Antibacterial potency of the coat of Citrus sinensis (orange) on Bacillus species

Background: In other to curb the resurgence of drug resistance, there is need to find cheaper, environmental friendly and readily available alternative chemotherapy for all patients for all ages. Extracts from plants has proven to be potent against wide range of pathogen such as bacteria, viruses, fungi and parasites of which Citrus sinensis is an important example. Both the aqueous and ethanoic extracts of Citrus sinensis were evaluated on some Bacillus species which were isolated from vegetables in nearby farm around the Oke Ogun Polytechnic Saki. Aim: The aim of this study was to evaluate the phytocompounds and antimicrobial activities of the coat of Citrus sinensis on some Bacillus species. Methods: The aqueous and ethanoic extract of the dried plant coat was evaluated for its antimicrobial activities on the isolated organisms using Kirby bauer disc diffusion method. The isolates were subjected to molecular identification using the polymerase chain reaction and subsequent Sanger sequencing techniques. There was high correlation between the isolates’ identity at all the levels and sequencing except in few. The FASTA format of the nucleotides sequences were submitted at the GenBank at NCBI database for accession numbers which were MW362290 (Bacillus cereus), MW362291 (Bacillus cereus), MW362292 (Bacillus weidmanii), MW362293 (Bacillus cereus), MW362294 (Bacillus cereus) and MW362295 (Bacillus thuringiensis). Results: The active phytocompounds present in the aqueous and ethanol solvent were saponin, alkaloid, flavonoid, tannin, coumarin, steroid, terpenoid, cardiac glycosides, quinones, anthraquinones and phenol while Anthocyanin was present only in aqueous extract. These extracts both showed high antibiotics activities on all the isolated organisms. All the extracts recorded considerable antibiotic potency against all the isolates making the extracts of Citrus sinensis coat a suspect containing active biocidal agents. Conclusion: The coat of Citrus sinensis showed high antimicrobial properties against some Bacillus species, the antimicrobial effects was as a result of active phytochemicals present in the coat. This study established biocidal activities in both aqueous and ethanolic extracts. Its utilization for its pharmaceutical would be of great advantage both economically and environmentally

Environmental and psychosocial predictors of breast cancer screening among women in Gwagwalada Area Council, Abuja, North Central, Nigeria

Introduction: Breast cancer (BC) is the leading cause of morbidity and mortality among women. Although screening is a known cost-effective strategy for reducing its burden, uptake remains sub-optimal. This study was designed to determine environmental and psychosocial predictors to uptake of screening services among women in Gwagwalada area council, Federal Capital Territory (FCT). Methods: A descriptive cross-sectional study was conducted, and 514 women aged ≥25 years were interviewed using a semi-structured interviewer administered questionnaire. Data on socio-demography, knowledge, practice, and environmental/psychosocial barriers to screening was collected. Data analysis was done using IBM Statistical Packages for Social Sciences version 23. Results: The mean age of respondents was 38.36±11.6years. 275(53.5%) had good knowledge while 239(46.5%) had poor knowledge about BC. Assessment of utilization of screening method showed that 115(22%) of respondents had ever conducted a Breast Self-Examination while 1(0.2%) had conducted a mammography. Poor access routes (aOR:0.29 (95% CI: 0.118-0.701)), high cost of screening (aOR:0.29 (95% CI: 0.133-0.620)) and long waiting hours (aOR:0.25 (95% CI: 0.107-0.567)) were identified environmental predictors. Fear of positive diagnosis (aOR:11.41 (95% CI: 3.157-41.270)), fear of being tagged promiscuous (aOR:0.07 (95% CI: 0.007-0.810)), deficiency in awareness programs (aOR:0.39 (95% CI: 0.160-0.960)) and not aware of screening age (aOR:0.29 (95% CI: 0.102 – 0.809)), were found to be psychosocial predictors of screening. Conclusion: Screening for breast cancer among women in Gwagwalada area council was influenced by environmental and psychosocial factors. Findings from this study points to a great need in increasing sensitization programs, screening sites and subsidizing cost of screening services

Attitude to the Menopause and Sex amongst Middle-Aged Women in a Family Medicine Clinic in Ibadan, Nigeria

Background. Menopause is the expected end of reproductive life. Having a positive attitude towards it has been shown to result in a positive experience, while a negative attitude is associated with negative experiences and symptoms. Traditionally, women often abstain from sex after menopause. The study aimed to determine the level of awareness and perceptions about the menopause and sex in perimenopausal women attending a general outpatient clinic. Methods. Women over 40 years were recruited from the Family Medicine Department of University College Hospital, excluding those who were menopausal. Data analyses were done with chi-square test (p<0.05). Results. Most (302; 86.4%) of the 352 surveyed participants were aware of the menopause. Only 36.1% anticipated associated symptoms. About half (55.7%) were indifferent to menopause onset, while 23% had a positive attitude and 21.4% had a negative attitude, respectively. Younger women were less likely to have a positive attitude to the menopause (p=0.04). There were negative cultural beliefs towards sex. Sexual activity was low and declined with age (p<0.001). Many women would like treatment to improve their sexual activity. Conclusion. Most participants had a favourable disposition towards the menopause, though sexual relationships suffer. Counselling and treatment should be offered

Effect of Pregnancy and Childbirth on Sexuality of Women in Ibadan, Nigeria

A study of 375 antenatal attendees to assess women's views and experience in sexual matters during pregnancy and following childbirth. Explanatory variables included the perception women had of sex during pregnancy and after childbirth. Outcome variables were frequency and satisfaction of sexual activity. The commonest reasons for having coitus in pregnancy were marital harmony and facilitation of delivery. Libido rose throughout pregnancy but orgasms were less often experienced. The man-on-top position became less practised. Vaginal intercourse remained the commonest type. Masturbation and anal intercourse increased, while oral sex declined throughout. Marriage (OR 9.0, 95% CI 1.0–79.5) and current cohabitation (OR 13.6, 95% CI 1.6–113.4) were predictors of sex in pregnancy. Dyspareunia and partners' extramarital affairs were deterrent. Vaginal delivery and episiotomy were not significant predictors of postnatal sex. The respondents and their partners seem able to adapt to pregnancy changes and enhance their marital bonds. Anticipatory guidance and informed counselling may encourage this

Short CommunicationAttitude of Infertile Women to Child Adoption in Nigeria

Infertility has serious consequences especially in Africa where a high premium is place on child bearing. An interviewer-administered questionnaire was administered on 396 consenting women seeking infertility treatment at the gynaecological clinic of the University College Hospital, Ibadan in an attempt to assess the attitude of infertile women in Nigeria to child adoption and its acceptability as a management option for infertility. Most (64%) believed its culturally unacceptable and only 17% will try it as an option. Sustained advocacy, community mobilization and enactment of supportive laws were some of the suggestions made by respondents to improve its uptake.Keywords; Infertility, Adoption, Assisted ConceptionNig. J. Physiol. Sci. 25(2010) 47 – 4

Risk factors for blood transfusion in traumatic and postpartum hemorrhage patients: Analysis of the CRASH-2 and WOMAN trials.

BACKGROUND: Hemorrhage is a leading cause of death after trauma and childbirth. In response to severe hemorrhage, bleeding patients often receive transfusions of red blood cells, plasma, platelets, or other blood components. We examined risk factors for transfusion in acute severe bleeding in two trials of over 20,000 patients to better understand factors associated with transfusion likelihood. STUDY DESIGN AND METHODS: We conducted a cohort analysis of data from the CRASH-2 and WOMAN trials, two multinational trials that recruited patients with traumatic and postpartum hemorrhage, respectively. For each trial, we examined the effect of 10 factors on blood transfusion likelihood. Univariate and multivariate Poisson regressions were used to analyze the relationship between risk factors and blood transfusion. RESULTS: Of the 20,207 traumatic hemorrhage patients, 10,232 (51%) received blood components. Of the 20,060 women with postpartum hemorrhage, 10,958 (55%) received blood components. For patients who suffered from traumatic hemorrhage, those greater than three hours from injury to hospitalization were more likely to be transfused (ARR 1.37; 95% CI, 1.20-1.56). Postpartum hemorrhage patients had an increased likelihood of transfusion if they gave birth outside the hospital (ARR 1.30; 95% CI 1.22-1.39), gave birth more than three hours before hospitalization (ARR 1.09; 95% CI 1.01-1.17), had a Caesarean section (ARR 1.16; 95% CI 1.08-1.25), and if they had any identifiable causes of hemorrhage other than uterine atony. CONCLUSION: Several risk factors are associated with an increased likelihood of transfusion in traumatic and postpartum hemorrhage patients. Altering modifiable factors, by reducing time from injury or childbirth to hospitalization, for example, might be able to reduce transfusions and their complications. TRIAL REGISTRATION: CRASH-2 is registered as ISRCTN86750102, ClinicalTrials.gov NCT00375258 and South African Clinical Trial Register DOH-27-0607-1919. WOMAN is registered as ISRCTN76912190, ClinicalTrials.gov NCT00872469, PACTR201007000192283, and EudraCT number 2008-008441-38

Knowledge of tuberculosis management using directly observed treatment short course therapy among final year medical students in South Western Nigeria

Introduction: Equipping medical graduates with the competence to manage tuberculosis is not just  imperative but also urgent as the diseases have been consistently listed as one of the major causes of morbidity and mortality in Nigeria. However, there were no baseline studies done on knowledge of final year medical students on various aspects of TB diagnosis and management under directly observed treatment short course therapy (DOTS) which forms the basis of this study. Methods: A total of 241 final year medical students from three medical colleges in Nigeria were  interviewed. The questions assessed their knowledge about various modes of transmission, symptoms  and management of tuberculosis under DOTS. Results: More than half of the respondents (i.e. 69%) had poor knowledge on TB disease. Only 33.6%  mentioned sputum smear as the best tool of diagnosing TB according to guideline. Poor knowledge was  also exhibited when asked of various categories under DOTS treatment regimen, as 46.1% correctly  mentioned cat 1 and 2. Minority 18.7% and 6.7% had complete knowledge of 6 months duration for new  TB cases and 8 months for re-treatment cases respectively. Less than one tenth, i.e. 4.6% and 2.9%   could correctly defined what is called a new TB case and re-treatment cases according to standard  guideline. Conclusion: The study reveals gross inadequacies in TB knowledge and management practices among Nigerian final year medical students. There is urgent need for incorporation of National TB guideline into existing undergraduate medical education curriculum as well as students rotation through activities in DOTS clinic.Key words: Tuberculosis, Directly observed treatment short course therapy (DOTS)

Effect of tranexamic acid on coagulation and fibrinolysis in women with postpartum haemorrhage (WOMAN-ETAC): protocol and statistical analysis plan for a randomized controlled trial.

Background: Postpartum haemorrhage (PPH) is a leading cause of maternal death. Tranexamic acid has the potential to reduce bleeding and a large randomized controlled trial of its effect on maternal health outcomes in women with PPH (The WOMAN trial) is ongoing. We will examine the effect of tranexamic acid on fibrinolysis and coagulation in a subset of WOMAN trial participants. Methods. Adult women with clinically diagnosed primary PPH after vaginal or caesarean delivery are eligible for inclusion in the WOMAN trial. In a sub-group of trial participants, blood samples will be collected at baseline and 30 minutes after the first dose of tranexamic acid or matching placebo.  Our primary objective is to evaluate the effect of tranexamic acid on fibrinolysis. Fibrinolysis will be assessed by measuring D-dimers and by rotational thromboelastometry (ROTEM). Secondary outcomes are international normalized ratio (INR), prothrombin time (PT), activated partial thromboplastin time (APTT), fibrinogen, haemoglobin and platelets. We aim to include about 180 women from the University College Hospital, Ibadan in Nigeria. Discussion:  This sub-study of WOMAN trial participants should provide information on the mechanism of action of tranexamic acid in women with postpartum haemorrhage. We present the trial protocol and statistical analysis plan. The trial protocol was registered prior to the start of patient recruitment. The statistical analysis plan was completed before un-blinding. Trial registration: The trial was registered: ClinicalTrials.gov, Identifier NCT00872469 https://clinicaltrials.gov/ct2/show/NCT00872469; ISRCTN registry, Identifier ISRCTN76912190 http://www.isrctn.com/ISRCTN76912190 (Registration date: 22/03/2012)

Haematological and fibrinolytic status of Nigerian women with post-partum haemorrhage.

BACKGROUND: Early treatment with tranexamic acid reduces deaths due to bleeding after post-partum haemorrhage. We report the prevalence of haematological, coagulation and fibrinolytic abnormalities in Nigerian women with postpartum haemorrhage. METHODS: We performed a secondary analysis of the WOMAN trial to assess laboratory data and rotational thromboelastometry (ROTEM) parameters in 167 women with postpartum haemorrhage treated at University College Hospital, Ibadan, Nigeria. We defined hyper-fibrinolysis as EXTEM maximum lysis (ML) > 15% on ROTEM. We defined coagulopathy as EXTEM clot amplitude at 5 min (A5)  1.5. RESULTS: Among the study cohort, 53 (40%) women had severe anaemia (haemoglobin< 70 g/L) and 17 (13%) women had severe thrombocytopenia (platelet count < 50 × 109/L). Thirty-five women (23%) had ROTEM evidence of hyper-fibrinolysis. Based on prothrombin ratio criteria, 16 (12%) had coagulopathy. Based on EXTEM A5 criteria, 49 (34%) had coagulopathy. CONCLUSION: Our findings suggest that, based on a convenience sample of women from a large teaching hospital in Nigeria, hyper-fibrinolysis may commonly occur in postpartum haemorrhage. Further mechanistic studies are needed to examine hyper-fibrinolysis associated with postpartum haemorrhage. Findings from such studies may optimize treatment approaches for postpartum haemorrhage. TRIAL REGISTRATION: The Woman trial was registered: NCT00872469; ISRCTN76912190 (Registration date: 22/03/2012)

Community perception and acceptability of COVID-19 vaccine in south-west Nigeria: an online cross-sectional study

Background: The development of COVID-19 vaccines holds great potential for controlling the spread of SARS COV 2. Vaccines, irrespective of the disease are generally fraught with hesitancy, and Nigeria has a history of vaccine hesitancy. Objective: This study aimed at determining the perception of community members about the COVID-19 vaccine and their readiness to accept the vaccine in South West, Nigeria. Methods: A descriptive cross-sectional study design was employed to collect data from consenting adults using a structured online questionnaire for a period of three weeks. Data were subjected to a Chi-square test and logistic regression for bivariate and multivariate analysis, respectively. Results: A total of 807 respondents participated in the survey with 57.7% males and 42.3% females. Forty-five respondents (5.6%) had previously been diagnosed with COVID-19 while 11.5% of the respondents had co-morbidity. The overall perception of COVID-19 vaccines was good. Fifty–nine (59%) percent of the respondents were willing to accept the vaccine and will also encourage their family members to take the vaccine. Vaccine origin and cost were determinants of vaccine acceptability. Non-acceptability of the vaccine (61.6%) was based on possible adverse effects of the vaccine and mistrust of the government. Educational level, skill status, type of employment and sector of employment were associated (p < 0.001) with the acceptability of the COVID-19 vaccine. Conclusions: Citizens were willing to take COVID-19 vaccines, however, lack of trust in government programs might undermine the vaccine campaign. Hence, the government needs to rebuild trust with the citizens towards achieving a high vaccination rate for COVID-19