Regional Differences of Hepatitis C Virus Infection in Kentucky

Objective: Few studies have been conducted in Kentucky to investigate the statewide prevalence of HCV infection and its associated risk factors. The purpose of this study was to examine the factors related to HCV infection in the state, and specifically to investigate geographical differences of HCV infection between those residing in Appalachian vs. Non-Appalachian counties in Kentucky. Methods: The study sample (n =5205) was selected from a pool of 8300 high-risk individuals participating in a pilot cross-sectional study on HCV conducted by the Kentucky Department for Public Health. The pilot study involved serologically testing participants for antibodies against HCV infection and having participants complete an interview-administered questionnaire at the same time to examine behavioral and socio-demographic characteristics related to HCV infection. Univariate, bivariate, and logistic regression analyses were carried out using SPSS and maps were produced using ArcGIS software. Frequency distribution, adjusted odds ratios (AORs), and corresponding 95% confidence intervals (95% CIs) were reported. Results: Of the 5205 participants selected (2241 males, 2964 females; mean age, 30.4 ± 10.5 years); 9.8% tested positive for anti-HCV antibodies. Residence in Appalachian vs. Non-Appalachian Kentucky was not significantly associated with HCV antibody status. In the multivariate analysis, Blacks (AOR: 0.42, 95% CI: 0.26 – 0.66) and men who have sex with men (MSM) (AOR: 0.36, 95% CI: 0.17 – 0.73) were significantly less likely to be HCV positive after adjusting for all other variables. HCV seropositivity was positively associated with age (AOR: 1.03, 95% CI: 1.02 – 1.04), history of injection drug use (IDU) (AOR: 41.27, 95% CI: 31.94 – 53.31), and presence of tattoos (AOR: 1.49, 4 95% CI: 1.14 – 1.96). Gender was also found to significantly modify the association between residence and HCV antibody status, specifically in the Appalachian region. Conclusion: This was the first statewide analysis to examine the prevalence of HCV infection among high-risk population residing in Appalachia vs. Non-Appalachian counties in Kentucky. The main variables associated with HCV infection in these regions were age, Black race, history of IDU, MSM and presence of tattoos. Addressing these risky behaviors and particular populations through age- and gender-specific preventive and treatment measures may reduce the high prevalence of HCV infection in the state of Kentucky. However, more research is required to further characterize HCV-related risk factors with respect to residence in Appalachian vs. Non-Appalachian to determine how these measures can be effectively implemented

An Evaluation of Some Common Laboratory Materials by Xray Attenuation, for use as Human Tissue Substitutes

To develop readily available laboratory materials for probableuse as imaging phantoms or test objects, Laboratory MagnesiumSulphate (MgSO4) and Table salt (NaCl) were used in the ratio80:20% by weight with paraffin wax to form test materials(MgSO4:PW1) and (NaCl:PW2). Rice powder, gelatineseparately, and a combination of gelatine (20g in 100ml of warmwater) and 100g rice powder were also made into test objects.The ratios used were confirmed by matching differentconstituents by weight of the test samples with the web basedphoton interaction software XCOM designed by the NationalInstitute of Science and Technology, USA, to obtain closematching with tissue data. Each test object was made into 1 cmblocks for exposure to narrow beam x-rays over the diagnosticenergy range (50 – 150kV) under automatic exposure conditions.Good agreement within 10%, was found between the measuredand calculated values for four of the five tested samples.Matching of the tested materials with mass attenuationcoefficients of simulated tissue showed acceptable match at highphoton energies of 0.04 – 0,05 MeV and above for gelatine, PW1(paraffin wax + MgSO4.6H2O) and Rigel (Rice + gelatine). Thesematerials can therefore be used as tissue substitutes in imagequality studies

Effective doses in chest and abdominal radiography following the ICRP recommendations of 1991 and 2007 in a regional hospital.

Background: In 2007, the International Commission for Radiological Protection (ICRP), published a new set of tissues and tissue weighting factors as recommendations in the ICRP publication 103. This altered the parameters contributing to the calculation of effective dose, which is normally used as a single indicator of risk. Purpose: To assess the effect of the 2007 review of tissue weighting factors on measured doses in a clinical setting, using patient doses for chest (CXR) and abdominal (AXR) radiography. Materials & Methods: Patient entrance surface doses(ESD) obtained in a dose audit for chest (CXR) and abdomen (AXR) examinations with Harshaw type Lithium Fluoride thermoluminescent dosemeters (LiF-TLD 100) were used in a Monte Carlo calculation software, XDOSE, developed by the National Radiation Protection Board (NRPB) to calculate organ doses. Effective doses (E mSv) were calculated with both the ICRP 1991 and 2007 recommendations of tissue weighting factors. A 2-sample t-statistic was used to test for differences between the results for both recommendations. Tests were at the 95% confidence interval. Results: The mean effective doses for CXR were found to be 0.04 (range 0.019 to 0.092) mSv and 0.03 (range 0.011 to 0.069) mSv for the 1991 and 2007 recommendations, respectively. Mean abdominal effective dose values were 0.78 (range 0.16 to 2.98) mSv for the 1991 wƮ factors, and 0.49 (range 0.099 to 1.97) mSv for the 2007 recommended factors. The mean percentage difference between the effective doses calculated with wƮ recommendations of 1991 and 2007 respectively came to 1.7 ± 0.6 % with a range between 0.8 and 3.3 % for CXR (p < 0.05) and 35.9 ± 5.6 with a range of 20.8 to 42.3%, for AXR (p = 0.05). Conclusion: Effective doses showed statistically significant differences between the values calculated from the 1991 and 2007 wƮ values for chest radiography. There is however, insufficient evidence to accept a difference for the abdominal effective doses. Wider studies are required to confirm this result

Audit of visual outcome of cataract surgeries in a private eye hospital in Port Harcourt, Nigeria

Aim: The aim was to determine the quality of cataract surgeries in Port Harcourt, and ascertain the difference in the outcome, if any, between small incision cataract surgery (SICS) and extra capsular cataract extraction (ECCE).Materials and Methods: This is a retrospective study carried out in a Private Eye Hospital in Port Harcourt between August 2006 and November 2012. Case notes of 83 consecutive patients (92 eyes) who had either SICS OR ECCE with posterior chamber intraocular lens (PCIOL) were included in the study. Demographic data and data concerning ocular and systemic co-morbidities were retrieved from patients’ case notes. Best-corrected visual acuity was measured with Snellen’s chart preoperatively, and 6 weeks following surgery. The visual outcome was categorized, using the World Health Organization (WHO) recommendation, as good (>6/18), borderline (6/24-6/60), or poor (<6/60). Statistical software package Epi-info version 6.04d was used to analyze our data.Result: A total of 92 eyes of 83 patients who had cataract surgeries was included in the study. Sixty-seven eyes (73%) had ECCE + intraocular lens (IOL) while 25 eyes (27%) had SICS + IOL. At 6 weeks postoperative, 66.3% of cases had good visual outcome while about 9.8% of cases had a poor outcome.Conclusion: Since only 66.3% of cases had good visual outcome and 9.8% had poor outcome, cataract surgical outcome in Port Harcourt is below the acceptable WHO standards of >85% and <5% for good and poor outcomes respectively. Steps to improve good outcome will include proper postoperative hygiene of patients, good preoperative evaluation of all cases, and improvement in surgeons’ skills. Good visual outcome was associated more with ECCE (71.7% of 67 eyes) than SICS (52% of 25 eyes) probably due to inadequate experience of the surgeons in SICS. This difference was, however, not statistically signifi cant.Keywords: Audit, cataract surgery, visual outcom

An Assessment of Image Quality of Radiographs in a Nigerian Teaching Hospital by Film Densitometry

3000 radiographs covering chest, upper limb, lower limb,lumbar spine (AP) and skull (PA) from the University ofCalabar teaching hospital (UCTH) were retrospectivelystudied by densitometry to assess the degree of variationin radiographic contrast over a ten year period (1999 –2008). The results show that variation in meanradiographic contrast from year to year was statisticallyinsignificant (p < 0.05) for the respective projectionsstudied. This result implies a relatively basicstandardisation in image quality arising from consistencyin technique acquired over time. The results would serveas a baseline for developing a more robust qualityassurance programme in the hospital

Ocular problems among public service retirees in a Southern Nigerian Metropolitan City

Background: Advancing age is a recognized risk factor for blindness and visual impairment worldwide. More than 82% of all blind people are 50 years or older. This therefore places a huge public health and socioeconomic burden on the populace, often leading to social dependence.Aim: To determine the pattern, profile, and risk factors of eye diseases among retired public servants in Port Harcourt City, Nigeria.Materials and Methods: Participants were retired public servants who consented to ocular examinations at their pension pay points in Port Harcourt during the 2012 World Sight Day. Visual acuity, ocular examinations including fundoscopy and intraocular pressure measurements were recorded and subsequently analyzed using Statistical Package for Social Sciences version 20. Results: Five hundred and ninety‑two persons were studied; 455 males and 137 females (F: M = 1:3.3). The Mean age was 68.7 ± 7.6 years (range: 56–97 years). Using World Health Organization/ International Agency for Prevention of Blindness criteria for visual assessment 239 (40.4%) had good vision, 203 (34.3%) had moderate visual impairment, 48 (8.1%) had severe visual impairment, while 102 subjects (17.2%) were blind. Cataract was the leading cause of blindness 56 (54.9%), followed by glaucoma 18 (17.7%), uncorrected refractive error 19 (18.6%), and diabetic retinopathy 9 (8.8%).Conclusion: Visual impairment and blindness are common causes of ocular morbidity among retirees of public service in Port Harcourt. It is therefore advocated that special eye health care intervention by governments and nongovernmental agencies be extended to these groups of people.Keywords: Metropolitan city, ocular problems, retiree

Optimizing Students’ Performance in English through Quality Teacher Education

Research has established significant connection between quality teacher education and student achievement. This cannot but be a concept in considering the performance of students in English language, a skill-based school subject. This paper examines the course content for language education for trainee teachers in the University of Calabar. This study appraises and validates the adequacy of the curriculum content to meet the language needs of the trainees with regard to transferring their learning to meeting the curriculum demands of secondary school English language learner. Suggestions towards optimizing quality teacher and professional education with the aim of improving performance in English language are proffered. Keywords: Student’s performance, English language, quality teacher education, curriculum content, trainee teachers

Citric acid Production from Agricultural Wastes using Aspergillus niger Isolated from some Locations within Kaduna Metropolis, Nigeria

This investigation was carried out to assess citric acid production by Aspergillus species isolated in some locations within Kaduna metropolis Nigeria using standard methods. Fungal isolates identified as Aspergillus niger were obtained from samples collected from four (4) different locations.  Isolates were subjected to substrate preference test using local substrates such as wheat straw, rice straw and potato peel powder. Wheat straw supported the highest growth value of 41%. Screening of A. niger isolates for the production of citric acid showed that the isolate from Kawo (Kw) gave the highest yield of citric acid (0.38g/100ml) on basal screening media. Optimization of pH and temperature were carried out and the optimum temperature and pH for citric acid production by isolate Kw was 30OC (0.65g/100ml) and pH 6.0. The wheat straw treated with 5 N HCl produced a high yield of citric acid with a value of 25.60g/kg while the untreated wheat straw produced a yield of 13.3g/kg. Molecular characterization to confirm the identity of the fungal isolates was carried out by the amplification and sequencing of the 5.8S gene of the ribosomal RNA and the two intergenic spacers ITS1 and ITS2 of the strains. By comparison (BLAST) of Aspergillus niger isolate to reference sequence in the gene bank, a sequence similarity of 99% to 100% of other Aspergillus niger strain was obtained. Various methods of strain improvement techniques could be adopted to increase citric acid production by the A. niger isolates obtained from this study

An Analysis of repeated examinations in conventional film–screen radiography (FSR).

Background: X-ray is an ionising form of radiation used inconventional radiography and this can result in deleterious biologicalchanges in the body if not regulated. Radiation safety is an importantpractice in a medical facility that utilizes radiation in any form fordiagnosis, intervention or treatment. Repeat of non-diagnosticradiographs add to the radiation received by the patient and thepersonnel. The committee on quality assurance in diagnostic X-rayrecommended a repeat rate of 5 – 7% or less.Purpose: The purpose of this study was to determine image repeatrate and the causes of repeat in a University Teaching Hospital.Materials and Methods: It was a prospective study involving allroutine radiographic cases in department over a two month periodduring which 1251 examinations were carried out. Radiographs wereassessed for diagnostic quality by Radiologists following the usualclinical protocols in radiology film review. The number ofradiographs in each examination type which did not meet diagnosticcriteria and therefore required repeat, were isolated and counted.Results are presented in simple percentages.Results: The overall repeat rate was 8.6%. The highest repeat ratewas observed in radiographs of the lumbosacral region (53.06%) andthe lowest rate in the leg (2%). Under-exposure was the leadingcause of repeat (41.67%), while film fog was the least cause(0.93%). Inappropriate selection of exposure factors and poor patientpositioning by radiographers who are mainly interns (n=8) andjunior radiographers (n=4) contributed most to the repeats. Patientfaults or poor darkroom practice were the other reasons for repeats.Conclusion: The rate of repeat is above the accepted limitsrecommended by the committee on quality assurance in diagnosticX-ray (5 – 7% or less). It has increased above the 4% previouslyobtained (1992 assessment). The rate can be reduced if the juniorcadre radiographers are better supervised and a quality assuranceprogram instituted

Sonographic Correlation of Liver Dimension and Anthropometric Variables of Height, Weight and Body Mass Index (BMI)

Background: Estimation of liver size can be used as an index to monitor various aspects of liver disease and response to therapy.Purpose: To evaluate the relationship between anthropometric variables (Height, Weight and Body Mass Index) with liver size was carried out in subjects with clinically and sonographically confirmed normal liver.Materials & Methods: This prospective sonographic study was carried out in Calabar, Uyo, Zaria and Makurdicosmopolitan cities of Nigeria. Scans were performed on 388 subjects and their liver sizes measured in the Midclavicular and anterior axillary lines, respectively. Patients’ heights and weights were also measured and used to calculate their respective body mass indices.Results: Mean liver diameter in the study population was 12.9±1.7cm (Range 9.2 – 15.2cm) and 11.6±1.7cm (Range 8.0 – 14.5cm) at the midclavicular and anterior axillary lines respectively. About 98.5 % of the study population had liver sizes ≤15.0cm while 1.5% had sizes at the upper limits of 15.3 – 16cm. Height and BMI appeared to have sone influence on liver size (r=+60; P<0.05, +0.65; P<0.05) respectively at the midclavicular line but not at the anterior axillary line. An insignificant relationship was observed with weight and liver size (r= +0.1; P<0.05) both in the MCL and AAL.Conclusion: Liver size is affected more by individual’s height and body mass index and less by their weight in the region studied