Examining the profound effects of COVID19 on mental health: A comprehensive systematic review on anxiety and depression

The COVID-19 pandemic has presented challenges to humanity, economically and in health and wellbeing. The associated limited social isolation and lifestyle changes has increased the risk for mental health services, especially among vulnerable people. This highlights the need for mental health services, burden that already stretch the health systems. This review presents an exposition on COVID-19 and mental health, and ways to minimise, and possibly prevent, their effect on the psychological well-being of those people. We searched four databases (Academic Search Complete, CINAHL Plus, PsycINFO and PsycARTICLES) using specific search terms and eligibility criteria. Of the 33 included studies, 31 were quantitative, and one qualitative and mixed method each. The studies were analysed using thematic narrative synthesis that resulted in three main themes: (a) the internal and external influences on COVID-19 behaviour, (b) the impact of COVID-19 on health and well-being and (c) the coping strategies used. Since COVID-19 will exist for the foreseeable future, understanding its impact on health and mental well-being and the coping techniques to be adopted are important now than ever. This study contributes to such an understanding along with suggestions regarding ways to minimise the impact of COVID-19 on mental health using context-appropriate strategies

Engaging research ethics committees to develop an ethics and governance framework for best practices in genomic research and biobanking in Africa: the H3Africa model [Commentary]

In the past decade, there has been an increase in genomic research and biobanking activities in Africa. Research initiatives such as the Human Heredity and Health in Africa (H3Africa) Consortium are contributing to the development of scientific capacity and infrastructure to support these studies on the continent. Despite this growth, genomic research and biobanking have raised important ethical challenges for key research stakeholders, including members of research ethics committees. One of these is the limited ethical and regulatory frameworks to guide the review and conduct of genomic studies, particularly in Africa. This paper is a reflection on a series of consultative activities with research ethics committees in Africa which informed the development of an ethics and governance framework for best practices in genomic research and biobanking in Africa. The paper highlights the engagement process and the lessoned learned

Comparative Antioxidants Status of Leaves Extracts of Some Common Antimalarial Plants in West Africa

Objective: Malaria chemotherapy remains relevance and gives way to the re-evaluation of medicinal plants that has already gain approval in the traditional treatments of Malaria. This work evaluated and compared the antioxidant status of methanol leaves extracts of Azadirachta Indica (MAI), Vernonia Amygdalina (MVA) and Carica Papaya (MCP). Methods: Phenols, Flavonoids,percentage inhibition of lipid peroxidation and radical scavenging activities using 1,1-diphenyl-2- picryl hydrazyl (DPPH) and Hydroxyl radicals were determined spectrophotometrically based on international standardized methods . Results: Total Phenolic content in garlic acid equivalence (GAE)were expressed maximally at 700μg/ml by 0.015±0.002, 0.019±0.017, 0.013±0.006 mg/g and flavonoids contents at 350μg/ml by 0.063±0.004, 0.020±0.031, 0.049±0.002 Mg/g quercetin equivalence (QE) for MAI, MVA and MCP respectively. DPPH scavenging activities of 78.60, 55.55 and 54.96 % were obtained at 350μg/ml by MAI, MVA and MCP respectively in the order MAI>MVA>MCP. At 300μg/ml, the extracts scavenged hydroxyl radicals significantly( p≤0.05) by72.00, 77.80 and 53.15 % in the order MVA>MAI>MCP. Intriguingly, extracts also convered significantly (p≤0.05), 50% cell protection as they inhibited lipid peroxidation by50.00, 66.20 and 64.30% in the order MVA>MCP>MAI at 350μg/ml, respectively. Conclusion: Antioxidative properties exhibited by extracts may be correlated with their antimalarial functions, bioactive contents and suggestive of MVA as more potent antimalarial of the evaluated plants which may serve as template for malaria drugs and its local usage encouraged in poverty- stricken malarial-endemic areas of West Africa

Erratum to 'Exploring the cost-effectiveness of high versus low perioperative fraction of inspired oxygen in the prevention of surgical site infections among abdominal surgery patients in three low- and middle-income countries' [BJA Open 7 (2023) 100207]

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Acetaminophen Induces Mitochondrial Permeability Transition in Rats Without Causing Necrotic Liver Damage

Mitochondrial Permeability Transition (MPT) is reported as the mechanism of acetaminophen induced hepatic damage, however, rat models are resistant to acetaminophen induced toxicity. The occurrence and degree of mitochondrial permeability transition after treatment with 400 mg kgG1 of acetaminophen in albino Wistar rats were assessed. Animals were randomly distributed into seven groups; control, 12, 24, 36, 48, 60 and 72 h based on varying time (in hour) post acetaminophen prior to sacrifice after treatment. Mitochondrial Membrane Permeability Transition (MMPT) pore opening and mitochondrial cytochrome c release were estimated. Opening of MMPT pore and cytochrome c release were observed in 12, 24, 36 and 72 h, when compared with the control group. Liver function and histological results indicated no liver damage. It is concluded that toxic dose of acetaminophen induced mitochondrial permeability transition in rat hepatic tissues without leading to necrotic damage suggesting that rat hepatic tissues evade damage by mechanisms downstream of MPT

Visual impairment among eye health workers in a tertiary eye centre in Ghana

Objective: To determine causes of visual impairment (VI) among staff of the Eye Centre at the Korle Bu Teaching Hospital.Design: This was a cross-sectional study.Setting: The Eye Centre, Korle Bu Teaching Hospital (KBTH), from October 2016 to March 2017 on all consenting members of staff.Participants: Eighty-four (79.3%) of 106 consenting staff members participated in this study.Data collection/Intervention: A detailed history (demographic, ocular, medical co-morbid conditions), ocular examination and relevant diagnostic investigations were conducted. Interventions initiated included treatment for glaucoma, dry eye and allergic conjunctivitis and spectacles prescription for refractive errors.Main outcomes: Prevalence of avoidable causes of VI (glaucoma, cataract, refractive errors). Secondary outcomes included prevalence of unavoidable causes of VI. Results Eighty-four (79.3%) members of staff participated in this study. Most of the participants were females, 54(64.3 %). Age ranged from 23 to 60 years with an average of 35.8±9.9 years (mean ± SD). Prevalence of VI was 9.5 % (8/84), all due to uncorrected refractive error. Other known causes of VI included open angle glaucoma in 12(14.3 %), macular scar of unknown cause, 1(1.2 %) and sutural cataract, 1(1.2 %) but were all visually insignificant.Conclusions: The prevalence of VI among the staff of the Eye Centre of the KBTH was 9.5 %, all due to refractive errors. Other known causes of avoidable visual impairment and blindness encountered were glaucoma (14.3 %), macular scar (1.2 %) and cataract (1.2 %), all asymptomatic. Routine eye screening should be part of periodic medical examination for employees

Perception and practice of Kangaroo Mother Care after discharge from hospital in Kumasi, Ghana: A longitudinal study

BACKGROUND: The practice of Kangaroo Mother Care (KMC) is life saving in babies weighing less than 2000 g. Little is known about mothers' continued unsupervised practice after discharge from hospitals. This study aimed to evaluate its in-hospital and continued practice in the community among mothers of low birth weight (LBW) infants discharged from two hospitals in Kumasi, Ghana. METHODS: A longitudinal study of 202 mothers and their inpatient LBW neonates was conducted from November 2009 to May 2010. Mothers were interviewed at recruitment to ascertain their knowledge of KMC, and then oriented on its practice. After discharge, the mothers reported at weekly intervals for four follow up visits where data about their perceptions, attitudes and practices of KMC were recorded. A repeated measure logistic regression analysis was done to assess variability in the binary responses at the various reviews visits. RESULTS: At recruitment 23 (11.4%, 95%CI: 7.4 to 16.6%) mothers knew about KMC. At discharge 95.5% were willing to continue KMC at home with 93.1% willing to practice at night. 95.5% thought KMC was beneficial to them and 96.0% beneficial to their babies. 98.0% would recommend KMC to other mothers with 71.8% willing to practice KMC outdoors.At first follow up visit 99.5% (181) were still practicing either intermittent or continuous KMC. This proportion did not change significantly over the four weeks (OR: 1.4, 95%CI: 0.6 to 3.3, p-value: 0.333). Over the four weeks, increasingly more mothers practiced KMC at night (OR: 1.7, 95%CI: 1.2 to 2.6, p = 0.005), outside their homes (OR: 2.4, 95%CI: 1.7 to 3.3, p < 0.001) and received spousal help (OR: 1.6, 95%CI: 1.1 to 2.4, p = 0.007). Household chores and potentially negative community perceptions of KMC did not affect its practice with odds of 0.8 (95%CI: 0.5 to 1.2, p = 0.282) and 1.0 (95%CI: 0.6 to 1.7, p = 0.934) respectively. During the follow-up period the neonates gained 23.7 sg (95%CI: 22.6 g to 24.7 g) per day. CONCLUSION: Maternal knowledge of KMC was low at outset. Once initiated mothers continued practicing KMC in hospital and at home with their infants gaining optimal weight. Continued KMC practice was not affected by perceived community attitudes

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Валидация шкалы суммарной оценки мышечной силы (MRC sum score) для использования у русскоязычных пациентов с хронической воспалительной демиелинизирующей полинейропатией

Background. The use of rating scales and questionnaires is essential in an evaluation of disease course, treatment response, the disability level and quality of life in patients with chronic inflammatory demyelinating polyneuropathy. The Medical Research Council (MRC) scale and its modification Medical Research Council sum score (MRCss) are widely used for measurement of motor deficit in patients with neuromuscular disorders. However, its usage is limited by the absence of the validated version for Russian-speaking patients.Aim. To validate MRCss scale in patients with chronic inflammatory demyelinating polyneuropathy with development of a Russian version.Materials and methods. We enrolled 50 patients with chronic inflammatory demyelinating polyneuropathy (25 with typical chronic inflammatory demyelinating polyneuropathy and 25 with Lewis–Sumner syndrome). At the first step we conducted linguocultural ratification according to the standard protocol. At the second step the psychometric parameters were evaluated, such as reliability, validity and sensitivity.Results. The developed Russian version of MRCss scale demonstrated the high level of reliability, validity and sensitivity.Conclusion. As a result, we developed a validated Russian version of MRCss scale, recommended for clinical practice and research. Введение. Использование международных шкал и опросников является неотъемлемой частью работы с пациентами с хронической воспалительной демиелинизирующей полинейропатией и позволяет объективно оценивать динамику состояния пациента, ответ на терапию, степень инвалидизации и качество жизни. Шкала Medical Research Council для оценки мышечной силы (MRC Muscle Scale) и ее модификация Medical Research Council sum score (MRCss) широко используются у пациентов с поражением периферического нейромоторного аппарата для оценки степени выраженности двигательного дефицита. Однако применение шкалы в Российской Федерации ограничено отсутствием русскоязычной, валидированной версии.Цель исследования – провести валидацию шкалы MRCss у пациентов с хронической воспалительной демиелинизирующей полинейропатией с разработкой русскоязычной версииМатериалы и методы. В исследование включено 50 пациентов с хронической воспалительной демиелинизирующей полинейропатией (25 пациентов с типичным вариантом заболевания, 25 – с синдромом Льюиса–Самнера). Первым этапом проведена лингвистическая ратификация оригинальной англоязычной версии шкалы согласно общепринятым рекомендациям. На 2-м этапе валидации проведена оценка психометрических показателей разработанного русскоязычного варианта шкалы: надежности, содержательной валидности, чувствительности.Результаты. Получена русскоязычная версия шкалы MRCss, которая продемонстрировала высокий уровень надежности, чувствительности и валидности.Заключение. По результатам проведенной работы представлена валидированная, русскоязычная версия шкалы MRCss, рекомендованная для клинической и научно-исследовательской работы у русскоязычных пациентов.