Awareness and extent of knowledge of taxonomies of nonverbal communication channels among healthcare providers in South Eastern Nigeria

Communication is vital between health care providers and their clients. Though not often studied, nonverbal communication has been found to be a vital element within the total communication process. Its place in healthcare provision cannot be overemphasized. With various taxonomies or channels of nonverbal communication, the purpose of this study was to ascertain healthcare providers’ ability to identify the taxonomies of nonverbal communication. Participants for the study were healthcare providers at the antenatal clinic of three Tertiary Health Institutions in South Eastern Nigeria. The instrument for data collection was questionnaire. Statistical analysis of data was performed using Chi-square. Significant level was placed at p<0.05. Findings showed that all the healthcare providers were aware of nonverbal communication. Predominant numbers of health care providers use nonverbal communication to interact with their clients (X2=8.167, p<0.05) and significant numbers of the healthcare providers did not show gender bias in attending to their clients (X2=5.638, p<0.05). However, insignificant numbers of healthcare providers did not apply their knowledge of proxemics and chrone Verbalmics (X2=1.333; p=0.248 & X2=1.286; p=0.257) respectively nor did they understand the taxonomies of kinesics, chronemics, haptics and proxemics. The finding in this study, showed poor understanding of taxonomies of nonverbal communication channels amongst the healthcare providers despite widespread awareness of nonverbal communication. This study thereby concludes that nonverbal communication may be poorly taught in medical school possibly due to non-existence of a curriculum tailored to suit the training

Haematologic Indices in Pulmonary Tuberculosis with or without HIV Co-Infection in South Eastern Nigeria

To evaluate the changes in haematologic indices in patients with pulmonary tuberculosis (PTB) with or without Human Immune Deficiency Virus (HIV) co-infection in South Eastern Nigeria. The study population included 116 subjects (60 = males; 56 = females), recruited from 2 study centers: mile 4 Hospital Abakaliki Ebonyi State and Nnamdi Azikiwe University, Teaching  Hospital Nnewi, Anambra State, both in Nigeria. PTB + HIV (n = 20); PTB infection ( n = 27) and HIV sereopositive (n = 28). The PTB and HIV negative; control subjects were 41 (n = 41). Blood samples collected from subjects in Ethylene diamine tetra acetic acid (EDTA) container were used for the analysis of the Haemtological cells count,  packed cell volume (PCV) and Haemoglobin estimation using routine methods as described (Dacie and Lewis, 1984). HIV screening was done with Stat pak kit and confirmatory test by Western blot method. Erythrocyte sedimentation rate (ESR) was by Westergren method. Haemoglobin estimation (Hb), packed cell volume (PCV) values were significantly lower in patients with PTB (11.27±1.62 g/dl, 0.35±0.04 l/l) compared with control values (13.67±1.46 g/dl 0.41 ± 0.05 l/l) (p < 0.05). Patients with HIV seropositive showed significantly low PCV values of (0.36 ± 0.04 l/l) compared with the control subjects (0.41 ± 0.05 l/l) (p < 0.05). PTB patients showed higher TWBC counts (6062.5 ± 1481.83109/l) when compared those with HIV infection (3841.38±735.58 x 109/l) as well as normal control value (4363.64±551.66 x 109/l) (p < 0.05). Male and female values compared in this work showed no significant difference (p > 0.05). The results showed that the effect of PTB and HIV infection have caused some haematological deregulation. It also showed that sex has little or no effect on the studied parameters. Keywords: Pulmonary tuberculosis (PTB); Human ImmunoDeficiency Virus (HIV) and Hematologic Indice

Fibrinogen Concentration and Thrombin Levels in Pregnant Women in Nnewi, Anambra State, South, Eastern Nigeria.

This study was aimed at looking at the influence of pregnancy on fibrinogen concentration and thrombin time (TT) levels. A total of 195 pregnant women between 18 and 35 years were recruited, 59 were in their first trimester (group A), 61 second trimester (group B) and 75 the third trimester (group C). A total of 150 apparently healthy non pregnant women were used as normal control (group D). Blood samples which was collected from each of the participants after obtaining informed consent was tested for the fibrinogen concentration using Clauss method and thrombin time using two stage method. The study was approved by Nnamdi Azikiwe University Teaching Hospital Ethical Committee Nnewi. ANOVA and students t-test were used for statistical analysis. The results showed that fibrinogen concentration (mg/dL) were significantly higher (p<0.05) in group A, B and C as compared with the control group. TT (s) were significantly higher (p<0.05) in group A, B and C compared with the control group. This study therefore suggests that the increase in these coagulation factors observed are due to increased thrombin generation, inflammatory state of pregnancy and fibrinogen being an acute-phase protein. It is important to obtain a baseline of these parameters for all pregnant women during antenatal visits, in order to detect any abnormality early. Key words: Fibrinogen concentration, thrombin time and pregnancy

Assessment of Alpha Fetoprotein Levels and Gamma Glutamyl Transferase Activity in Hepatitis B and Hepatitis C Seropositive Subjects in Nnewi, Nigeria

Hepatitis B and hepatitis C viral infections are the leading cause of liver cirrhosis and hepatocellular carcinoma worldwide. These conditions, which mar the hepatic functional integrity, are characterized by alterations in the liver function markers such as alpha fetoprotein (AFP) and gamma glutamyl tranferase (GGT). In the present study, a total of 90 subjects were recruited. Out of this number, 30 were hepatitis B seropositive subjects, 30 hepatitis C seropositive individuals and the remaining 30 were apparently healthy individuals. The last group served as the control. Serum alpha fetoprotein levels were estimated by the Enzyme Linked Immunosorbent Assay (ELISA) technique and the method adopted for the determination of gamma glutamyl transferase activity was the kinetic-spectrophotometric procedure. The mean serum level of alpha fetoprotein was significantly higher in hepatitis B seropositive subjects compared with the control (P<0.05). The same pattern was observed when the mean serum activity of GGT of the hepatitis B seropositive subjects was compared with that of the control (P<0.05). Furthermore, the mean serum level of AFP and the mean serum GGT activity were significantly higher in hepatitis C seropositive individuals compared with the control (P<0.05). In contrast, no significant difference was observed in the mean serum levels of alpha fetoprotein in hepatitis B seropositive individuals compared with that of hepatitis C seropositive subjects (P>0.05). A positive correlation existed between AFP levels and GGT activity in hepatitis B seropositive subjects (r=0.31) and between AFP levels and GGT activity in hepatitis C seropositive subjects (r=0.25). These findings suggest that evaluation of serum alpha fetoprotein levels and gamma glutamyl transferase activity may be a valuable adjunct in the assessment of disease progression in hepatitis B and hepatitis C seropositive individuals. Keywords: Hepatitis, alpha fetoprotein, glatamyl transferase, disease progression

Active case finding and evaluation of IL-6 production among household contacts of pulmonary tuberculosis patients in a high disease setting

Background: Tuberculosis (TB) is a top infectious disease killer worldwide and remains a huge public health concern. However, most TB case findings are limited to self-referral (passive case finding), when individuals develop symptoms of TB. Only 15% of disease burden in Nigeria are reported. In view of this, it is important to assess the latent and active disease burden amongst HHC of TB patients suffering from pulmonary TB. In addition, it has been suggested that IL-6 levels could be used as a prognostic marker in exposed individuals. IL-6 levels were assessed in this cohort.Methods: A total of 205 subjects participated in this study, comprising 62 pulmonary TB index cases and 143 of their household contacts. Also, 54 apparently healthy subjects were recruited to serve as controls. Active case finding was performed amongst the HHC, using sputum and blood samples; they were tested for active TB. Blood samples were also collected for measuring IL-6 levels.Results: Findings reveal 6.3% previously undiagnosed active TB among the HHC of the TB patients and a significantly higher number of latently infected TB cases compared to the control population (p=0.0078). There were significant differences when comparing HIV co-infected index group to their HIV negative counterparts (P=0.032). Significantly different IL-6 levels were found among the study groups and sub-groups (p<0.0001), with significantly higher levels in TB mono-infection compared to in TB/HIV co-infection (p=0.031).Conclusions: These results demonstrate the importance of active TB case finding for TB control and the possible role of IL-6 as a diagnostic marker in TB control

Evaluation of Zinc and Copper and Immunological Implication in Menstrual Cycle of HIV Infected Females in Nnewi, Nigeria

Zinc and Copper are essential for the immune system and the interaction between reproductive system and immune cells plays important immunoregulatory roles in menstrual cycle of women. It is estimated that nearly 16 million women are living with HIV/AIDS worldwide, making up approximately half of all infections. Importantly, the understanding of the burden of HIV/AIDS lies within resource limited areas particularly Sub-Saharan Africa. This was a prospective study designed to evaluate the immunological implication of Zinc and Copper in menstrual cycle of HIV infected females in NAUTH, Nnewi, Nigeria. The study composed of 120 premenopausal females with regular menstrual cycle (between 27-31 days) and aged 15-45 years. 30 were apparently healthy females recruited as Control group while 90 were HIV infected females grouped as HIV stage 1, HIV stage 2 and HIV stage 2 on ART (n=30 respectively). Blood samples were collected at follicular (7th - 13th day) and luteal (21st -23rd day) phases of menstrual cycle after obtaining their informed consent for determination of Zinc, Copper, Interleukin-6, interleukin-4 and TNF? using AAS and ELISA methods. The result showed significantly lower levels of Zn and Cu  with significantly higher levels of IL-6, IL-4 and TNF? in HIV infected females with or without therapy compared to Control at both phases of menstrual cycle (P&lt;0.05). The Zn levels was significantly higher in stage 2 HIV infected females on ART compared to their counterparts not on ART (P&lt;0.05). The significantly lower levels of Zn and Cu with increased levels of cytokines indicate immunosuppression and active inflammatory response in HIV infected females at both phases of menstrual cycle which was improved in the participants who were placed on ART. Keywords: Copper; Zinc; Immunological Implication; HIV; Menstrual cycle; Reproductive age

Packed cell volume and serum iron in subjects with HIV-malaria co-infection in Nnewi, South-Eastern Nigeria

The present study was designed to assess the PCV and serum iron in HIV-malaria co-infected subjects in Nnewi, South Eastern Nigeria. 207 participants aged between 16-72 (44 ± 28) years were recruited andclassified as follows based on standard screening and WHO criteria: (i) Asymptomatic HIV stage I subjects with or without malaria. (ii) Symptomatic HIV stage II subjects with or without malaria and not on (ART). (iii) HIV/AIDS subjects with or without malaria and on ART. (vi) HIV seronegative control subjects with or without malaria. Blood sample from these participants were analyzed for HIV seroreactivity, Plasmodium falciparum antigen, parasite density, serum iron concentrations and PCV using Standard Laboratory methods. The result showed that serum iron and PCV were significantly reduced amongst all the groups studied when compared with the control (

Effect of moderate - vigorous intensity physical exercise on female sex hormones in premenopausal university students in Nnewi, Nigeria

Background: Sedentary lifestyle and diseases associated with it is on the increase in our communities, state and country as a whole. The objective was to determine the effect of exercise on ovarian reserve status of the participants using day 3 FSH, LH and estrogen values and the ovulatory status of the participants using day 21 progesterone values. Methods: The study was a prospective comparative study. A total of 30 participants were recruited for this work. They were divided into 2 groups: 15 subjects that did exercise for 1 month and 15 controls that didn’t do any form of exercise. Baseline blood samples were collected from the two groups on day 3 and day 21 of the menstrual cycle. The subjects started exercise on day 1 of the next menstrual cycle. Blood samples were collected from the subjects and control on day 3 and day 21 of the next menstrual cycle. Results:There was significant reduction in weight and therefore BMI of the study group compared to control group and study group baseline after one month of exercise (P<0.05). There were no significant differences in the baseline levels of Estrogen, FSH, LH and progesterone between the subjects and control groups before the exercise, but after 1 month of exercise, there were significant differences in the levels of estrogen, FSH, LH and progesterone in these groups (P<0.01). Among the study group there were significant differences in the baseline and final levels of Estrogen, FSH, LH and Progesterone (P<0.01). Conclusions: The hormonal pattern shows that moderate-vigorous exercise may increase the responsiveness and sensitivity of the follicles to FSH and LH with attendant increase in ovulatory status of young females.

Modulation of the immune response to Mycobacterium tuberculosis during malaria/M. tuberculosis co-infection

Tuberculosis (TB) causes significant morbidity and mortality on a global scale. The African region has 24% of the world's TB cases. TB overlaps with other infectious diseases such as malaria and HIV, which are also highly prevalent in the African region. TB is a leading cause of death among HIV-positive patients and co-infection with HIV and TB has been described as a syndemic. In view of the overlapping epidemiology of these diseases, it is important to understand the dynamics of the immune response to TB in the context of co-infection. We investigated the cytokine response to purified protein derivative (PPD) in peripheral blood mononuclear cells from TB patients co-infected with HIV or malaria and compared it to that of malaria- and HIV-free TB patients. A total of 231 subjects were recruited for this study and classified into six groups; untreated TB-positive, TB positive subjects on TB drugs, TB- and HIV-positive, TB- and malaria-positive, latent TB and apparently healthy control subjects. Our results demonstrate maintenance of interferon (IFN)-γ production in HIV and malaria co-infected TB patients in spite of lower CD4 counts in the HIV-infected cohort. Malaria co-infection caused an increase in the production of the T helper type 2 (Th2)-associated cytokine interleukin (IL)-4 and the anti-inflammatory cytokine IL-10 in PPD-stimulated cultures. These results suggest that malaria co-infection diverts immune response against M. tuberculosis towards a Th-2/anti-inflammatory response which might have important consequences for disease progression

Modulation of the immune response to Mycobacterium tuberculosis during malaria/M. tuberculosis co-infection

Tuberculosis (TB) causes significant morbidity and mortality on a global scale. The African region has 24% of the world's TB cases. TB overlaps with other infectious diseases such as malaria and HIV, which are also highly prevalent in the African region. TB is a leading cause of death among HIV-positive patients and co-infection with HIV and TB has been described as a syndemic. In view of the overlapping epidemiology of these diseases, it is important to understand the dynamics of the immune response to TB in the context of co-infection. We investigated the cytokine response to purified protein derivative (PPD) in peripheral blood mononuclear cells from TB patients co-infected with HIV or malaria and compared it to that of malaria- and HIV-free TB patients. A total of 231 subjects were recruited for this study and classified into six groups; untreated TB-positive, TB positive subjects on TB drugs, TB- and HIV-positive, TB- and malaria-positive, latent TB and apparently healthy control subjects. Our results demonstrate maintenance of interferon (IFN)-γ production in HIV and malaria co-infected TB patients in spite of lower CD4 counts in the HIV-infected cohort. Malaria co-infection caused an increase in the production of the T helper type 2 (Th2)-associated cytokine interleukin (IL)-4 and the anti-inflammatory cytokine IL-10 in PPD-stimulated cultures. These results suggest that malaria co-infection diverts immune response against M. tuberculosis towards a Th-2/anti-inflammatory response which might have important consequences for disease progression