Multiple Antibiotic Resistance (MAR) indices of Pseudomonas and Klebsiella species isolates in Lagos University Teaching Hospital

Background/Objectives: Pseudomonas and Klebsiella infections are important nosocomial infections because of the attendant significant morbidity, mortality and socio-economic impact. These infections are difficult to treat due to the innate and acquired resistance mediated by the organisms’ genome and other transferable genetic elements. We determined the multiple antibiotic resistance indices of Pseudomonas spp and Klebsiella spp isolated from clinical specimens in Lagos University Teaching Hospital.Methods: 110 clinical isolates were evaluated using MicrobactTM 24E (Oxoid, UK) and Pseudomonas and Klebsiella species isolates were 34 and 21 respectively. The antimicrobial susceptibility patterns of the  Pseudomonas and Klebsiella isolates were determined by Kirby-Bauer’s disc diffusion method and results interpreted by CLSI interpretative values. Multiple Antibiotic Resistance index (MAR) were calculated.Results: MAR index of the Pseudomonas and Klebsiella samples was 0.4, as 31 (91.2%) and 14 (66.7%) of Pseudomonas spp and Klebsiella spp respectively were multi drug resistant. Isolates of Pseudomonas spp demonstrated the highest level of resistance to Ceftazidime (79.4%), Cefixime (76.5%), Cedipime (50%) and Piperacillin (44.1%); while that of Klebsiella spp were carbenicillin (76.4%), pipericillin (71.4%), cefixime (52.4%) and cefradoxil (42.9%) respectively. There was a low levelof resistance to quinolones and aminoglycosides.Conclusion: The MAR index shows increase in the rates of resistance among these organisms thus making antimicrobial susceptibility surveillance and testing more crucial in selecting empiric regimen or definitive treatment.KEY WORDS: Lagos, multiple antibiotic resistance (MAR), antimicrobial susceptibility, Pseudomonas and Klebsiella spp

Sensitivity and responsiveness of Ibadan stroke-specific pain scale

Sensitivity and responsiveness to change are important psychometric properties of outcome measures, especially in evaluating therapeutic effectiveness (Dromeric and Redeng, 2003). The consequences of an outcome measure that lacks responsiveness are the same as a diagnostic test that has poor sensitivity or specificity (Scrimshaw and Maher, 2001). The ability of an instrument to be sensitive to within patient change is very important in clinical trials especially in a disease like stroke where the impact is often life-long and multi-dimensional (Poissant et al, 2003).The purpose of this study therefore was to investigate the responsiveness of the Ibadan Stroke-Specific Pain Scale (IbSSPS) in evaluating post-stroke pain.Fifty-six patients with first-incidence stroke experiencing post-stroke pain were assessed for pain. Sensitivity to change was assessed by analysing changes in the IbSSPS scores before and after six weeks of physiotherapy with the Wilcoxon-sign rank test. Standardized effect size (SES) and standardized response mean (SRM) were used to assess responsiveness.The overall IbSSPS and its four domains were sensitive to change after 6 weeks of physiotherapy. It was therefore concluded that the IbSSPS is a sensitive and responsive scale that can be used to evaluate pain in stroke survivors.Keywords: Post-stroke pain, Stroke-specific Pain Scale, sensitivity, responsivenes

Management of Knee Osteoarthritis: Knowledge and Adherence to Clinical Practice Guidelines Among Physiotherapists in Selected Hospitals in Lagos State, Nigeria

Osteoarthritis of the knee joint (OA) is one of the most common conditions resulting to chronic disability predominantly in elderly population. The management of knee OA has been characterized by variations among physiotherapists within Lagos state, Nigeria. However, there is a need for physiotherapists as a whole to embrace evidence –based clinical practice guidelines in the management of this condition. This study was aimed at determining if the physiotherapist’s characteristics (such as age, highest educational attainment, year of induction, years of experience and setting of practice) influence the knowledge and adherence to clinical practice guidelines in knee OA management and to find out if there is a need to develop clinical practice guidelines in the management of knee OA. This was a cross-sectional descriptive survey involving 104 physiotherapists from selected health care facilities in Lagos state. They were required to complete a 33-item questionnaire which collected information on socio-demographic data, work experience, treatment activities and their knowledge and adherence to knee OA clinical practice guidelines. Only a small percentage (16.30%) of the respondents were knowledgeable about knee OA clinical practice guidelines while even a smaller percentage (14.40%) of the respondents adhere to knee OA clinical practice guidelines. Knowledge and adherence were influenced by setting of practice (p=0.001, p=0.027). Majority (93.30%) of the respondents recommended the need for knee OA clinical practice guidelines in Nigeria. A small population of the respondents is knowledgeable and adheres to knee OA clinical practice guidelines. Some of the characteristics of the physiotherapists influence the knowledge and adherence to knee OA clinical practice guidelines. However, findings show that there is a need to develop a knee OA clinical practice guideline in Nigeria in other to standardize and improve effective treatment outcome in patient care

MICELLIZATION OF QUARTERNARY BASED CATIONIC SURFACTANTS IN TRIETHANOLAMINE-WATER MEDIA: A CONDUCTOMETRY STUDY

The effect of polar organic solvent, triethanolamine (TEA) on the micellization of a mixture of dodecyltrimethylammonium bromide (DETABr) and hexadecyltrimethylammonium bromide (HATABr) has been studied by conductance measurements at temperature range of 298.1 to 313.1K in steps of 5.1K. The values of the critical micelle concentration (CMC*) and the extent of counter-ion binding were obtained by fittings of the specific conductivity-concentration curve to the integrated form of the Boltzmann-Sigmoid equations. The values of CMC* was found to decrease with increase in the percentage composition of TEA. The degree of counter-ion binding of the mixed micelles (β) was determined from the ratio of the slopes corresponding to the post (A2) and pre-mixed micellar regions (A1). The thermodynamic quantities ( and ) was evaluated with the aid of the equilibrium model of mixed micelle formation. The negative deviation of the CMC* from the ideal system, the spontaneity, and the increased degree of randomness of the system were discussed on the basis of hydrophobic-solvophobic interactions of the monomers at elevated temperature

Bioaccumulation of heavy metals in frequently consumed leafy vegetable grown along Nigeria-Benin Seme Border, West Africa

Vegetable growing along major highways with heavy vehicular movement has been a serious concern to food safety specialist in large cities. The contributions of heavy metals in selected vegetables through atmospheric deposition were quantified using atomic absorption spectrophotometer. The level of some heavy metal (.Pb, Cu, Fe, and Cr) were examined in the edible portion of Telfciria occidentals, Corchorus olitorius, Celocia argentea, and Thymus Vulgaries, grown along Nigeria-Republic of Benin border Seme. The results showed that the levels of heavy metal ranged from 21.69 ± 7.36 μg/g Cu to172.87 ±62.05 μg/g Fe in Telfaria occidentalis, 21.74±13.00 μg/g Pb to 304.50±72.77 μg/g Fe in Corchorus olitorius, 16.75±10.54 μg/g Pb to 260.74±215.37 μg/g Fe in Celocia argentea and 23.53±3.52 μg/g Cu to 406.33±225.06 μg/g Fe in Thymus Vulgaries were recorded in site A. The value heavy metal contamination obtained from site B ranged from 18.91±11.98 μg/g Pb to 166.49 ± 86.22 μg/g Fe in Telfaria occidentalis, 16.57± 9.22 μg/g Pb to 292.36±196.33 μg/g Fe in Corchorus olitorius, 19.99±8.54 μg/g Pb to 354.03±302.80 Fe in Celocia argentea and 21.73±8.44 μg/g Pb to 388.20±226.39 μg/g Fe in Thymus Vulgaries. The order of contamination in the vegetable sample was Fe > Cr > Cu > Pb. The data were analyzed with t-test and ANOVA. There were no significant different between the (p< .05) between the level of heavy metal in vegetable at each sampling site. The high levels of metal in the sampled vegetable may be attributed to excessive application of fertilizers and other agro chemical, as well the use of use of waste water for washing the vegetables. The obtained results were higher than the threshold value of WHO, FEPA and China stipulated standards for mature plant tissue except for copper in all the analyzed vegetable. Therefore, the consumption of these vegetables as food may pose possible health hazards to human

Relationship between estimated VO2max and handgrip strength in healthy young Nigerian adults

Purpose: This study investigated the relationship between estimated oxygen consumption (VO2max) and handgrip strength (HGS) among healthy young Nigerian adults. Methods: This was a cross sectional study, which involved 400 volunteers (171 males; 229 females) aged between 18–40years. Participants’ HGS was assessed using a CAMRY EH-101 hand dynamometer while VO2max was estimated using a standard formula that includes measurement of resting heart rate. Demographic data was summarized using percentages, mean and standard deviation. Physical activity level of the participants was assessed using long form of the International Physical Activity Questionnaire. Independent t-test was used to compare the mean values of the variables between male and female participants. Pearson’s correlation was used to determine the strength of relationship between estimated VO2max and HGS, while multiple regression analysis was conducted to determine the predictors of estimated VO2max using HGS as well as body mass index (BMI), physical activity (PA) level, age and sex as co‐variates. Level of significance was set at p<0.05. Results: HGS, VO2max and PA level were significantly (p= 0.001) different between male and female participants. There was a significant moderate correlation between HGS and VO2max (r= 0.40, p= 0.001). The results of the regression analysis showed that HGS is not significant predictor of estimated VO2max; whereas, sex, BMI and PA level were significant predictors of estimated VO2max. Conclusion: Although HGS is moderately correlated with estimated VO2max, HGS may not be a relevant tool for predicting estimated VO2max in healthy young adults