Tuberculosis and poverty: the contribution of patient costs in sub-Saharan Africa – a systematic review

Background: Tuberculosis (TB) is known to disproportionately affect the most economically disadvantaged strata of society. Many studies have assessed the association between poverty and TB, but only a few have assessed the direct financial burden TB treatment and care can place on households. Patient costs can be particularly burdensome for TB-affected households in sub-Saharan Africa where poverty levels are high; these costs include the direct costs of medical and non-medical expenditures and the indirect costs of time utilizing healthcare or lost wages. In order to comprehensively assess the existing evidence on the costs that TB patients incur, we undertook a systematic review of the literature. Methods: PubMed, EMBASE, Science Citation Index, Social Science Citation Index, EconLit, Dissertation Abstracts, CINAHL, and Sociological Abstracts databases were searched, and 5,114 articles were identified. Articles were included in the final review if they contained a quantitative measure of direct or indirect patient costs for treatment or care for pulmonary TB in sub-Saharan Africa and were published from January 1, 1994 to Dec 31, 2010. Cost data were extracted from each study and converted to 2010 international dollars (I$). Results: Thirty articles met all of the inclusion criteria. Twenty-one studies reported both direct and indirect costs; eight studies reported only direct costs; and one study reported only indirect costs. Depending on type of costs, costs varied from less than I$1 to almost I$600 or from a small fraction of mean monthly income for average annual income earners to over 10 times average annual income for income earners in the income-poorest 20% of the population. Out of the eleven types of TB patient costs identified in this review, the costs for hospitalization, medication, transportation, and care in the private sector were largest. Conclusion: TB patients and households in sub-Saharan Africa often incurred high costs when utilizing TB treatment and care, both within and outside of Directly Observed Therapy Short-course (DOTS) programs. For many households, TB treatment and care-related costs were considered to be catastrophic because the patient costs incurred commonly amounted to 10% or more of per capita incomes in the countries where the primary studies included in this review were conducted. Our results suggest that policies to decrease direct and indirect TB patient costs are urgently needed to prevent poverty due to TB treatment and care for those affected by the disease

THE INFLUENCE OF TYPE OF CUTTING AND GROWING MEDIUM ON GROWTH AND FLOWERING OF SCORPION ORCHID (Arachnis maingayi) Hook.f. Schltr

Orchids are of importance primarily for their horticultural appeal and accounts for 8% of the world floricultural trade. Scorpion orchid (Arachnis maingayi Hook) is highly prized for its beautiful long lasting flowers, but it is under-exploited in many countries including Nigeria. There is the need to determine the best type of cutting and growing medium protocols for commercial production of this species. Seven homogenous growing media (sawdust, topsoil, charcoal, coconut husk, wood shavings, maize cobs and rice husk) and two types of cutting (apical and non-apical) were compared in a factorial experiment laid out in Completely Randomized Design with six replications at the Federal University of Agriculture, Abeokuta, Nigeria between 2010 and 2012. Data collected on plant height, number of leaves, leaf area, shoot dry weight, days to spiking, length and number of spike, size and number of florets were subjected to analysis of variance and Tukey’s HSD at p ≤ 0.05 to separate treatment means. Apical cuttings were significantly (p ≤ 0.05) superior to non-apical cuttings in terms of all parameters assessed except floret diameter which was statistically similar. For growing medium, dry matter accumulation and spike yield were in the order of charcoal > rice husk > maize cob > topsoil > wood shavings > coconut husk. Apical cuttings planted in charcoal or rice husk gave the best results relative to other media. Thus, apical cutting is the best propagating technique and charcoal or rice husk is the best growing medium for scorpion orchid cultivation. &nbsp

Dynamic Response of an Inclined Railway Bridge Supported by Winkler Foundation Under a Moving Railway Vehicle

An investigation into the dynamical behaviour of an inclined railway bridge traversed by uniform partially distributed moving railway vehicle, and supported by an elastic foundation is carried out. The effects of shear deformation and rotatory inertia are taken into consideration. The resulting coupled partially differential equations are solved using finite difference method. It was found that the foundation moduli and angle of inclination of the bridge have significant effect on the deflection of the bridge

Socio-Economic Benefits of Microgravity Research

Microgravity researches are conducted in low gravity environments. These low gravity environments can be achieved in a number of ways including parabolic aircraft flights, sounding rockets, drop towers, clinostat.  Gravity dominates everything on Earth, from the way life has developed to the way materials interact. The reduction of gravity causes significant changes in the chosen sample which could be cells, plants, micro-organisms and small samples from material sciences. The changes that occur as a result of the effect of microgravity have led to discoveries that have been found to be of socio-economic benefits. Socio-economic benefits involve benefits in wealth, health, economic, environment. Sustainable development in an economy includes economic growth, environmental protection and social equality. Space technology applications such as in microgravity stimulate economic growth and improve the quality of life of people, in this way, it is beneficial to mankind.  Overall, products manufactured in microgravity environments have key properties usually surpassing the best terrestrial counterparts. Commercially, these products have attractive features that facilitate marketing. This review considers the various benefits of microgravity research in life-sciences such as in microbiology, pharmacy, and medicine

Some aspects of the Seed Germination and Seedling Growth of two Savanna tree Species: Prosopis africana and Dialium guineense

Studies were made on some aspects of the seed germination and seedling growth of two multipurpose trees. These include the effect of pre-sowing treatments, seed sizes and gibberellic acid on the germination of seeds and seedling growth. The tree species include Prosopis africana (Guill. & Perr.) Taub. and Dialium guineense (Wild). Two seed sizes designated small- size (Ss) and Big-size (Bs) were identified in the seed. The effect of gibberellic acid (GA3) had a greater significance effect (P < 0.05) on seed germination of both D. guineense and P. africana seeds. The big size seeds had a significant effect (P < 0.05) on the seed germination when compared to the small size seeds. The hydration/dehydration, pre-sowing treatments on the seeds did not have any significant effects on germination

Variational Iteration Method for Natural Frequencies of a Cantilever Beam with Special Attention to the Higher Modes

In this work, the variational iteration method (VIM) is used to calculate the natural frequencies of a cantilever prismatic beam especially for the higher modes of vibration. The solutions yielded by VIM are validated by comparing with the natural frequencies of the said beam for lower modes earlier obtained using analytical method and the differential transform metho

Electrocatalytic properties of prussian blue nanoparticles supported on poly(m-aminobenzenesulfonic acid)–functionalized single-walled carbon nanotubes toward the detection of dopamine

Edged plane pyrolytic graphite electrode (EPPGE) was modified with and without Prussian blue (PB) nanoparticles and polyaminobenzene sulphonated single-walled carbon nanotubes (SWCNTPABS) using the chemical deposition method. The electrodes were characterised using microscopy, spectroscopy and electrochemical techniques. Results showed that edged plane pyrolytic graphite-single-walled carbon nanotubes-prussian blue (EPPGE-SWCNT-PB) electrode gave the best dopamine (DA) current response which increases with increasing PB layers

How Effective is the Treatment of Locally Advanced and Metastatic Breast Cancer in Developing Centres?: A Retrospective Review

BACKGROUND: The use of chemotherapy in advanced metastatic breast cancer remains a subject of controversy. The thought of MicKinnon et al (early 1950s) that the course of breast cancer was unaffected by chemotherapy has been refuted by results of treatment in the developed countries. The poor result of treatment in developing centres still compares with prechemotherapy era. Consequently, The McKinnon’s thought may still lurk. We compared the survival of chemotherapy treated with chemotherapy untreated cancer of breast patients.METHOD: Records of breast cancer patients who presented and died between January 2010 and May  2014 were reviewed. The primary outcome was overall survival. Records of patients that received  chemotherapy with or without other tumor directed specific therapy were compared with records of patients who did not receive any tumor directed therapy.RESULT: Thirty-one patients received chemotherapy while 25 patients did not. All were females, more than 90% were of the patients had advanced or metastatic disease. Treatments were not biologically  directed and treatment plans were largely compromised and suboptimal. The overall mean survival was  19.2 ±9.2 months, and the median duration was 17.5 months(range 6-44months). The overall survival  was not statistically different between the two groups (p= 0.230, unequal variance assumed). The  objective of using neoadjuvant chemotherapy for fungating lesions was not achieved.CONCLUSION: In advanced and metastatic breast cancer, outcomes of patients who receive  suboptimal regimen of cytotoxic chemotherapy do not differ from chemotherapy untreated patients.KEYWORDS: breast cancer, suboptimal treatment, untreated, chemotherap

COMPARATIVE EVALUATION OF GENOTYPING AND CULTURE-BASED TECHNIQUES FOR FUNGAL KERATITIS DETECTION

The study aims to compare the direct polymerase chain reaction with microbial culture for the detection and fungal pathogens in infectious keratitis. &nbsp;A total of 81 corneal ulcers were culture and analyzed prospectively. PCR was performed with all corneal scrapping with fungal and bacteria specific primers. PCR products were analysed and compared with the culture results using standard methods. Of the 81 samples, 80 were positive by PCR, 51 for fungi and 29 for bacteria. Out of 51 PCR positive samples, 22 samples were culture positive and 29 were culture negative. The majority of PCR genotyped samples matched the positive culture results. The positive detection rate of 80/81 (98.8%) with high suspicion of fungal keratitis and positive detection rate of direct PCR 50/51(98.0%) were observed. The sensitivities for the diagnosis of fungal keratitis with direct PCR and culture were 98.0% (50/51) and 43.1% (22/51) (p&lt; 0.001) whereas the specificities were 100.0% (2/2) and 100.0% (1/1) respectively. The time required to complete the direct PCR was only 3 hours. The direct PCR assay is a rapid diagnostic technique with high sensitivity and specificity for infectious keratitis and it is expected to have impact on the diagnosis and treatment of infectious keratitis. &nbsp

IMPULSIVE DIFFERENTIAL SYSTEM WITH VARIABLE TIMES

Results on mild solution of nonclassical ordinary differential equations(NODE) with variable times and impulsive conditions are studied. The moments of impulsive effect depend on the solution