Addressing substance abuse among healthcare professionals in a tertiary healthcare facility in Nigeria: a case study of Nnamdi Azikiwe university teaching hospital

Background: The use of psychoactive substances is prevalent worldwide, including among healthcare workers whose well-being, productivity, and effectiveness in addressing substance addiction in patients and the wider community can be significantly impacted. However, the extent of substance misuse among healthcare professionals in Nigeria, with its substantial social and public health implications, remains poorly understood. This research focused on the prevalence, attitudes, substances used, and influencing factors regarding substance misuse among staff at Nnamdi Azikiwe university teaching hospital (NAUTH) in Nnewi. Methods: A descriptive cross-sectional study was conducted involving 194 healthcare workers, using a multi-stage sampling method. Data were collected via a semi-structured self-administered questionnaire and analyzed with SPSS version 20. Results were presented in tables, considering p values less than 0.05 as significant. Results: Of the 197 respondents, 63.5% were female and 36.5% male, spanning various professions including doctors, nurses, and other healthcare specialists. Notably, 66% of participants had used substances in their lifetime. Alcohol was the most commonly abused substance, with significant percentages of moderate and high-risk users. Socialization and peer pressure were identified as the predominant factors influencing substance use, with significant statistical associations found between substance use and variables such as profession, sex, and duration of practice. Conclusions: The study highlighted a considerable prevalence of alcohol use among healthcare workers, who generally held a moderate view towards substance misuse and identified socialization and peer pressure as key factors. These findings underscore the pressing need for targeted training and intervention strategies for substance addiction among healthcare workers in Nigeria

Evaluation of hematological parameters and platelet yield in voluntary blood donors by plateletpheresis: a one-year study at the blood centre in a teaching hospital

Background: The present study was planned to compare of pre and post donation hematological parameters in healthy donors by plateletpheresis. Also to assess the platelet yield following plateletpheresis procedure with its correlation to pre donation platelet count. Methods: This is a retrospective cross-sectional study carried out in the Blood Centre of a tertiary care hospital in Haryana, India between January to December 2022. Plateletpheresis was done on Trima Accel Automated Collection System with ACD‐A as an anticoagulant. The data was collected from the hospital for hematological parameters (Hb, hematocrit, Total WBC count, total platelet count) pre and post donation. Categorical data is presented as frequency, percentage, mean±SD range. Correlation was established between the pre donation platelet count and the platelet yield. Results: A total of 125 donors were included in the study with majority of the donors 69 (55.2%) in the age group 21-30 years. Mean age of the donors included in the study was 31.58±7.5 years. The levels of hemoglobin dropped from 14.16±0.95 to 13.92±1.002 gm/dl, hematocrit dropped from 41.19±1.33 to 40.91±2.89%, total WBC count reduced from 7.64±1.38 to 7.61±1.36 103/ l and platelet count dropped from 279.5±62.96 to 259.9±58.38 lac/ l. There was a significant drop in the levels of platelet post donation by 7.01% compared to pre donation levels. majority of the donors (44%) had a mean platelet yield 2.49±0.33 with a platelet count between 1.5-2.5x1011/l. The maximum platelet yield was 4.93±0.34 in 6% donors with pre-donation platelet count of >4.5 5x1011/l. A linear significant relationship was established between the platelet count and the platelet yield (r=0.99). Conclusions: There were significant changes in the pre donation and post donation hematological parameters among the donors. It was concluded that donors with a high pre-donation platelet count can be considered for better platelet yield

Carotid intima-media thickness in patients with non-alcoholic fatty liver disease: a study from eastern part of India

Background: Carotid intima-media thickness (CIMT) is a reliable marker of atherosclerosis and cardiovascular events. Association between CIMT with non-alcoholic fatty liver disease (NAFLD) is well known; however, such data are limited from India. This study aimed to assess CIMT in NAFLD patients compared to the healthy control, its relationship with other metabolic covariates, and predators of increased CIMT. Methods: In an observational study, involving 150 subjects (84 NAFLD and 66 healthy controls), B-mode ultrasound was used for the evaluation of CIMT. Results: The mean CIMT was significantly higher in NAFLD patients compared to the control group: 0.77±0.27 versus 0.57±0.11 mm on left side, p<0.001 and 0.79±0.22 versus 0.54±0.12 mm on right side, p<0.001. The difference was significant even after adjustment of metabolic confounders. Eight NAFLD patients had carotid plaques compared to none in the controls. The mean CIMT did not differ significantly between lean, overweight and obese subjects. A progressive increase in mean CIMT was noted with increasing grades of hepatic steatosis. High CIMT values (>95th percentile value in controls, 0.79 mm) were found in 52.3% of NAFLD. On multivariate regression analysis, age [odds ratio (OR) 1.42, p<0.001], serum HDL cholesterol [OR 0.92), p=0.02] and NAFLD [OR: 3.5, p<0.001] were found to be independently associated with high CIMT. Conclusions: NAFLD was significantly associated with CIMT which increased progressively with increasing grades of hepatic steatosis. Over half of NAFLD had increased CIMT, and NAFLD along with higher age and lower HDL- cholesterol independently predicted high CIMT values

Bacterial vaginosis and the role of prebiotics and probiotics: current practices

Bacterial vaginosis (BV) is characterized by overgrowth of opportunistic bacteria and a decrease in the levels of Lactobacilli. BV is commonly encountered by gynaecologists practicing in India. The opinions of 21 gynaecologists across India regarding diagnosis and management of BV were sought via focussed group discussions. In Indian women, BV is more common in the reproductive age group, perimenopausal women, women with polycystic ovarian disease (PCOD), pregnant women, and in teenagers/pubertal age group. BV is often underestimated as it is not diagnosed by family physicians. The panel of experts opined that they preferred to conduct screening for BV in all high-risk pregnant cases, women with bad obstetric history such as premature abortions and women with a history of tuberculosis. One challenge faced by clinicians in the real-world setting is recurrent infections of BV in their patients. For the treatment of BV, antibiotics can be prescribed along with pre-probiotics to avoid dysbiosis and to prevent recurrence of BV. Pre-probiotics should be administered in sufficient amounts for adequate management of BV. More than 80% of Lactobacilli species should be present in an ideal pre-probiotic to ensure adequate production of acid and bacteriocins for the destruction of unhealthy bacteria and prevention of microfilm formation. The results with the pre-probiotics used will depend on the quality of the formulation and the maintenance of the cold chain. Prebiotic -probiotic supplementation may be considered a new adjuvant treatment for BV

A rare case of symptomatic bilateral pheochromocytoma

Pheochromocytoma with reported incidence of 2-8 per million, is a rare and special tumor with its own unique clinical and pathological features, originating from the amazingly intelligent neuroendocrine cells of chromaffin cells of the adrenal medulla. It may behave as ‘great masquerader’ and be sweet and predictable as a child, while at times act as a ‘treacherous murderer’ crashing and tearing everything in its path with fierce rage, the main cornerstone of the disease being surgical excision. Here, we report a rare case of middle aged female presenting with hypertensive crisis which necessitates intensive care unit (ICU) management where she responded well to anti-hypertensives and radiological investigations were suggestive of bilateral pheochromocytoma. The course of treatment consisted of array of investigations to ascertain the diagnosis before embarking on bilateral adrenalectomy keeping in mind the consequences of absence of adrenal and subsequent possibility of Nelsons syndrome, which we were able to treat successfully. Here we want to highlight the consideration of bilateral adrenal tumors as a differential diagnosis for suprarenal growths, subsequent surgical course and post-operative medical treatment highlighting the importance of mineralocorticoids and glucocorticoids for day to day functioning

Riding under the influence: unravelling substance abuse patterns among motorcyclists in South-Eastern Nigeria

Background: Drug and substance abuse has been outlined as a worldwide problem that is wreaking havoc on both social and public health across many nations. It is a global problem that affects both developed and developing countries. The objective of this study was to assess substance abuse among Okada riders in Nnewi, Anambra State, Eastern Nigeria. Methods: Drug and substance abuse has been outlined as a worldwide problem that is wreaking havoc on both social and public health across many nations. It is a global problem that affects both developed and developing countries. The objective of this study was to assess substance abuse among Okada riders in Nnewi, Anambra State, Eastern Nigeria. Results: About 221 Okada riders were assessed. Majority of them were middle aged. The mean age of the respondents were 39.5±11.1 years, with a range of 19-65 years. About 100% of the respondents were aware of substance abuse. Overall 73.3% of the respondents abuse at least a substance, with alcohol recording the highest use with 93.8% prevalence. About 77.2% of the abusers have taken these drugs before driving, and 65.2% have been involved in an accident, however only 5.4% admitted it was as a result of substance used. Conclusions: The prevalence of substances use among Okada riders in Nnewi was high. There was however a high awareness of the negative consequences of use of substance. Non-governmental organizations should target Okada riders for interpersonal communication interventions to help mitigate the use of substances

A systematic review of clinical applications and diagnostic efficacy of intravascular optical coherence tomography in cardiology

Intravascular Optical Coherence Tomography (OCT) has emerged advanced imaging modality in cardiology, offering high-resolution visualization of coronary artery structures. Since its inception in the late 1990s, OCT has undergone significant advancements, transitioning from time-domain to frequency-domain systems, thereby enhancing its clinical viability and diagnostic efficacy. We aimed to comprehensively assess the clinical applications and diagnostic efficacy of intravascular OCT in cardiology, particularly in guiding percutaneous coronary interventions (PCI) and evaluating coronary artery diseases. In methodology, A systematic search was conducted in PubMed and Google Scholar databases for studies published between 2013 and 2023, comparing OCT with intravascular ultrasound (IVUS) and conventional angiography (C.A.) in guiding PCI procedures. Studies were selected based on predefined inclusion and exclusion criteria, focusing on major adverse cardiovascular events (MACE), cardiac death, and revascularizations as outcomes. In results we included 28 studies from databased and 3 manuals, highlighting OCT's superior resolution in identifying thin-capped fibroatheromas (TCFAs), optimizing stent placement, and assessing plaque composition. Comparative analyses revealed no significant differences in clinical efficacy between OCT and IVUS, with both modalities showing superiority over C.A. in reducing cardiovascular events. The OCTIVUS trial further confirmed the non-inferiority of OCT-guided PCI compared to IVUS-guided PCI, with lower procedural complications reported in the OCT group. In conclusion, Intravascular OCT has revolutionized the diagnostic and interventional landscape in cardiology, offering unparalleled insights into coronary artery pathology. Its high-resolution imaging capabilities facilitate accurate plaque characterization, stent optimization, and real-time intervention guidance, thereby improving clinical outcomes in PCI procedures. Future research should focus on expanding OCT's applications and further validating its efficacy in diverse clinical settings

Prevention and risk factors associated with incidence of central line associated bloodstream infection: a narrative review

Central line-associated bloodstream infections (CLABSI) are a critical concern in healthcare settings, associated with high mortality rates and substantial financial burdens. This article highlights the various risk factors contributing to CLABSI, emphasizing both intrinsic and extrinsic factors, such as patient age, gender, underlying medical conditions, and catheterization duration. The prevention of CLABSI is addressed through a comprehensive bundle of evidence-based interventions, including hand hygiene, proper catheter insertion, skin preparation, catheter kits, selection of catheters, and maintenance bundles. Antimicrobial lock and flush solutions are crucial in eradicating microbes within catheter lumens. Furthermore, chlorhexidine bathing is recommended to reduce skin contaminants. Implementing these strategies collectively can significantly reduce the incidence of CLABSI, enhancing patient safety and reducing healthcare expenditure

Observation of cardiac profile among the adult population of Sreemangal

Background: Cardiovascular diseases are a leading cause of morbidity and mortality worldwide. The prevalence and risk factors of CVDs vary across different populations and regions. This study aimed to observe the cardiac profile among the adult population of Sreemangal, Bangladesh, to identify the prevalence and risk factors of CVDs in this population. Methods: This prospective observational study was conducted over a six-month period at a public health camp in Sreemangal, Bangladesh. A total of 137 adult participants were purposively selected. Data were collected through a structured questionnaire and physical examination, including measurements of blood pressure and laboratory analysis of blood samples. Results: The study found that 44.53% of participants had elevated blood pressure, and 21.90% had stage 1 hypertension. Interestingly, 36.50% of participants were unaware of their hypertension status. Furthermore, 26.28% of participants had a known history of diabetes, but blood glucose level analysis revealed an additional 14.85% of participants were prediabetic, and 6.93% were diabetic based on fasting blood glucose levels. A statistically significant association was found between increasing age and the stage of hypertension (p<0.001), and between fasting and normal blood glucose levels and the stage of hypertension (p<0.005 and p<0.05, respectively). Conclusions: The findings of this study underscore the need for targeted interventions to prevent and manage CVDs in the adult population of Sreemangal, Bangladesh. These interventions should include regular screening for CVD risk factors, health education to increase awareness of these risk factors, and strategies to promote healthy lifestyle behaviors

Hepatitis B virus total core antibody status in unvaccinated general population in a community of Bangladesh

Background: Hepatitis B virus (HBV) infection poses a significant health challenge in Bangladesh, with the hepatitis B core antibody (anti-HBc) being a crucial marker due to its lifelong presence in the bloodstream. This study aimed to evaluate the prevalence of anti-HBc (total) positivity among unvaccinated adults in Northeastern Bangladesh. Methods: This cross-sectional observational study was conducted in the Sobhanighat area of Sylhet, Bangladesh, in collaboration with the department of gastroenterology, Sylhet MAG Osmani Medical College, from November 2022 to August 2023. A total of 216 participants were selected using consecutive sampling. HBsAg, anti-HBs, and anti-HBc (total) were tested for all subjects, and data were collected using a pre-formed questionnaire and analyzed using statistical package for the social sciences (SPSS) version 24. Results: Among the participants, 16 (7.4%) tested positive for anti-HBc (total), while HBsAg was positive in 6 (2.77%) individuals. Anti-HBs was detectable in 23 (10.6%) participants, with 3 (1.38%) showing isolated anti-HBc positivity. Notably, 20% of HBsAg-positive cases exhibited heterotypic anti-HBs. Moreover, 56.25% of respondents with anti-HBc (total) positivity had detectable anti-HBs (p<0.001). Gender did not show significant associations with HBsAg, anti-HBc (total), anti-HBs, or isolated anti-HBc (p>0.05). Conclusions: The study underscores a notable prevalence of anti-HBc (total) positivity among unvaccinated individuals in Bangladesh, indicative of past HBV exposure. It underscores the necessity for enhanced vaccination coverage and robust infection control measures to mitigate HBV transmission in this demographic