Roles of family dynamics on adherence to highly active antiretroviral therapy among people living with HIV/AIDS at a tertiary hospital in Osogbo, south-west Nigeria

Background: Adherence to highly active antiretroviral therapy (HAART) has been proven to be the only effective treatment for HIV/AIDS worldwide. Good adherence to HAART might require good family support.Objective: To determine the family dynamics and social support of people living with HIV/AIDS (PLWHA) and its roles on HAART adherence at an ARV treatment clinic in Osogbo, NigeriaMethod: Descriptive cross-sectional study. Consenting PLWHA on HAART were interviewed using pre-tested semistructured questionnaire incorporating Perceived Social Support- Family Scale and Family APGAR. HAART adherence was measured using patient self report.Results: A total of 379 PLWHA were interviewed. Their mean age was 40.8 (SD=9.9) years. Most (60.7%) were females. More than half (55.7%) were currently married and the majority (72.1%) had secondary education and were Yoruba (86.3%). Most respondents (95.5%) were adherent to HAART. Over 90% were satisfied with support received from their family while 82.3% were treated like other family members. Most attributed their HAART adherence to the care and support received from their family.Conclusion: Most PLWHA had good social support and were adherent to HAART.Keywords: Family dynamics; HAART adherence; NigeriaAfrican Health Sciences 2013; 13(4): 920 - 92

Regional block versus general anaesthesia for caesarean section and neonatal outcomes: a population-based study

<p>Abstract</p> <p>Background</p> <p>Anaesthesia guidelines recommend regional anaesthesia for most caesarean sections due to the risk of failed intubation and aspiration with general anaesthesia. However, general anaesthesia is considered to be safe for the foetus, based on limited evidence, and is still used for caesarean sections.</p> <p>Methods</p> <p>Cohorts of caesarean sections by indication (that is, planned repeat caesarean section, failure to progress, foetal distress) were selected from the period 1998 to 2004 (<it>N </it>= 50,806). Deliveries performed under general anaesthesia were compared with those performed under spinal or epidural, for the outcomes of neonatal intubation and 5-minute Apgar (Apgar5) <7.</p> <p>Results</p> <p>The risk of adverse outcomes was increased for caesarean sections under general anaesthesia for all three indications and across all levels of hospital. The relative risks were largest for low-risk planned repeat caesarean deliveries: resuscitation with intubation relative risk was 12.8 (95% confidence interval 7.6, 21.7), and Apgar5 <7 relative risk was 13.4 (95% confidence interval 9.2, 19.4). The largest absolute increase in risk was for unplanned caesareans due to foetal distress: there were five extra intubations per 100 deliveries and six extra Apgar5 <7 per 100 deliveries.</p> <p>Conclusion</p> <p>The infants most affected by general anaesthesia were those already compromised <it>in utero</it>, as evidenced by foetal distress. The increased rate of adverse neonatal outcomes should be weighed up when general anaesthesia is under consideration.</p

Evidence for perinatal and child health care guidelines in crisis settings: can Cochrane help?

<p>Abstract</p> <p>Background</p> <p>It is important that healthcare provided in crisis settings is based on the best available research evidence. We reviewed guidelines for child and perinatal health care in crisis situations to determine whether they were based on research evidence, whether Cochrane systematic reviews were available in the clinical areas addressed by these guidelines and whether summaries of these reviews were provided in Evidence Aid.</p> <p>Methods</p> <p>Broad internet searches were undertaken to identify relevant guidelines. Guidelines were appraised using AGREE and the clinical areas that were relevant to perinatal or child health were extracted. We searched The Cochrane Database of Systematic Reviews to identify potentially relevant reviews. For each review we determined how many trials were included, and how many were conducted in resource-limited settings.</p> <p>Results</p> <p>Six guidelines met selection criteria. None of the included guidelines were clearly based on research evidence. 198 Cochrane reviews were potentially relevant to the guidelines. These reviews predominantly addressed nutrient supplementation, breastfeeding, malaria, maternal hypertension, premature labour and prevention of HIV transmission. Most reviews included studies from developing settings. However for large portions of the guidelines, particularly health services delivery, there were no relevant reviews. Only 18 (9.1%) reviews have summaries in Evidence Aid.</p> <p>Conclusions</p> <p>We did not identify any evidence-based guidelines for perinatal and child health care in disaster settings. We found many Cochrane reviews that could contribute to the evidence-base supporting future guidelines. However there are important issues to be addressed in terms of the relevance of the available reviews and increasing the number of reviews addressing health care delivery.</p

Construct validation of an instrument to measure patient satisfaction with pharmacy services in Nigerian hospitals

Background: Patient satisfaction is a multidimensional construct that reflects the type and quality of service provided by healthcare providers, how well it is delivered, and the extent to which the expectations and needs of patients are met. As a performance measure, patient satisfaction has been defined as the personal evaluation of health care services and providers Objective: To develop a patient satisfaction scale, that could be used to assess the quality of pharmacy services provided in Nigerian hospitals and to determine the construct validity of the scale with a view to identifying the factors that may be considered relevant to the target users. Methods: The questionnaire was a 35–item inventory titled “Patient Satisfaction Survey (PSS)”. This study was carried out in three university teaching hospitals located in Southwestern Nigeria. The patient satisfaction survey instrument (PSS) was administered on 506 clinic outpatients who patronised the hospital pharmacies. Participation in the study was voluntary with appropriate informed consent. Ethical approval was obtained for this study from the Medical and Ethics Committee of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC) Results: Patients with post secondary education were in the majority with a frequency of 224 (44.3%) subjects. This was followed by a frequency of 116 (22.9%) for those with secondary education. Eighty-seven (17.2%) of those included in the main study had primary education 64 (12.7%) did not receive any formal education. Fifteen (3%) out of the 506 sampled did not indicate their level of education. Conclusion: This study developed a scale to measure patient satisfaction with pharmaceutical services in selected Nigerian university teaching hospitals. The final 25 item scale presents significant and stable coefficients of correlation and yielded six derived dimensions of patient satisfaction

An unusual oral habit presenting as Dentin Hypersensitivity

Dentine hypersensitivity is a condition generally reported by the patient after experiencing sharp, transient tooth pain. It is associated with a variety of exogenous stimuli. These include thermal, tactile and osmotic changes to name a few. There is substantial variation in pain response from one person to another. We present the case of a 30-year-old man with an unusual oral habit- office pin chewing and filing of the front tooth which resulted in dentine hypersensitivity. Clinical relevance: The role of daily oral habits and techniques of cessation were suggested in the management of dentine hypersensitivity.Keywords: Unusual oral habit, dentine hypersensitivity, case reportNigerian Hospital Practice Vol. 2 (3) 2008: pp. 54-5

Effect Of Aqueous Extracts Of Allium sativum On Some Parameters Of Oxidative Stress In Mice Brain

This invitro study investigates the effects of Allium sativum L., Liliaceae, garlic on some markers of oxidative stress induced by hydroxyl radicals (OH-) generated by Fenton's reaction and potentiated by L-glutamate. Garlic at doses between 50 200mg/mL significantly decreased the activities of catalase (CAT) and acetyl cholinesterase (AChE) in the brain tissues of experimental mice incubated with iron-hydrogen peroxide ascorbate in the absence (CAT, 3.1 ± 0.9 IU/L; AChE, 0.276 ± 0.05 ΔOD/min) or presence (CAT, 1.85 ± 0.8 IU/L; AChE, 0.135 ± 0.04 ΔOD/min) of 50mM L-glutamate (Control values: 12.5 ± 0.8 IU/L and 0.576 ± 0.09 OD/min; P < 0.05). Minimum inhibitory concentration (MIC) values of the garlic were found to be 125mg/mL and 150mg/mL for CAT and AchE respectively. The hydroxyl radicalinduced reduction of total protein, RNA and DNA levels in the brain homogenate was also corrected dose dependently by garlic. Physicochemical analysis of DNAs extracted from brain tissues further revealed inhibition of hydroxyl radical-induced leftward shift in melting curve by garlic at 150mg/mL. These results suggested that Allium sativum possessed neuroprotective and anti-DNA damaging effects. Key words: Allium sativum L., Liliaceae, garlic, oxidative stress, catalase, acetyl cholinesterase, brain tissues, mice. Nig. J. Nat. Prod. and Med. Vol.8 2004: 13-1

A Comparative Evaluation of the Physical and Chemical Properties of Tamarind (Tamarindus Indica L.) Seeds in Nigeria

The physical and chemical properties of tamarind seeds (Tamarindus indica L.) in Nigeria were investigated. Tamarind fruits were randomly collected from 18 towns in the savannah region of Nigeria. The seeds were manually separated from the pulp and membranes, sun-dried andthe physical properties determined. The seeds were then manually removed from the shells to expose the cotyledon. The proximate and antinutritional compositions of the cotyledons were determined in accordance with established analytical methods. Significant differences(p.0.05) were observed in all the quality attributes of the seeds. All the seed shells were black in colour. The length and width of the seeds varied from 10.59-12.64 mm and 8.84-10.87 mm, respectively. The number of seeds per pod, number of seeds per 100 g and density of the seeds ranged between 6 and 10, 202 and 352, and 0.77 and 4.03 g/ml respectively. The hydration capacity, hydration index and swelling capacity of the seeds were 0.21-0.34, 0.42-0.82, and 0.09- 0.37, respectively. The proximate composition of the seeds ranged from 7.87-10.37 % for moisture, 6.50-9.37 % for protein, 15.70-18.67 % for fat, 2.27-5.37 % for ash, 1.10-2.4 % for crude fibre and 55.97-64.07 % for carbohydrate. The seeds contained less than 0.40% tannin, 1.50 % phytate and 0.2 % saponin. The implication of the quality attributes of tamarind seeds in food processing and human nutrition was highlighted

The Inhibition of aflatoxin production from Aspergillus parasiticus NRRL 2999 by ethanol extract of Aframommon danielli flower

The inhibition of Aflatoxin production from Aspergillus parasiticus strain NRRL 2999 was investigated using ethanol extracts of Aframommon danielli flower at concentrations of 250ìg/g, 500ìg/g, 750ìg/g and 1000ìg/g with whole wheat bread as a substrate. Aspergillus parasiticus grew abundantly on whole wheat bread; growth on samples containing 250ìg/g and 500ìg/g extracts were scanty and those of 750ìg/g and 1000ìg/g were not visible. The percentagesaflatoxin (B1 + G1) inhibitions of the flower extract were 25.2% (250ìg/g), 43.5 (500ìg/g), 65.2% (750ìg/g) and 70.2% (1000ìg/g). The percentage inhibition for Tioconazole (100ìg/g) was 88%. The result showed that Aframommon danielli flower ethanol extract can prevent mould growthand aflatoxin production in foods.Key words: Aflatoxin, Aspergillus parasiticus, daniell