Orthodontic needs of patients with cleft lip and palate in Enugu, five years post repair

Background: Orthodontists play an integral role in the management of cleft lip and palate anomaly. This study looks at the frequency of  anomalies amenable to orthodontics in patients who have had surgery and the effect of early or late surgical intervention.Methodology: Patients aged 0-5 years with cleft of the lip and/or palate who were operated on by the plastic surgeon at the Good  Shepherd Specialist Hospital, Enugu between 1st July 2011 and 30th June 2014, were recalled after a minimum of five years post-surgery and examined to determine the absence or presence of dental anomalies, amenable to orthodontic treatment, which have arisen since surgical repair. Descriptive statistics and t-test were used for data analysis and significance was at 0.05.Results: Thirty-one children were operated upon in the period under review. Seventeen had timely (three months or less) lip repair. Seven had timely palate repair (18 months or less). Thirteen patients were successfully recalled, 12 had cleft lip repair while one had cleft palate repair. Repair was timely in 10 (83.3%) of the 12 that had lip repair with a mean frequency of four dental anomalies, while the two (16.7%) that had late repair had a mean frequency of five dental anomalies and this was not statistically significant (P value=0.711). The only isolated cleft palate patient successfully recalled had a late repair. All 13 patients had at least four dental anomalies amenable to orthodontics. Hypoplastic maxilla were the most commonly occurring (eight patients, 61.54%) dental anomaly amenable to orthodontic treatment. None of the patients had a clinically visible supernumerary tooth. Out of 13 patients reviewed, sis were males with a mean frequency of four dental anomalies while seven were females, also with a mean frequency of four dental anomalies. This was not  significant (P-value=0.553).Conclusion: There is need for the long term Orthodontic follow up of cleft lip and palate patients. The orthodontic management of dental anomaly should, therefore, be central in the planning and treatment of patients with cleft lip and palate

Bacteriological profile of selected fish species and water sample from Otuocha River Anambra State

Attempt to ensure fish food security is a continuous process and food safety is a global concern for consumers and food industry. Fish is an  important source of healthy and cheap source of animal protein that among its numerous benefit fish is widely acceptable, across socio-economic, age and religious barrier. However, supply of contaminated free fish is desirable to ensure safe consumption and a healthy consumer public`. The  objective of the study is to provide baseline information on the microbial quality of Otuocha river, hence establish the microbial quality of fish caught in Otuocha river. Five fish species (Aruis gigas, Bagrus bayad, Schilbe mystus, Chrysichthys nigroditatus and Protopterus annectens) and water sample were taken from Otuocha fish landing site and river respectively and transported to laboratory. The fish samples were cleaned with sterile distilled water and 1 g of skin, gills, intestine cut aseptically and labelled along with water sample before microbial analysis following standard method. The result obtained in water and fish samples showed high microbial load in Otuocha river and was attributed to anthropogenic sources. Nine different bacteria were isolated in fish samples while seven were isolated in water sample. The study concluded that Otuocha river has high microbial load, hence recommend that fish from Otuocha river should be properly cooked/smoked before consumption and sanitary standard of Otuocha river and its environs be improved while public enlightenment on waste disposal be undertaken. Key words: Microbial load, fish, water, Otuocha Rive

COMPARATIVE ASSESSMENT OF LIPID PROFILE IN PRE-MENOPAUSAL AND MENOPAUSAL WOMEN IN NNEWI NIGERIA

The study was aimed at determining the effect of menopause on lipid profile. A total of 100 apparently healthy subjects who comprised 50 menopausal women aged 45 – 77 years and 50 pre-menopausal women between the aged between 20-52 years were recruited. Ethical approval was obtained from the Faculty of Health Science and Technology, Nnamdi Azikiwe University ethics committee and informed consent of each participant was obtained prior to recruitment. We estimated serum levels of total cholesterol using the enzymatic end point method as described by Roeschlau et al., (1974), HDL was performed using the combination of phosphotungstate precipitation and enzymatic method as described by Burstein et al., (1980), LDL by the combination of polyvinyl sulphate precipitation and enzymatic method of Assman et al., (1984), VLDL was estimated using the method as described by Friedwald et al., (1972) and triglycerides by the enzymatic method as described by Tietz (1990). The results shows that the mean levels of serum triglycerides (TG) and low density lipoprotein cholesterol (LDL cholesterol) showed a statistically significant increase in menopausal women compared with the premenopausal subjects (P<0.05) while there was no significant difference in the mean values of serum high density lipoprotein cholesterol (HDL cholesterol), very low density lipoprotein cholesterol (VLDL cholesterol) and total cholesterol (P>0.05). There was a progressive increase in the mean levels of total cholesterol, triglycerides, LDL-cholesterol and VLDLcholesterol with duration of menopause while the levels of HDL-cholesterol decreased with duration of menopause. There were no significant variations among the various age categories of the menopausal subjects and the levels of the lipid parameters studied (p>0.05). The findings suggest that premenopausal women have less proatherogenic lipid profile than their menopausal counterparts

COMPARATIVE ASSESSMENT OF LIPID PROFILE IN PRE-MENOPAUSAL AND MENOPAUSAL WOMEN IN NNEWI NIGERIA

The study was aimed at determining the effect of menopause on lipid profile. A total of 100 apparently healthy subjects who comprised 50 menopausal women aged 45 – 77 years and 50 pre-menopausal women between the aged between 20-52 years were recruited. Ethical approval was obtained from the Faculty of Health Science and Technology, Nnamdi Azikiwe University ethics committee and informed consent of each participant was obtained prior to recruitment. We estimated serum levels of total cholesterol using the enzymatic end point method as described by Roeschlau et al., (1974), HDL was performed using the combination of phosphotungstate precipitation and enzymatic method as described by Burstein et al., (1980), LDL by the combination of polyvinyl sulphate precipitation and enzymatic method of Assman et al., (1984), VLDL was estimated using the method as described by Friedwald et al., (1972) and triglycerides by the enzymatic method as described by Tietz (1990). The results shows that the mean levels of serum triglycerides (TG) and low density lipoprotein cholesterol (LDL cholesterol) showed a statistically significant increase in menopausal women compared with the premenopausal subjects (P<0.05) while there was no significant difference in the mean values of serum high density lipoprotein cholesterol (HDL cholesterol), very low density lipoprotein cholesterol (VLDL cholesterol) and total cholesterol (P>0.05). There was a progressive increase in the mean levels of total cholesterol, triglycerides, LDL-cholesterol and VLDLcholesterol with duration of menopause while the levels of HDL-cholesterol decreased with duration of menopause. There were no significant variations among the various age categories of the menopausal subjects and the levels of the lipid parameters studied (p>0.05). The findings suggest that premenopausal women have less proatherogenic lipid profile than their menopausal counterparts

Effects of nutrition education of mothers on anthropometric indices of preschoolers and mothers’ nutrition knowledge in Umuguma, Imo State, Nigeria

Background: Many rural women have little or no knowledge of nutritive value of foods, and what constitute an adequate diet, as a result, most Nigerian families often depend on processed complementary foods low in nutrient density which contributes to growth faltering among infants. Objective: The study determined the anthropometric indices of the children and the nutritional knowledge of their mothers as well as evaluated the effect of nutrition education on the anthropometric indices of preschoolers. Methods: A community-based longitudinal study using stratified sampling technique was conducted among 284 mothers and children within the age of six months to five years in Umuguma Owerri-West Local Government Area, Imo State. Data on nutritional knowledge of the mothers and anthropometric measurements were collected before nutrition education and evaluation was carried out on the same group after six months of applied nutrition education programme. Mothers were taught on formulation and preparation of complementary and family food both for their families and their preschoolers using demonstration method. The anthropometric measurements were processed using the WHO Anthro-plus software. Descriptive statistics was used in analyzing the data. Chi- square was used to determine the significance of difference. The decision criterion was placed at P<0.05. Results: The study observed improvement in the women’s nutritional knowledge after nutrition education. The mean Z-Score of the children on anthropometric parameters was improved in both sexes but higher in female than male children after nutrition education. Prevalence of malnutrition present among the preschoolers (under nutrition and wasting) disappeared after nutrition education. Significant (P<0.05) associations was observed between mothers’ nutrition knowledge and preschoolers’ prevalence of wasting, stunting and underweight before nutrition education. But after nutrition education, there was no statistically significant (P>0.05) association between wasting, underweight and nutrition knowledge, though stunting had a significant (P<0.05) association with nutrition knowledge of the mothers. Conclusion: Nutrition education improved the nutritional knowledge of the mothers which improved the nutritional status of their children

Prevalence and Predictors of Stress among Bankers in Enugu State South-East Nigeria

Background: The work environment is rapidly changing and in recent times, occupational stress poses a threat to the health, morale and productivity of workers and the organization. This study sought to determine the prevalence and predictors of stress among bankers in a south-eastern state of Nigeria. Methods: A descriptive cross-sectional study was carried out among 370 bankers in Enugu State, Nigeria using the Health, Safety, Executive (HSE) management standards indicator tool. Multistage sampling method was used to select participants. Statistical analysis was done using SPSS 22.0. Level of statistical significance was set at p< 0.05.Results: The mean age of the participants was 34.54±6.3 years while the mean years of work was 6.01±4.7years. One hundred and seventy-four (47%) reported high level of stress due to relationship at work while 318 (85.9%) reported low level of stress due to roles. Being 35 years or less was found to a predictor of high (AOR 0.55, CI 0.30-1.02) level of stress due to control.Work experience of 5 years or less was found to be a predictor of both high (AOR 0.74, CI 0.40--1.37) and low (AOR 0.99, CI 0.40-1.37) levels of stress due to control.Conclusion: This study has shown that the prevalence of stress was high among bankers in Enugu State, South-East Nigeria. There is, therefore, the need for routine stress assessment and interventions in the banking industry especially for those at high risk. Keywords: Bankers; HSE Stress Questionnaire; Stress; Workplace; Southeast Nigeri

Assessment Of Tumour Necrosis Factor-Alpha (Tnf- Α) And Creatinine Levels In Echis Ocellatus Bite Victims In Jos Metropolis, Nigeria

This study was designed to assess tumour necrosis factor-alpha and creatinine levels in Echis ocellatus bite victims. A total of 50 subjects were recruited. Out of this number, 40 were victims of E. ocellatus bite and the remaining 10 were non-victims of snake bite who served as the control group. Blood samples were collected from the victims within 24 hours of the snake bite and EchiTAb-G antivenom administered within the same period. Another batch of blood sample was collected 48 hours post-administration of the anti-venom. Tumour necrosis factor-alpha (TNF-alpha) levels were estimated by the Enzyme Linked Immunosorbent Assay technique while creatinine levels were determined using kinetic-spectrophotometric procedure. The mean serum levels of tumour necrosis factor-alpha and creatinine were significantly increased in E. ocellatus bite victims compared with the control group (P<0.05). Furthermore, the mean serum level of TNFalpha was significantly lower in E. ocellatus bite victims, post-administration of anti-venom, compared with the pre-administration of anti-venom (P<0.05). In contrast, no significant difference was observed in the mean serum level of creatinine in E. ocellatus bite victims, post-administration of anti-venom, compared with the pre-administration of anti-venom (P>0.05). Moreover, the mean serum level of creatinine was found to be significantly increased in E. ocellatus bite victims, post-administration of anti-venom, compared with the control group (P<0.05), while no significant difference was observed in the mean serum level of tumour necrosis factor-alpha in E. ocellatus bite victims, post-administration of anti-venom, compared with the control group(P>0.05). A positive correlation existed between tumour necrosis factor-alpha and creatinine levels in E. ocellatus bite subjects (r= 0.782). Echis ocellatus bite is a risk factor for renal damage indicated by an elevated serum creatinine, thus health authorities should make EchiTAb-G anti-venom freely available in health facilities and administered as quickly as possible to reduce the risk of renal damage in Echis ocellatus bite-prone areas

The role of the employer in workplace violence: The health care workers' perspective

Background: Workplace violence affects millions of people on a yearly basis. It has important consequences both for the harassed and the employer. The aim of the study was to find out the role employers play in controlling workplace violence in a tertiary healthcare institution as perceived by the health care workers.Methods: The study was a descriptive cross-sectional study carried out among nurses and doctors at the University of Nigeria Teaching HospitalItukuOzalla (UNTH), using a pre-tested, self-administered and semi-structured questionnaire that was adapted from the workplace violence in the health sector country case studies research instruments by ILO/ICN/WHO/PSI. A sample size of 412 was obtained using the sample size determination formula for cross-sectional descriptive studies. Data was analysed using Epi Info version 3.5.4. Chi-square test was used to determine association with a significance level of p-value at 0.05.Results: Four hundred and twelve healthcare workers participated in the study, of which 111(26.9%) were doctors while 301 (73.1%) were nurses. One hundred and thirteen (27.4%) respondents felt there were policies on health and safety, 154 (37.4%) reported that there was no policy while 145 (35.2%) did not know if there was any existing policy. For measures in place to mitigate violence at the workplace, 240(58.3%) mentioned existing security measures, 174 (42.0%) improved surroundings, 96 (23.3%) reduced work alone hours, while only 89 (21.6%) mentioned restriction of public access.Conclusion: Very few healthcare workers had correct information about the existence of policies to protect them from violence at the workplace.Most employees only know about existing security measures with little or no knowledge of other measures that can be helpful in curbing violence in their workplace. Drafting, dissemination and implementation of policies to reduce workplace violence in our healthcare facilities is recommended. Keywords: workplace, violence, role of employers, health-worker

The practice of hepatocellular cancer surveillance in Nigeria

Background: Hepatocellular cancer is a disease of global and public health importance due to the widespread distribution of risk factors and associated high case fatality. Hepatocellular Cancer (HCC) in Sub-Saharan Africa is commonly seen among the younger age groups (<45 years) who present mostly in the terminal stage, when the disease is not amenable to any curative therapy. Hepatocellular Carcinoma surveillance employs the use of simple, cheap and readily available investigations, to detect early curable cancer in individuals with risk factors for HCC.Objectives:The aim of this study is to assess the practice of hepatocellular cancer screening among physicians.Methodolgy:This is a nationwide online survey carried out among physicians who care for patients with HCC. A questionnaire was sent out via a web link to all consenting doctors in Nigeria. The responses were collated in a cloud-based application and data was analysed using Epi-info version 20.Results:Atotal of 218 respondents, 142 were males (65.1 %) with a mean age of 37.6 ± 5.7 years. The modal age group was 31-40 years 153 (69.5%). The main factors considered as a hindrance to surveillance were; the cost of the tests (57.7%), failure of return of patients (50.5%) and not being aware of a surveillance program (45.2 %). The majority of the respondents were Gastroenterologists and Family Physicians. 54% of the gastroenterologists and 64% of the family physicians have never offered HCC surveillance to their patients.Conclusion:This survey highlights a knowledge gap in HCC surveillance among physicians. There is a need to make HCCsurveillance a daily routine among patients at risk by all physicians. Keywords: Surveillance, Hepatocellular Carcinoma, HBV, HCV, Cancer screening

Analysis of extemporaneous oral liquid from commercially available drugs in hospital

ABSTRACT The objective of this study was to identify drugs that received dose adjustments (DA) and pharmaceutical alternatives (PA) that avoid DA, and calculate the economic percentage of this replacement. A descriptive, observational and cross-sectional study was performed in a second level hospital. The pharmacy and nursing services was accompanied to identify the drugs that received DA and the compounding techniques. After identifying all the drugs that received DA, was identified in the Brazilian market the corresponding pharmaceutical alternative, with the Drugs Price List of Brazilian Health Regulatory Agency. For those drugs that was not available any PA, was performed a research of studies that describe compounding techniques in international scientific databases. Was identify 88 drugs that received DA, and these, 50 do not have any PA. Were identified compounding techniques to 40 drugs. Although any drug has your own particularity of compounding, the compounding techniques can be grouped in five categories. The standardization of 29 drugs can reduce in 28% the DA procedure and cost saving of 34,85%/month. We can conclude that every three drugs prescribed, one received DA and every three DA, one can be avoided by the selection of 29 PA, saving cost as well. The use and standardization of five techniques would attend the pharmaceutics recommendations for better dissolution, bioavailability and patient safety