Does health-related quality of life in asthma patients correlate with the clinical indices?

Background: Assessment of health-related quality of life (HRQOL) has been shown to be more relevant to patients who have chronic diseases such as asthma, as achieving the best possible quality of life is the  paramount objective in the management of such patients. This study assessed the quality of life of asthma patients and correlated it with the various clinical indices of asthma, such as age, sex, the duration of the asthma, medication used and its severity.Design: The study was a cross-sectional, analytical, case-control design, involving three approaches, i.e. quality of life, clinical assessment and lung function assessment. The patients who participated in this study completed the Asthma Quality of Life Questionnaire (AQLQ) and Asthma Control Questionnaire (ACQ). Statistical analysis was performed using Epi Info™ version 6.04.Setting and subjects: The clinical setting was the respiratory unit of the department of Medicine, University of Benin Teaching Hospital, Benin City, Nigeria. The recruited patients held various professions. A diagnosis of asthma was made using the clinical features of asthma and lung function measurements with a spirometer and MicroWright® Peak flow meters.Outcome measures: The outcome measures were the quality of life score scores and clinical indices of asthma in patients attending the respiratory unit of the University of Benin.Results: Subjects had significantly low lung function values when compared with the controls (p-value < 0.05). The quality of life of asthmatics was 4.82 ± 1.16 (1-7) and correlated with the duration of asthma (r = -0.83), body mass index, medication used (r = 0.96), asthma severity (r = 0.96) and gender (r = 1). The difference between male and female quality-of-life values was significant (p-value < 0.05). However, there was no correlation between age and quality of life (r = 0.06).Conclusion: The overall assessment showed that quality of life with regard to asthma was low in this study, and correlated with some clinical asthma indices. The determinants of quality of life in this study included the  duration of asthma, body mass index, asthma severity, medication use and gender

Pattern of Microbial Colonization of the Vagina of Diabetics in Ibadan, Nigeria

The pattern of microbial flora of the vagina of diabetics was studied, to advise on empirical regimen for the treatment of sepsis in diabetics with the lower genital tract as source. In 2003, microscopy, culture and sensitivity of high vaginal swabs from 60 consecutive non-insulin-dependent diabetics and 20 non-diabetics attending Oluyoro Catholic Hospital, Ibadan were done. The fasting plasma glucose was estimated. The prevalence of micro-organisms decreased with duration of diabetes. The isolates were Gardnerella vaginalis, Candida species, Staphylococcus epidermidis, Klebsiella species, Enterococcus faecalis, and viridans Streptococcus. Klebsiella species and Escherichia coli were incriminated in Gram negative bacilli (GNB) bacteraemia in diabetics in this environment. In addition to metronidazole, ceftazidime or ceftriazone should be used as first line drugs, while the quinolones should be reserved for the treatment of sepsis in diabetics where lower genital tract is the likely source of infection

Haematological Parameters and Histomorphological Effect of Varied Parts of Citrullus Lanatus Juice Fed to Adult Female Mice

Plants basically will continue to be the starting materials in making modern drugs. As a result of this, many believe in using herbal products than convectional drugs because of their easy accessibility, low side effects and affordability. Citrulluslanatus (popularly known as watermelon) is a citrus fruit known to contain among others, citrulline and lycopene with hepatoprotective actions on organs such as liver and kidney because of it bioactive and antioxidant properties. This study investigates the haemathological parameters and histopathological effects of crude C. lanatus juice on the liver and kidney of mice. Twenty five female mice weighing between 72 - 99g were randomly divided into five groups(A - E) of five mice each. Group A, were given water (control); group B, were given 2ml of watermelon flesh juice; group C, were given 2ml of watermelon flesh and seed juice, group D, were given 2ml of watermelon flesh and rind juice; and group E were given 2ml ofwatermelon flesh, seed and rind juice once daily for four weeks. At the end of experiment, animals were sacrificed and dissected. Blood sample were taken through cardiac puncture, liver and kidney tissue were excised also to determine the haematological and histopathological effects using routine diagnostic techniques. Highest blood and differential counts except WBC were obtained in groups exposed to crude C. lanatus juice when compared with the control.The liver of animals in all groups appears normal with no remarkable differences from the control. Also, no remarkable differences were recorded in the kidney of animals in all groups except group E which showed interstitial edema with some renal tubules within the cortex undergoing degeneration. From this study and at the dose and duration of study, every part of C. lanatushad no negative impact on the histopathology of the liver and kidney and also had the potential to boost the immune system

Assessment of cardiotoxic potential of methanol extract of red cultivar Allium cepa

The effects of oral administration of crude methanol extract of red cultivar Allium cepa (Onion) on serum cardiac troponin (cTnI) in cardiac muscle and some haematological parameters were investigated in this study. Fifty five (55) male albino rats were housed and fed with standard growers ration and water ad libitum. There were three major groups; A, B and C containing twenty five (25), twenty five (25) and five (5) rats respectively. Group C was the control group while groups A and B were sub-divided into 5 groups of 5 rats each. Group A was administered with red cultivar A. cepa extract at doses of 100 mg/kg, 200 mg/kg, 400 mg/kg, 800 mg/kg and 1200 mg/kg for 14 days while group B rats were administered with the doses of red cultivar A. cepa for 28 days. Blood samples were collected from the retro-orbital sinus for haematology and cardiac troponin-I assay, histopathological examination of the heart was also done. Haematology showed significant (p<0.05) progressive decrease in packed cell volume (PCV), red blood cell (RBC) and haemoglobin (Hb) concentration and there was progressive elevation of mean corpuscular volume (MCV). Dose-independent elevation of serum cardiac troponin-I (cTnI) with varying degrees of myocardial injuries was observed. This study further postulates a correlation between the A. cepa-induced anaemia and increased cTnI which may be caused by myocardial ischaemia. In conclusion, this study reported the capability of red cultivar A. cepa to induce anaemia and cause myocardial injury as expressed with statistical significant (p<0.01) increase in serum cTnI. Medicinal use of red cultivar A. cepa is therefore recommended to be limited to lower doses and for short duration to prevent the haemotoxic and cardiotoxic potentials.Keywords: Allium cepa, Cardiac troponin-I, Cardiotoxicity, Haemotoxicity, Medicinal, Red cultiva

In vitro resistance of gram-negative enteric bacilli from wound infections to honey

Letter to the Edito

Clinical effects of Garcinia kola in knee osteoarthritis

<p>Abstract</p> <p>Objectives</p> <p>Over the past years, there has been a growing number of knee osteoarthritis (KOA) patients who are not willing to comply with long-term non-steroidal anti-inflammatory drugs (NSAID) treatment and wish to use herbal anti- rheumatic medicine. This study assessed the clinical effects of <it>Garcinia kola </it>(GK) in KOA patients.</p> <p>Patients and methods</p> <p>Prospective randomized, placebo controlled, double blind, clinical trial approved by the institutional medical ethics review board and written informed consent obtained from each patient. All KOA patients presenting at the Obafemi Awolowo University Teaching Hospital complex were recruited into the study. The patients were grouped into four (A = Placebo, B = Naproxen, C = <it>Garcinia kola</it>, D = Celebrex). The drugs and placebo were given twice a day per oral route. Each dose consisted of 200 mg of <it>G. kola</it>, Naproxen (500 mg), Celebrex (200 mg) and Ascorbic acid (100 mg). The primary outcome measure over six weeks study period was the change in mean WOMAC pain visual analogue scales (VAS). Secondary outcome measures included the mean change in joint stiffness and physical function (mobility/walking).</p> <p>Results</p> <p>143 patients were recruited, 84 (58.7%, males – 24, females – 60) satisfied the selection criteria and completed the study. The effect of knee osteoarthritis bilateralism among the subjects was not significant on their outcome (p > 0.05). The change in the mean WOMAC pain VAS after six weeks of <it>G. kola </it>was significantly reduced compared to the placebo (p < 0.001). Multiple comparisons of the mean VAS pain change of <it>G. kola </it>group was not lowered significantly against the naproxen and celebrex groups (p > 0.05). The onset of <it>G. kola </it>symptomatic pain relief was faster than the placebo (p < 0.001). However, it was slower than the active comparators (p > 0.05). The duration of therapeutic effect of <it>Garcinia kola </it>was longer than the placebo (p > 0.001). <it>G. kola </it>period of effect was less than naproxen and celebrex (p < 0.001). <it>G. kola </it>subjects had improved mean change mobility/walking after six weeks better than the control group(p < 0.001). The mean change in mobility of the <it>G. kola </it>group when compared to the active comparators was not significantly better (p < 0.05). The mean change of knee joint stiffness (p < 0.001) and the change of mean WOMAC score (p < 0.001) were improved on <it>Garcinia kola </it>as compared to the placebo. The mid term outcome of eleven <it>Garcinia kola </it>subjects after cessation of use had a mean pain relief period of 17.27 +/- 5.15 days (range: 9–26 days). There was no significant cardiovascular, renal or drug induced adverse reaction to <it>Garcinia kola</it>.</p> <p>Conclusion</p> <p><it>Garcinia kola </it>appeared to have clinically significant analgesic/anti-inflammatory effects in knee osteoarthritis patients. <it>Garcinia kola </it>is a potential osteoarthritis disease activity modifier with good mid term outcome. Further studies are required for standardization of dosages and to determine long-term effects.</p

Self-medication with antibiotics for the treatment of menstrual symptoms in southwest Nigeria: a cross-sectional study

Background: Self-medication with antibiotics is an important factor contributing to the development of bacterial antibiotic resistance. The purpose of this study was to evaluate the prevalence of self-medication with antibiotics for the treatment of menstrual symptoms among university women in Southwest Nigeria. Methods: A cross-sectional survey was administered to female undergraduate and graduate students (n = 706) at four universities in Southwest Nigeria in 2008. The universities were selected by convenience and the study samples within each university were randomly selected cluster samples. The survey was self-administered and included questions pertaining to menstrual symptoms, analgesic and antibiotic use patterns, and demographics. Data were analyzed using descriptive statistics and logistic regression. Results: The response rate was 95.4%. Eighty-six percent (95% CI: 83-88%) of participants experienced menstrual symptoms, and 39% (95% CI: 36-43%) reported using analgesics to treat them. Overall, 24% (95% CI: 21-27%) of participants reported self-medicated use of antibiotics to treat the following menstrual symptoms: cramps, bloating, heavy bleeding, headaches, pimples/acne, moodiness, tender breasts, backache, joint and muscle pain. Factors associated with this usage were: lower levels of education (Odds Ratio (OR): 2.8, 95% CI: 1.1-7.1, p-value: 0.03); nonscience major (OR: 1.58, 95% CI: 1.03-2.50, p-value: 0.04); usage of analgesics (OR: 3.17, 95% CI: 2.07-4.86, p-value: <0.001); and mild to extreme heavy bleeding (OR: 1.64, 95% CI: 1.01-2.67, p-value: 0.05) and pimples/acne (OR: 1.57, 95% CI: 0.98-2.54, p-value: 0.06). Ampicillin, tetracycline, ciprofloxacin and metronidazole were used to treat the most symptoms. Doctors or nurses (6%, 95% CI: 4-7%), friends (6%, 95% CI: 4-7%) and family members (7%, 95% CI: 5-8%) were most likely to recommend the use of antibiotics for menstrual symptoms, while these drugs were most often obtained from local chemists or pharmacists (10.2%, 95% CI: 8-12%). Conclusions: This is the first formal study to report that approximately 1 out of 4 university women surveyed in Southwest Nigeria self-medicate with antibiotics to treat menstrual symptoms. This practice could provide monthly, low-dose exposures to antibiotics among users. Further studies are necessary to evaluate the impacts of selfmedication on student health

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children &lt;18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p&lt;0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p&lt;0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p&lt;0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

An economic analysis of maggot as an alternative source of animal protein in broiler production

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