Element Levels in Plasma of Cancer Patients

This study investigated the levels and the trend of some plasma elements in cancer patients. A total number of seven hundred (700) patients with different types of cancer (leukemia, ovarian, prostate, breast, colon, cervical, uterine, ovarian) attending University Teaching Hospitals and Federal Medical Centers in Southwestern Nigeria, and three hundred (300) healthy subjects who served as control subjects were examined. The plasma levels of Zn, Fe, Ca, Mg, Mn and Cu were determined by atomic absorption spectrophotometry while Na and K, were analysed using flame emission photometry.The alterations observed in plasma profile of elements of the cancer patients when compared with the control may be a useful indicator in the detection of the initial changes occurring in neoplastic cells. A significant increase (p<0.05) was recorded in the plasma level of  lead and  cadmium when compared with the control and among the cancer types which suggests their involvement in the generation of reactive oxygen species which could lead to lipid peroxidation,  DNA damage and alteration in gene expression. Keywords: cancer, elements, plasma, alteration, patients

STATUS OF PLASMA ELECTROLYTES, UREA, CREATININE, AND C-REACTIVE PROTEIN IN CANCER PATIENTS.

 Objective: Cancer is a major health problem not only in developed countries but also in developing countries like Nigeria. This study was designed to study the status of plasma electrolytes, urea, creatinine, and C-reative proteins (CRPs) in freshly diagnosed cancer patients.Methods: Plasma electrolytes (sodium [Na+], potassium [K+], chlorine [Cl-], and bicarbonate [HCO3-]), urea, creatinine, and CRP were estimated in four different types of cancer (liver, colon, cervical, and uterine) patients attending Ekiti State University Teaching Hospital Ado Ekiti Nigeria. A total of 250 patients (between age of 45 and 70 years) consisting of 50 patients in each cancer type and 50 normal subjects as control were considered in this study.Results: The result obtained revealed a significant (p<0.05) increase in the plasma levels of Na+, Cl-, creatinine, and CRP in all the cancer types when compared with the control subjects. Plasma urea level decreased significantly in patients with colon (3.16±0.70 mmol/L) and liver (3.03±1.75 mmol/L) cancer when compared with the control subjects (4.80±1.12 mmol/L). K+ and HCO3_ level was not significantly (p>0.05) different in all cancer types when compared with the control subjects.Conclusion: This study revealed a possible link between plasma electrolytes, creatinine, CRP, urea, and cancer which could be useful in the assessment and management of cancer

User Evaluation Indicates High Quality of the Surveillance Outbreak Response Management and Analysis System (SORMAS) After Field Deployment in Nigeria in 2015 and 2018

During the West African Ebola virus disease outbreak in 2014–15, health agencies had severe challenges with case notification and contact tracing. To overcome these, we developed the Surveillance, Outbreak Response Management and Analysis System (SORMAS). The objective of this study was to measure perceived quality of SORMAS and its change over time. We ran a 4-week-pilot and 8-week-implementation of SORMAS among hospital informants in Kano state, Nigeria in 2015 and 2018 respectively. We carried out surveys after the pilot and implementation asking about usefulness and acceptability. We calculated the proportions of users per answer together with their 95% confidence intervals (CI) and compared whether the 2015 response distributions differed from those from 2018. Total of 31 and 74 hospital informants participated in the survey in 2015 and 2018, respectively. In 2018, 94% (CI: 89–100%) of users indicated that the tool was useful, 92% (CI: 86–98%) would recommend SORMAS to colleagues and 18% (CI: 10–28%) had login difficulties. In 2015, the proportions were 74% (CI: 59–90%), 90% (CI: 80–100%), and 87% (CI: 75–99%) respectively. Results indicate high usefulness and acceptability of SORMAS. We recommend mHealth tools to be evaluated to allow repeated measurements and comparisons between different versions and users.Peer Reviewe

User Evaluation Indicates High Quality of the Surveillance Outbreak Response Management and Analysis System (SORMAS) After Field Deployment in Nigeria in 2015 and 2018.

During the West African Ebola virus disease outbreak in 2014-15, health agencies had severe challenges with case notification and contact tracing. To overcome these, we developed the Surveillance, Outbreak Response Management and Analysis System (SORMAS). The objective of this study was to measure perceived quality of SORMAS and its change over time. We ran a 4-week-pilot and 8-week-implementation of SORMAS among hospital informants in Kano state, Nigeria in 2015 and 2018 respectively. We carried out surveys after the pilot and implementation asking about usefulness and acceptability. We calculated the proportions of users per answer together with their 95% confidence intervals (CI) and compared whether the 2015 response distributions differed from those from 2018. Total of 31 and 74 hospital informants participated in the survey in 2015 and 2018, respectively. In 2018, 94% (CI: 89-100%) of users indicated that the tool was useful, 92% (CI: 86-98%) would recommend SORMAS to colleagues and 18% (CI: 10-28%) had login difficulties. In 2015, the proportions were 74% (CI: 59-90%), 90% (CI: 80-100%), and 87% (CI: 75-99%) respectively. Results indicate high usefulness and acceptability of SORMAS. We recommend mHealth tools to be evaluated to allow repeated measurements and comparisons between different versions and users

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways