Effect of neuro-developmental therapy (NDT) on disability level of subjects with cerebral palsy receiving physiotherapy at the University of Nigeria Teaching Hospital, Enugu, Nigeria

Aim and Objective: Cerebral palsy (CP) describes a group of disorders causing activity limitation which is attributed to non-progressive disturbances that occur in the developing fetal or infant brain. The rehabilitation of children with CP has focused on increasing functionality in their daily activities. The objective of this study was to assess the disability levels of cerebral palsy patients receiving physiotherapy treatment at Physiotherapy department, University of Nigeria Teaching Hospital, Enugu, Nigeria.Methods: The study is a retrospective-repeated measures design, involving the use of Gross Motor Function Classification System (GMFCS) and the medical records of the patients. The duration and frequency of treatment were obtained from the patients’ folders. They were initially assessed on the first visit and re-assessed after 3, 6 and ≥ 12 months of physiotherapy (Neuro-developmental therapy [NDT]) exercises using GMFCS. Simple percentage (%), Kruskal Wallis and Mann-Whitney tests were used in data analyses.Results: The highest number of disability recovery cases are in the treatment frequency group of > 2 treatment per week 17(56.68%) and the first 3-6 months of treatment duration15 (50%) of NDTPhysiotherapy. However, Disability level reduces with longer (>12 months) treatment duration. Results also showed significant frequency and duration treatment effects on disability level following NDT-Physiotherapy at p< 0.05.Conclusion: It was concluded that both duration and frequent of treatment were important factors in the management of CP using NDTPhysiotherapy.Key words: Cerebral palsy, Disability, Gross Motor Function, Neuro-developmental therapy

Effect of aerobic exercise training on cardiovascular parameters and CD4 cell count of people living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome: A randomized controlled trial

Objective: Despite the significant positive effect of Highly Active  Antiretroviral Therapy on physical and psychosocial well.being of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA); decreased physical activity and its associated cardiovascular risk still pose some consequences for health and general well.being. This study investigated the effect of an 8 week aerobic exercise training on cardiovascular parameters and CD4 cell (T.cells) count of PLWHA.Materials and Methods: This randomized controlled trial recruited 30 age matched PLWHA who were randomly assigned into exercise group (EG) (n = 15) and control group (CG) (n = 15) respectively. The PLWHA were patients receiving treatment in Presidentfs Emergency Plan for AIDS relief at the HIV clinic of the University of Nigeria Teaching Hospital, Nigeria. The EG in addition to conventional therapy received moderate intensity continuous exercise training (60.79% of the maximum heart rate [max]) of between 45 and 60 min, 3 times/week for 8 weeks, while the CG received conventional therapy involving antiretroviral therapy and counseling only. Systolic blood pressure (SBP), diastolic blood pressure (DBP), maximum oxygen uptake (VO2 max) and CD4 cell count were assessed at baseline (week 1) and week 8 respectively. Analysis of co.variance and Pearson correlation tests were used in data analysis.Results: Findings of the study revealed a significant effect (ANCOVA test) of moderate intensity continuous exercise training program on, SBP, DBP, VO2 max and CD4 cell count at P < 0.05. Changes in VO2 max significantlycorrelated (Pearson correlation test) with changes in CD4 cell count (r = 0.528) at P < 0.05.Conclusion: Moderate intensity aerobic exercise is an effective  complementary therapy in lowering blood pressure and increasing CD4 cell count in PLWHA.Key words: Aerobic exercise, cardiovascular parameters, CD4 count, human immunodeficiency virus/acquired immune deficiency syndrome, Nigeri

Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014

BACKGROUND: Poor maternal and child health indicators have been reported in Nigeria since the 1990s. Many interventions have been instituted to reverse the trend and ensure that Nigeria is on track to achieve the Millennium Development Goals. This systematic review aims at describing and indirectly measuring the effect of the Maternal, Newborn, and Child Health (MNCH) interventions implemented in Nigeria from 1990 to 2014. METHODS: PubMed and ISI Web of Knowledge were searched from 1990 to April 2014 whereas POPLINE® was searched until 16 February 2015 to identify reports of interventions targeting Maternal, Newborn, and Child Health in Nigeria. Narrative and graphical synthesis was done by integrating the results of extracted studies with trends of maternal mortality ratio (MMR) and under five mortality (U5MR) derived from a joint point regression analysis using Nigeria Demographic and Health Survey data (1990-2013). This was supplemented by document analysis of policies, guidelines and strategies of the Federal Ministry of Health developed for Nigeria during the same period. RESULTS: We identified 66 eligible studies from 2,662 studies. Three interventions were deployed nationwide and the remainder at the regional level. Multiple study designs were employed in the enrolled studies: pre- and post-intervention or quasi-experimental (n = 40; 61%); clinical trials (n = 6;9%); cohort study or longitudinal evaluation (n = 3;5%); process/output/outcome evaluation (n = 17;26%). The national MMR shows a consistent reduction (Annual Percentage Change (APC) = -3.10%, 95% CI: -5.20 to -1.00 %) with marked decrease in the slope observed in the period with a cluster of published studies (2004-2014). Fifteen intervention studies specifically targeting under-five children were published during the 24 years of observation. A statistically insignificant downward trend in the U5MR was observed (APC = -1.25%, 95% CI: -4.70 to 2.40%) coinciding with publication of most of the studies and development of MNCH policies. CONCLUSIONS: The development of MNCH policies, implementation and publication of interventions corresponds with the downward trend of maternal and child mortality in Nigeria. This systematic review has also shown that more MNCH intervention research and publications of findings is required to generate local and relevant evidence

Therapeutic role of continuous exercise training programme on the lipid profile of male hypertensive patients in Kano, North-West Nigeria

Background: Some of the reported factors that increased the risk for coronary events in hypertensive individuals include elevated total cholesterol (TC), reduced high density lipoprotein cholesterol (HDL) and physical inactivity. Aim: To investigate the effect of continuous exercise training programme on blood pressure and lipid profile in subjects with hypertension.Methods: Two hundred and seventeen male patients with mild to moderate essential hypertension were age-matched and grouped into continuous and control groups. The continuous (n=112; 58.63 ± 7.22 years) group involved in an 8 weeks continuous training (60-79% HR max reserve) programme of between 45 minutes to 60 minutes, while age-matched controls hypertensive (n=105; 58.27± 6.24 years) group remain sedentary during this period. Cardiovascular parameters [Systolic blood pressure(SBP)& diastolic blood pressure (DBP)], VO2max, TC, HDL and Artherogenic Index were assessed. Students' t-test and Pearson correlation test were used in data analysis. Results: Findings of the study revealed significant decreased effect of continuous training programme on SBP, DBP, TC and significant increased effects on VO2max and HDL level at p< 0.05. Also there was a significant negative and positive correlation between changes  in VO2max and changes in TC and HDL respectively. Conclusions: Continuous exercise training programme is an effective adjunct non-pharmacological management for hypertension and a means of normal regulation of lipid profile. Keywords: Hypertension, Blood pressure, Lipid profile, Continuous exercis

Knowledge and attitude toward interdisciplinary team working among obstetricians and gynecologists in teaching hospitals in South East Nigeria

Chukwuemeka Anthony Iyoke,1 Lucky Osaheni Lawani,2 George Onyemaechi Ugwu,1 Leonard Ogbonna Ajah,2 Euzebus Chinonye Ezugwu,1 Paul Onah,1 Chidinma Ifechi Onwuka1 1Department of Obstetrics and Gynaecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria; 2Department of Obstetrics and Gynaecology, Federal Teaching Hospital, Abakaliki, Nigeria Background: Interdisciplinary team working could facilitate the efficient provision and coordination of increasingly diverse health services, thereby improving the quality of patient care. The purpose of this study was to describe knowledge of interdisciplinary team working among obstetricians and gynecologists in two teaching hospitals in South East Nigeria and to determine their attitude toward an interdisciplinary collaborative approach to patient care in these institutions. Methods: This was a questionnaire-based cross-sectional study. Data analysis involved descriptive statistics and was carried out using Statistical Package for the Social Sciences software version 17.0 for Windows. Results: In total, 116 doctors participated in the study. The mean age of the respondents was 31.9±7.0 (range 22–51) years. Approximately 74% of respondents were aware of the concept of interdisciplinary team working. Approximately 15% of respondents who were aware of the concept of interdisciplinary team working had very good knowledge of it; 52% had good knowledge and 33% had poor knowledge. Twenty-nine percent of knowledgeable respondents reported ever receiving formal teaching/training on interdisciplinary team working in the course of their professional development. About 78% of those aware of team working believed that interdisciplinary teams would be useful in obstetrics and gynecology practice in Nigeria, with 89% stating that it would be very useful. Approximately 77% of those aware of team working would support establishment and implementation of interdisciplinary teams at their centers. Conclusion: There was a high degree of knowledge of the concept and a positive attitude toward interdisciplinary team working among obstetricians and gynecologists in the study centers. This suggests that the attitude of physicians may not be an impediment to implementation of a collaborative interdisciplinary approach to clinical care in the study centers. Keywords: team working, interdisciplinary, Nigeria, obstetrics, gynecolog

Preference for anonymity in sperm donation for artificial insemination: an experience from low-resource settings in Nigeria

Euzebus Chinonye Ezugwu,1,2 George U Eleje,3,4 Chukwuemeka A Iyoke,1,2 Sunday G Mba,5 Henry C Nnaji,2 Chukwunonso I Enechukwu,4 Peter O Nkwo1,2 1Department of Obstetrics and Gynecology, Faculty of Medical Sciences, College of Medicine, University of Nigeria, Ittuku Ozalla Campus, Enugu State, Nigeria; 2Department of Obstetrics and Gynecology, University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu State, Nigeria; 3Department of Obstetrics and Gynecology, Faculty of Medicine, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria; 4Department of Obstetrics and Gynecology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Anambra State, Nigeria; 5Department of Obstetrics and Gynecology, Enugu State University Teaching Hospital, Enugu State, Nigeria Objective: Anonymous sperm donation is a common practice in Nigeria with its associated legal and ethical challenges. This study aimed to investigate infertile couples’ opinions about issues of sperm donor anonymity and to determine factors that might influence their preferences.Methods: A cross-sectional, multicentered, questionnaire-based study was conducted among infertile couples attending infertility clinics in three tertiary hospitals in the south-eastern region of Nigeria over a period of 6 months.Results: A total of 450 infertile couples were recruited consecutively from the three study centers. However, 450 females and 352 males (total=802) participated in the study. The level of awareness of artificial insemination using donor sperm for the management of male infertility among the respondents was 69.2%, while its acceptability rate was 62.7%. The majority of the respondents indicated their preference for secrecy and anonymity in sperm donation. Approximately 84% of the respondents indicated that the mode of conception should never be disclosed to the donor-conceived child, and ~92% of them indicated that the identity of the sperm donor should never be revealed to the donor-conceived child. Fear of adverse effect of such disclosure on the child and the possible of rejection of the father in order to seek for the donor were the major reasons for their preference for anonymity.Conclusion: Although it has been argued that every child has a right to know their genetic parents, the reasons proffered by the respondents for their preference for anonymity cannot be totally ignored. Establishing a regulatory body and enacting laws that will address both the ethical and legal issues associated with gamete donation in the developing world will go a long way in promoting openness and honest communication with donor-conceived children. Keywords: disclosure, anonymity, artificial insemination, donor sperm, infertile couple, Nigeri

Synthesis of benzylidenemalononitrile by Knoevenagel condensation through monodisperse carbon nanotube-based NiCu nanohybrids

Monodisperse nickel/copper nanohybrids (NiCu@MWCNT) based on multi-walled carbon nanotubes (MWCNT) were prepared for the Knoevenagel condensation of aryl and aliphatic aldehydes. The synthesis of these nanohybrids was carried out by the ultrasonic hydroxide assisted reduction method. NiCu@MWCNT nanohybrids were characterized by analytical techniques such as X-ray diffraction (XRD), X-ray photoelectron spectroscopy (XPS), transmission electron microscopy (TEM), high-resolution transmission electron microscopy (HR-TEM), and Raman spectroscopy. According to characterization results, NiCu@MWCNT showed that these nanohybrids form highly uniform, crystalline, monodisperse, colloidally stable NiCu@MWCNT nanohybrids were successfully synthesized. Thereafter, a model reaction was carried out to obtain benzylidenemalononitrile derivatives using NiCu@MWCNT as a catalyst, and showed high catalytic performance under mild conditions over 10-180 min.Dumlupinar UniversityDumlupinar University [2014-05, 2015-35, 2015-50]; Duzce UniversityDuzce University [2015.26.04.371]The authors would like to thank Dumlupinar University (2014-05, 2015-35, and 2015-50) and Duzce University (grant no. 2015.26.04.371) for funding.WOS:0005563883000122-s2.0-85088705103PubMed: 3272817