A Comparative Study of Quinine and Artemether in the Treatment of Severe Malaria in Nigerian Children

Purpose: Nigeria has adopted quinine as the drug of first choice in the treatment of severe malaria and artemether as an alternative therapy. The purpose of this study was to ascertain whether artemether is a comparable alternative to quinine in the management of severe malaria in Nigerian children. Methods: We conducted a randomized prospective study comparing quinine and artemether therapies in 90 Nigerian children with severe malaria. Results: Mortality was lower in quinine group (13.0 %) than artemether (15.9 %), Odds Ratio (OR) = 0.446 (95 % Confidence Interval (CI), 0.124 to 1.603, p = 0.249 ). The parasitaemia clearance on day 3 by quinine and artemether was 96.8 and 99.0 % (p = 0.422), respectively, while on day 14 it was 100 % for both medicines. Fever clearance by quinine and artemether was 87.7 and 90 % (p = 0.753), respectively, on day 3 but it increased to 100 and 96.42 % (p = 0.072), respectively, on day 14. For the quinine group, 71.74 % of the patients spent less than one week in the hospital versus 61.76 % for the artemether group (p = 0.829, OR = 0.883, 95 %CI = 0.284 to 2.742). Conclusion: Artemether is a comparable alternative to quinine in the treatment of severe paediatric malaria.Key words: Artemether; Nigerian children; Paediatric; Quinine; Severe malaria.

Oral health knowledge, perceptions and behaviour among nursing students in a Nigerian tertiary hospital

Aim: The purpose of the study was to investigate oral health knowledge, perceptions and behaviour amongst nursing students in a Nigerian tertiary hospital. Materials and methods: The study was conducted at University of Nigeria Teaching Hospital on 244 respondents aged 17 to 40 years, using self administered structured questionnaire. Result: Respondents showed high level of oral health knowledge. Most of them (68.3%), had never visited a dentist with females accounting for 144 (67.7%) (P > 0.05). About 58.0% of the respondents brushed once a day. Majority, 155 (70.5%), of females perceived their oral health as good as against 14 (58.3%) males. Conclusion: The respondents had good oral health knowledge, but poor oral health behaviour. Importance of regular dental visit, frequent tooth brushing, should be stressed. Keywords: Oral health, knowledge, behaviour, Nursing students, tertiary hospital. Tanzania Dental Journal Vol. 14 (1) 2007: pp. 26-2

Hand hygiene: knowledge and practice by health care workers in a tertiary health care facility in south east Nigeria

Background: The prevalence of health care associated infections can be reduced by hand hygiene (HH). This study is aimed at determining the knowledge and practice of HH among healthcare workers (HCWs).Method: descriptive cross-sectional study using semi-structured questionnaire among HCWs selected by cluster sampling was carried out at University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu.Results: Respondents were 629, mostly females (64.4%), married (62.3% and aged between 19 and 59 years. About 63% received training on HH. Average knowledge score was 80.3%. All respondents knew about the following moments of HH: before exiting patient’s care area and after contact with body fluids. However, 45.6% and 54.2% knew that HH was indicated before touching a patient and after removing hand gloves respectively. Only 12.2% of respondents washed hands before patients. All doctors and nurses washed hands before aseptic procedures. Regular access to HH resources were 17.6%, 7%, 5.5%, and 1.7% among medical laboratory scientists (MLS), doctors, nurses, and health attendants respectively.Conclusion: knowledge of HH was generally high but practice was poor for some moments of HH like before wearing gloves and leaving patients’ care area. Unavailability of HH resources was implicated.Keywords: Hand hygiene, knowledge, practice, healthcare worker

How Unsafe is Myomectomy at Caesarean Section?

Objective: To provide evidence on the safety or otherwise of the practice of myomectomy during Caesarean section.Methods: This was a prospective, randomized, case controlled study conducted at the Obio Cottage Hospital, Port Harcourt, Nigeria, between November 2011 and October 2012. 42 Caesarean section patients, who also had myomectomy, were compared with those who had Caesarean section alone. The Caesarean myomectomy cases also had the number, location and size of the fibroids removed analyzed.Results: 446 women were delivered by Caesarean section and 42 of these had Caesarean myomectomy. The mean ages were similar. Between 1 and 23, uterine fibroids were removed. The mean blood loss from the  Caesarean myomectomy and Caesarean section was 584.72 and  695.71mls respectively. There was no statistical difference in the blood loss, Hematocrit deficit and length of hospital stay (p values of 0.053, 0.299 and 0.334 respectively) while the duration of surgery and number of sutures used were statistically different between the two groups (p value < 0.001 in both). The post-operative complications were similar.Conclusions: This study found that Caesarean myomectomy is a safe procedure in experienced hands and has obvious advantages to the patient.Keywords: Caesarean section, Myomectomy, Blood loss, Port Harcourt

Biocidal effects of dennettia tripetala, zingiber officinale and benlate on seedborne fungal pathogen (fusarium moniliforme) of watermelon (citrullus lanatus) varieties.

This study was carried out to investigate the effect of plant extracts, African pepper fruit (Dennettia tripetala) and Ginger (Zingiber officinale) on seed borne fungal pathogens of Watermelon (Citrullus lanatas) seeds. Watermelon seeds were extracted for seed health test using blotter paper method. The antifungal effects of ethanol and acetone extracts of the two plant extracts and synthetic fungicide were studied under in- vitro experiment against the seed borne fungal pathogen of Watermelon at 0%, 50% and 75%. It was a 3x3 factorial experiment at 5% Probability level laid out in a Completely Randomized Design experiment with three replications Ninety percent germination was obtained in the germination and seed health test of Watermelon seeds. Seed borne fungal pathogen (Aspergillus spp. and Fusarium spp.) were identified. The potential of these organisms for pathogenicity were tested using Kock’s postulate. The result of the pathogenicity test showed that Fusarium spp. was pathogenic. All plant extracts and Benlate inhibited the fungus (Fusarium moniliforme) in culture. The inhibition was also greater as concentration increased from 50% to 75%.  It was also observed that ethanol extraction solvent did better than acetone. Generally, Dennettia tripetala extract performed better than Zingiber officinale. It could therefore be recommended that the two plant extracts used in this investigation which were very effective in the control of Fusarium moniliforme of watermelon could be an alternative to the synthetic fungicide. It could also be suggested that further studies be carried out to isolate, identify, characterize and standardize the bioactive components of these phytochemicals in a bid to commercializing their production

Nanostructured Clay (NC) and the Stabilization of Lateritic Soil for Construction Purposes

The use of Nanostructured Clay additive in lateritic soil stabilization and their effect at different percentages on the natural soil was investigated. The preliminary tests on the soil showed it was an A-2-7 soil, according to AASHTO classification. The soil sample was also observed to be silty clayey sand and the general rating as a sub-grade material was ‘GOOD’. The consistency limits result shows that the value of the LL for the natural soil is 47% and 25.15% was recorded for the plastic limit (PL) and finally the PI was 21.85% i.e. highly plastic soil. Further, the effect of the addition of NC in the proportions of 3%, 6%, 9%, 12% and 15% by weight of the stabilized Umuntu Olokoro lateritic soil was investigated. The consistency limits results showed that the addition of variable proportions of NC considerably improved the plasticity of the stabilized soil which gave 13.8%; a medium plastic material at 15% NC addition, compared to the preliminary result of 0% by weight additive which gave 21.85%; a highly plastic material. The strength properties’ test showed significant improvements with the addition of NC; CBR test result recorded 29% at 15% by weight proportion of NC which satisfies the material condition for use as sub-base material and the UCS test results similarly improved consistently and recorded a maximum UCS of 340.18kN/m2 at 15% by weight proportion of NC addition which satisfies “very stiff” material consistency for use as sub-base material. With the foregoing, the addition of various proportions of NC to the stabilized lateritic soil has presented to be a Geotechnical solution to the varied environmental failures on the road pavements. Hence NC satisfies all the material conditions for use as a sub-base material for the stabilization and improvement of the strength characteristics of lateritic soils. Finally, we call on the relevant agencies to use NC as an additive in stabilizing weak lateritic soils for use as either sub-grade or sub-base materials to save both cost and the structural failures on the roads in south eastern Nigeria. Keywords: Environmental Geotechnics; Pavement Geotechnics; Soil Stabilization; Weak Lateritic Soil; South Eastern Nigeria

Health state utilities of a population of Nigerian hypertensive patients

<p>Abstract</p> <p>Background</p> <p>Establishment of the health impact of hypertension on quality of life of Nigerians is a step towards controlling the disease. The study aimed to provide a Nigerian specific reference list of utility scores of hypertensive patients with various interacting conditions.</p> <p>Findings</p> <p>An interviewer-based, cross-sectional study was conducted using hypertensive patients in two purposively selected tertiary hospitals located in South-Eastern Nigeria. Health Utility Index Mark 3 (HUI3) was used.</p> <p>A total of 384 participants with either hypertension alone or with hypertension-associated complications were interviewed in the two tertiary hospitals.</p> <p>The overall mean utility score was 0.35 +/- 0.42. Patients with hypertension alone had the highest overall mean utility score (0.57 +/- 0.29) while hypertensive patients with stroke had the lowest overall mean score (0.04 +/- 0.36). Being a male, increase in age and mean arterial blood pressure, emergency visit and loss of work due to illness were associated with significant decrease in overall utility scores.</p> <p>Conclusions</p> <p>This study presented a reference for health state utilities of a population of Nigerian hypertensive patients.</p