Patterns of antiepileptic drug use and seizure control among people with epilepsy in a suburban community in Southeast Nigeria

Background Epilepsy is characterized by episodic and unpredictable seizure recurrences which are often amenable to medical treatment. Simple and readily available medications can be used to control seizures in epilepsy. However, in many communities in developing countries seizure control among people living with epilepsy is still poor. Method We assessed the patterns of antiepileptic drug use and seizure control among persons living with epilepsy in a suburban community in Southeast Nigeria found in a two phase cross-sectional study. Detailed information on epilepsy treatment, seizure control and patterns of antiepileptic drug use (AED) by those diagnosed with epilepsy was determined by use of a semi-structured interviewer administered questionnaire. Further verification of the type of antiepileptic drugs (AEDs) was done by drug inspection. Result The total of 29 cases of active epilepsy comprising 16 (55.2%) males and 13 (44.8%) females were found. Those receiving AEDs at the time of survey were 7 (24.1%), 11(37.9%) who had previously used AEDs had stopped and the remaining 11 (37.9%) were AEDs naïve. Carbamazepine monotherapy was used by 57.1% (n=4) while phenobarbitone was used by 42.9% (n=3). The antiepileptic drugs were prescribed in all these cases by medical personnel. Over 82% of the persons with active epilepsy found were having more than one seizure per month. Conclusion Active epilepsy was prevalent in this suburban community with only 24.1% (n=7) of them receiving treatment with AEDs. Seizure control was poor even among those receiving AEDs and carbamazepine monotherapy was most commonly used AEDs

Repeated Radionuclide therapy in metastatic paraganglioma leading to the highest reported cumulative activity of 131I-MIBG

131I-MIBG therapy for neuroendocrine tumours may be dose limited. The common range of applied cumulative activities is 10-40 GBq. We report the uneventful cumulative administration of 111 GBq (= 3 Ci) 131I-MIBG in a patient with metastatic paraganglioma. Ten courses of 131I-MIBG therapy were given within six years, accomplishing symptomatic, hormonal and tumour responses with no serious adverse effects. Chemotherapy with cisplatin/vinblastine/dacarbazine was the final treatment modality with temporary control of disease, but eventually the patient died of progression. The observed cumulative activity of 131I-MIBG represents the highest value reported to our knowledge, and even though 12.6 GBq of 90Y-DOTATOC were added intermediately, no associated relevant bone marrow, hepatic or other toxicity were observed. In an individual attempt to palliate metastatic disease high cumulative activity alone should not preclude the patient from repeat treatment

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Tropical Data: Approach and Methodology as Applied to Trachoma Prevalence Surveys

PURPOSE: Population-based prevalence surveys are essential for decision-making on interventions to achieve trachoma elimination as a public health problem. This paper outlines the methodologies of Tropical Data, which supports work to undertake those surveys. METHODS: Tropical Data is a consortium of partners that supports health ministries worldwide to conduct globally standardised prevalence surveys that conform to World Health Organization recommendations. Founding principles are health ministry ownership, partnership and collaboration, and quality assurance and quality control at every step of the survey process. Support covers survey planning, survey design, training, electronic data collection and fieldwork, and data management, analysis and dissemination. Methods are adapted to meet local context and needs. Customisations, operational research and integration of other diseases into routine trachoma surveys have also been supported. RESULTS: Between 29th February 2016 and 24th April 2023, 3373 trachoma surveys across 50 countries have been supported, resulting in 10,818,502 people being examined for trachoma. CONCLUSION: This health ministry-led, standardised approach, with support from the start to the end of the survey process, has helped all trachoma elimination stakeholders to know where interventions are needed, where interventions can be stopped, and when elimination as a public health problem has been achieved. Flexibility to meet specific country contexts, adaptation to changes in global guidance and adjustments in response to user feedback have facilitated innovation in evidence-based methodologies, and supported health ministries to strive for global disease control targets

Efficacy of Major Plant Extracts/Molecules on Field Insect Pests

Insect pests are considered the major hurdle in enhancing the production and productivity of any farming system. The use of conventional synthetic pesticides has led to the emergence of pesticide-resistant insects, environmental pollution, and negative effects on natural enemies, which have caused an ecological imbalance of the predator-prey ratio and human health hazards; therefore, eco-friendly alternative strategies are required. The plant kingdom, a rich repertoire of secondary metabolites, can be tapped as an alternative for insect pest management strategies. A number of plants have been documented to have insecticidal properties against various orders of insects in vitro by acting as antifeedants, repellents, sterilant and oviposition deterrents, etc. However, only a few plant compounds are applicable at the field level or presently commercialised. Here, we have provided an overview of the broad-spectrum insecticidal activity of plant compounds from neem, Annona, Pongamia, and Jatropha. Additionally, the impact of medicinal plants, herbs, spices, and essential oils has been reviewed briefl

Predictors of Job Stress among Secondary School Teachers in Ogun State, Nigeria

This study investigated the predictive effect of dispositional and situational factors on teachers' job stress in Remo Educational Block of Ogun State. The study adopted a descriptive survey research design of an ex post facto type. Four research hypotheses were formulated and tested at 0.05 level of significance. Data were collected using a standardise inventory tagged Teachers Occupational Stress Inventory developed by Kingsley [1]. Research instruments were administered to one thousand five hundred (1,500) teachers that were randomly selected across the three (3) major local government areas. Data were analysed using descriptive analysis, t-test and Multiple Regression Statistical Analysis. The findings of this study revealed that situational factors (job demands, role and change) job and dispositional factors (control, relationship, and support) accounted for 78.1% of the variance in the teachers' job stress (R = 795; R2 = 783; Adj. R2 = .781; F (5, 1494) = 101.333; P &lt; .05). The study also indicated the strength of causation of the predictor variables in favour of situational factors (&amp;#946 = .711; t = 6.974; p &lt;.05). Also, the study revealed that teachers were significantly more prone to stress caused by situational and dispositional factors based on class taught, work experience and school type but not on gender. It is therefore recommended that school authorities should provide the necessary resources that would be required by the teachers with more emphasis on creating a stimulating work environment.Keywords: Stimulating health environment, Job stress, situational factors, Secondary School, Mental health.Nigerian Journal of Parasitology, Vol. 32 [1] March 2011, pp.123-12

Effect of Rational Emotive Theraphy in the Reduction of Bullying Behaviour of Youth

Over the past 10 years, there have been a growing recognition of the widespread prevalence and serious harm of bullying in schools. Governments, teachers, educators and parents alike are not comfortable, particularly as youth behaviours begin to disrupt their families, social interactions and performance in schools. Consequently, it became necessary to embark on investigating the effect of Rational Emotive Behaviour Therapy (REBT) in the reduction of bullying behavioural tendencies among the youngsters in Ogun State. This study investigated the Interactive effects of gender and class differences on bullying behavioural tendencies among the population. Using a multi-stage approach, a total of sixty (60) secondary school students (30 males and 30 females; 30 JSS and 30 SSS) identified to have exhibited high bullying behavioural tendencies were randomly drawn from two public co-educational schools from Ikenne Local Government Area of Ogun State after administering a standardised assessment inventory [The Adolescent Peer Relation Instrument (APRI)]. A 2x2 pre -test, post- test control group design was used. Group one was exposed to REBT while the control received a “placebo” treatment of study habit. Three research hypotheses were formulated and tested at 0.05 significant levels. Both descriptive and inferential statistics were used to analyse the data. Also, percentages, Analysis of variance (ANOVA), Analysis of covariance (ANCOVA) and Duncan Multiple Range Test (DMRT) for post-hoc test were employed for the study. Results showed significant differences between the pre and posttest mean scores of the participants in the treatment group and those in the control [F (2, 60) = 9.345; p &lt; 0.05], Significant differences were also found in the bullying behavioural tendencies of participants based on (i) gender [F (2, 30) = 15.956; p&lt; 0.05].and (ii) in class [F (2, 30) =13.109; p &lt; 0.05], Based on the findings, it was recommended that all caregivers must continuously update their skills on the use of psychotherapy so as to help youngsters live meaningful and fulfilled lives.Keywords: Rational Emotive Behaviour Therapy, Bullying, Adolescents, Reduction, effectNigerian Journal of Parasitology, Vol. 32 [2] September 2011, pp. 297-30

Proximate, Functional and Anti-Nutritional Properties of Boiled Ukpo Seed (Mucuna flagellipes) Flour

gUkpoh (&lt;i&gt;Mucuna flagellipes&lt;/i&gt;) seed flour is one of the soup thickeners used in most rural Igbo-speaking communities of Southern Nigeria. Its preparation is usually associated with long cooking time which is required to soften the cotyledon before grinding as well as reduce the anti-nutritional components of the seed. This work was therefore aimed at determining the effect of boiling time on some functional properties and antinutritional properties of the ukpo seed flour. The result obtained showed that there were slight reductions in the protein, fat and ash content as boiling time increased probably due to leaching. All the functional properties analysed increased significantly (p .0.05) with increasing boiling time. The water absorption, oil absorption and emulsion capacities increased from values of 1.60 ml/g, 1.23 ml/g and 9.3 ml/g respectively at 0 minutes to 3.2 ml/g, 2.8 ml/g and 17.66 ml/g respectively at 60 minutes. The bulk density and swelling index also increased from 0.72 g/ml to 1.17cm3/cm3 and from 1.02 g/ml to 1.36 cm3/cm3 respectively. The oxalate, tannin, saponin, phenol and phytate contents decreased significantly (p .0.05) with increasing boiling time. The values at 60 minutes boiling time were 0.14%, 0.182%, 0.434%, 0.146% and 0.719% respectively. These results suggest that heat treatment improves the performance of the Ukpo flour in soup thickening while reducing to a large extent the anti-nutritional properties.Keywords: Thickners, anti-nutritional, functional properties

Prevalence of Methicillin–Resistant Staphylococcus aureus (MRSA) from Nasal Swabs of Hospitalized Children in Abakaliki

Staphylococcus aureus is a major bacterial pathogen that causes different community and hospital-acquired infections. Over time, strains of S. aureus have become resistant to different antibiotics including penicillinase-resistant penicillins. Having data on the local antimicrobial susceptibility pattern of this pathogen is necessary for selection of appropriate antibiotics for empirical treatment of infections due to it. This study was undertaken to determine the prevalence of methicillin resistant Staphlococcus aureus in nasal swabs of children admitted in the pediatric ward of Ebonyi State University Teaching Hospital, Abakaliki, Nigeria. One hundred and five consecutive isolates of MRSA were isolated from nasal swabs of children in pediatrics wards of EBSUTH using standard microbiology techniques. Susceptibility studies of MRSA isolates to various classes of antibiotics were determined by disc diffusion methods. The overall susceptibility of isolated MRSA strains to antimicrobial agents was 100% for vancomycin,10% for ciprofloxacin, 40% for ceftazidime, 25% forcefotaxime,48% forcefoxitin,10% for penicillin, 65% for erythromycin, 75% for clindamycin, 37% for amikacin, 18% for co-trimoxazole, 15% for oxacillin and 29% for cloxacillin. In conclusion prevalence of MRSA was low and other than vancomycin, clindamycin and erythromycin, none of the tested antibiotics are appropriate for empirical treatment of serious MRSA infection in our area.Keywords: MRSA, Antibiotics susceptibility, Nasal swab, Children, Pediatrics wardNig J. Biotech. Vol. 24 (2012) 1-

Epidemiology of active epilepsy in a suburban community in Southeast Nigeria: A door‑to‑door survey

Context: Epilepsy is one of the most common neurologic conditions afflicting an estimated 65 million people the world over. Current community‑based data on the prevalence of active epilepsy in Africa are sparse.Aims: This study was aimed at determining the prevalence and profile of active epilepsy in a suburban community in Southeast Nigeria.Methods: It was a two phase cross‑sectional descriptive study. In the first phase, those with possible active epilepsy were identified in a door‑to‑door survey using a modification of the World Health Organization Neuroscience research protocol. In the second phase, cases of active epilepsy were identified and the clinical forms of epilepsy diagnosed based on the International League against Epilepsy guidelines 1993.Results: A total of 6,800 persons was screened in the first phase of the study. There were 29 cases (16 males and 13 females) of active epilepsy. The point prevalence of active epilepsy was 4.3/1,000 (95% confidence interval (95% CI): 2.7‑5.9) for the total population, 4.9/1,000 (95% CI: 2.5‑7.3) for males and 3.7/1,000 (95% CI: 1.7‑5.7) for females. The age‑adjusted prevalence for the total population was 4.1/1,000 (US Population 2000). Classified using clinical criteria only, generalized seizures occurred in 62.1% (n = 18) while partial seizures occurred in 37.9% (n = 11) of cases.Conclusions: The prevalence of active epilepsy in Southeast Nigeria is comparable to that found in developed and some developing countries but less than that reported in suburban Southwest Nigeria about three decades ago.Keywords: Active epilepsy, prevalence, profil