Pain, range of motion and activity level as correlates of dynamic balance among elderly people with musculoskeletal disorder

Background: Assessment of impairment and disability measures on dynamic balance status of elderly patients is well documented in the rehabilitation of neuromuscular disorders. Few studies however considered similar evaluation in musculoskeletal disorders.Objective: To determine the influence of pain, hip range of motion and level of activity on dynamic balance among elderly people with hip osteoarthritis (OA).Methods: Elderly patients with hip OA participated in the cross-sectional survey. The impairment measures were assessed using the visual  analogue scale and double-arm universal goniometer whilst their levels ofactivity were assessed with the Barthel Index. Participants performed Turn-180 on two trials by taking steps clockwise and anti-clockwise round a sturdy arm chair. The total number of steps taken to complete each Turn-180 was determined. Descriptive statistics were used to summarize data whilst Pearson moment correlation coefficient determined the correlations of the variables at 95% confidence interval.Results: The study involved 87 participants comprising 40(46%) males and 47(54%) females. The age of the participants ranged from 60 to 74years with a mean of 65.8±4.5years. There was a positive and significant correlation (r=0.596; p<0.001) between the participants’ pain and steps taken to complete Turn-180. The participants’ hip flexibility and the level of activity were also significantly and inversely correlated with the performance of Turn-180.Conclusion: The dynamic balance of the sampled elderly patients was considerably influenced by pain, hip flexibility and level of activity, thereby putting premium on the assessment of the variables during  musculoskeletal rehabilitation of elderly patients.Keywords: Pain, Hip flexibility, Activity level, Turn-180, Dynamic balanc

Hydrocarbon contaminated water remediation using a locally constructed multi-stage bioreactor incorporated with media filtration

The present study investigated the coupling effect of biodegradation and media filtration in treating hydrocarbon contaminated water. The study recorded reductions in total petroleum hydrocarbon, total dissolved solids, turbidity and microbial load. The study was essentially a simulated pump and treat process that involved the pumping of hydrocarbon contaminated water for treatment in a locally designed multi-stage bioreactor incorporated with media filtration. A mixed consortium of hydrocarbon-eating microbes was applied in the study. Hydrocarbon-eating microbes were isolated from hydrocarbon contaminated soils obtained from selected mechanic workshops. Bamboo chips and coconut husk chips were applied as support media for microbial attachment within the bioreactor compartment of the treatment setup. Applied support media were approximately 2-4 cm in size. Media filters applied comprised three locally manufactured candle filters two of which were respectively impregnated with granular activated charcoal and sand. The coupling effect of biodegradation and media filtration recorded over 99 % (> 8.7 mg/L) total petroleum hydrocarbon removal. Microbial load reduction ranged from 3.57±0.11E+20 to 7.45±0.26E+20 Colony forming unit/mL, total dissolved solids reduction from 30.00±5.66 to 131.00±0.00 mg/L and turbidity reduction from 39.00±1.41 to 123.50±0.71 nephelometric turbidity units. Biodegradation accounted for 69.70±0.63 and 90.72±2.36 % total petroleum hydrocarbon removal respectively for bamboo chips and coconut husk chips

Urine dipstick as a screening test for urinary tract infection

Background: Febrile illnesses are common among children in Ghana and are often diagnosed as malaria, thus overlooking urinary tract infection (UTI) as a possible cause of fever. Aims: To determine the prevalence of UTI among febrile children,5 years and to estimate the sensitivity, specificity and positive and negative predictive values of urine dipstick as a screening test. Methods: From March to July 2004, children aged 3-60 months attending an outpatient clinic at Komfo Anokye Teaching Hospital, Kumasi were systematically screened for UTI using Combi 10 dipstick (CyBow TM). All dipstick-positive and a sample of dipstick-negative urines underwent microscopy and culture (i.e. gold standard) from clean-catch or catheterised urine. Results: Of 1393 children (median age 20 months), 112 (8%) had a positive dipstick and 29 of these (25.9%) had UTIs; 118/ 1278 (9.2%) children with a negative dipstick had urine cultured, one of whom (0.8%) had a UTI. The prevalence of UTIs was 2.1% (30/1393) and was higher among females (RR 3.99, 95% CI 1.76-9.04). 70% of UTIs were in children,2 years of age (p=50.08). The sensitivity, specificity and positive and negative predictive values of dipstick were 96.7%, 58.8%, 26.1% and 99.2%, respectively. Use of dipstick as a screening test for UTI was comparable to microscopic analysis for pyuria. 90% of all UTIs were clinically misdiagnosed (70% as malaria). Escherichia coli was the predominant isolate (60%). Co-trimoxazole and ampicillin, commonly used to treat uncomplicated UTIs at first level in Ghana, showed 0% and 8.3% in-vitro sensitivities, respectively. Ciprofloxacin and cefuroxime (widely used at regional/ tertiary level) showed good sensitivities, 99.0% and 86.2%, respectively. Conclusions: Urine dipstick should be promoted as a screening test for UTI. First-line use of cotrimoxazole and ampicillin for UTI should be reviewed

Biodegradation of used lubricating engine oil contaminated water using indigenous hydrocarbon degrading microbes in a fixed bed bioreactor system

The performance of a mixed population of hydrocarbon-degrading microbes in removing hydro-carbon contaminant in water was investigated using a fixed bed bioreactor system. The hydro-carbon-degrading microbes used for the study were isolated from oil-contaminated soil and fur-ther cultured in a nutrient medium. Sample concentrations of 500 mg/L, 1000 mg/L, 2000 mg/L and 6000 mg/L were studied. Each sample concentration was studied at loading rates of 0.5 L/min, 1.0 L/min, and 2.0 L/min for a week. Total petroleum hydrocarbon (TPH), pH, tempera-ture, dissolved oxygen (DO), conductivity and the microbial population density were measured to ascertain the progress of microbial degradation of the oil contaminant in the water. A minimum degradation rate of 36.83±0.00 % was achieved at the least administered loading rate of 0.5 L/min at 1000 mg/L oil concentration. Maximum degradation rate of 93.85±0.00 % was also achieved at loading rate of 1.0 L/min at the highest oil concentration of 6000 mg/L. The mini-mum and maximum degradation rates were achieved at microbial populations of 1.53E+13±0.00 and 1.50E+13±0.00, respectively. The hydrocarbon degradation occurred in an optimum pH range of 6.63±0.20 and 7.32±0.11 and a temperature range of 27.3±0.76 and 29.9±0.41 °C

Effect of anti-malarial interventions on trends of malaria cases, hospital admissions and deaths, 2005-2015, Ghana

Background Since 2005, the Government of Ghana and its partners, in concerted efforts to control malaria, scaled up the use of artemisinin-based combination therapy (ACT) and insecticide-treated nets (ITNs). Beginning in 2011, a mass campaign of long-lasting insecticidal nets (LLINs) was implemented, targeting all the population. The impact of these interventions on malaria cases, admissions and deaths was assessed using data from district hospitals. Methods Records of malaria cases and deaths and availability of ACT in 88 hospitals, as well as at district level, ITN distribution, and indoor residual spraying were reviewed. Annual proportion of the population potentially protected by ITNs was estimated with the assumption that each LLIN covered 1.8 persons for 3 years. Changes in trends of cases and deaths in 2015 were estimated by segmented log-linear regression, comparing trends in post-scale-up (2011–2015) with that of pre-scale-up (2005–2010) period. Trends of mortality in children under 5 years old from population-based household surveys were also compared with the trends observed in hospitals for the same time period. Results Among all ages, the number of outpatient malaria cases (confirmed and presumed) declined by 57% (95% confidence interval [CI], 47–66%) by first half of 2015 (during the post-scale-up) compared to the pre-scale-up (2005–2010) period. The number of microscopically confirmed cases decreased by 53% (28–69%) while microscopic testing was stable. Test positivity rate (TPR) decreased by 41% (19–57%). The change in malaria admissions was insignificant while malaria deaths fell significantly by 65% (52–75%). In children under 5 years old, total malaria outpatient cases, admissions and deaths decreased by 50% (32–63%), 46% (19–75%) and 70% (49–82%), respectively. The proportion of outpatient malaria cases, admissions and deaths of all-cause conditions in both all ages and children under five also fell significantly by >30%. Similar decreases in the main malaria indicators were observed in the three epidemiological strata (coastal, forest, savannah). All-cause admissions increased significantly in patients covered by the National Health Insurance Scheme (NHIS) compared to the non-insured. The non-malaria cases and non-malaria deaths increased or remained unchanged during the same period. All-cause mortality for children under 5 years old in household surveys, similar to those observed in the hospitals, declined by 43% between 2008 and 2014. Conclusions The data provide compelling evidence of impact following LLIN mass campaigns targeting all ages since 2011, while maintaining other anti-malarial interventions. Malaria cases and deaths decreased by over 50 and 65%, respectively. The declines were stronger in children under five. Test positivity rate in all ages decreased by >40%. The decrease in malaria deaths was against a backdrop of increased admissions owing to free access to hospitalization through the NHIS. The study demonstrated that retrospective health facility-based data minimize reporting biases to assess effect of interventions. Malaria control in Ghana is dependent on sustained coverage of effective interventions and strengthened surveillance is vital to monitor progress of these investments