Asian Journal of Medical Principles and Clinical Practice

The Growing Trend of Psychiatric Emergencies in the Modern World: A Literature Review

Fouad Mahmoud Alrahal — 2024-01-02

Psychiatric emergencies represent critical situations wherein individuals face acute mental health crises that necessitate immediate intervention to ensure their safety and well-being. These emergencies can occur and develop in various forms, and the most popular variants include suicidal ideation, severe psychotic episodes, overwhelming anxiety, or acute intoxication. The growing prevalence of psychiatric emergencies in the modern world raises concerns about the complex interplay of societal, environmental, and individual factors contributing to mental health crises. One important aspect of psychiatric emergencies is the heightened vulnerability of individuals in the face of contemporary stressors. Economic uncertainties, political instability, and rapid societal changes can exacerbate pre-existing mental health conditions or trigger acute episodes. Similarly, the influence of technology and social media introduces novel challenges, affecting interpersonal relationships, self-perception, and the amplification of mental health stressors. Environmental factors, including climate change and urbanization, add another layer of complexity to the landscape of psychiatric emergencies. Disruptions in the environment can influence mental health, and the consequences may be more pronounced in vulnerable populations. Moreover, access to mental health resources remains uneven, contributing to disparities in the prevalence of emergencies among different demographic groups. This study aims to elucidate the multifaceted factors influencing this growing trend, exploring the implications for individuals, communities, and healthcare systems. In addressing the implications of this trend, this review aims to inform strategies for early intervention, prevention, and the improvement of mental health services. It emphasizes the importance of community-based initiatives, destigmatization efforts, and the integration of mental health awareness into public health campaigns.

Digital Breast Tomosynthesis and Advanced Radiology Techniques: A Review of Their Role in Elderly Females with Breast Cancer

Gilan Abdel Aziz Ahmed Abdel Aziz Ramadan — 2024-03-06

Breast cancer is considered one of the leading causes of women’s mortality and morbidity worldwide. Despite several treatment and therapeutic procedures available, this sector still needs to be improved. The reason for this mainly lies in the fact that women mainly get diagnosed very late in the disease process and when this happens, usually not much could be done to save their lives. However, thanks to the advancements taking place in the field of medical science, there is strong hope that people will see better days in the future. Digital breast tomosynthesis (DBT) has emerged as a promising tool in breast cancer screening and diagnosis, offering enhanced imaging capabilities over traditional mammography. The aging population presents unique challenges in breast cancer detection and management, necessitating tailored approaches to imaging. This review shall focus on the recent research findings, technological advancements, and clinical outcomes related to DBT in elderly females with breast cancer. This review provides an update on the utilization of advanced radiology techniques in DBT specifically tailored for elderly females with breast cancer. Additionally, the article discusses the role of DBT in guiding treatment decisions and assessing treatment responses in elderly breast cancer patients. Insights into the benefits, limitations, and future directions of DBT in this demographic are provided, with implications for clinical practice and research highlighted. Overall, this review highlights the evolving landscape of DBT in addressing the unique needs of elderly females with breast cancer and sets the stage for further advancements in this critical area of breast imaging.

A Reflection on the Incidence and Frequency of Different Injury Patterns of Some of the Most Prevalent Orthopedic Sports Injuries in Players

Yasar Fayaz — 2024-01-04

Background: Orthopedic injuries in sports encompass a diverse array of patterns and incidences across various athletic disciplines.

Main Review: Professional football reveals fluctuating injury rates during competition and training, with thigh-related strains and hamstrings emerging as common occurrences. Equestrian sports notably feature fractures as a significant majority among reported cases, emphasizing their inherent risk. Ice hockey players commonly face shoulder injuries, exhibiting distinct lesion patterns that impact return-to-play durations. Rugby injuries predominantly affect lower limbs, often leading to player removal from the game. In contrast, basketball players grapple with ACL and meniscal injuries alongside heightened ankle sprains and bone stress incidents that hamper performance.

Conclusion: This comprehensive review underscores the complexity of orthopedic injuries prevalent in diverse sports. It emphasizes the variability in injury rates, distinctive injury patterns, and their differential impacts on various body regions. Understanding these nuances becomes imperative in formulating targeted preventive measures and rehabilitation strategies tailored to each sport.

The Prevalence of Opioid Overdose in Young VS. Old Patients: A Literature Review

Fouad Mahmoud Alrahal — 2024-01-29

Opioids are a class of drugs that include prescription painkillers like oxycodone, hydrocodone, and morphine, as well as illicit drugs such as heroin. Opioids act on the central nervous system, particularly the respiratory centers in the brain. An overdose can cause slow and shallow breathing, which can lead to a lack of oxygen in the body. Common signs of opioid overdose include pinpoint pupils, confusion, unconsciousness, and difficulty breathing. The skin may become pale or clammy, and the person's lips or fingertips may turn blue or gray. Individuals with a history of opioid use disorder, those taking high doses of prescription opioids, or those using opioids in combination with other substances are at an increased risk of overdose. Opioid overdose is a serious and potentially life-threatening medical emergency that occurs when an individual consumes a toxic amount of opioids, leading to respiratory depression, unconsciousness, and if left untreated, death. Opioid overdose is a significant public health concern, and efforts are ongoing to address both the immediate crisis of overdose and the broader issues of opioid misuse and addiction. Public awareness, education, and access to life-saving interventions like naloxone play critical roles in reducing the impact of opioid overdose on individuals and communities. This study highlights the importance of public health initiatives aimed at mitigating the impact of opioid overdose. Increased awareness, access to naloxone, and comprehensive treatment options for opioid use disorder are fundamental components of a holistic response to this pressing public health crisis. By developing a deeper understanding of opioid overdose and its implications, stakeholders can work collaboratively to implement effective strategies that save lives and address the root causes of opioid-related harm. It also lays a firm background on the misuse of opioids that leads to such problems in the future, thereby warning the physicians and medical personnel regarding an up-and-coming problem that would change the world, but mostly for the worse.

Therapeutic Approach of Sodium Glucose Co-transporter Inhibitors to Reduce Mortality and Morbidity in Type 2 DM Patients with Cardio Vascular Disorders

Samreddy Bhavani — 2024-02-10

Diabetes mellitus is a metabolic syndrome, characterized by inadequate control of blood glucose levels and it is classified into Type 1, Type 2, maturity-onset diabetes of the young (MODY), gestational diabetes, neonatal diabetes, and steroid-induced diabetes. As per the epidemiological data, 537 million adults of the age between 20-79 years age-old are suffering from diabetes. Diabetic mellitus is one of the major risk factors for cardiovascular disease (CVD), people with type 2 diabetes mellitus (T2DM) have higher cardiovascular morbidity and mortality. T2DM leads to an increased risk of cardiovascular disease, with diabetes-induced micro and macrovascular complications is that major causes of morbidity and mortality in patients with T2DM. whose of 102 studies found that T2DM was associated with a 2-fold increased risk of vascular diseases such as coronary heart disease and stroke, independent of other risk factors including age, sex, smoking, body mass index, and systolic BP. The kidney’s role in the reabsorption of glucose from the glucose filtrate has led to an investigation of SGLT2 as a potential therapeutic target for T2DM. SGLT2 inhibitors decrease the capacity of the proximal tubule to reabsorb glucose from the glomerular filtrate. Clinical studies have shown that SGLT2 inhibitors improve glycemic control when employed in patients with both early and late stages of T2DM.SGLT2 inhibitors have the potential to reduce CV risk in patients with T2DM not only through beneficial effects on glycemic control, but also via beneficial effects on body weight, bp, lipids, and serum uric acid.

An Overview of the Advanced MRI Techniques Used for the Early Detection of Stroke and other Cerebrovascular Diseases

Gilan Abdel Aziz Ahmed Abdel Aziz Ramadan — 2024-03-13

Stroke or cerebrovascular accidents pose a great threat to the health and mortality of individuals. Although strokes are now seen to be reversible, if they are not caught and intervened with, then they could lead to deadly consequences in the long term. In the modern world today, there are several interventions, therapeutic measures, and diagnostic facilities that help detect early changes within the brain in no time. Similarly, several advanced MRI techniques play a great role in the early detection of stroke and other cerebrovascular diseases in emergencies. These techniques include diffusion-weighted imaging (DWI), which allows for the visualization of acute ischemic lesions within minutes of symptom onset, aiding in rapid diagnosis. Perfusion-weighted imaging (PWI) provides valuable insights into tissue perfusion and viability, helping to identify areas of ischemia and guide treatment decisions. Susceptibility-weighted imaging (SWI) enhances the detection of hemorrhagic strokes and microvascular abnormalities, which is highly important for prompt intervention. Additionally, magnetic resonance angiography (MRA) offers detailed visualization of the cerebrovascular anatomy, aiding in identifying occlusions or stenosis contributing to cerebrovascular diseases. By integrating these advanced MRI techniques into emergency protocols, clinicians can swiftly and accurately diagnose cerebrovascular emergencies, enabling timely interventions and improving patient outcomes. This article will discuss advanced MRI techniques utilized in emergency scenarios for early detection of stroke and other cerebrovascular diseases. Rapid and accurate diagnosis is crucial for timely intervention and improved patient outcomes in such critical scenarios. Conventional MRI protocols often face limitations in providing timely information due to lengthy acquisition times and limited sensitivity to acute pathologies. Furthermore, ongoing advancements in MRI technology, including ultrafast sequences and artificial intelligence-based image analysis, hold promise for further improving the efficiency and accuracy of emergency cerebrovascular imaging.

Community-Acquired Pneumonia in Pediatric Patients

Maha Saied Ahmed Eldohemy — 2024-04-03

Community-acquired pneumonia (CAP) remains a significant cause of morbidity and mortality in pediatric patients worldwide. Epidemiological studies reveal variations in the incidence and prevalence of CAP among different age groups, geographic locations, and socioeconomic backgrounds. Various pathogens, including bacteria, viruses, and atypical organisms, contribute to the development of CAP in children, with Streptococcus pneumoniae being the most common bacterial cause. Clinical presentation can range from mild respiratory symptoms to severe respiratory distress, necessitating hospitalization and intensive care. Diagnosis relies on a combination of clinical assessment, radiological findings, and microbiological tests, although challenges persist in distinguishing viral from bacterial etiologies. Management involves appropriate antimicrobial therapy, supportive care, and consideration of vaccination status. However, rising antimicrobial resistance poses challenges in treatment selection, emphasizing the importance of reasonable antibiotic use. Prevention strategies, including vaccination against common pathogens and promotion of hygiene measures, play a crucial role in reducing the burden of CAP in pediatric populations. Overall, a multidisciplinary approach involving pediatricians, infectious disease specialists, radiologists, and public health officials is essential for effectively managing and preventing CAP in children. Further research is needed to address emerging pathogens, optimize diagnostic strategies, and refine treatment guidelines to improve outcomes in pediatric patients with CAP. This abstract provides a comprehensive review of the epidemiology, etiology, clinical presentation, diagnosis, management, and prevention strategies related to CAP in children. It will help understand the ever-changing trends in the field of child-care that come with the prevalence of pneumonia in pediatric patients.

Causes of Sudden Dimness of Vision: A Retrospective Study at the University Teaching Hospital, Awka, Nigeria

Bernard Chukwunonyerem Ochiogu — 2024-01-15

Aim: To determine the causes of sudden dimness of vision at the Chukwuemeka Odumegwu Ojukwu University Teaching Hospital. Awka, Nigeria.

Methods: This is a retrospective hospital-based survey carried out at the Chukwuemeka Odumegwu Ojukwu University Teaching Hospital Awka, Nigeria. The case notes of new patients seen at the Eye Unit of the hospital from January 2017 to December 2021 were examined. Those with a history of sudden dimness of vision were identified and relevant data were extracted and analyzed using descriptive statistics.

Results: A total of 3755 new patients were seen during the study period, of which 191 (5.1%) presented with sudden dimness of vision. Three people had bilateral lesions making a total of 194 involved eyes. Of the 191 patients, 101(52.9%) were male while 90 (47.1%) were female (M: F ratio 1.1:1). The age range was 1 year to 84years, and the mean and median age were 40.2years and 34years respectively while the bimodal age distributions of 30years and 60years (7patients each) was noted. The age range of 21-30years presented more cases of sudden vision loss at 37 (19.4%).

Generally, ocular injuries were responsible for more sudden dimness of vision 102 (53.4%), with contusion being the highest 31 (16.2%) of the traumatic diagnosis. Non-traumatic causes were responsible for 89 (46.6%) sudden dimness of vision. Forty-one eyes (21.1%) had visual acuity of 6/9 – 6/18, 85 (44%) had visual acuity of 6/18-3/60, while 68 (35.8%) presented with visual acuity of <3/60.

Conclusion: Sudden dimness of vision is a serious concern to the affected and relations. The causes are divers and may be traumatic or non-traumatic, with the traumatic type in the majority. Traumatic types of sudden dimness of vision are more common in younger age groups than older adults, and males sustain more traumatic sudden dimness of vision than in female folks. Avoiding trauma-risky tasks, applying safety measures, and adequately managing existing systemic morbidity may mitigate the trend.

Comparative Neuroprotective Effects of Atorvastatin and Ethanolic Fruit Extract of Fragaria ananassa on the Cerebellum of Methamphetamine- Intoxicated Adult Male Wistar Rats

Nwankwo M. O. — 2024-01-31

Methamphetamine (METH) is a powerful, highly addictive stimulant that affects the central nervous system. It takes the form of a white, odourless, bitter-tasting crystalline powder that easily dissolves in water or alcohol. Oxidative stress and elevated levels of reactive oxygen species (ROS) is one of the main cause of cellular damage as a result of METH exposure. Numerous plants are known to be rich in potent phytochemicals which have been used in folkloric and orthodox medicine in the prevention and treatment of different ailments. Strawberry (Fragaria ananassa) as a plant contains several polyphenols with strong antioxidant and anti-inflammatory activities as well as flavonoids, anthocyanins, and ellagic acid with strong neuroprotective efficacy. This research was designed to compare the neuroprotective effects of atorvastatin and ethanolic extract of Fragaria ananassa on the cerebellum of methamphetamine-intoxicated Wistar rats. Forty adult male Wistar rats were divided into 8 groups of 5 rats each. Group A was the negative control and had food and water only. Group B was the positive control and was exposed to 10mg/kg/body weight of METH without treatment. Groups C and D were administered 200mg/kg/body weight of extract and 10 mg/kg/bw of atorvastatin (ATVS) (a standard drug) without exposure to METH respectively. Groups E was exposed to 10mg/kg of METH and treated with 10mg/kg/bw of ATVS while F and G were exposed to 10mg/kg of METH and were treated 50mg/kg/bw and 100mg/kg/bw of the ethanolic extracts respectively. Group H was exposed to 10mg/kg of METH and treated with 200mg/kg/bw of the extract plus 10mg/kg/bw of ATVS. The results of antioxidant studies show that the atorvastatin conferred more protection against oxidative stress than the ethanolic extract of strawberry. However, its histological results show that both have equal neuroprotective effects as depicted with normal cerebellar architecture whereas its combined treatment conferred more neuroprotection on the cerebellum of Wistar rats.

Ultrasonographic Findings in Pre-operative Cataract Patients in A Private Eye Clinic in South East, Nigeria

L. I. Eweputanna — 2024-01-31

This research investigated the pre-operative ultrasonographic findings in cataract patients from a private eye clinic in South East Nigeria. The study comprised a total of 117 patients with an average age of 65±11.9, 56.4% of whom were male. Most patients (88%) had poor pre-operative visual acuity, with a substantial proportion (86.3%) exhibiting afferent pupillary defect in the eye slated for operation. The study highlighted that a notable 59.8% of the patients underwent biometry. Notably, in addition to thickening and increase echogenicity of the lenses in the study population; the ocular ultrasound identified abnormalities in 43.6% of the eyes. Specifically, the occurrence of vitreous degeneration was the most common finding (39.3%), while vitreous hemorrhage was less common (0.9%). A statistically significant correlation was found between the presence of posterior synaechie and the ultrasound findings. In addition to ocular lesions, 33.3% of patients had systemic diseases, with hypertension being the most prevalent (25.6%). The ocular co-morbidity rate was 43.9%, primarily characterized by glaucoma (26.4%) and age-related macular degeneration (12.0%). These results underline the importance of pre-operative ocular ultrasound in detecting ocular abnormalities among cataract patients, and its critical role in planning for surgical intervention. These findings also emphasize the need to manage co-existing ocular and systemic diseases among cataract patients to optimize surgical outcomes.

Phenotypic Characterization and in vitro Susceptibility Testing of Fungi Isolated from Madiga Bread (Local Staple Food) in Yenagoa Metropolis, Nigeria

Oluwayemisi Agnes Olorode — 2024-02-07

Local bread known as "madiga" is typically enjoyed by residents of Nigeria's Niger Delta region. The aim of this study is to assess madiga bread for inbuilt pathogenic fungi in evaluating its level of edibility in Yenagoa Metropolis. A total of 42 samples was obtained and analyzed include; Hand swabs from factory workers (8/19%), hand swab of madiga vendors (6/14%), madiga bread gotten from market (12/29%), and madiga bread from factories (16/39%). The samples were processed using the following methods: culturing on Saboraud Dextrose Agar, identifying fungal isolates microscopic with Lacto-Phenol Cotton blue, staining the samples with Grama stain, germ tube test, cultivating yeast isolates on CHROMagar Candida (CAC), and standardizing the pure isolates using the 0.5 McFarland turbidity standard. From the samples, 206 fungi in total were isolated. Madiga breads obtained from factories 80 (39%) have the highest isolation rate. Aspergillus niger 120(58%), Aspergillus flavus 23(11%), Aspergillus fumigatus 5(3%), Candida tropicalis 21(10%), Candida parapilosis 21(10%), Microsporum auidouini 14(7%), and Penicillin spp 2(1%), are the seven distinct fungal species that was been isolated. The pure fungal isolates were subjected to antifungal susceptibility testing using the following methods: Agar diffusion and Kirby Buer techniques with Clotrimazole (50ug), Econazole (20ug), Caspofungin (5ug), Ketoconazole (15ug), Nystatin (100lu), and Fluconazole (25ug) on Saboraud Dextrose Agar. Clotrimazole was the most effective antifungal agent against all of the fungal isolates, exhibiting a 100% susceptibility rate and 8.3% resistance to fluconazole. Because of the high rate of fungal isolation from the samples that were analyzed, which is a result of the inadequate hygiene practices used in the Madiga bread's manufacturing and distribution. It is suggested that the government implement regulations to ensure appropriate monitoring of Madiga bread production and provide workers at the factory with training on essential hygiene protocols.

Associations of Chronic Kidney Disease in a Cohort of Stable First-degree Relatives of Chronic Kidney Disease Patients at a Tertiary Health Facility in South Eastern Nigeria

Bartholomew C. Ozuemba — 2024-02-09

Background: First degree relatives (FDRs) of chronic kidney disease (CKD) patients have a greater prevalence of the risk factors for CKD than the general population and should be screened for kidney disease. There is paucity of data on the occurrence of CKD and its risk factors in the stable FDRs of CKD patients. This study was aimed at determining the associations between the various risk factors for CKD and hitherto undiagnosed CKD among the FDRs of the CKD patients.

Methodology: This was an observational prospective study involving 150 FDRs of CKD patients carried out in Nnewi, South-eastern Nigeria. Simple sampling technique was used to select the CKD probands while a stratified sampling technique was used to enroll the FDRs of the CKD subjects.

The subjects were screened for CKD using urine albumin creatinine ratio (uACR) and estimated glomerular filtration rate (eGFR). These were repeated after three months for the FDRs with initial abnormal results (uACR ≥ 30mg/g and/or eGFR < 60ml/min/1.73m2) based on the definition of CKD. Also, the risk factors for CKD that included hypertension, diabetes mellitus (DM), obesity, age, gender, cigarette smoking, heavy alcohol consumption, hyperuricaemia, herbal medication use and dyslipidaemia were assessed.

Results: Age, gender, hypertension, cigarette smoking, heavy alcohol consumption, dyslipidaemia, hypercholestrolaemia and hyperuricaemia were found to have significant association with the occurrence of CKD in the FDRs of CKD patients (P ˂ 0.001; P < 0.038; P ˂ 0.001; P = 0.008; P ˂ 0.001; P ˂ 0.01 & P ˂ 0.001 respectively).

There was no significant association between CKD and DM and herbal medication use (P = 0.782 & P = 0.081 respectively).

Logistic regression analysis showed that age (P = 0.009, OR 1.079, 95% C.I = 1.019 – 1.141), hypertension (P = 0.004, OR 10.602, 95% C.I = 2.085 – 53.920), and heavy alcohol consumption (P = 0.003, OR 12.657, 95% C.I = 2.316 – 69.159) were independent predictors for CKD among the FDRs.

Conclusion: Age, gender, hypertension, significant cigarette smoking, heavy alcohol consumption, dyslipidaemia, hypercholaestrolaemia and hyperuricaemia were significantly associated with the prevalence of CKD in FDRs of CKD patients while age, hypertension and heavy alcohol consumption were independent predictors of CKD in this group of subjects.

Effectiveness of Intravenous Iron Therapy in Patients with Iron Deficiency Anemia Presented to Emergency Department; Retrospective Study

Muqbil Sayer Alshammari — 2024-02-19

Background: Patients admitted to the Emergency Department (ED) frequently with moderate to severe iron deficiency anemia (IDA). Our goal was to investigate the safety, side effects, and results of parenteral iron treatment for IDA patients presented to HMG ALRYAN hospital in Riyadh's emergency room.

Materials and Methods: This is a retrospective study, conducted in emergency department of HMG ALRYAN hospital Riyadh, among adult IDA patients presented to emergency department for IV iron therapy. The data was collected by authors from hospital electronic database, then entered and analysed using SPSS v 24.

Results: A total of 296 iron deficiency patients were included, their mean age was 35.3 ± 11.2. Females constitute 94.6% of study sample. Mean of baseline hemoglobin concentration was 10.6 ± 1.9. 1/12 later hemoglobin concentration mean was 12.2 ± 1.6. The baseline serum iron concentration ranged from 1 - 155.1 mcg/dL, with mean ± SD of 9.5 ± 16.1. The results showed a significant association between age regarding baseline serum iron concentration, and 1/12 later serum iron concentration, where the younger age ones had higher response to iron. The statistical analysis showed a significant association between adverse effect, and admission to hospital for adverse effect (P=0.003), where most of those who hadn’t adverse effects were D/C.

Conclusion: Among included patients 5.4% had adverse effects to IV iron to treat IDA. The younger age patients had a significantly higher response to IV iron therapy.

Barriers and Strategies of Reporting Medical Errors at Benghazi Medical Center: A Cross-sectional Study in Benghazi City, Libya

Randa Gadalla — 2024-02-23

Background: Reporting medical errors (MEs) prevents potential harm to the patient. This is while patient safety is a major priority in the health system and focuses on the goal of preventing medical errors before these errors cause death, injury, or harm to the patient so medical errors are one of the major factors affecting the quality of hospital services and reducing patient safety in health care systems.

Aims: To study the Barriers and Strategies of Reporting Medical Errors (MEs) at Benghazi Medical Center (BMC).

Methods: A cross-sectional study was conducted from August to October 2021 at Benghazi Medical Center (BMC). The data was collected using a validated questionnaire where random sampling was used to represent the BMC, a represented sample of 500 clinical staff (280 physicians, 220 nurses)

Results: 219 nurses and 281 physicians from the sample stated that reporting medical errors was inadequate. The highest mean for measuring the barriers that prevent the reporting of medical errors was 3.4749 for nurses, and 3.6263 for physicians, which represents medical error reporting is inadequate. While measuring Strategies for Improving the Reporting of medical errors was 4.5662 for nurses, and 4.7794 for Physicians, which represents There should be clear guidelines and procedures for reporting errors.

Conclusion: The highest measuring the barriers that prevent the reporting of medical errors was the complexity of the work, while the highest measure in the strategy to improve the reporting system was the necessity of having clear controls and procedures for reporting medical errors.

Hepatitis B Virus Vaccination Awareness and Coverage among Adults Attending Ophthalmology Clinic in Southeast, Nigeria

Arinze Anthony Onwuegbuna — 2024-02-26

Background: Hepatitis B virus (HBV) is a public health problem affecting millions of people globally and causing severe morbidity and mortality. Sub-Saharan Africa is an endemic region for HBV. But this infection is preventable.

Aim: To determine hepatitis B virus vaccination awareness and coverage among adults attending ophthalmology clinic in Anambra State, Nigeria.

Methods: This was a prospective, descriptive, cross-sectional survey to determine hepatitis B vaccination awareness and coverage among adults attending ophthalmology clinic in Anambra State, Nigeria using a pretested, self-administered and interviewer-administered semi-structured questionnaire. Information such as sociodemographics, awareness and knowledge of hepatitis B infection and hepatitis B vaccination were collected and analyzed using descriptive variables and tests of significance.

Results: A total of 264 participants were enrolled having met the inclusion criteria. There were 110(41.7%) males and 154(58,3%) females with a ratio of 1:1.4, and the age range of 20-87 years. The mean age was 60.6 years ± 14.8 years. Majority of the participants 96.6 % (n=255) were aware of HBV infection. However, 245(89.4%) do not know how HBV is transmitted. Also, 184(69.7%) do not know about HBV vaccination while 61(23.1%) subjects had received HBV vaccination at least once. Lack of awareness of vaccine is the main reason for not being vaccinated against HBV.

Conclusion: Hepatitis B vaccination coverage among adult patients attending ophthalmology clinic in Nigeria is poor. This is mostly due to lack of awareness of HBV vaccination.

Assessment of Equipment Programming Efficiency for Blood Component Preparation to Enhance Accuracy in Service Settings and Quot

Neha Singh — 2024-03-04

Background and Objective: Component preparation is the backbone of blood centre services. Every blood centre follows standard operative techniques, for component preparation and accepts units with match quality uses for patient services. For component preparation units specific equipment named a refrigerated centrifuge machine is used, which works on the principle of centrifugal force and centripetal force. The best programming defined the above quality standard for every separated unit. The objective of the above study is the evaluation of programming of component preparation over centripetal, centrifugal forces acceleration, and deceleration with time intervals. Selection for the best program, which would matches the standard.

Materials and Methods: The study was observed over two different highly specialized equipment refrigerated cytocentrifuge machines known as (Rota Silenta and Thremofisher centrifuge), they are programmed for component preparation. Various programming followed by their Acceleration, Deceleration, Mid-interval Time, RPM, RCF, and Gravitational force,(G) were studied. Prepared products (PRBC, FFP, PC and WBC), their quality frequency was checked with a Fully Automated Hematology Analyzer evaluated.

Results: HERAEUS CRYOFUGE 16 Centrifuge results outcome was better compared to ROTA SILENTA 630 RS. The best programming of Heraeus croyofuge ACCELERATION (8) mins, DACCELARTION (8) mins and mid-interval (3) mins RPM,2350 and 3450 of 30 cm radius G Computed RCF was 2096 and 4018 noted. The above programming gives the best yield of platelets-287ug/dl, least contamination of FFP of RBC (.01) and platelets (24) ug/dl, prepared PRBC was HCT (69%), RBC was (9.6) ug/dl, and platelets contamination was (186) ug/dl. Among ROTA SILENTA best programmed was Acceleration (8), MID-Interval (3) and Deceleration (4) mins at RPM (2190,3250) with radius ( 29.5) cm along G computed RCF(1342,3018)noted respectively, which gave best product after processing.

Conclusion: Section of best programming meets the quality standard and produces the best efficacy in terms of platelets preparation (yield), (hematocrit)-and PRBC preparation. Prepared FFP was less contaminated with RBC and matched with the defined log reduction of WBC. The selection of programming can enhance the quality criteria and meet the above standard product.

Prevalence, Attitudes and Smoking Habits among Healthcare Professionals in Southwest Nigeria

Oluwaseun R. Omole — 2024-03-07

Background: Smoking among healthcare professionals poses significant challenges to public health efforts, particularly in regions like Southwest Nigeria, where smoking prevalence remains relatively high despite tobacco control measures. Understanding the prevalence and attitudes towards smoking among healthcare professionals is crucial for designing effective tobacco control interventions.

Methods: A cross-sectional study was conducted among 800 healthcare professionals in Southwest Nigeria. Data on socio-demographic characteristics, smoking habits, attitudes towards smoking, workplace environment, and lifestyle factors were collected using a structured questionnaire. Statistical analysis was performed using SPSS version 20.0, including descriptive statistics and chi-square tests.

Results: The prevalence of smoking among healthcare professionals was 9.13%, with 31.75% being former smokers and 59.12% never smoked. Factors significantly associated with smoking prevalence included gender (p < 0.001), age (p = 0.016), occupation (p = 0.037), education level (p = 0.049), years of experience (p = 0.025), beliefs about smoking harms (p < 0.001), and attitudes towards workplace smoking policies (p < 0.001). Most participants believed smoking was harmful (76.25%) and could adversely affect professional performance (68.38%). However, only 4.92% had participated in smoking cessation programs.

Conclusion: Despite high awareness of smoking harms, a significant proportion of healthcare professionals in Southwest Nigeria smoke. Workplace environment and attitudes towards smoking cessation programs are critical determinants of smoking behaviour. Strengthening tobacco control policies, promoting smoking cessation interventions, and creating supportive workplace environments are essential for reducing smoking prevalence among healthcare professionals in Nigeria.

Comparison between Widal Test and Stool Culture in the Diagnosis of Typhoid Fever in the Clinical Set-Up in Niger Delta Region of Nigeria

Oluwayemisi A. Olorode — 2024-03-19

Among Enterobacteriacae are causative agents of typhoid fever, Salmonella typhi and Salmonella paratyphi , a common infection among the inhabitants of Bayelsa State and in Nigeria at large. The aim of this study was to compare the widal test and stool culture for adopting better technique in the diagnosis of Salmonella species and its antibiotic susceptibility evaluation in the clinical setup in Bayelsa. A total of four hundred 400 {stool 200} {blood 200} samples collected from Diete Koki Memorial Hospital, Niger Delta University clinic and Federal Medical Centre, Bayelsa State were immediately taken to the medical microbiology laboratory, Niger Delta University for culture and serological test using Deoxycholate Citrate agar, Selenite-F broth and Smart Diagnostic Kit-Ref F-Kit8X5C.LOT:521-14 respectively. The standardized pure isolates to 0.5 McFarland turbidity standard were subjected to gram staining, biochemical tests and susceptibility testing using Kirby Beur agar diffusion method on Muller Hinton agar. Findings showed that out of two hundred (200) stool samples analyzed, one hundred and twenty-four 124(62%) Salmonella species were isolated 44(22%) Proteus and 32(16%) Escherichia Coli. Of one hundred and twenty-four Salmonella species isolated, 44(35.5%) were Salmonella typhi, 52(42%) Salmonella paratyphi A, while 28(22.5%) were of other Salmonella Species. Serological test on 200 blood samples analyzed revealed eighty-eight 88(44%) Salmonella typhi, eight 8(4%) Salmonella paratyphi A, 12(6%) Salmonella paratyphi B and zero (0%) Salmonella paratyphi C. Serological testing revealed eighty- four 84(42%) negative titre level and some patients with positive serological test had positive stool culture, while some negative but had positive growth of Proteus specie and Escherichia Coli. Antimicrobial susceptibility testing revealed ciprofloxacin as the most potent antibiotic with 100%, followed by ofloxacin 85% for salmonella infection and there was no significant difference at p=0.5 in their effectiveness. One hundred and twenty-four (124) patients were positive to cultural method and eighty-four 84 to serological method. Serological test detects early infection of Salmonella species while stool culture detects late infection (3weeks of incubation). These study has x-ray that both techniques (serological and cultural) should be adopted for effective diagnosis of Salmonella species in the health facilities. In conclusion serological test is Sensitive while stool culture is specific.

Assessing Knowledge, Attitudes, and Practices of Blood Donors in India during the Covid-19 Pandemic: A KAP Analysis Study

Pandeep Kaur — 2024-03-22

Background: An awareness of knowledge, attitudes, and practices (KAP) of blood donors towards COVID-19 pandemic is essential to avoid blood inventory crisis. It is therefore necessary to gain a perspective on the impact of COVID-19 on attitude of blood donors and an understanding of the key aspects of their motivation.

Methods: A prospective longitudinal study was conducted at The Department of Immunohematology and Blood Transfusion at a tertiary care teaching hospital in India over four months spanning over December 2021 to March 2022. The chi-square analysis was performed to evaluate the relationship of knowledge, attitude & practices of donors with their demographic parameters. A p-value of less than 0.05 was considered significant at a confidence interval (CI) of 95%.

Results: A total of 632 donors were included in the study and assessed for donor attitude and fear factors related to blood donation during COVID-19 pandemic. The mean age of the study population was 31 years. In terms of donor attitude, most common positive attitude was that they “would donate blood in the blood center where mask and sanitizer are available for all staff and blood donors”. Most common negative attitude was that “they had been in close contact with a patient who had a respiratory infection, so they should not donate blood”. Among the demographic variables, residential status, education & donation frequency showed a significant (p <0.05) association with donor attitude factors while its association with age and gender was found to be statistically insignificant (p >0.05).

Conclusions: Adequate sharing of information and proper communication of the precautionary measures at blood centers to contain the spread of covid-19 infection and effective counseling would help in motivating and retaining blood donors. Interventions should be implemented directed at donor population to create awareness and neutralize the myths associated with blood donation during COVID-19 pandemic.

Characterization and Preliminary Structural Elucidation of Flavonoids in the Seed of Telfairia occidentalis

Samuel Nzube Nwosu — 2024-03-22

Flavonoids are a group of plant compounds with a potential health benefits, including ant-oxidant, anti-inflammatory, and anti-carcinogenic properties. This study aimed to characterize the flavonoids in the seed of Telfaria Occidentalis using thin-layer chromatography (TLC) and Ultraviolet(UV) analysis.

Telfaria Occidentalis was extracted using methanol, and the extracts were analyzed using TLC and UV. The retention factors (Rf) of the flavonoids were determined, and the UV spectra were compared to those of standard compounds.

The TLC analysis revealed the presence of four flavonoids in the extracts of Telfaria Occidentalis, with Rf values of 6.00, 26.00, 37.00, 63.00 which were consistent with Vitexin, Gossypetin, Quercetin, and Kaempetrol respectively. The UV spectra of these compounds were also consistent with these flavonoids. These results shows that Telfaria Occidentalis is rich in flavonoids with potential health benefits. However, further research are needed to confirm the structures and chemical bonds of these flavonoids.

Prevalence and Determinants of Complementary and Alternative Medicine Use in Subjects with Hypertension in a Tertiary Centre in South East Nigeria

Michael Chinweuba Abonyi — 2024-03-30

Objective: To study the prevalence and determinants of the use of complementary and alternative medicine (CAM) in patients with hypertension (HTN).

Methods: Two hundred and fifty patients visiting the medical outpatient Clinic at Enugu State University Teaching Hospital in Southeast Nigeria were interviewed. Information was obtained on the patients' demographics, type(s), duration, pattern and disclosure of CAM use, sources of recommendation and reasons for using CAM.

Results: The prevalence of CAM use was 4.4%. The most commonly used CAM was biologic-based therapy; bitter leaf (Vernonia amigdalina) (90.9%), Ginger (90.9%), garlic (72.7%), Cinnamon (45.5%), bitter kola (Garcinia kola) (36.4%), lemon grass (9.1%), green tea (9.1%), guava (9.1%) and mango leaves (9.1%). This was followed by manipulative and body-based (exercise and relaxation), and then spiritual method (fasting and prayer). Most subjects used CAM concurrently with orthodox medicine (63.6%), and neither knew the constituent of what they were taking (72.7%) nor revealed to their healthcare provider (HCP) that they were on CAM (81.8%). The most common reason for the non-disclosure is that the HCP will discourage them (66.7%). Most subjects used CAM to manage hypertension (54.5%).

Conclusion: A proportion of patients receiving orthodox medication for HTN also use CAM. A better treatment outcome would emanate from education of HCP and the general public on CAM use, legislation on the control of unwholesome and harmful use of CAM, and well-funded research on proven and potential CAM modalities for the benefit of humanity.

Possible Effect of Cinnamomum camphora on Pain Amelioration and Pain Threshold in Mechanically Induced Pain in Female Wistar Rats

Kanayo Mercy Odia — 2024-04-05

Background: Camphor, a long-standing chemical used in various home treatments, has been extensively studied for its antibacterial, antipruritic, and contraceptive properties, and is a key ingredient in topical home treatments. The study investigated the possible effect of Cinnamomum camphora essential oil on pain amelioration and pain threshold in mechanically induced pain in female Wistar rats.

Method: the study involves 25 adult Wistar rats, divided into five groups and each group was administered different milliliters of Cinnamomum camphora, except for group 1, pains were induced in the rats via experimental procedure; passive avoidance, paw withdrawer test, and tail clip test. Data obtained were analyzed using IBM SPSS version 23.

Results: Group 2 showed a significant increase in avoidance time, a significant increase in pain threshold, and a significant decrease in pain sensitivity compared to the control group. The reverse was the case of group 4 when compared to the control group. Interestingly, the effects of C. camphora oil were more on the low-dose group than on the high-dose group.

Conclusion: These results suggest that C. camphora has an analgesic effect and is dose-dependent.

Secondary Breast Angiosarcoma: A Case Report and Review of Literature

Woroud Raed Fauomi — 2024-02-29

Angiosarcoma a very aggressive tumor of the vascular endothelium with a different clinical presentation that have been shown between primary and secondary patterns, but both represented a diagnostics challenge because of the nonspecific imaging finding in disease.

Secondary angiosarcoma which is still a rare neoplasm presented in female patient as a palpable unilateral mass after long term exposure to radiation therapy for breast cancer, final diagnosis needs a pathological report which is obtained post-surgical that’s why preoperative diagnosis by using imaging modalities and biopsy is important to avoid misdiagnosis to this rare neoplasm.

We reported a special case of 61 female patient with secondary angiosarcoma arises near the scar of previous breast surgery due to invasive ductal carcinoma, patient was exposed to radiation therapy, chemotherapy and have positive family history.