Sequential Low Cost Interventions Double Hand Hygiene Rates Among Medical Teams in a Resource Limited Setting. Results of a Hand Hygiene Quality Improvement Project Conducted At University Teaching Hospital of Kigali (Chuk), Kigali, Rwanda

Objective: To assess the impact of multimodal low-cost interventions on hand hygiene practices among medical teams.Design: A four week prospective observational studySetting: Medical wards of the University Teaching Hospital of Kigali (CHUK), Kigali, Rwanda.Subjects: Medical teams comprising students, residents and consultant physicians.Interventions: During week one, baseline hand sanitising rate (HSR) – the percentage of hand hygiene opportunities during which hands were sanitised- was recorded. On week two, alcohol based handrubs (ABHRs) were provided and placed strategically on every ward. For week three and four respectively, hand hygiene posters (HHPs) were placed at entry sites of each ward at eye level and subsequently at the head of each patient’s bed.Main Outcome Measures : Post-intervention HSR was recorded weekly during morning ward rounds. The differences between pre-intervention and post-intervention HSRs as well as end-of-study pre- and post-contact HSR were assessed for significance using Pearson chi square test.Result: A total of 780 HHOs were covertly observed throughout the study. Baseline HSR was 24.8%. During week 2, there was a non-significant increase in HSR (26.6% vs. 24.8%, p =0.66). Overall, hand sanitising rates doubled from 24.8% to 50.6% following all study interventions (p <0.001). There was a significant increase in post-patient contact and pre-patient contact HSRs with rates improving from 25.2% to 58% and 24.5% to 43% respectively (P<0.01).Conclusion: Our study showed that low-cost interventions involving ensuringavailability of ABHRs and posting HHPs significantly increased HSRs among medical teams but post-intervention rates were suboptimal

Proliferative effect of the calcium channel blocker Nifedipine on human embryonic kidney cells

Background: Numerous epidemiological studies have shown a positive as well as negative association between chronic use of calcium channel blockers and the increased risk of developing cancer. However, these associations were enmeshed with controversies in the absence of laboratory based studies to back up those claims. The aim was to determine in mechanistic terms the association between the long-term administrations of nifedipineand increased risk of developing cancer with the aid of human embryonic kidney (HEK293) cell line.Methods: Cell counting using the Trypan blue dye exclusion and 3-[4, 5-Dimethylthiazol-2-yl]-2, 5-diphenyl-tetrazolium bromide (MTT) assays were used to investigate the effect of nifedipine on the growth pattern of HEK293 cells.Results: Nifedipine had a proliferative effect on HEK293 cells growth and this proliferation is more profound at low concentrations of nifedipine than high concentrations and the proliferation was statistically significant (p<0.01).Conclusions: The chronic use of nifedipine is associated with increased proliferation of cells with concomitant elevation of polyamines concentration and elevated polyamine levels have been implicated in many malignant transformations and hence, these provide possible explanation on the link between long term use of nifedipine and development of some human cancers

Analgesic, anti-inflammatory and antipyretic activities of ethanol extract of Annona senegalensis leaves in experimental animal models

Background: This study was carried out to establish the analgesic, anti-inflammatory and antipyretic effects of the ethanol extract of Anonna senegalensis leaves in experimental animals.Methods: The analgesic activity was measured using the abdominal constriction and tail flick tests. The anti-inflammatory activity was performed using xylene and egg-albumen paw induced tests, while the antipyretic activity was measured using brewer’s yeast and 2, 4 dinitrophenol induced pyrexia tests, respectively.Results: The leaf extract at all doses used exhibited significant (p<0.05) analgesic, anti-inflammatory and antipyretic activities.Conclusions: Results show that ethanol leaf extract of Anonna senegalensis possess therapeutic potential against pains and feverish conditions, supporting the claims of its this plant as remedy for similar ailments

Tyramine Induced Hypertension (TIH)-A review

Tyramine is a naturally occuring trace amine derived from the amino acid tyrosine and acts as a catecholamine releasing agent. It occurs widely in plants and animals. These include spoiled, picked, aged, smoked or fermented meat, chocolate, alcoholic beverages, fermented foods such as cheese, sour cream, yogurt, shrimp paste, soy sauce, broad (fava) beans, green bean, pods, snow peas endamine, avocados, bananas, pineapples, egg plants, figs, red plums, raspberries, peanuts, brazil nuts, coconuts, processed meat, yeast, etc. Biochemically, tyramine is produced by the decarboxylation of tyrosine via the action of the enzyme tyrosine decarboxylase. In humans, tyramine is produced from tyrosine in the presence of Dopa decarboxylase. Tyramine is taken up into nerve terminals by norepinephrine reuptake transporter (NET) and causes the release of catecholamines. It has been proposed that this results from reverse transport of NET. The effects of tyramine are increased in the presence of MAO inhibitors. Tyramine is physiologically metabolized by monamine oxidases (primarily MAO-A), FMO3, PNMI, DBH and CYP2D6. In humans, if monoamine oxidase inhibitors (MAOI’s) and foods high in tyramine are ingested, tyramine is not degraded and a hypertensive crisis can result from tyramine displacing stored monoamines such as dopamine, norepinephrine, and epinephrine from synaptic vesicles. The first sign of this were discovered by a British pharmacist who noticed his wife, who at the time was on monoamine oxidase inhibitor medication, has several headaches with moderately elevated blood pressure when eating cheese. This is why the crisis is still called “cheese effect” or “cheese crisis”, although other foods can cause the same problem, or much betier ‘Tyramine induced hypertension’. Symptoms and signs include Headache (main symptom), palpitation, high blood pressure (160/90 to 220/115mmHg), and associated complications like hemorrhage, hemplegia, intracranial hemorrhage, cardiac arrhythmias, cardiac failure, pulmonary oedema, and death. Agents normally used to lower blood pressure during a hypertensive crisis include: Nifedipine, a calcium channel blocker; Phentolamine, a reversible non selective alpha adrenergic antagonist and Prazosin, a sympatholytic agent

Nutritional and Anti–Nutritional Evaluation of Garri Processed by Traditional and Instant Mechanical Methods

Aim: The aim of this study is to evaluate the nutritional and anti-nutritional composition of garri processed by traditional and instant mechanical methods. Place and Duration of Study: This study was carried out in Achara, Uturu and analyses were done at the Biochemistry and Central Laboratories of Gregory University, Uturu, Abia State between March and July, 2017. Methods: Cassava was harvested and processed in Achara area of Uturu, Abia State. For garri processed by instant mechanical method, cassava was grated and dewatered using hydraulic press and were roasted (fried) within 24 hours of harvest. For garri processed by traditional method, the grated garri was allowed to stay for 24 hours in the sack before dewatering using sticks. The dewatering process took 3 days before roasting. The nutritional and anti-nutritional composition of raw cassava mash, garri processed by traditional and instant mechanical methods were evaluated using standard methods. Results: The result of the analysis showed that garri processed by traditional method was higher in most of the nutritional factors but lower in all of the anti-nutritional factors investigated when compared with those of garri processed by instant mechanical method and raw cassava mash. Garri processed by traditional method was significantly higher in vitamin A but lower in vitamin C when compared with garri processed by instant mechanical method at p&lt;0.05. Garri with palm oil has its cyanogenic glucoside significantly reduced when compared with garri without palm oil at p&lt;0.05. Conclusion: Long period of fermentation (3 – 5 days) of cassava product is recommended as garri processed by traditional method was nutritionally better than that processed by instant mechanical method due to the longer period of fermentation