bluuebunny/crossref_metadata_2025 huggingface dataset:
Correlation between biofilm formation and carbapenem resistance among clinical isolates of Klebsiella pneumoniae
Authors: Ali Rahdar Hossein , Shiri Malekabad Ebadallah , Dadashi Ali-Reza , Takei Elahe , Keikha Masuod , Kazemian Hossein , Karami-zarandi Morteza
Published: October 2020

Background: Klebsiella pneumoniae is a Gram-negative enteric bacterium that causes nosocomial infections; this bacterium has survived from harsh condition using biofilm formation in hospital equipment and cause severe infection. In the other hand, the emergence and extension of carbapenem resistance burden among K. pneumonia producing biofilm is the current concern of public health services. There are controversial findings about this subject. The aim of this study was to evaluate the correlation between biofilm formation and resistance to carbapenem among clinical isolates of K. pneumoniae.Methods: A total of 160 K. pneumoniae isolates were collected from various infections of hospitalized patients. The Carba NP test and molecular methods were used for detection of carbapenem resistance isolates of K. pneumonia. Subsequently, the ability for biofilm production was performed from all isolates. Finally, Correlation of biofilm formation among carbapenem resistant isolates was calculated using χ2 and Fisher’s exact tests.Results: Among K. pneumoniae isolates 42.5% have carbapenemase activity by Carba NP test, while carbapenemase genes were detected in 35.6% of isolates in amplification assay. Moreover, there are 52.5% (n= 84) of all isolates were formed a strong biofilm, while 38.1% (n= 61) and 9.3% (n= 15) of isolates were middle and weak biofilm producer, respectively. Among carbapenem resistant cases (n= 68), there are 77.9% (n= 53) and 22% (n= 15) of isolates were reported as strong and middle biofilm producer, respectively. We see a significant correlation was seen between biofilm formation ability and carbapenem resistant isolates (p-value < 0.00001).Conclusion: The increase of carbapenem resistance burden in biofilm producing isolates of K. pneumoniae is considered as serious alert and the basic measures to combat this phenomenon is imperative.
Colorectal Anastomosis Leak: Rate , Risk Factors and Outcome in a Tertiary Teaching Hospital, Addis Ababa Ethiopia, a Five Year Retrospective Study
Authors: Wako Gutema , Teshome Henok , Abebe Engida
Published: October 2020

BACKGROUND: Anastomotic leakage is a morbid and potentially fatal complication of colorectal surgery. Determination of perioperative risk factors for colorectal anastomosis leak helps to identify patients requiring increased postoperative surveillance.METHODS: Institution based retrospective study was done to determine colorectal anastomosis leak rate and risk factors associated with it at a teaching hospital in Addis Ababa Ethiopia. Patients operated from January 2013 to December 2017 G.C were included. Univariate analysis followed by a multivariate logistic regression model was used to determine the influence of patient factors and operative events on postoperative anastomotic leakage.RESULTS: Inclusion criteria were met by 221 patients. Mean age of patients was 46.44(SD=19.1) with range of 1 to 85 years. Male accounted to 166 (74.8%) of the patients. Anastomotic leakage occurred in 12 (5.2%) of the patients. Mean time to diagnosis was 9.55 days (95% CI, 7.2-11.8) after surgery. Univariate analyses showed high preoperative level of creatinine, ASA score III and IV, emergency operation, operative time more than three hours, and malignant diseases were associated with colorectal anastomosisleak. Multivariate logistic regression model failed to show an association. Colorectal anastomosis leak increased the inpatient mortality rate by 50%. Median length of hospitalization in colorectal anastomosis leak group was 27.5 days, versus 7 days in patients without leak.CONCLUSION: Colorectal anastomosis leak remains common problem after colorectal surgery resulting significant post-operative mortality and morbidity.
A Giant Egg-like symptomatic Loose Body in the Peritoneal Cavity: A Case Report
Authors: Teklewold Berhanetsehay , Kehaliw Anteneh , Teka Melat , Berhane Bereket
Published: October 2020

Background: Peritoneal loose bodies are rare lesions that are usually found as an incidental finding during abdominal surgery. Large loose bodies, measuring more than 5 cm, are rare and only a few cases are reported in the literature. Peritoneal loose bodies are usually infarcted appendices epiploicae, which become detached and appear as a peritoneal loose body in the abdominal cavity.Case Presentation: We report here the first case, in the local Ethiopian context, of a giant “egg-like” loose peritoneal body measuring 7 × 6 cm found in a 50-year-old man who presented with a cramping abdominal pain and features of abdominal obstruction. The current hypothesis as regards these bodies and the diagnostic challenges is discussed.Conclusion: Small peritoneal loose bodies are common but giant and symptomatic ones’, like the one discussed here, are very rare and a diagnostic challenge. And, in the context of intestinal obstruction, a high index of suspicion is needed in order to diagnose them.
Developing a Model for Accreditation of Iranian Teaching Hospitals: A Qualitative Study
Authors: Sharifi Marziye , Raeissi Pouran , Abolghasem Gorji Hasan , Aryankhesal Aidin
Published: October 2020

Background: Among different factors, accreditation is being widely used across the world to improve quality and safety in hospitals. Therefore, the purpose of the present study was to develop an accreditation model for teaching hospitals in Iran.Methods: This qualitative study was conducted in four phases from January, 2017 to March, 2018. To this end; firstly, existing accreditation models were extracted and reviewed comparatively. Within the second stage, dimensions and components of the accreditation model were extracted through semi-structured interviews. In the third stage, a new instruction was developed via integrating the findings from the first and the second stages. Finally, the model was validated in two phases of Delphi method and a specialized forum in the fourth step. Qualitative findings were then analyzed using content analysis method.Results: Models of Joint Commission International (JCI) and Word Federation for Medical Education (WFME) in other 6 countries were reviewed and compared with the current Iranianmodel. Extracted dimensions discovered to complement the present model included learner assessment, continuous reviews and revisions, and educational productivity. The final model was also developed with 12 dimensions and 94 standards. Content validity ratio (CVR) and content validity index (CVI) were also estimated to be 0.40 and 0.80, respectively. As well, the second round of Delphi method could increase the number of model standards to 97. Moreover, Cohen’s kappa coefficient was calculated to be at least0.71.Conclusion: This study led to the development of a comprehensive model for scientific accreditation of teaching hospitals through reviewing documentation, combining and comparing global approaches, as well as integrating them with the views of domesticexperts.
Burden of Care and Psychological Distress in Primary Caregivers of Patients with Type -2 Diabetes Mellitus in A Tertiary Hospital in Nigeria
Authors: Adebusola Jane Ogunmodede , Olatunji Abiodun , Alfred Bamiso Makanjuola , John Kola Olarinoye , James Ayodele Ogunmodede , Olubunmi Ideraoluwa Buhari
Published: October 2020

BACKGROUND: Caregivers play an important role in the management and care of individuals with chronic medical conditions. This is because; they provide emotional, physical, financial as well as spiritual support to their wards. However, the process of caregiving is usually associated with feelings of burden and psychological distress.METHODS: This study was a descriptive, cross-sectional, clinicbased study done at the endocrinology clinic of a Teaching hospital in Northern Nigeria. It was done utilizing the Zarit Burden Interview, the General Health Questionnaire (12 item version) and a socio-demographic questionnaire designed by the authors. The levels of burden as well as the factors associated with burden and psychological distress in one hundred caregivers of patients with Type 2 Diabetes Mellitus were assessed. Statistical analysis was done using chi square, independent T test and linear regression.RESULTS: Forty- two percent (42%) of caregivers experienced little or no burden, 47% had mild to moderate burden, 8% had moderate to severe burden, while 3% had severe burden. When the ZBI scores were dichotomized into ‘low’ and ‘high’ burden, 89% were found to experience low burden, while 11% experienced high burden. On logistic regression, females were found to be four times more likely to experience high burden, while Thirty-five (35%) percent of caregivers had a GHQ score of > 3, signifying psychological distress and psychological distress was found to be significantly associated with burden.CONCLUSION: Many Nigerian caregivers of patients with Type 2 Diabetes Mellitus experience burden and psychological distress associated with caregiving, especially female caregivers and those taking care of those taking care of patients with complications. It is therefore important for clinicians to recognize burdened caregivers and intervene appropriately in order to improve the quality of care of these patients.
Incidence, Clinical Manifestation, Treatment Outcome, and Drug Susceptibility Pattern of Nontuberculous Mycobacteria in HIV Patients in Tehran, Iran
Authors: Seifu Gizaw Feysia  , Malihe Hasan-nejad  , Siroos Amini  , Gholamreza Hamzelou  , Hossein Kazemian  , Jalil Kardan-Yamchi  , Morteza Karami- Zarandi  , Mohammad Mehdi Feizabadi
Published: October 2020

BACKGROUND: Nontuberculous mycobacterial (NTM) infections have radically increased worldwide due to the increase in HIV infections. The disease activity increases with progressive immunodeficiency.METHODS: A total of 216 HIV seropositive patients suspected of having mycobacterial infection were recruited for this study. Clinical samples were collected from each patient and cultured on Lowenstein-Jensen media. Detection and species identification were simultaneously done using Reverse Blot Hybridization Assay System. Also, the minimum inhibitory concentrations (MIC) for each isolate were determined in 7H9 broth media for 10 antibiotics.RESULTS: In this study, 4 rapid and 4 slow-growing NTM species were isolated and identified. Mycobacterium fortuitum was the most common NTM species, 3/8 (37.5%), followed by Mycobacterium kansasii, 2/8 (25%). The cases were identified as pulmonary disease, 5/8 (62.5 %), disseminated infection, 2/8 (25%), and skin abscess, 1/8 (12.5%). M. chelonae and Mycobacterium avium were isolated from patients diagnosed with disseminated infection with treatment failure. The skin abscess was caused by infection with M. simiae. The results of the MIC testing were as follows: M. kansasii and M. fortuitum were susceptible to amikacin (AMK); M. avium to clarithromycin (CLA); M. fortuitum 2/3 (67%) to ciprofloxacin (CIP); 1/2 (50%) of M. kansasii isolates to CLA, and M.chelonae to rifampin (RIF), linezolid (LIN), AMK, and CIP atmedium and high concentrations.CONCLUSION: AMK showed incredible in vitro activity against M. kansasii and M. fortuitum. Also, M. avium was susceptible to CLA, whereas M. simiae and M. chelonae were resistant to the tested drugs in this study.
Health Workers’ Awareness and Knowledge of Current Recommendation of Intermittent Preventive Treatment in Pregnancy in South-Western Nigeria
Authors: Oluwasomidoyin Olukemi Bello  , Olaolu Oni
Published: October 2020

BACKGROUND: Malaria in pregnancy is of public health significance because of its associated maternal and fetal complications. This study aimed to assess health workers’ awareness and knowledge of the current World Health Organisation (WHO) recommendation of intermittent preventive treatment in pregnancy with Sulfadoxine-Pyrimethamine (IPTp-SP).METHODS: A cross-sectional study among 148 health workers who offer obstetrics care in selected health facilities in Ibadan, Nigeria using a self-administered questionnaire to evaluate their awareness and knowledge of the current WHO IPTp-SP. Information on their socio-demographic and professional characteristics, awareness, knowledge and practice of the current IPTp recommendation were obtained. Data analysis involved descriptive and bivariate analyses using SPSS version 20.0 with level of significance set at p<0.05.RESULTS: The majority, 85(57.4%), of the health workers had been providing obstetrics care for less than 5 years with most of them, 114(77.0%), practicing at tertiary health facility. More than half, 92(62.2%), of them were aware of the current WHO IPTp-SP recommendation while about two-fifth (39.1%) had its correct knowledge. Of the health workers who were knowledgeable of the current IPTp-SP recommendation almost three-quarter, 29(72.2%) of them prescribed it. The health workers’ professional cadre (p<0.001) and duration of providing obstetrics care (p=0.012) were significantly associated with their awareness and correct knowledge of the current IPTp-SP recommendation.CONCLUSION: Most of the health workers are aware but not knowledgeable of the correct administration of the current IPTp- SP recommendation. Likewise, many of them do not prescribe it. This calls for regular training and update of health workers and institutional protocol so as to effectively reduce the prevalence of malaria in pregnancy and its complications.
Isolation and Immunological Detection of Mycobacterium Tuberculosis from HIV and Non-HIV Patients in Benue State, Nigeria
Authors: Francis Enenche Ejeh1  , Ann Undiandeye  , Kenneth Okon  , Haruna Moshud Kazeem  , Ayuba Caleb Kudi
Published: October 2020

BACKGROUND: Immunological techniques are important tools for tuberculosis epidemiology; although its use is underutilized in Nigeria. In this study, we report the epidemiological outlook of Mycobacterium tuberculosis among HIV patients in Benue State, Nigeria.METHODS: Sputum samples were collected from 425 suspected TB patients from July 2016 to February 2018 and subjected to acid-fast microscopy, GeneXpert MTB/RIF, processed using NALC-NaOH and cultured on Lowenstein-Jensen media. The isolates obtained were identified by SD-Bioline® assay.RESULTS: The prevalence of TB by acid-fast microscopy was 35(15.9%). The prevalence of TB by acid-fast bacilli was significantly (χ2 = 8.458; P = 0.003) highest among the 15-34 years age group (22.0%) compared with other age groups. TB prevalence was significantly (χ2 = 4.751; P = 0.029) higher among patients from rural areas than those from urban center (23.8% vs 14.1%). GeneXpert assay detected 64(15.1%) TB cases of which patients from rural areas had significantly (χ2 = 8.104; P = 0.017) higher prevalence of TB than patients from urban areas (23.8% vs 12.9%). The overall rifampicin resistance TB was 3.1%. Also, patients from rural areas had significantly (χ2 = 10.625; P = 0.005) higher rifampicin resistance compared with patient from urban areas (8.3% vs 1.3%). Of the 126(29.7%) mycobacterial isolates, 42(33.33%) were identified as MTBC and 84 (66.67%) as NTM by SD-Bioline®assay.CONCLUSIONS: The study revealed that Mycobacterium tuberculosis infection is still a major public health problem, with relatively high prevalence rate of rifampicin resistance among HIV positive patients. Further studies are needed for early detection and treatment intervention necessary for infection control.
Pulmonary Nocardiosis in Suspected Tuberculosis Patients: A Systematic Review and Meta-Analysis of Cross-Sectional Studies
Authors: Susan Mansuri Mehrabadi  , Mina Taraghian  , Aliyar Pirouzi  , Azad Khaledi  , Alireza Neshani  , Somaye Rashki
Published: October 2020

BACKGROUND: nocardiosis is an opportunistic infectious disease in immunocompromised patients. The most common form of nocardiosis infection in humans is pulmonary nocrdiosis caused by inhaling Nocardia species from the environment. Thus, this study aimed to evaluate the pulmonary nocardiosis in patients with suspected tuberculosis using systematic review and meta-analysis.METHODS: We conducted a systematic search for cross-sectional studies focused on the pulmonary nocardiosis among patients with pulmonary tuberculosis based on the Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) published from January 2001 to October 2019. The search was conducted in MEDLINE/PubMed, Web of Science, Scopus, Cochrane Library, Google Scholar, Science Direct databases, and Iranian databases. Medical subject headings (MeSH) and text words were searched: “pulmonary nocardiosis”, “nocardiosis”, OR “nocardial infection”, “pulmonary nocardial infections/agents”, AND “pulmonary tuberculosis”, OR “pulmonary TB”, AND “Iran”. Two of the reviewers enrolled independently articles published in English and Persian languages according to the inclusion and the exclusion criteria. Comprehensive Meta-Analysis software (Version 3.3.070) was used for meta-analysis.RESULTS: Only 4 studies met the eligibility criteria. The pulmonary nocardiosis prevalence varied from 1.7% to 6.7%. The combined prevalence of nocardiosis among patients with suspected pulmonary tuberculosis in Iran was 4.8% (95% CI: 3-7.3, Q=5.8, Z=12.7). No heterogeneity was observed between studies because I2 was 48.3. N. cyriacigeorgica and N. asteroides were reported as the prevalent isolates, respectively.CONCLUSIONS: This review showed in patients suspected TB when they were negative in all diagnosis laboratory tests, nocardiosis cases which be considered.
Severity of Injury and Associated Factors among Injured Patients Who Visited the Emergency Department at Wolaita Sodo Teaching and Referral Hospital, Ethiopia
Authors: Robera Olana Fite  , Mamo Mesele  , Mathewos Wake  , Masresha Assefa  , Ayele Tilahun
Published: October 2020

BACKGROUND: An injury is a physical damage that occurs when the body is exposed to an excessive amount of energy. Physical agents, radiation, chemical agents, biological agents and physiological needs deprivation can cause injury. The study was aimed at assessing the severity of injury and identifying the factors associated with it among injured patients.METHODS: A cross-sectional study was conducted among patients who visited the emergency department of Wolaita Sodo Teaching and Referral Hospital from January 1, 2012 -January 1, 2017. A total of 320 patient records were included in the study and selected using simple random sampling. Statistical association was done for categorical variables using Chi-square. Rank correlation was done for three ordered options independent variables, Chi-squared test for trend used for two options independent variables, and General Chi-square test of independence used for independent variables with not ordered three and above options. Multivariate multinomial logistic regression was conducted. A P-value <0.05 was taken as a significant association.RESULTS: The study indicated that the majority (45.3%), 128(40%) and 47(14.7%) had minor, moderate and severe injury, respectively. Residence (AOR 0.462; 95%CI 0.268, 0.798), cause of injury (AOR 3.602; 95%CI 1.336, 9.714), night time injury (AOR 4.895; 95%CI 1.472, 16.277), afternoon time injury (AOR 8.776; 95%CI 2.699, 28.537), and chest injury (AOR 2.391; 95%CI 1.048, 5.454) were significant predictorsof moderate injury. Afternoon time of injury (AOR; 4.683; 95%CI 1.137, 19.296) and head, neck and spinal cord injury (AOR; 4.933; 95%CI 1.945, 12.509) were predictors of severe injury.
Prevalence Rate of Diabetes and Hypertension in Disaster-Exposed Populations: A Systematic Review and Meta-Analysis
Authors: Farzad Gohardehi  , Hesam Seyedin  , Shandiz Moslehi
Published: October 2020

BACKGROUND: Non-communicable diseases (NCD) such as hypertension (HTN) and diabetes mellitus (DM) have been one of the major health problems in the world. The aim of this study was to evaluate the prevalence rate of DM and HTN following natural and man-made disasters that impose significant economic and psychological burdens on human communities.METHODS: In this systematic and meta-analysis review, all crosssectional studies that at least one of their objectives was to measure the prevalence of HTN or DM in individuals affected by natural and man-made disasters were included. Literature review was done in international databases including PubMed, Scopus and Web of Science, from database inception to February 17, 2019. The extracted data included the bibliographic characteristics of the article, the age of the participants, number of participants, gender, sample size, outcome, duration of the follow-up, and prevalence of DM and HTN. Data were analyzed by STATA software (version11) and random effect method and the I2 index were used to investigate heterogeneity between the articles.RESULTS: A total of 16 articles met the inclusion criteria. Based on the quality assessment, 11 papers were categorized as moderate and 5 paper were categorized as high quality. The prevalence of HTN and DM in disaster-exposed populations were 47.35 (CI 95%: 38.53-56.17) and 13.56 (CI 95%: 10.12-17.01), respectively.CONCLUSION: The results of this study show a high prevalence of HTN and DM in survivors of major disasters, which is higher in comparison to the general population.
Participants' Opinion about Conduct of Morbidity and Mortality Conferences in Surgical Practice in a Tertiary Hospital, Ethiopia
Authors: Berhanetsehay Teklewold  , Tilahun Deresse  , Goytom Kinfe  , Henok Teshome
Published: October 2020

BACKGROUND: Morbidity and mortality conference has both educational and quality improvement purposes. However clear evidences for the effectiveness of the morbidity and mortality conferences in improving patient safety is lacking.METHODS: A facility based cross sectional study was conducted at St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia, to assess participants’ opinion on benefits and functioning of morbidity and mortality conferences. Univariate analysis was used to determine the influence of professional type on participants’ opinion about the morbidity and mortality conferences.RESULT: A total of 98 participants completed the survey. The majority of the participants agreed that there was a structured system of case identification (67.3%), meeting format (72.4%), the conferences were conducted every month (79.6%), it is blame free (71.4%) and system of care was focus of discussion (70%). Most (88.8%) participants agreed that the conferences were important for improvement of patient safety and quality of care, whereas 67.3% of the participants believed that there is no written term of reference and prior dissemination of agendas. Only 40% agreed that there is multidisciplinary team involvement. Fifty one percent of them disagreed that there is a follow up on the implementation of the forwarded recommendations.CONCLUSION: Even though the majority of the participants were satisfied with the mortality and morbidity conferences, most disagreed on the presence of written term of reference, earlier dissemination of agendas, multidisciplinary team involvement and follow up on the implementation of the forwarded recommendations.
Perforated Peptic Ulcer Disease in a Tertiary Hospital, Addis Ababa, Ethiopia: Five Year Retrospective Study
Authors: Henok Teshome  , Mekbib Birega  , Mekdim Taddese
Published: October 2020

BACKGROUND: Peptic ulcer perforation is one of the two major acute complications of peptic ulcer disease with significant morbidity and mortality.METHODS: Institution based retrospective review was done to determine patient presentation, management and postoperative complications of perforated peptic ulcer disease (PPUD) at a tertiary hospital in Addis Ababa, Ethiopia. Patients operated on from January 2013 to December 2017 were included. Univalent analysis was used to determine the influence of patient and operative events on postoperative outcomes.RESULT: Totally, 136 patients were studied. Males outnumbered females by a ratio of 5.5:1. The mean age of patients was 36.05±16.56 years. Seventy-one (52.2%) patients presented after twenty-four hours of onset of symptoms. Most perforations were located on the first part of the duodenum (117,86%). There were 73 postoperative complications recorded in 31(22.8%) patients. Old age, being female, presence of comorbidity, hypotension, tachycardia, and delayed presentation were significantly associated with postoperative morbidity (P<0.05). Nine (6.6%) patients died at the hospital. Mortality was significantly associated with old age, comorbid illness, tachycardia, and development of post-operative complications (P<0.05). The postoperative hospital stay of the patients with complications was 18.6 ± 14.7 days which was significantly higher than that of patients without complication 6.7±2.7days (P=0.001).CONCLUSION: Old age, being female, presence of comorbidity, hypotension, tachycardia, and delayed presentation were significantly associated with postoperative morbidity. Old age, comorbid illness, tachycardia and development of post-operative complications were found to increase the risk of mortality.
Why COVID-19 is Less Severe in Pediatric Patients?
Authors: Abraham Haileamlak
Published: October 2020

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Superior Performance of Magnetic Nanoparticles for Entrapment and Fixation of Bovine Serum Albumin In-Vitro
Authors: Mansour Binandeh  , Farrokh Karimi  , Sadegh Rostamnia
Published: October 2020

BACKGROUND: In recent years, extensive studies have been performed on magnetite nanoparticles (MNPs) and their applications, which have shown the current project to be one of the major applications by laboratory results.METHODS: The nanoparticles synthesized in this project were deposited by the co-precipitation method, which structure was identified by analyzers such as SEM, FT-IR, and EDX. The aim of this project is the adsorption and fixation of biomolecule (BSA (bovine serum albumin) protein on the surface of magnetic nanoparticles.RESULTS: The adsorption results by electrophoresis and spectrophotometric analyzers showed an absorption rate above 55% ie; 55% of the protein is fixed on the MNPs nanoparticles. This absorption is due to the high level of functionality of magnetic nanoparticles for adsorption of protein. The results of the EDX analysis also show the possible electrostatic bonding between the nanoparticles and the protein, this is derived from –OH with –NH2 groups of the nanobiocompound (MNPs /protein). After bonding, the two are easily separated.CONCLUSION: In this project, the Fe3O4 nanoparticles was synthesized and identified by SEM, FT-IR, and EDX analyzers and finally reacted with the BSA protein (for the absorption of protein on MNPs) under experimental conditions at a standard temperature of 25° C. The results showed that about 55% of the protein was fixed on magnetic nanoparticles.
Functional Haplotypes in the ADIPOQ Gene are Associated with Underweight, Immunosuppression and Viral Suppression in Kenyan HIV-1 Infected Antiretroviral Treatment Naive and Experienced Injection Substance Users
Authors: Shaviya Nathan  , Budambula Valentine  , Were Tom
Published: October 2020

BACKGROUND: Human immunodeficiency virus and injection substance use have an influence on genes and gene expression. These effects could be beneficial or detrimental in defining disease outcomes. Adiponectin gene is key in modulating metabolic and immunoregulatory functions. Understanding the effects of human immunodeficiency virus and injection substance use on the gene in the context of antiretroviral therapy is important for predicting disease outcomes.METHODS: This cross-sectional genetic study determined polymorphisms in the promoter region of adiponectin gene. Two variants were analyzed: rs2241766 and rs266729. Polymorphisms were associated with clinical markers of disease outcome; underweight, immunosuppression and viral suppression. The variants were genotyped via random fragment length polymorphism.RESULTS: GC haplotype was associated with higher odds of having underweight (OR, 2.21; 95% CI, 1.83-4.60; P=0.008 vs. OR, 2.30; 95% CI, 1.89-4.71; P=0.006) in antiretroviral treatment -naive and experienced injection substance users andimmunosuppression (OR, 1.90; 95% CI 1.67-3.98, P=0.041) in naive. Bonferroni correction revealed GC haplotype carriers only to have low body mass index in both naive (median, 14.8; IQR, 3.2kg/m2; P<0.002) and experienced (median, 15.2; IQR, 3.2 kg/m2; P<0.002) injection substance users. Circulating total adiponectin levels were higher in naive (median, 19.5; IQR, 7.9 μg/ml) than - experienced (median, 12.0; IQR, 4.4 μg/ml) injection substance users (P<0.0001). GC carriers presented with low serum adiponectin levels in both study groups.CONCLUSION: The study revealed haplotypes of adiponectin gene at loci rs2241766 and rs266729 that could determine disease outcomes in human immunodeficiency virus -1 antiretroviral treatment- naive and experienced injection substance users.
The Relationship between Social Capital and Self-Efficacy in Women with Gestational Diabetes Mellitus: A Cross Sectional Study
Authors: Sedigheh Hasani Moghadam  , Elham Yousefi Abdolmaleki  , Fatemeh Alijani  , Nastaran Bagherian Afrakoti  , Jila Ganji
Published: October 2020

BACKGROUND: Self-efficacy is one of the most likely determinants of glucose self-management and self-monitoring by diabetic patients. Also, social capital is one of the effective social factors that may affect health behaviors. The aim of this study was to evaluate the relationship between social capital and selfefficacy in women with gestational diabetes mellitus (GDM).METHODS: This descriptive- analytical cross-sectional study was conducted on 212 women with GDM in two diabetes center in Mazandaran, north of Iran, from April to July 2019. Patients' social capital and self-efficacy levels were measured using the Social Capital Questionnaire (SCQ) and Confidence in Diabetes Self-Care Scale questionnaire, respectively.RESULTS: Among eight dimensions of social capital, the highest and the lowest mean scores were related to proactivity (21.3) and tolerance of diversity (5) dimensions. The mean (standard deviation=SD) of self-efficacy total score was 40.7(18.2), indicating moderate self-efficacy. Pearson correlation coefficient indicated that there was significant positive relationship between all dimensions of social capital and self-efficacy (p˂0.05). In addition, the results of multiple regression analysis indicated that community participation, neighborhood connections, family and friends' connections, tolerance of diversity and work connections, explained 55% of the variance in self-efficacy in women with GDM (p˂0.05).CONCLUSION: The results highlighted a significant positive relationship between social capital and self-efficacy in women with GDM. Improving women’s social capital may enhance their self-efficacy in controlling GDM.
Indications and Outcome of Patients who had Re-Laparotomy: Two Years’ Experience from a Teaching Hospital in a Developing Nation
Authors: Kirubel Abebe  , Biniyam Geremew  , Befekadu Lemmu  , Engida Abebe
Published: October 2020

BACKGROUND: Complications from abdominal surgery may necessitate a second or more surgeries, re-laparotomy. It is associated with significant morbidity and mortality. Data on relaparotomy from the developing nations is limited. This study aims to assess the indications and outcome of patients who had relaparotomyMETHODS: A retrospective review of medical records of all patients who underwent Re-laparotomy at St. Paul’s Hospital Millennium Medical College from January 2016 to December 2017 was done.RESULT: Of 2146 laparotomies, 6.9% (149) needed re-laparotomy and 129 patients were analyzed. Most (123,95.3%) had on-demand re-laparotomy. Patients operated on emergency made 70.5% (91) of the cases making the ratio of emergency to elective surgery 2.4:1. The three most common surgeries that needed re-laparotomy were, Perforated appendicitis (35,27.1%), bowel obstructions (28,21.7%) , and trauma (20,13.4%). The most common indications for relaparotomy were intra-abdominal abscess (57,44.23%), wound dehiscence (17,13.2%) and anastomotic leak (15 ,11.6%). Surgical site infection (128,100%) and malnutrition (58,45%) were the leading complications. The overall mortality rate was 12.8 % (19). There was no statically significant difference in mortality rate between on-demand and planned re-laparotomy (P=0.388), urgency of the primary surgery (P=0.891) and the number of relaparotomy (p=0.629). Re-laparotomy for anastomotic leak(p=0.001) and patients above fifty years of age (P=0.015) had significant associations with mortality.CONCLUSION: Intra-abdominal abscess collection, wound dehiscence and anastomotic leak were the most common indications of re-laparotomies. Age above fifty years and anastomotic leaks were significantly associated with mortality
Anemia Burden, Types and Associated Risk Factors among Kenyan Human Immunodeficiency Virus-1 and Mycobacterium Tuberculosis Co-infected Injection Substance UsersAnemia Burden, Types and Associated Risk Factors among Kenyan Human Immunodeficiency Virus-1 a
Authors: Abonyo Collins  , Shaviya Nathan1  , Budambula Valentine  , Were Tom
Published: October 2020

BACKGROUND፡ Although injection substance users and individuals co-infected with Human Immunodeficiency Virus-1 and Mycobacterium tuberculosis suffer marked hematologic derangements, the rates, levels, morphologic types and associated risk factors of anemia among Human immunodeficiency virus and Mycobacterium tuberculosis coinfected injection substance users has not been reported in Kenya.METHODS: This cross-sectional study determined anemia rates, levels and morphologic types. Anemia was associated with clinical markers of disease- underweight, immunosuppression and viral load. Complete blood count, CD4 T-cell enumeration and viral load were determined via standard laboratory methods.RESULTS: All injection substance users had higher rates of anaemia (HIV+TB+ ISUs, 79.3%; HIV-TB+ISUs, 70.0%; HIV+TB- ISUs, 56.6% and HIV-TB- ISUs, 56.2%) relative to non-ISUs (16.6%; P<0.05). A significant proportion of HIV+TB+ISUs (47.8%) developed severe anemia than other clinical groups. The commonest morphologic type of anemia in HIV+TB+ISUs was microcytic hypochromic (43.5%) followed by normocytic hypochromic (17.4%) relative to the other clinical groups. HIV+TB+ ISUs with CD4 T-cells <200/uL (OR: 2.94, 95% CI: 1.41-6.13, P=0.004) and CD4 Tcells of 200-349/uL (OR: 3.24, 95% CI: 1.66-6.31, P=0.001) associated with higher odds of developing anemia.CONCLUSION: This study revealed that severe anemia and microcytic hypochromic anemia are the most common erythrocytic sequelae among Human Immunodeficiency Virus-1 and Mycobacterium tuberculosis co-infected ISUs. Those with CD4 T-cells < 350/uL are utmost expected to develop anemia.
Severe Acute Malnutrition among Unoperated Ethiopian Children with Congenital Heart Disease: A Wake-up Call to Reverse the Situation, A Retrospective Cross-Sectional Study
Authors: Bruk Assefa  , Henok Tadele
Published: October 2020

BACKGROUND፡ Children with Congenital Heart Disease (CHD) are at increased risk for severe acute malnutrition (SAM). We aimed to determine the magnitude and determinants of SAM among children with CHD in a tertiary hospital.METHODS: Retrospective cross-sectional study was conducted among children with CHD between 2016 and 2019. Clinical and anthropometric data were retrieved from medical records. Anthropometric assessment was done by using WHO standard growth curves. Data analysis was done using Statistical Package for Social Sciences V22. Statistical significance was set at p-value<0.05, and multivariable logistic regression was used to determin predictors.RESULTS: There were 2400 pediatric admissions during the study period,CHD accounted for 6.5%(156) of admissions. For review, 141 records were eligible. The gender distribution was comparable, males 51.1% (72). Infants (<12 months) and older children (>12 months) accounted for 57.4% (81) and 42.6% (60) of study subjects, respectively. SAM was documented in 51.8% (73) of the study subjects, [95% CI: 44.7-60.2]. Infants had higher odds of SAM compared to children aged >12 months[adjusted odds ratio (AOR)= 4.48, 95%CI:2.07-9.70]. Anemic children had higher odds for SAM[AOR =3.76, 95% CI:1.54-9.18]. Children without acyanotic CHD with heart failure(HF) were 58% less likely to develop SAM[AOR= 0.42, 95% CI:0.19-0.96].CONCLUSION: The burden of SAM among children with CHD is high. Younger age,anemia and acyanotic CHD with HF predicted SAM.Screening for anemia and targeted anthropometric assessment are recommended for early SAM detection.
Modern Trends in Ownership and Acquisition of Large-scale Lands in Teshie and Kasoa, Ghana
Authors: Miller Appau Williams , Tannor Oliver , Peres Ofori
Published: October 2020

With the rising urbanisation of some parts of Ghana, the demand for land for various purposes is inevitable. The article assesses current trend of  large-scale land acquisition in Teshie and Kasoa. The study used semi-structured interviews to solicit primary data from key informants such as chiefs at Nyanyano-Kasoa and Tsie-We family head at Teshie, land guards, and investors who acquire large scale lands in these areas to identify the trends in such acquisitions between 2014 to 2019.The study uncovered that though there are variations in the nature of land ownership in Teshie and Kasoa, multiple sale of lands, poor land management practices, litigation and land guarding are common practices in both areas. The study found that there is an institutional gap as both the state and traditional institutions have not really done much to deal with the challenges  confronting LSLAs in these areas. It is recommended that land owning groups be engaged and educated by the Lands Commission in collaboration with Customary Lands Secretariat on proper ways to manage and sell their lands to avoid multiple sales and the conflicts that it brings. The Ghana police service should crackdown on land guarding which is an illegal activity.

Keywords: Large-scale, Land Acquisition, Land Ownership, Customary Land Secretariat, Traditional Authorities
Substance Abuse among In-School and Out-Of-School Youth in Sokoto, Northwestern Nigeria
Authors: Sarkingobir Y. , Dikko M.
Published: October 2020

The objective of this study was to investigate substance abuse amongst in-school and out-of-school youth in Sokoto, northwestern Nigeria using cross-sectional descriptive survey. In the course of the survey, the commonly use substances, causes, effects, and protection were assessed. The data obtained show that, most of the respondents were males (93%), only few were females (6.7%). All the respondents were Muslims. Most of the out-of-school youth (OSY) were married (80%) and only 6.7% are married among in-school youth (ISY).The respondent’s age was within 18-22 years in most cases. Most (80%) of ISY were at senior secondary classes, 46.7% of OSY left school after primary education, 26.7% never attended school. Most of the respondents have more than 2 kids (93.3%), only 6.7% have about 10 kids. Commonly cited drugs are: cigarette, cannabis, alcohol,  inhalants, tranquilizers, opiates, and hallucinogens. Reasons for substance abuse were: social/ peer pressure, rebellion, overwork/learning, shyness, fear, parental influence, fun and lack of role model. It also revealed that ISY started drug use earlier than the OSY. Friends, drug pushers, curiosity introduced youth to drugs. Effects of substance abuse are: bad temper, disturbed sleep, ill-health, depression, anxiety, tiredness, disrespect, failure at workplace/school on individual. At family level the effects include: disgrace, breakdown of relationship, loss of confidence in child, and ill-health. While at friend’s level, the effects include: breakdown of relationship, fear, anxiety. And at community or society levels, the effects listed were: crime, reduced productivity, violence, ill-health, high cost of treatment, accidents. To protect youth from substance abuse diverse efforts by governmentand NGOs and interventions are required.

Keywords: Substance abuse, drug, out-of-school youth, in-school youth, key informants, public health
Economic Analysis of Cassava Flour and Garri Production in Ibarapa Local Government Area, Oyo State, Nigeria
Authors: Adesope A.A. , Olumide-Ojo O. , Oyewo I.O. , Ugege B.H. , Oyelade A.A.
Published: October 2020

Cassava, an edible root crop and a reliable and relatively inexpensive source of carbohydrate, is widely grown and processed into different foods such as cassava flour and garri. The study analyzed the costs and returns in cassava flour and garri production and also determined the factors influencing its production in the study area. A two- stage sampling technique was used to generate primary data used for this study. The first stage involved the purposive selection of Ibarapa North Local Government Area (LGA), because it has more cassava producers and processors than other LGAs. The second stage involved the random selection of 15 villages out of the 23 in the LGA. From the selected villages, 170 respondents were randomly selected while only 150 copies of the structured questionnaire administered were retrieved. Results from the primary data shows that 28.3% of garri producersproducers had no formal education and 46.7% were between the ages of 30 and 39years. The regression analysis shows that the quantity of garri sold (ß =5.4099), transportation cost (ß =-0.2994), peeling cost (ß = -0.4249), and grating cost (ß = 0.6878) were all  significant to the total revenue of cassava flour sold. Price, inadequate capital, transportation, land tenure and markets were factors influencing garri and cassava flour production. Analysis of the costs and returns revealed that processing cassava into garri gave a higher gross margin even though processing of cassava was profitable, indicating that there is a significant difference between flour and garri production. Inputs, market, good and infrastructural facilities should be provided so as to increase production capacity and hence food security.

Keywords: Cassava, Cassava flour, Garri, Gross margin, Nigeria
Effect of Alum-treated Groundnut (Arachis hypogea) Shell Meal on Blood Chemistry and Carcass Characteristics of Broiler Chickens
Authors: Egbewande O.O.
Published: October 2020

Effect of alum-treated groundnut (Arachis hypogea) shell (ATGNS) meal was studied on the blood chemistry and carcass characteristics of broiler chickens. Two hundred and forty (240) day-old broiler chicks of Anak strain were used for the study in a completely randomized design for eight weeks. The chicks were allotted into six groups of forty chicks each and further divided into four replicates of ten chicks each.Groundnut shell (GNS) was processed by soaking it in water containing alum in ratio 1kg of groundnut shell: 15 litre of water: 600g of alum for three, four, five and six days. Wheat offal was included at 10% in T1 as positive control, 4% wheat offal and 6% untreated groundnut shell (GNS) in T2 as negative control, and 4% wheat offal with 6% treated GNS in treatments 3, 4, 5 and 6 at three days, four day, five days and six days of processing respectively. Results on haematological parameters were not significantly (p>0.05) different except mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH). Birds in T5 performed better than others in mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) with highestvalues of 123.83% and 41.93pg respectively, while birds in T3 had the lowest values of 115.28% and 39.05pg in the two parameters respectively. There were significant (p<0.05) differences in serum total protein, albumin and globulin, while other parameters measured showed no significant (p>0.05) differences in serum biochemical studies. Birds fed treatment 1 (T1) had the highest values of 3.95 and 2.72g/dl in total protein and globulin respectively, while the lowest values 2.55 and 0.97g/dl were obtained from birds in T6 respectively. Cut-up parts showed significant (p<0.05) differences in head, neck, back and thigh across treatment means with the exception of other parameters considered. The live weights of birdson processed groundnut shell meal, although not significantly (p>0.05) different, were better (p<0.05) than those on untreated groundnut shell meal (T2). Birds in T6 had the highest values (2.95, 4.60 and 12.53%) in head, neck and thigh respectively. The highest weight (18.02%) of back was recorded in T1. Birds in T4 had the highest values of 19.60 and 4.20% in breast muscle and shank respectively, while those in T3 recorded the lowest (14.65%) in breast muscle, and those in T2 had the lowest (3.56%) in shank. The results in conclusion, showed that alum-treated groundnut shell(ATGNS) could replace wheat offal at 6% level of inclusion by improving carcass yield as well as maintainingblood profile of broiler chickens.

Keywords: Groundnut shell, alum, blood chemistry, carcass, broiler
Establishment and Early Regeneration of Stem Cuttings from Chicken Weed (Portulaca quadrifida L.) as Influenced by Soil Types
Authors: Garba Y. , Musa M. , Mustapha A.B. , Bagudo H.A. , Majin N.S. , Gana M.
Published: October 2020

Differences in the ability of soil are a requirement for early regeneration of a plant. It was a pot experiment carried out at Sokoto in the Sudano Sahelian agro-ecological Zone of Nigeria. The objective was to investigate the regenerative ability of stem cuttings of Chicken weed on different soil type as a strategy for the weed control. The experimental set up was 3 × 7 factorial arrangement in a Completely Randomized Design. The treatments consisted of seven stem cuttings types namely (NLA-D - node leaf attached at distal stem location, NLR-D - node leaf removed from distal stem location, NLA-P- node leaf attached at proximal stem location, NLR-P- node leaf removed from proximal stem location, IN-D - internodes at distal stem location, IN-P- internodes from proximal stem location and SRA- stem roots attached) and three soil textural class (Sandy, Silty clay and Loamy sand). Result revealed that Silty clay recorded highest number of survived plants. Plant height, number of leaves, nodes, internodes and internodes length were greatly favoured by sandy soil. Loamy sand supported the earliness to leaf emergence and flowering. NLA-D supported the early regeneration of the plant in all stem cuttings tested, but earliness to leaf emergence and flowering was better with NLAP. This finding gave information that Chicken weed regenerate profusely and control measures should be administers to save target crop from yield losses.

Keywords: distal, proximal, stem cuttings, soil textural class, regeneration