Physicochemical Evaluation of the Effects of Total Suspended Solids, Total Dissolved Solids and Total Hardness Concentrations on the Water Samples in Nsukka Town

ABSTRACT: The problem of environmental pollution due to toxic metals has begun to cause concern now in most major metropolitan cities. Nsukka environs have been plagued with perennial problem of water supplies round the year and a better understanding of its water physicochemically status will help to address this daunting problem and issues of human health. The analysis carried out was on the utility water supplies in Nsukka area. Thirteen sampling areas consisting of four boreholes, six dugwells and three springs were chosen for this research work. A total of 26 water samples were taken from the sampling areas during the dry season and another 26 samples during the wet season. Water samples were collected from these sampling areas and refrigerated at 4 0 C for processing. Harch Model C50 digital multirange meter was used to measure total dissolved solid. Complexiometric titration was employed in the determination of total hardness of water samples. Bacteriological analysis of the water samples were carried out to ascertain whether there was faecal contamination by the use of multiple tube/most probable number techniques. It was observed that total suspended solid concentration of water samples from dugwell sources was found to have significant increase (p<0.05) when compared with the water samples from the samples obtained from borehole and spring sources during both dry and rainy seasons. Total dissolved solid concentration was found to be significantly higher (p<0.05) in the water sample from dugwell sources when compared with the total dissolved solid concentration in the water samples from both borehole and spring sources during both dry and rainy seasons. Water sample from dugwell sources had showed significant increase (p<0.05) in the level of total hardness as compared with water samples from borehole and spring sources during dry and rainy seasons. Also, there was significant increase (p<0.05) in the level of total hardness of water sample from borehole sources when compared with the spring sources during dry and rainy seasons. Therefore, from the foregoing, it could be concluded that these boreholes, springs and dugwells water tested in Nsukka town are physicochemically good for human consumption as all the physicochemical parameters tested conformed to WHO, SON and NAFDAC water quality standards except Iyi-adoro spring water which might not be very good for consumption during rainy season because of possible bacteria contamination

Comparative Study on the Nutritional Properties of Citrullus colocynthis, Irvingia gabonensis and I. wombolu Seeds

Background: The effects of malnutrition due to food insecurity demand continuous and urgent efforts to salvage the situations. There are needs to compare the nutritional and anti-nutritional status of edible plant materials commonly used to help consumers make a scientific-based informed decision.Objective: to determine and compare the nutritional and anti-nutritional contents of three seeds - Citrullus colocynthis, Irvingia gabonensis and I. wombolu.Materials and methods: The seeds sourced from Nsukka Market and were analyzed for mineral, proximate, vitamin and anti-nutrient compositions using standard protocols.Results: The concentration of sodium, copper, magnesium, zinc and phosphorous were higher in C. colocynthis seed compared to Irvingia species. I. wombolu had the highest calcium, and potassium contents. I. gabonensis had the highest iron content. C. colocynthis had the highest protein content, while the two Irvingia seeds had higher total fats, fatty acids, and calorific values compared to C. colocynthis seed. Vitamin C, in C. colocynthis was the least total vitamin content and the least antinutrient.Conclusion: This study demonstrates that seeds of Citrullus colocynthis, Irvingia gabonensis and I. wombolu are rich in nutritive factors, in varying proportions, and are low in antinutrient contents. With the results of this comparative study, consumers are therefore encouraged to make evidence-based decision on the choice of the seed to consume in line with their nutritional and health needs

Building Community-Engaged Multidisciplinary Partnerships to Improve Medication Management in Elderly Patients With Multiple Chronic Conditions

Purpose: Many studies in preventing adverse drug events have been researcher-driven, yet few have engaged patients in the development of a project. This project aims to engage minority elderly patients with multiple chronic conditions in the development of research questions and strategies to improve medication safety. Methods: Elderly patients (≥ 65 years old) who were prescribed 7 or more chronic medications were recruited through a university-based aging resource network in a historically African American community in Houston, Texas. Patients and a caregiver participated in a multidisciplinary workgroup comprised of a physician, pharmacists, a nurse, health educators, and a social worker. Patients were engaged by utilizing the 4 patient-centered outcomes research engagement principles. The workgroup created a strategic plan, completed an environmental scan, identified research problems, and reviewed current evidence-based approaches in the literature. Workgroup findings were presented to a broader audience within a community town hall setting, and input was collected from a community-wide survey. Results: From April 2018 to July 2018, 3 patients and 1 caregiver participated in 5 multidisciplinary workgroup meetings. A total of 74 seniors attended the town hall meeting, and 69 completed the surveys. The most common drug-related problems among survey participants were doubts about drug advertisements (79%) and drug interactions (70%). Most participants (88%) were more comfortable in receiving face-to-face counseling compared to an app or virtual visits. Findings aided in developing 3 grant proposals. Conclusion: This narrative provides a roadmap for conducting multidisciplinary, patient-centered participatory research to refine research strategies in minimizing drug-related problems

A Qualitative Analysis to Understand Perception about Medication-Related Problems among Older Minority Adults in a Historically Black Community

Older adults taking multiple chronic medications experience an increased risk of adverse drug events and other medication-related problems (MRP). Most current literature on medication management involves researcher-driven intervention, yet few studies investigate patients’ understanding of MRP in a diverse community setting. This report investigates patients’ perception of MRP and patient-centered strategies among a cohort of the older adult group in a historically Black urban community. The study design is qualitative using structured open-ended questions in a multidisciplinary patient-centered focus group. Patients (age 65 years or older) taking seven or more medications were recruited. The group comprises patients, caregivers, pharmacists, health educators, a physician, and a nurse. Recordings of the group discussion are transcribed verbatim and analyzed using thematic content analysis and categorized by codes developed from the social-ecological model. The group reports patient-provider relationships, previous experience, fear of side effects played important roles in medication adherence. There is an unmet need for medication management education and tools to organize complex medication lists from multiple providers. This study provides important insights into MRP experienced by minority older adults and provided researchers with potential strategies for future interventions

Thigh-length compression stockings and DVT after stroke

Controversy exists as to whether neoadjuvant chemotherapy improves survival in patients with invasive bladder cancer, despite randomised controlled trials of more than 3000 patients. We undertook a systematic review and meta-analysis to assess the effect of such treatment on survival in patients with this disease

Azithromycin in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial

Background Azithromycin has been proposed as a treatment for COVID-19 on the basis of its immunomodulatory actions. We aimed to evaluate the safety and efficacy of azithromycin in patients admitted to hospital with COVID-19. Methods In this randomised, controlled, open-label, adaptive platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), several possible treatments were compared with usual care in patients admitted to hospital with COVID-19 in the UK. The trial is underway at 176 hospitals in the UK. Eligible and consenting patients were randomly allocated to either usual standard of care alone or usual standard of care plus azithromycin 500 mg once per day by mouth or intravenously for 10 days or until discharge (or allocation to one of the other RECOVERY treatment groups). Patients were assigned via web-based simple (unstratified) randomisation with allocation concealment and were twice as likely to be randomly assigned to usual care than to any of the active treatment groups. Participants and local study staff were not masked to the allocated treatment, but all others involved in the trial were masked to the outcome data during the trial. The primary outcome was 28-day all-cause mortality, assessed in the intention-to-treat population. The trial is registered with ISRCTN, 50189673, and ClinicalTrials.gov, NCT04381936. Findings Between April 7 and Nov 27, 2020, of 16 442 patients enrolled in the RECOVERY trial, 9433 (57%) were eligible and 7763 were included in the assessment of azithromycin. The mean age of these study participants was 65·3 years (SD 15·7) and approximately a third were women (2944 [38%] of 7763). 2582 patients were randomly allocated to receive azithromycin and 5181 patients were randomly allocated to usual care alone. Overall, 561 (22%) patients allocated to azithromycin and 1162 (22%) patients allocated to usual care died within 28 days (rate ratio 0·97, 95% CI 0·87–1·07; p=0·50). No significant difference was seen in duration of hospital stay (median 10 days [IQR 5 to >28] vs 11 days [5 to >28]) or the proportion of patients discharged from hospital alive within 28 days (rate ratio 1·04, 95% CI 0·98–1·10; p=0·19). Among those not on invasive mechanical ventilation at baseline, no significant difference was seen in the proportion meeting the composite endpoint of invasive mechanical ventilation or death (risk ratio 0·95, 95% CI 0·87–1·03; p=0·24). Interpretation In patients admitted to hospital with COVID-19, azithromycin did not improve survival or other prespecified clinical outcomes. Azithromycin use in patients admitted to hospital with COVID-19 should be restricted to patients in whom there is a clear antimicrobial indication. Funding UK Research and Innovation (Medical Research Council) and National Institute of Health Research