Validation of the multidimensional WHOQOL-OLD in Ghana: A study among population-based healthy adults in three ethnically different districts

Objectives: Study of well-being of older adults, a rapidly growing demographic group in sub-Saharan Africa, depends on well-validated tools like the WHOQOL-OLD. This scale has been tested on different populations with reasonable validity results but has limited application in Africa. The specific goal of this paper was to examine the factor structure of the WHOQOL-OLD translated into three Ghanaian languages: Ga, Akan, and Kasem. We also tested group invariance for sex and for type of community (distinguished by ethnicity/language). Methods: We interviewed 353 older adults aged 60 years and above, selected from three ethnically and linguistically different communities. Using a cross-sectional design, we used purpose and convenience methods to select participants in three geographically and ethnically distinct communities. Each community was made up of selected rural, peri-urban, and urban communities in Ghana. The questionnaire was translated into three languages and administered to each respondent. Results: The results showed moderate to high internal consistency coefficient and factorial validity for the scale. Using confirmatory factor analysis, we found that the results supported a multidimensional structure of the WHOQOL-OLD and that it did not differ for males and females, neither did it differ for different ethnic/linguistic groups. Conclusions: We conclude that the translated versions of the measure are adequate tools for evaluation of quality of life of older adults among the respective ethnic groups studied in Ghana. These results will also enable comparison of quality of life between older adults in Ghana and in other cultures

Diagnosis and management of preeclampsia in community settings in low and middle-income countries

Hypertensive disorders of pregnancy contribute significantly to maternal mortality and morbidity. Preeclampsia belongs to the spectrum of hypertensive disorders of pregnancy and if undiagnosed and/or untreated leads to fatal consequences for both the mother and the baby. Early detection and prevention of preeclampsia is limited by uncertainty in the knowledge about its etiopathogenesis. While much work has been done in establishing clinical guidelines for management of preeclampsia in the hospital or tertiary care settings, there is considerable lack of work in the domain of evidence-based guidelines for screening, identification and management of preeclampsia at the community-level. The article reviews these issues with special considerations and to challenges faced in low and middle-income countries. There is a need to focus on low-cost screening and interventions in the community to achieve a significant impact on preventable maternal and fetal mortality in order to control the burden of preeclampsia significantly as well as investing on more research at primary care level to improve the evidence base for community-level interventions

An increase in livestock density increases forage nutritional value but decreases net primary production and annual forage nutritional yield in the alpine grassland of the Qinghai-Tibetan Plateau

Pasture biomass and quality are dependent on herbivore grazing andprecipitation, but the responses of vegetation to the interactive effects ofclimate and grazing regimes remain unclear. We conducted an eight-yearsheep grazing experiment with 4 stocking rates (0, 3.5, 5.5, and 7.5 sheep/ha) inan alpine meadow of the northeastern Tibetan Plateau. The above-ground netprimary productivity (ANPP) and forage nutritional value (FNV) of four dominantspecies (Poa annua, Kobresia humilis, Astragalus adsurgens and Potentillafruticosa) were measured during a wet year (360 mm rainfall) and a droughtyear (216 mm rainfall). The FNV was used as indicator of forage quality and wascalculated from the crude protein (CP) content, in vitro true dry matterdigestibility (IVTD), metabolic energy (ME) yield, and neutral detergent fiber(NDF) content of the plant. The stocking rate explained a minimum of 76% ofthe variations of ANPP, and the precipitation sub-additive effect for ANPPranged from 5% to 12%. The interaction of sheep stocking rate and precipitationaffected ANPP of the 4 species, except for P. fruticosa. The FNV of the pastureincreased with increasing grazing pressure, but ANPP and forage nutritionalyield (FNY) decreased. In calculating FNY, the increase in FNV did notcompensate for the decrease in ANPP. In non-grazed plots, the CP yielddeclined sharply (18%-55%) in response to drought, but there was no effecton ME yield. The interaction between stocking rate and precipitation affected forage quality of the 4 plant species differently. The grassland ANPP and FNYcould be maintained at a grazing intensity of 3.5 sheep/ha in wet and dry years.Our results highlight that stocking density affects pasture ANPP and FNV, and iscontingent on rainfal

Formulation, characterization and wound-healing potential of emulgel and in-situ gel containing root extract of Saussurea lappa Clarke (Asteraceae)

Purpose: To investigate the wound-healing potential of herbal formulations (emulgels and in situ gels) containing Saussurea lappa root extract  (SLRE) via excision wound induction in albino rats. Methods: Preliminary phytochemical analysis of the methanol extract of roots of Saussurea lappa (SLRE) was performed using standard  procedures. In vitro anti-inflammatory assay of SLRE was conducted using heat-induced hemolysis method at a concentration of 100 μg/mL. Acute  toxicity of SLRE was also evaluated in mice at a single dose of 1000 mg/kg for 24 h. Emulgels and in situ gels were prepared using different concentrations of SLRE and assessed for their organoleptic and physical properties. In vitro drug release studies of the prepared formulations were carried out by Franz diffusion cell and the data fitted into various pharmacokinetic models. Wound healing was assessed using excision wound induction (380 mm2) on dorsal surface of male albino rats. Each formulation (F4, F5, F6, G1, G2 and G3) and pyodine gel (standard) were applied topically (0.5 g) for 20 days. Wound contraction was measured every fourth day. Results: SLRE showed 42.8 % inhibition in heat-induced hemolysis on erythrocyte membrane model, compared to aspirin (positive control).  Moreover, SLRE did not cause mortality in mice at the given doses. All the formulations were stable after one month stability check at 40 °C for emulgels and at 25 °C for in situ gels. All the formulations followed first order drug release pattern. In situ gel (G3) exhibited better wound healing (100 ± 0.0028) than emulgel (F6, 99 ± 0.004) containing 5 g extract and standard pyodine gel (91 ± 0.014, p <0.05). Conclusion: The results indicate that in situ gel of SLRE exhibits significant wound healing in rats. Thus, the findings present a strategy for the formulation of gel products with better wound healing potentials. Keywords: Saussurea lappa, Wound healing, Emulgel, In situ gel, Herbal formulatio

Ethambutol Induced Ocular Toxicity in Patients Receiving “Directly Observed Treatment Short-Course” Therapy

Background: To determine the frequency of Ocular toxicity due to Ethambutol in Category-1 patients after receiving DOTS therapy. Methods: Category-1 tuberculosis patients of 15-60 years (both gender) with normal ocular parameters on ophthalmological assessment at time of initiation of DOTS therapy were included in the study. A total of 242 eyes (121 patients) were studied for any change in the vision or occurrence of any other ocular symptom while on the Ethambutol treatment. Each patient was followed up for Ethambutol compliance status at the completion of one month and again at two months of treatment, all the ophthalmological assessments for ocular toxicity were repeated for every selected patient. Category-2 patients with sputum smear positive who have relapsed, who have treatment failure or who are receiving treatment after treatment interruption were excluded from the study. The patient’s information was gathered on a specifically designed proforma. The information on the proforma was filled by the researchers themselves. Results: Out of 121 patients (242 eyes), 64 (52.9%) were males and 57 (47.1%) were females. There was no sign of ocular toxicity after a month period. However, after second month ocular toxicity was developed in 02 (1.65%) of the patients. Besides, decrease in visual acuity, color vision abnormalities, decrease in contrast sensitivity, and optic disc abnormalities were also observed in these 02 patients. Conclusion: There is a possibility of the occurrence of ocular toxicity when the Ethambutol is taken by the tuberculosis patients. Thus, the early identification of ocular symptoms and signs is vital to avoid unnecessary delay in diagnosis and probable irreversible visual loss