 2023

Background: Coronavirus disease 2019 (COVID-19) is a viral infection that has been reported in virtually every country. Healthcare workers (HCW) are more at risk of COVID-19 than the general population making them a priority group for vaccination. Before the roll out of COVID-19 vaccines in Nigeria, some HCW were using some repurposed, unapproved drugs to possibly prevent the disease. This study evaluated the frequency and pattern of drug use for COVID-19 prevention.

Methods: This was a prospective cross-sectional study of HCW conducted in Southern Nigeria. Data was obtained from the participants using a questionnaire and blood sample was obtained for SARS-CoV-2 antibody testing. Data was analysed using the statistical package for social sciences (SPSS) version 23.

Results: One hundred and sixty-six participants were enrolled in this study. Thirty-two (19.3%) of them had taken a repurposed medication as prophylaxis for COVID-19. The most used drugs were Vitamin C (9%), Azithromycin (8.4%) and Zinc (6.6%). History of contact with patient with confirmed COVID-19 and being a pharmacist were independent factors associated with the use of COVID-19 prophylaxis.

Conclusion: Several HCW in Nigeria take drugs to possibly prevent COVID-19. These medications may not offer significant protection against COVID-19. There is an urgent need to increase uptake of COVID-19 vaccines in HCW in Nigeria.

Keywords: COVID-19; Chemoprophylaxis; Healthcare workers.
Impacts of Covid-19 & black fungus on diabetes patients in India
Authors: P Belmon Anchana , Auxillia Jeraldin
Published: October 2023

The Novel coronavirus disease Covid-19 is a highly acute respiratory, viral pathogenic and pandemic disease caused by the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) virus which leads to a heavy loss of mankind worldwide. The origin of the virus is not well known as it confirms the transfer of disease from person to person. As the disease is a novel clinical trial of antiviral drugs only seems to be better for emergency pathogenic Covid-19 impacts. The after all effect of Covid-19 results severely elevated glucose levels causing Diabetes Mellitus. The various symptoms of black fungus also report a heavy impact on diabetic patients. The analysis of Covid-19, mucormycosis and Covid vaccines with respect to diabetes is described in the paper.

Keywords: Diabetes mellitus; diabetes complications; diabetic patient.
Comparison of knowledge, perception and willingness to receive covid-19 vaccines among tertiary students in Osun State, Nigeria
Authors: Adeyemi Johnson Wale , Parakoyi Bayo Dauda
Published: October 2023

Background: Vaccination remains a potent way to curb the present covid-19 global pandemic.

Objectives: To assess knowledge, perception and willingness to receive covid-19 vaccines among tertiary students in Nigeria.

Methods: In the descriptive cross-sectional study, a sample size of 750 respondents was randomly selected from a university, polytechnic and college of education (COE) in Osun State, Nigeria. Independent sample T and Pearson correlation tests were used to analyse the responses.

Results: There was a significant increase in the percentage score of poor perception, relative to good perception among the university and polytechnic respondents. Among the COE respondents, significant increases in the percentage scores of poor knowledge, perception and willingness to receive covid-19 vaccines, relative to the good variables were observed. Weak positive correlations between knowledge and willingness & perception and willingness to receive covid-19 vaccines among all the respondents were noted. In addition, there was a significant increase in good perception to covid-19 vaccines among university and COE, relative to polytechnic respondents. Asides, a significant increase in good willingness to receive covid-19 vaccines was observed among the university, compared to COE respondents.

Conclusion: There is poor knowledge, perception and willingness to receive covid-19 vaccines among tertiary students in Osun State, Nigeria.

Keywords: Covid-19 vaccines; knowledge; perception; tertiary students; willingness.
A retrospective study on side effects of first-line antiretroviral drugs on HIV patients based on 1A, 2A, and 5A regimen records at Zomba Central Hospital, Malawi
Authors: Sindie Ruth , Mwakilama Elias , Chizala Pachalo , Namangale Jimmy
Published: October 2023

AIDS is an incurable disease that is common in Africa. Patients with HIV/AIDS having a CD4 count of less than 240 are put on life prolonging ARV drugs. The ARVs have serious side effects on some patients which may be handled by treating them or switching patient’s drug to one with no or less serious side effects. However, before doing this, more understanding of the circumstances that lead to a side effect is vital. We use statistical analyses to link side effects of 1A, 2A, and 5A treatment regimens to the patient’s social and demographic characteristics based on hospital data records. A retrospective review of patients’ master cards (2011-2014) was done to assess adverse effects associated with different ARV regimens. Out of the 901 patients that showed side effects, 65.37% were females aged 31-40 and 34.63% were males. Comparatively, 1A regimen showed more side effects than 2A and 5A regimens. Age, gender and occupation correlated significantly with regimen symptoms (p< 0.05). Unlike men, women had the following extra side effects; cough, peripheral neuropathy and leg pains as compared to lipodystrophy. Our results show that old people (50years+) are less likely to get skin rash and other symptoms compared to lipodystrophy (RRR=0.973). Further, the probability of either having cough (0.0021, p< 0.05), or skin rash (0.0021, p< 0.05), as a side effect, on average, decreases as age increases with the same sex and weight. The probability of having peripheral neuropathy (0.0042, p< 0.01), however, increases with age. Knowledge of HIV patient’s socio-demographics and the patient’s regimen side effects can be utilised to appropriately manage severe ARV side effects. A therapy consideration that takes into account chemicals in ARV regimen responsible for specific side effects can be directed to patients with compatible socio-demographic characteristics.

Keywords: HIV/AIDS; ARV regimens; symptoms; side effects; socio-demographics; multinomial logistic regression.
Efficacy of arthroscopic internal fixation with countersunk screw in the treatment of talus fracture
Authors: Sun Bo , Liu Shibo , Xue Xinxin , Gao Yunfeng , Fu Shijie , Wang Pei
Published: October 2023

Objective: To explore clinical effects of arthroscopic internal fixation with countersunk screw in the treatment of talus fracture.

Methods: Forty-eight patients with talus fracture treated in hospital of Chengde Medical University from February 2015 to December 2019 were enrolled for present investigation. The patients with talus fracture were randomly assigned into two groups, with twenty-four patients per group. The patients with talus fracture in the observation group were treated with arthroscopic internal fixation with countersunk screw, while the traditional open reduction and internal fixation were applied for the ones in control group. The clinical efficacy of the patients was evaluated three months after the operation, and the preoperative and postoperative ankle joint functions, fracture-healing time, hospital stay, and complications were carefully compared between observation and control group.

Results: A total efficiency as high as 91.67% was showed in observation group, which is distinctly better than the effective rate of control group (66.67%, P<0.05). Before operation, ankle function scores (AOFAS) of control group and observation group is 42.08 ± 4.29 and 41.75±5.31 with no significantly difference (P>0.05); while after the surgery, AOFAS scores of control group is significantly lower than that of observation group: (66.28±7.51 vs. 53.0 ±6.79, P<0.05). Moreover, healing time and hospitalized duration of observation group are 3.19±1.04 months and 3.57±0.97 days, which are also significantly shorter than 4.18±1.25 months and 8.28±2.54 days in control group, respectively, (P < 0.05). And the total complication rate in control group is 20.83%, which is higher than 8.33% in observation group (P >0.05).

Conclusion: Arthroscopic internal fixation with countersunk screw can significantly improve the efficacy and ankle joint functions, shorten the fracture-healing time and hospital stays without increasing the incidence of complications.

Keywords: Arthroscopy; countersunk screw; curative effect; internal fixation; talar fracture.
Effects of interventional vascular embolization at different timing on prognosis and serum S100 calcium-binding protein B level of patients with aneurysmal subarachnoid hemorrhage
Authors: Yue Peidong , Zhang Lei , Wang Bin
Published: October 2023

Objective: To evaluate the effects of interventional vascular embolization at different timing on the prognosis and serum S100calcium-binding protein B (S100B) level of patients with aneurysmal subarachnoid hemorrhage (aSAH).

Methods: A total of 229 aSAH patients enrolled from January 2016 to January 2020 were divided into an early-stage group(n=66), a middle-stage group (n=95) and a late-stage group (n=68. Their baseline data, serum indices and clinical outcomes werecompared. The factors affecting their prognosis were analysed. The value of serum S100B level for predicting the prognosis wasevaluated.

Results: The early-stage group had the highest GOS score, and the late-stage group had the lowest score (P<0.05). Older age,large diameter of aneurysm, high Hunt-Hess grade upon admission, late surgical treatment and high S100B level were risk factorsfor the poor prognosis of aSAH patients. The optimal cut-off value of S100B for predicting the prognosis was 2.785 μg/L.The area under the receiver operator characteristic curve, sensitivity, specificity, Youden index and 95% confidence interval were0.892, 84.3%, 86.3%, 0.706 and 0.844-0.940, respectively.

Conclusion: Early vascular interventional embolization is beneficial to the alleviation of brain injury and the reduction of serumS100B level.

Keywords: Aneurysmal subarachnoid hemorrhage; interventional vascular embolization; prognosis; S100 calcium-binding proteinB; timing.
Using a shortened uncuffed endotracheal tube as a nasopharyngeal airway: a useful adjunct during fiberoptic intubation training among anesthesia residents
Authors: A Salem Hosni , Aly Rayan Ayman , Abotaleb Usama , Shafiq M Abdel-wahap Essam , A Elzoughari Ismail , A Taha Alafifi Mohammed , Kamal Abdelbasset Walid , M Abodonya Ahmed
Published: October 2023

Background: Fiberoptic intubation (FOI) is considered a beneficial modality used to intubate life-threatening airway patients.This study aims at assessing the effectiveness of shortened uncuffed endotracheal tube as a nasopharyngeal airway during FOI.

Methods: Between January 2019 and March 2021, this prospective randomized controlled trial has enrolled 62 adult patients(56 males and 6 females) with normal airways scheduled for elective oral FOI classified American Society of Anesthesiologists(ASA I-III), their age ranged 20-60 years. The patients were randomized into two equal groups (31 per each); in group I, FOIwas carried using lingual traction, and in group II, FOI was carried out with lingual traction plus a shortened uncuffed endotrachealtube as a modified nasopharyngeal airway to maintain oxygenation. The time taken to successful tracheal intubation andother technical parameters have been measured. The heart rate (HR), mean arterial pressure (MAP), oxygen saturation (SpO2),end-tidal carbon dioxide (EtCO2), and any associated complications have been measured.

Results: During insertion of the scope, the SpO2 was significantly decreased in group I (92.55 ± 7.94) compared to group II(97.42 ± 6.34), p=0.009. The heart rate, MAP, and EtCO2 were found to be insignificantly different in both groups (p>0.05).The time needed for intubation in group I (2.78±0.98 min) was prolonged compared with group II (1.95±1.02 min) p =0.002.The number of attempts was comparable in both groups, while the number of successful intubations from the 1st attempt was12 (39%) compared to 18 (58%) in groups I and II respectively, p=0.36. The overall success rate by juniors was 71% in group Icompared to 84% in group II, p=0.66 with a lower incidence of using rescue oxygen and other facilitating maneuvers.

Conclusions: The modified nasopharyngeal airway is a useful modality to facilitate oral FOI by anesthesia resident trainees.

Keywords: Nasopharyngeal airway; Endotracheal tube; Training of FOI.
Risk factors analysis of endoscopy and TIPS in the treatment of secondary esophagogastric varicose bleeding with cirrhosis
Authors: Liu Xiaoyan , Wang Yanli , Zheng Lei , Zhu Jinzhao
Published: October 2023

Objective: To analyse the risk factors of secondary hemorrhage and survival rate in cirrhotic patients with esophagogastric varicealrupture and to compare the efficacy and safety of endoscopic hemostasis and TIPS (transjugular intrahepatic portosystemicshunt).

Methods: A total of 120 patients with secondary bleeding after endoscopic treatment of esophagogastric varicose bleeding withcirrhosis in our hospital during the past 3 years were retrospectively analysed. There were 65 males and 55 females, ranging inage from 49 to 74 years old, with an average of (59.5 ± 8.4) years old. The etiology, degree of varicose veins, bleeding location,hemostasis method, Infection, ascites, portal vein thrombosis or cancer thrombus, albumin, platelets, prothrombin activity, ChildPugh (Child-Pugh classification is a diagnostic criterion for liver reserve function) grade were compared in each group. The riskfactors of treatment failure and analyse the survival time was analysed.

Results: There were statistically significant differences in varicosis degree, infection, ascites, portal vein thrombosis or cancerthrombus, child Pugh grade, albumin and prothrombin activity between the failed Endoscopy group and the successful hemostasisgroup (P< 0.05). There were statistically significant differences in child Pugh grade, albumin and prothrombin activity betweenthe failed TIPS treatment group and successful hemostasis group (P< 0.05). There was no significant difference in 1-yearsurvival between the endoscopy group and the TIPS group.

Conclusion: Severe varicose veins, infection, ascites, portal vein thrombosis or cancer thrombus, child pugh classification, albumin,and prothrombin activity were the major risk factors for failed secondary endoscopic therapy, child Pugh classification,albumin and prothrombin activity were the main risk factors for failure TIPS treatment. There is no significant difference inlong-term survival between the two methods.

Keywords: Liver cirrhosis; esophagogastric varicose bleeding; Endoscopy; TIPS.
Relationship of body mass index to percent body fat determined by deuterium isotopic dilution and impedancemetry among Tunisian schoolchildren
Authors: Jemaa Houda Ben , Sarra Khlifi , Karmous Inchirah , Henda Jamoussi , Khalid El Kari , Hassan Aguenaou , Abdallah Aouidet , Amani Mankaï
Published: October 2023

Objectives: This study aims to evaluate the relation of body mass index (BMI) to fat mass among children by two techniquesimpedancemetry and deuterium oxide dilution (D2O).

Methods: This study was carried out in 156 schoolchildren aged between 8 and 11 years. The children received interrogationspecifying lifestyle and food habits. Body composition was determined using the impedancemetry and D2O technique.

Results: The results showed a difference between the percentage of obese and overweight children according to BMIZ classification(30.1%), bioelectrical impedance method (14.7%) and D2O technique (42.9%). Despite the difference between the lasttwo classifications, we found a significant correlation between body fat percentages determined by impedancemetry and D2Otechnique (r = 0.695, p<0.01). Bioelectrical impedance analysis underestimated %BF by 78.02% in overall children, by 70.05%in boys and by 84.73% in girls compared to D2O technique.

Conclusion: This study has demonstrated that the percentage of overweight and obesity varied according the methods used.Further development of body composition methods is needed in children for the real determination of the obesity prevalenceand therefore a better monitoring of this public health problem.

Keywords: BMI; body fat; deuterium isotopic dilution; impedancemetry; obesity.
Prevalence and predictors of hepatitis C infection among antenatal attendees in a tertiary hospital in Southern Nigeria
Authors: Oluwedolapo Shittu Ganiyu , Monday Abasiattai Aniekan , Jackson Umoiyoho Aniefiok , Abraham Onwuezobe Ifeanyi
Published: October 2023

Background: Hepatitis C virus infection as it specifically relates to pregnancy has been a neglected condition, thus its recognitionand treatment in pregnancy is relevant because of the risks of the long-term complications of the infection in the mother,potential effects of the infection on the pregnancy and risk of vertical transmission to the newborn.

Objectives: To determine the proportion of pregnant women with serologic markers of hepatitis C infection, identify risk factorsas well as factors that predict the occurrence of the infection in them.

Methodology: Over a 3-week period, blood samples from 456 pregnant women were assessed for antibodies to hepatitis Cvirus, while a pre-tested questionnaire was used to obtain socio-demographic data and the presence of risk factors in the Universityof Uyo Teaching Hospital, Nigeria.

Results: The prevalence of HCV infection in pregnancy was 4.6%. No known risk factors for HCV infection in pregnancy wereidentified. Only increasing gestational age was a predictor of HCV infection in pregnancy in the study.

Conclusion: The prevalence of hepatitis virus infection among the study population was high. Second trimester and increasinggravidity were protective of the infection in pregnancy. There is therefore need for introduction of general routine screening ofall pregnant women presenting for antenatal care.

Keywords: Hepatitis C virus infection; pregnant women; Uyo; prevalence of hepatitis C.
A 5-year review of research ethics applications in a tertiary health and educational institution in Nigeria
Authors: Amajuoyi Ndububa Dennis , Olurotimi Ogundokun Akinjide , Oluwole Ayoola Oluwagbemiga , Babalola Adeyemi Adebanjo , Ayodele Bolarinwa Rahman , Olumuyiwa Ogundipe Taiwo , Ayo Salako Abdulkadir , Oladiipo Aboderin Aaron , Temitope Afolabi Olusegun , Taiwo Adenekan Anthony , Oluwatosin Taiwo Ige , Gold Akanbi Oluwabanke
Published: October 2023

Background: African contribution to global research output is said to be low. Poor funding and poor skills in grant writing havebeen suggested as important factors for this situation.

Objectives: Applications for research ethics clearance in a hospital were reviewed to have an overview of the planned studiesand the proportion of them that attracted national and international funding.

Methods: A review of all applications for ethical clearance received by the institutional review board of a university teachinghospital at Ile-Ife, Nigeria, from 2016 to 2020. They were analysed according to study nature, scope, purpose, and sponsorshipusing descriptive statistics presented as frequency tables and charts.

Results: A total of 878 applications were reviewed. There were 803 (91.5%) applications for local, 45 (5.1%) for national multicentre,and 30 (3.4%) for international multicentre studies. Applications for medical fellowship were 352 (40.0%) while 208(23.8%) were from academic staff for non-degree research. There were 610 (69.5%) applications for self-sponsored studies.Only 18 (2.0%) and 26 (3.0%) received sponsorship from national and international donor agencies, respectively.

Conclusions: Local studies formed the bulk of the submissions for ethics clearance. National and international donor fundingof research is abysmally low in this Nigerian tertiary institution studied.

Keywords: Research ethics applications; study sponsorship.
Microbiological quality and proximate analysis of locally produced soymilk drinks sold in Calabar Metropolis; a public health assessment
Authors: G E John , E A Okpo , J Akpanke , C U Okoro , P A Omang , J A Lennox
Published: October 2023

Background: This study was aimed at evaluating the microbial quality and proximate analysis of soymilk produced and soldwithin Calabar Metropolis.

Methodology: Soymilk samples were purchased in pairs from five locations in Calabar Metropolis. The samples collected weresubjected to microbiological and proximate analysis to ascertain the hygienic standards of the products and nutrient contents.

Results: The result showed that the highest heterotrophic bacterial count of 5.3 × 105 cfu/ml was recorded in soymilk samplesold in Goldie market while the least (2.7 × 104 cfu/ml) was recorded at Watt market. The mean fungal count was highest inAkim market samples (5.8 x 104 cfu/ml) and lowest in Atimbo market samples (2.4 x 103 cfu/ml). The probable bacterial andfungal isolates were identified as: Pseudomonas aeruginosa, Bacillus sp, Escherichia coli, Klebsiella sp, Salmonella sp, Streptococcus sp,Staphylococcus aureus, Aspergillus sp, Rhizopus sp, Penicillium sp and Mucor sp. All the isolated bacteria species were found to be resistant to more than 50% of the antibiotics used. Proximate composition analysis of the soymilk samples revealed high moisture,carbohydrate and protein contents.

Conclusion: The microbial population detected in terms of number and types reflected poor hygienic standard of production.

Keywords: Soymilk; contamination; public health; hygiene; foodborne illnesses.
Restless legs syndrome in chronic renal failure patients on dialysis
Authors: Behrens van Tonder Carin , Joubert Gina , Moodley Anand
Published: October 2023

Background: Restless legs syndrome (RLS) occurs in patients with chronic renal failure (CRF).

Objectives: To determine the prevalence and morbidity of RLS in CRF patients on dialysis.

Methods: This cross-sectional questionnaire-based study included 100 dialysis patients (50 on haemodialysis [HD]; 50 on peritonealdialysis [PD]). A focused lower limb examination was done. Patients were classified with RLS when reporting uncomfortablefeelings in their legs that improved with movement and worsened when resting and at night.

Results: Gender distribution was equal. The median age was 43 (19–67) years. Six patients (HD and PD n=3 each) had internationalcriteria-confirmed RLS. Twenty-four patients reported symptoms suggestive of RLS. Fourteen and 16 patients with RLSsymptoms were on HD and PD, respectively. Sleep disturbances occurred in 43.3% (n=13) of patients with RLS symptoms,compared to 20.0% (n=20) of the large cohort. Sleep disturbances, peripheral sensory loss, chronic disease-related anaemia,increased urea and decreased albumin levels were more common among patients with RLS symptoms.

Conclusion: RLS symptoms occurred in 30.0% of the entire cohort, although only 6.0% met the international criteria. The typeof dialysis had no impact on the incidence of symptoms. Identifying RLS in patients with CRF on dialysis will allow for earlyintervention.

Keywords: Restless legs syndrome; chronic renal failure; haemodialysis; peritoneal dialysis; symptoms.
Vertebral changes in the lumbar spine of adults presenting with chronic low back pain at a Referral Hospital in western Kenya
Authors: Stellah Papa Imade , Walter Adero Sulman , Marera Domnic , Washington Otieno , Isaac Masoni
Published: October 2023

Background: Chronic low back pain is a common musculoskeletal symptom affecting the lower part of the spine. It is described as pain  and discomfort around the lumbar region lasting for more than twelve weeks. The symptoms of chronic low back pain might range from  a dull ache to a stubbing or shooting sensation. This nature of pain may be localized around the axial region or radiate to the lower limbs  affecting the patients’ daily activities. The aim of this study, therefore, was to evaluate vertebral changes in the lumbar spine of adults  presenting with chronic low back pain at Kakamega County General and Referral Hospital.

Methods: This was a cross-sectional  quantitative descriptive study whereby; patients’ data was collected during patients’ presentation at orthopedic outpatient clinic and MRI  department. Purposive sampling of lumbar spine Magnetic resonance imaging scans was used to obtain data. A total of 144 patients  were selected using the Yamane Taro formula. Anatomical vertebral changes of the lumbar spine were assessed from the  selected MRIs to evaluate the structural causes of chronic low back pain. Descriptive statistics such as frequency and percentage were  used in analyzing the data.

Results: It was noted that osteophytes were the most pathological changes causing chronic low back pain  while fractures were the least common. Osteophytic changes in the vertebra and desiccation of the intervertebral discs can predispose  one to chronic lower back pain.

Conclusion: The study recommends early screening and treatment of lower back pain to avert its  sequelae.
Influence of Statist Inter-ethnic Economic Transformation in the Management of Inter- ethnic Conflicts in Bungoma County, Kenya
Authors: Mulati Job Chebai , Iteyo Crispinous
Published: October 2023

Globally, disputes over economic resources often complicated inter-ethnic conflicts. In Kenya, specifically in Bungoma County inter-ethnic economic reasons underpinned 1963 including 1992 conflicts. Objective of the study was to examine the influence of statist inter-ethnic economic integration in management of inter-ethnic conflict in Bungoma. A conceptual framework underpinned by Lederach’s Conflict Transformation and Gultang’s Conflict Triangle guided the study. A descriptive research design was applied. The study was conducted in Bungoma County. Population was sampled by Simple Radom and Purposively. The sample size of 400 participants used was derived from 1375065 population using Yamane 1967 formula. Questionnaires, interviews, Focus Group Discussions and document analysis were instruments used. Microsoft Excel, thematisation, corroboration and verification analysed data. The findings were: Unlike eldership 42%, intermarriage 23% and culture 20%, 15% of respondents agreed that trade initially influenced inter-ethnic co-existence. Its role was alienated and differentiated by colonization. Statist inter-ethnic economic transformation mutated from inter-ethnic inequitable: Economic distribution and access to lack of resources and high population all rated at 16% to inter-ethnic economic political neglect 21%, economic stagnation 15% and competition over resources 17%. Inter-ethnic economic integration diversity policies identified were to be guided by economic equity, population spread and affirmative action. Challenges established were inter-ethnic iniquities in economic, education and development. The study recommends enforcement of inter-ethnic equity policies in resource distribution, jobs and in development.