Cost of treatment as a barrier to access and continuity of healthcare for patients with mental ill-health in Lagos, Nigeria

In Nigeria, there are several barriers to access to effective mental healthcare, e.g. cost, distance to the mental health facility, social stigma, cultural beliefs, attitudes and taboos. This study aimed at i) determining the cost of treatment of a random sample of psychiatric patients and to compare the sample with a matched group of patients from the internal medical department clinics; ii) assessing the impact of cost on access to care and maintenance treatment for the study group in the context of their exclusion from the Lagos State free health services and the National Health Insurance Scheme. Medical records of 100 patients currently attending the outpatients’ clinic of the Department of Psychiatry of the Lagos State University Teaching Hospital (Ikeja, Nigeria) were randomly selected and audited. A similar exercise was also conducted for patients attending the medical outpatients’ clinic in the same hospital. The monthly costs of prescribed medications were computed and compared. The monthly cost of treatment of patients from the Department of Psychiatry compared to patients with physical ailments from the medical outpatients’ clinic was found to be significant vis à vis the average income of average Nigerians. Contrary to expectations, the mean cost of drug treatment borne by medical outpatients was much higher (N=2549.07 vs N=1904.5) (P<0.05) than that of patients attending the psychiatric outpatients’ clinic. However, the expensive cost for the psychiatric patients far exceeded the expensive costs for the medical patients. The findings from this study showed that the average monthly cost of treatment of patients attending the psychiatric clinic was lower than patients from the medical outpatients’ clinic. However, the most expensive cost for psychiatric patients far exceeded the most expensive cost for medical patients. This study also revealed that there is no free health program covering psychiatric treatment anywhere in Nigeria and mental health drugs are funded from personal and family expenses. It is thereby suggested that policy makers should change policy regarding the coverage of Nigerians with mental illness. In doing so, the major barrier to assess and the treatment gap can be reduced

Evaluation of selected Chinese cassia (Cinnamomum cassia Blume) accessions for chemical quality

Twenty five Chinese cassia (Cinnamomum cassia) accessions were analysed at 15% moisture level for bark oil, bark oleoresin and leaf oil percentages. Bark oil ranged from 1.2 to 4.9%, leaf oil 0.4 to 1.6% and bark oleoresin 6.0 to 10.5%. Cinnamaldehyde was the major constituent in both leaf and bark oils. Accessions A, and C, had high bark oleoresin and D" D3 and D, high bark oil and cinnamaldehyde contents. &nbsp

Performance of paprika and paprika alike chillies (Capsicum annuum L.) under warm humid tropics

A study was conducted to evaluate the performance of 21 paprika alike chillies (indigenous germplasm) and nine paprika lines (exotic collections) under rain-shelter. Highly significant variation was recorded among the genotypes for all the characters. The results indicated that Kt-Pl-19 variant – I, ICBD-6, ICBD-12, ICBD-13, ICBD-11 were promising for yield and yield attributing characters, while ICBD-12, ICBD-11, ICBD-2, ICBD-13, Kt-Pl-19 variant – I proved to be better for high seed numbers. With respect to total extractable colour, ICBD-5, ICBD-7, ICBD-4, ICBD-1, ICBD-18 were measured with high colour value, among the indigenous germplasm. Among the exotic collections, PBC-171, SSP-1999, EC-18, EC-45, EC-71 proved better for yield and yield attributing characters. The genotypes, Paprika King, EC-45, PBC-171, EC-43 produced maximum number and weight of seeds, whereas PBC-171, IMI-5, EC-71, EC-45 were found promising for high colour value. Based on these observations, the genotypes Kt-Pl-19 variant -I, ICBD-6, ICBD-12, PBC-171, SSP-1999 and EC-18 were found suitable for high yield, whereas ICBD-12, ICBD-11, Paprika King, EC-45 and PBC-171 for high seed numbers and ICBD-5, ICBD-7, ICBD-4, PBC-171, IMI-5, EC-71 for high colour value in Kerala. Among the various traits, wide range of variation was recorded for number of seeds per fruit and narrow range of variation for fruit length. &nbsp

IISR Keralashree - a high yielding and high quality nutmeg (Myristica fragrans Houtt.)

An accession of nutmeg IC-537218 derived from an open pollinated seedling progeny of a high yielding tree from Burliar, Nilgiris, Tamil Nadu, was evaluated under a farmer participatory mode at three locations in two states, Kerala and Tamil Nadu, for yield characters, for 13 years and this accession was found superior for mace and nutmeg yield over the existing variety, IISR Vishwashree, in all the yield parameters studied. The tree is a pure female which flowers profusly and bears oblong shaped yellow fruits. The aril is thick and covers the entire seed and is dark red in colour. The nut is bold and brownish black in colour. The mace and nut of the new variety is rich in sabinene. &nbsp

Water Quality and Performance Assessment of Porous Asphalt Mix Modified Using Charcoal Powder

Porous pavements are used to allow infiltration of water for increasing ground water storage. Bio char (Charcoal) is a low cost adsorbent used for the removal of heavy metals and other contaminants. This project examines the possibility of using bio char in porous asphalt mixes and efficiency of the asphalt layer modified with charcoal in removing contaminants from typical storm water. Bio char is added by partial replacement of fine aggregates of size less than 2.36 mm. Preliminary Marshall tests indicated that bio char content of about 1to 2 % is not seriously affecting the properties of porous asphalt mix. Marshall test without charcoal has given the optimum binder content as 5 %. Therefore for the study, samples for Marshall tests were prepared keeping the optimum binder content as 5 % and varying the charcoal content as 1, 1.5 & 2 %. From the drain down, air void, flow and stability requirement it was seen that 1.5 % of charcoal is the optimum. Subsequently for the water quality analysis of water infiltrating through the porous asphalt layer samples are prepared using 1.5 % charcoal. Typical storm water is prepared by adding nitrate & chromium to deionized water. Water quality analysis revealed that charcoal modified asphalt layer can remove 97.2 % nitrate, 56 % of chromium from the storm water, and improve the quality of ground water

Chemical composition of leaf oils of Myristica beddomeii (King), Myristica fragrans (Houtt.) and Myristica malabarica (Lamk.)

Essential oil constituents of leaves of three Myristica species namely, Myristica beddomeii, M. fragransand M. malabarica were determined by gas chromatography and gas chromatography-massspectrometry. M. fragrans was dominated by monoterpenes (91%), M.  beddomeii contained mono-(48%) and sesquiterpenes(35%) whereas M. malabarica was dominated by sesquiterpenes (73%).The leaf oil of M.  beddomeii was dominated by α-pinene (19.59%), t-caryophyllene (14.63%) andβ-pinene (12.46%).  The leaf oil of M. fragrans contained sabinene (19.07%), α-pinene (18.04%), 4-terpineol (11.83%), limonene (8.32%) and  β-pinene (7.92%) as major compounds, while t-caryophyllene (20.15%), α-humulene (10.17%), nerolidol (9.25%) and  δ-cadinene (6.72%) werepredominant in the oil of M. malabarica. Linalool, α-terpineol, t-caryophyllene, β-elemene and γ-elemene were present in all the three species. This is the first report on the essential oil compositionof M. beddomeii leaves. &nbsp

'IISR Thevam', 'IISR Malabar Excel' and 'IISR Girimunda'- three new black pepper (Piper nigrum L.) clones

Based on 7 years' performance at Valparai (Tamil Nadu) (3000 ft MSL), and 2 years' performance at Peruvannamuzhi (Kerala) and quality evaluation, three black pepper lines namely, Call. 1041, HP-813 and HP-I05 were superior and proposed for release as 'IISR Thevam', 'IISR Malabar Excel' and 'IISR Girimunda', respectively. These lines were superior to at least one of the controls for more than one character at one or both the locations. Trials laid out at farmers' fields in four northern districts of Kerala also indicated the superiority of these lines. Call. 1041 besides out-yielding control, exhibited a high degree of field tolerance to foot rot disease, whereas HP-813 had oleoresin content as high as 12%. &nbsp

Rubber Clay Nanocomposites

The use of nanofillers allows the development of nanocomposites with improved properties and novel applications. The technological goal is possible due to the new compounding method that allows a particle dispersion in the nanometer scale increasing the specific surface area.Fil: Cova Sánchez, Mariajose. Instituto Nacional de Tecnología Industrial. Instituto Nacional de Tecnología Industrial - Caucho; Argentina. Universidad Nacional de San Martín. Instituto de Investigación e Ingeniería Ambiental. - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación e Ingeniería Ambiental; ArgentinaFil: Bacigalupe, Alejandro. Universidad Nacional de San Martín. Instituto de Investigación e Ingeniería Ambiental. - Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Instituto de Investigación e Ingeniería Ambiental; Argentina. Instituto Nacional de Tecnología Industrial. Instituto Nacional de Tecnología Industrial - Caucho; ArgentinaFil: Escobar, Mariano Martin. Instituto Nacional de Tecnología Industrial. Instituto Nacional de Tecnología Industrial - Caucho; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Mansilla, Marcela Angela. Instituto Nacional de Tecnología Industrial. Instituto Nacional de Tecnología Industrial - Caucho; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentin

Assessing Tuberculosis Case Fatality Ratio: A Meta-Analysis

Background: Recently, the tuberculosis (TB) Task Force Impact Measurement acknowledged the need to review the assumptions underlying the TB mortality estimates published annually by the World Health Organization (WHO). TB mortality is indirectly measured by multiplying estimated TB incidence with estimated case fatality ratio (CFR). We conducted a meta-analysis to estimate the TB case fatality ratio in TB patients having initiated TB treatment. Methods: We searched for eligible studies in the PubMed and Embase databases through March 4(th) 2011 and by reference listing of relevant review articles. Main analyses included the estimation of the pooled percentages of: a) TB patients dying due to TB after having initiated TB treatment and b) TB patients dying during TB treatment. Pooled percentages were estimated using random effects regression models on the combined patient population from all studies. Main Results: We identified 69 relevant studies of which 22 provided data on mortality due to TB and 59 provided data on mortality during TB treatment. Among HIV infected persons the pooled percentage of TB patients dying due to TB was 9.2% (95% Confidence Interval (CI): 3.7%-14.7%) and among HIV uninfected persons 3.0% (95% CI: 21.2%-7.4%) based on the results of eight and three studies respectively providing data for this analyses. The pooled percentage of TB patients dying during TB treatment was 18.8% (95% CI: 14.8%-22.8%) among HIV infected patients and 3.5% (95% CI: 2.0%-4.92%) among HIV uninfected patients based on the results of 27 and 19 studies respectively. Conclusion: The results of the literature review are useful in generating prior distributions of CFR in countries with vital registration systems and have contributed towards revised estimates of TB mortality This literature review did not provide us with all data needed for a valid estimation of TB CFR in TB patients initiating TB treatmen

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio