Cognitive Impairment in Patients with Type 2 Diabetes Mellitus: Perspectives and Challenges

Type 2 Diabetes Mellitus is associated with elevated blood glucose level, abnormal abdominal fat deposition, insulin resistance and a number of complications including embryopathy, cardiovascular diseases, nephropathy, neuropathy, microangiopathy and retinopathy. Complications extending to the central nervous system may have a deteriorating effect on mental health including a decline in cognitive functioning. This could be a reason for depression, lack of compliance towards medication/treatment, and the inability of patients to meet the day-to-day management demands of the disease. Due to the high metabolic demand for energy in the brain, perturbations in glucose metabolism can noticeably impact cognitive performance. This review discusses and enlightens on the factors contributing to cognitive impairment in Type 2 Diabetes Mellitus. An understanding of the mechanisms of diabetes‐related cognitive impairment and the resulting behaviors of patients can help healthcare professionals implement treatments to significantly improve health status and quality of life of patients with diabetes

Theatre and laboratory workers’ awareness of and safety practices against hepatitis B and C infection in a suburban university teaching hospital in Nigeria

Introduction: The consistent use of barrier protection among theatre workers is low in this region, so also is hepatitis B virus (HBV) vaccination. We assessed the level of awareness of HBV and hepatitis C virus (HCV), HBV vaccination and adoption of safety measures by theatre and laboratory workers. Methods: Structured questionnaires were administered to these workers which assessed level of knowledge of the viruses, practice of barrier protection and level of HBV vaccination. Results: Of 169 participants 32.5% were laboratory workers, 67.5% were theatre workers; 29.6% males, 70.4% females. Most 94% (159) were aware that HBV and HCV are viral infections, while 77% (127) and 72.1% (119) knew HBV and HCV are transmitted through blood transfusion and needle stick injuries; a correct knowledge was significantly better among respondents with tertiary education (OR 2.7; 95%CI 1.2-6.3 and OR 2.3; 95%CI 1.0-5.1 respectively). Although 49.1% (80) were aware unprotected sex was a route of transmission, laboratory staff was twice as likely to have this knowledge (OR 2.1; 95% CI 1.08-4.08). Only 67.5% (114) use safety measures consistently, while 86 (54.8%) had received the vaccine of which only 48 (29.78% of total respondents) had completed three (3) doses; more likely among those with tertiary education (OR 2.6; 95%CI 1.2-5.8). Conclusion: Most (94%) workers were aware of the risk of HBV and HCV and HBV vaccine (92.9%) but only few (29.78%) completed vaccination. Unfortunately, only 2/3 use protective measures consistently. There is need to make vaccination of health care workers against HBV infection a firm policy and ensure complete and consistent adherence to work standard safety measures. Pan African Medical Journal 2012; 13:

Brucella seropositivity in chicken and risk factors for Brucella infection at the animal-human interface in Anambra State, Nigeria

Aim: Brucellosis is an important bacterial zoonosis devastating both animal and human populations in many parts of the world. A seroepidemiological study of avian Brucella infection was conducted to determine the disease prevalence, risk factors, and hence the role of chicken in the epidemiology of brucellosis in Anambra State, Nigeria. Materials and Methods: Rose Bengal plate test was used to test for Brucella antibody in sera samples collected from 410 chickens surveyed. The interview schedule was used to elicit information on the socioeconomic status, awareness of brucellosis and predisposing practices of poultry farmers, live bird sellers, and poultry carcass processors in the study area. Results: An overall seroprevalence of 3% was recorded. Sex (female), free-range management system, breed (indigenous breed), and mix farming were the determinants of avian brucellosis in the state. Risk factors that may enhance human Brucella infection at the animal-human interface are non-use of personal protective clothing; poor awareness on brucellosis and methods of the disease spread or control, cohabitation with animals, and eating while on duty. Conclusion: Chicken may be among the reservoirs of Brucella infection in Anambra State. There is an urgent need for an effective control program against brucellosis in the study area, using a coordinated One Health approach bearing in mind the public health and economic consequences of brucellosis

Gender Comparison Of Alpha-Fetoprotein, CD4, Albumin and Some Liver Enzymes in Symptomatic HIV Subjects on Antiretroviral Therapy

The emergence of Human Immunodeficiency Virus (HIV) has remained an issue of global discuss till date as it continues to invade and ravage the world’s population despite the efforts been made globally at tackling the impact of the virus. This is a case controlled study designed to comparatively evaluate the alpha-fetoprotein, CD4+ T-cell count, albumin and some liver enzymes activities in male and female symptomatic HIV subjects on antiretroviral therapy in NAUTH Nnewi, South Eastern Nigeria. A total of seventy one (71) participants who were aged between 18 and 60 years attending the voluntary counseling and testing unit (VCT) and antiretroviral therapy unit (ART) of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi as well as 25 control subjects were randomly recruited for the study    . CD4 count, alpha fetoprotein (AFP), albumin, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase activities were estimated by standard laboratory methods. Results showed no significant differences in the mean values of AFP, CD4 count, albumin, ALT, AST and ALP  compared between male and female symptomatic HIV infected individuals on ART and symptomatic HIV infected male and female subjects NOT on ART (p>0.05) respectively. Also, there was no significant difference in ALT and AST activities when compared between male and female HIV seronegative control (p>0.05) although ALP activity was significantly higher in female control subjects than in males (p=0.01). This revealed no gender specific differences in mean values of alpha fetoprotein, albumin, CD4 T-cell count, and liver enzyme activities between male and female HIV infected symptomatic individuals on antiretroviral therapy and symptomatic HIV infected persons NOT on antiretroviral therapy

The Phytochemistry, Ethnobotanical, and Pharmacological Potentials of the Medicinal Plant-Vernonia amygdalina L. (bitter Leaf)

Background Vernonia amygdalina is traditionally used to treat a variety of diseases including diarrhoea, fungal and bacterial infections, inflammation, cancer, diabetes, and its squeezed juice can be applied on wounds. Objective This study reviewed the phytochemistry, ethnopharmacological, and pharmacological potentials of Vernonia amygdalina. Methods Literature search of relevant papers (1994-2021) were performed using ScienceDirect, Springer, Wiley and PubMed databases. For this review study, only publications written in English were utilized. Results The bioactive compounds extracted from Vernonia amygdalina includes 6β,10β,14β trimethylheptadecan-15 α-olyl-15-O-β-D-glucopyranosyl-1,5 β olide, glucuronolactone, 11 α-hydroxyurs-5,12-dien-28-oic acid-3 α,25-olide, 10-geranilanyl-O-β-D-xyloside, 1-heneicosenol O-β-D-glucopyranoside, apigenin, luteolin (3´,4´,5,7tetrahydroxyflavone), vernolide, hydroxyvernolide, 3′-deoxyvernodalol , vernodalol, diterpene (ingenol-3-angelate), vernomygdin, 4-methylumbelliferone, cephantharin, cryptolepine, isocryptolepine, neocryptolepine, courmarins, vernolepin, and vernoniosides. Various in vivo and in vitro studies revealed that V. amygdalina and its bioactive components possess pharmacological activities such as antioxidant, anti-inflammatory, anticancer, antimicrobial, hepatoprotective, antimicrobial, antidiarrheal, anti-diabetic, and neuroprotective activities. Conclusion This review demonstrated that V. amygdalina possess therapeutic effects against a wide variety of diseases. The efficacy of V. amygdalina in ameliorating diseases is attributed to its antioxidant activity and ability to improve the antioxidant system. Despite the vast pharmacological activities of V. amygdalina, more human clinical trials are needed to identify effective and safe doses for treatment of various diseases

Clinical Study Effectiveness of Green Tea in a Randomized Human Cohort: Relevance to Diabetes and Its Complications

Epidemiological studies have argued that green tea could mitigate diabetes and its complications. This study investigated the phytophenolic profile of Mauritian green tea and its antioxidant propensity. The effect of green tea on the risk factors: waist-hip ratio, glucose level, arterial pressure, antioxidant status, and alanine aminotransferase (ALT) in prediabetics was assessed. The experimental group consumed 3 cups of green tea daily for 14 weeks followed by a 2-week washout period. The control group followed a water regimen. Green tea contained high level of phenolics related to its antioxidant power. Green tea suppressed waisthip ratio of women from a significant increase and suppressed mean arterial pressure of men and women from a significant decrease after week 14. It reduced ALT level in women by 13.0% ( < 0.1) while increasing the antioxidant potential of men and women sera by 2.7% ( < 0.1) and 5.1% ( < 0.1). The study timescale may have been too short to enable demonstration of effects on fasting plasma glucose and HbA1c outcomes. Green tea regimen could form part of a healthy lifestyle that might ameliorate features of metabolic syndrome and subsequent risks for diabetes and its complications. This trial is registered with ClinicalTrials.gov NCT01248143

Epididymal Sperm Characteristics, Testicular Morphometric Traits and Growth Parameters of Rabbit Bucks Fed Dietary Saccharomyces cerevisiae and/or Zinc Oxide

ABSTRACT The objectives of this twelve-week feeding trial were to determine the effects of dietary Saccharomyces cerevisiae and/or zinc oxide on epididymal sperm characteristics, testicular morphometric traits, and growth parameters of bucks. 16 (New Zealand White) bucks 16-wk-old, weighing 2.8kg were randomly allotted to one of 4 treatment groups. Each treatment was replicated four times, with 1 buck per replicate, in a completely randomized design (CRD). Each treatment group was randomly assigned to one of the four commercial experimental diets designated thus: TA = control diet with no additives, TB = 0.12g/kg Saccharomyces cerevisiae, TC = 150mg/kg zinc oxide and TD = 0.12g/kg Saccharomyces cerevisiae +150 mg/kg zinc oxide. Although treatment had no effect (p>0.05) on final body weight, average daily weight gain and feed conversion ratio, epididymal sperm characteristics and testicular morphometric traits differed significantly (p<0.05). Bucks on TB(Saccharomyces cerevisiae-based diet) had improved (p<0.05) sperm concentration, motility and live sperm, tubule diameter, epididymal volume, volume fraction of duct, and total duct volume, but decreased testicular volume. Bucks fed TA (control diet) had improved volume fraction of tubule but recorded the highest incidence of head and tail sperm abnormality. Though, TC(zinc oxide-based diet) enhanced (p<0.05) seminal vesicle volume, sperm pH was better among bucks fed TD (Saccharomyces cerevisiae + zinc oxide-based diet). It can be concluded that dietary inclusion of Saccharomyces cerevisiae at 0.12g/kg of feed improved epididymal sperm characteristics and testicular morphometric traits of rabbit bucks

Sero-prevalence of hepatitis B virus and hepatitis C virus among HIV patients in a suburban University Teaching Hospital in South-East Nigeria

Abstract Introduction: Highly active antiretroviral therapy (HAART) has improved survival of human immunodeficiency virus (HIV) patients. Concurren

Anti‑malaria prescription in pregnancy among general practitioners in Enugu state, south east Nigeria

Background: The national policy on malaria control recommends use of intermittent preventive treatment with sulfadoxine/pyrimethamine (IPT‑SP) for chemoprophylaxis against malaria in pregnancy; and use of quinine and arthemisinin‑based combination therapy (ACT) for acute treatment of malaria in the first, and second/third trimesters, respectively. In Nigeria, a large proportion of pregnant women are seen by the general practitioners (GPs). Objective: To determine the pattern of anti‑malaria prescription in pregnancy among GPs in Enugu state, and access the level of conformity with the national policy on malaria control. Materials and Methods: Questionnaires were administered to a cross‑section of 147 GPs that attended the 2010 Enugu state branch of the Nigeria Medical Association Scientific Conference/Annual General Meeting/Election. Results: The mean age of the GPs was 37 ± 3.6 (range 27-70) years. Quinine was the commonly (45.6% (n = 67)) prescribed anti‑malaria drug in the first trimester while in the second/third trimester ACT was commonly (48.3% (n = 71)) prescribed. Seventy‑six (51.7%) practitioners prescribed IPT‑SP for chemoprophylaxis against malaria while the rest (48.3%) prescribed other drugs. GPs who obtained MBBS qualification less than or equal to 5 years prior to the survey were more likely to comply with the national policy on malaria control in their prescriptions (P &lt; 0.05). Conclusion: The pattern of anti‑malaria prescription among GPs in Enugu state is varied, and conformed poorly to the evidence‑based national policy on malaria control. There is need for continuing professional development to keep the GPs abreast with current trends in malaria treatment during pregnancy.Keywords: Anti‑malaria prescription, Enugu state, general practitioners, pregnancyNigerian Medical Journal | Vol. 54 | Issue 2 | March-April | 201