Pattern of Motion Restriction in Nigerian Patients with Knee Osteoarthritis

In the Western population, knee osteoarthritis (OA) has been shown to present a characteristic passive motion restriction pattern, called the capsular pattern (extension restriction to flexion restriction ratio ranging from 0.03 to 0.50). The pattern of motion restriction of Nigerian patients with OA has not been previously reported. This study was conducted to determine the pattern of motion restriction in Nigerian patients with knee osteoarthritis. Participants were 50 patients with knee OA (OA Group/OAG), recruited consecutively from two secondary health institutions and 50 age and sex-matched controls (Control Group/CG) without symptoms of OA. Goniometric measurements of passive and active knee motion of participants were taken. Data was analysed using the independent t-test. The OAG, aged 58.1±10.7 years has had OA for 4.0±4.5 years. The CG was aged 55.9±10.3 years. Mean active extension (1.5±5.2°) of the OAG differed significantly (P < 0.05) from that of the CG (0°), but the two groups did not differ significantly in passive extension (OAG = 1.2°±4.4°; CG = 0°). The CG (125.9°±4.6°) had significantly higher (P= 0.0001) active knee flexion than the OAG (99.9°±15.5°). Passive knee flexion of the CG (134.5°±5.0°) was significantly higher (P=0.000) than that of the OAG (110.4°±14.8°). Mean active extension and flexion restriction of OAG was 2.1±5.7° and 26.0±15.4° respectively. Mean passive extension restriction was 1.2±4.4° and passive flexion restriction was 24.0±14.8°, giving a ratio of 0.05 for OAG. Our findings suggest that the passive motion restriction pattern seen in Nigerian patients with knee osteoarthritis is the capsular pattern. KEY WORDS: motion restriction, patients, knee osteoarthriti

Training of front-line health workers for tuberculosis control: Lessons from Nigeria and Kyrgyzstan

Efficient human resources development is vital for facilitating tuberculosis control in developing countries, and appropriate training of front-line staff is an important component of this process. Africa and Central Asia are over-represented in global tuberculosis statistics. Although the African region contributes only about 11% of the world population, it accounts for at least 25% of annual TB notifications, a proportion that continues to increase due to poor case management and the adverse impact of HIV/AIDS. Central Asia's estimated current average tuberculosis prevalence rate of 240/100 000 is significantly higher than the global average of 217/100 000. With increased resources currently becoming available for countries in Africa and Central Asia to improve tuberculosis control, it is important to highlight context-specific training benchmarks, and propose how human resources deficiencies may be addressed, in part, through efficient (re)training of frontline tuberculosis workers. This article compares the quality, quantity and distribution of tuberculosis physicians, laboratory staff, community health workers and nurses in Nigeria and Kyrgyzstan, and highlights implications for (re)training tuberculosis workers in developing countries

Mutual influence of uniaxial tensile strain and point defect pattern on electronic states in graphene

The study deals with electronic properties of uniaxially stressed mono- and multi-layer graphene sheets with various kinds of imperfection: point defects modelled as resonant (neutral) adsorbed atoms or molecules, vacancies, charged impurities, and local distortions. The presence of randomly distributed defects in a strained graphene counteract the band-gap opening and even can suppress the gap occurs when they are absent. However, impurity ordering contributes to the band gap appearance and thereby re-opens the gap being suppressed by random dopants in graphene stretched along zigzag-edge direction. The band gap is found to be non-monotonic with strain in case of mutual action of defect ordering and zigzag deformation. Herewith, the minimal tensile strain required for the band-gap opening (≈12.5%) is smaller than that for defect-free graphene (≈23%), and band gap energy reaches the value predicted for maximal nondestructive strains in the pristine graphene. Effective manipulating the band gap in graphene requires balanced content of ordered dopants: their concentration should be sufficient for a significant sublattice asymmetry effect, but not so much that they may suppress the band gap or transform it into the “quasi- (or pseudo-) gap”

Leprosy: International Public Health Policies and Public Health Eras

Public health policies continue to play important roles in national and international health reforms. However, the influence and legacies of the public health eras during which such policies are formulated remain largely underappreciated. The limited appreciation of this relationship may hinder consistent adoption of public health policies by nation-states, and encumber disinvestment from ineffective or anachronistic policies. This article reviews seven public health eras and highlights how each era has influenced international policy formulation for leprosy control—“the fertile soil for policy learning”. The author reiterates the role of health leadership and health activism in facilitating consistency in international health policy formulation and implementation for leprosy control