Pattern of Right Ventricular Changes in Patients with Uncomplicated Systemic Hypertension at a Tertiary Centre in Southwest Nigeria.

BACKGROUND AND AIMS: Hypertension is an independent risk factor for cardiovascular complications. The effect of systemic hypertension on the right ventricle (RV) has received less attention probably due to its complex structure and location. The aim of the study was to assess the effect of systemic hypertension on the structure and function of the right ventricle using transthoracic echocardiography. METHOD: One hundred hypertensives and 100 healthy controls were recruited into the study. Transthoracic echocardiography was used to measure RV wall thickness (RVWT) in diastole, RV internal dimensions in diastole, tricuspid annular plane systolic excursion (TAPSE), right ventricular filling velocities (TE and TA), and RV systolic excursion velocity (RVSm). These measurements were repeated on the left ventricle. RESULTS: There was significantly thicker RV wall (0.51 + 0.08cm vs 0.44+0.08cm; p=0.001) in the hypertensive group and higher frequency of RV hypertrophy (48.45% vs 18.75%; p<0.001). Tricuspid annular plane systolic excursion (TAPSE) and the tricuspid annular peak systolic excursion velocity (TSm) were significantly lower in the hypertensive group (2.34+0.45cm vs 2.50+0.36cm; p=0.008, and 11.70+3.03cm/s vs 12.60+2.93cm/s p=0.039, respectively), though no participant had abnormal TAPSE. Tricuspid E/A ratio was lower in the hypertensive group (1.13+ 0.33 vs 1.24+0.27; p=0.011). The tricuspid E/A ratio had positive correlation with mitral E/A ratio. CONCLUSION: Right ventricular structural and functional changes are found in systemic hypertension, even in the absence of other systemic complications. These changes could have been mediated by ventricular interdependence and altered humoral factors.

CONTEXTES ET OBJECTIFS: L'hypertension artérielle est un facteur de risque indépendant pour les complications cardiovasculaires. L'effet de l'hypertension artérielle systémique sur le ventricule droit (VD) a reçu moins d'attention probablement en raison de sa structure complexe et de son emplacement. L'objectif de l'étude était d'évaluer l'effet de l'hypertension artérielle systémique sur la structure et la fonction du ventricule droit en utilisant l'échocardiographie transthoracique. MÉTHODE: Cent hypertendus et 100 témoins en bonne santé ont été recrutés dans l'étude. L'échocardiographie transthoracique a été utilisée pour mesurer l'épaisseur de la paroi du VD (EPVD) en diastole, les dimensions internes du VD en diastole, l'excursion plane systolique annulaire tricuspide (TAPSE), les vitesses de remplissage ventriculaire droit (TE et TA), et la vitesse d'excursion systolique ventriculaire droit (RVSm). Ces mesures ont été répétées sur le ventricule gauche. RÉSULTATS: Il y avait une paroi du VD significativement plus épaisse (0,51 ± 0,08 cm vs 0,44 ± 0,08 cm ; p=0,001) dans le groupe hypertendu et une fréquence plus élevée d'hypertrophie ventriculaire droite (48,45% vs 18,75% ; p<0,001). L'excursion plane systolique annulaire tricuspide (TAPSE) et la vitesse maximale systolique annulaire tricuspide (TSm) étaient significativement plus basses dans le groupe hypertendu (2,34 ± 0,45 cm vs 2,50 ± 0,36 cm ; p=0,008, et 11,70 ± 3,03 cm/s vs 12,60 ± 2,93 cm/s p=0,039, respectivement), bien qu'aucun participant n'ait eu de TAPSE anormal. Le rapport E/A tricuspide était plus bas dans le groupe hypertendu (1,13 ± 0,33 vs 1,24 ± 0,27 ; p=0,011). Le rapport E/A tricuspide avait une corrélation positive avec le rapport E/A mitral. CONCLUSION: Des modifications structurales et fonctionnelles du ventricule droit sont retrouvées dans l'hypertension artérielle systémique, même en l'absence d'autres complications systémiques. Ces changements pourraient avoir été médiés par l'interdépendance ventriculaire et des facteurs humoraux modifiés. MOTS-CLÉS: Hypertension ; Échocardiographie ; Hypertrophie ventriculaire droite ; Dysfonction diastolique ventriculaire droit.

COVID-19 and Activities of Daily Living Among Primary Health Care Workers in Ekiti State, South-West Nigeria.

BACKGROUND AND OBJECTIVES: Globally, COVID-19 has greatly impacted humans physically, socially, mentally, and economically. No doubt, healthcare workers seemed to bear the greatest impact. The study therefore assessed the impact of COVID- 19 on the primary healthcare workers' daily activities in Ekiti, Southwest, Nigeria. METHODS: The study was a cross-sectional study using a quantitative data collection method among 716 primary healthcare workers. Respondents were selected using an online convenience sampling method via their social media platforms. Data was collected, collated, and analyzed using SPSS version 25 software and presented as frequency tables, mean and standard deviation. Bivariate/multivariate analyses were conducted using t-tests and ANOVA statistics. The level of statistical significance was set at p<0.05. RESULTS: The mean age of respondents was 44.4+6.4SD with less than half (47.1%) between 41-50 years age group. The majority of the respondents (89.4%) were female and almost all (96.2%) were married. Ninety percent (90%) had ever heard of Coronavirus and (85.8%) had to spend more money on activities of daily living such as transportation (90.1%), groceries (80.6%), assisting relations (95.8%) and sanitary measures (disinfection) at home (95.0%). COVID-19 had a huge negative impact on the majority (89.7%) of healthcare workers with a mean score of 22+4.8. CONCLUSION: COVID-19 negatively impacted the daily living and professional duties of primary healthcare workers which reflected in their psychological, physical, social and economic well-being. Disease outbreaks are unlikely to disappear soon, hence, global proactive interventions and homegrown measures should be adopted to protect healthcare workers and save their lives.

CONTEXTES ET OBJECTIFS: Globalement, la COVID-19 a grandement impacté les êtres humains physiquement, socialement, mentalement et économiquement. Sans aucun doute, les travailleurs de la santé semblent être les plus touchés. L'étude a donc évalué l'impact de la COVID-19 sur les activités quotidiennes des travailleurs des soins de santé primaires à Ekiti, au Sud-Ouest du Nigeria. MÉTHODES: L'étude était une étude transversale utilisant une méthode de collecte de données quantitative auprès de 716 travailleurs des soins de santé primaires. Les répondants ont été sélectionnés en utilisant une méthode d'échantillonnage de convenance en ligne via leurs plateformes de médias sociaux. Les données ont été collectées, compilées et analysées à l'aide du logiciel SPSS version 25 et présentées sous forme de tableaux de fréquence, de moyenne et d'écart-type. Des analyses bivariées/multivariées ont été réalisées à l'aide de tests t et d'ANOVA. Le niveau de signification statistique a été fixé à p<0,05. RÉSULTATS: L'âge moyen des répondants était de 44,4+6,4 SD avec moins de la moitié (47,1 %) dans le groupe d'âge de 41 à 50 ans. La majorité des répondants (89,4 %) étaient des femmes et presque tous (96,2 %) étaient mariés. Quatre-vingt-dix pour cent (90 %) avaient déjà entendu parler du Coronavirus et (85,8 %) avaient dû dépenser plus d'argent pour les activités de la vie quotidienne telles que le transport (90,1 %), les courses (80,6 %), l'aide aux relations (95,8 %) et les mesures sanitaires (désinfection) à domicile (95,0 %). La COVID-19 a eu un impact négatif important sur la majorité (89,7 %) des travailleurs de la santé avec un score moyen de 22+4,8. CONCLUSION: La COVID-19 a eu un impact négatif sur la vie quotidienne et les devoirs professionnels des travailleurs des soins de santé primaires, ce qui s'est reflété dans leur bien-être psychologique, physique, social et économique. Les épidémies de maladies ne disparaîtront probablement pas de sitôt, c'est pourquoi des interventions proactives mondiales et des mesures locales doivent être adoptées pour protéger les travailleurs de la santé et sauver leurs vies. MOTS-CLÉS: COVID-19, Main-d'œuvre de la santé, Soins de Santé Primaires, Systèmes de Santé, Dépression.

Profile and Correlates of Sleep Quality and Obstructive Sleep Apnoea among Young Persons in Ibadan, Southwestern Nigeria.

BACKGROUND: Sleep breathing disorders (SDB), especially obstructive sleep apnoea (OSA), are poorly studied in the young population. This study aimed to determine the prevalence of OSA and its associated risk factors among young persons. METHODS: A cross-sectional study design was used, and participants aged 16-35 years were recruited from five tertiary institutions in Ibadan, South Western, Nigeria. The study used a structured questionnaire, stadiometer, weighing scale, tape measure, and digital blood pressure machine to collect data. Patient Health Questionnaire (PHQ 9), Generalized Anxiety Disorder-7(GAD-7), and Pittsburgh sleep quality index (PSQI) were used to assess depression, anxiety, and sleep quality respectively. To assess the risk of OSA, we used both the STOP-Bang questionnaire and the NOSAS score. The Statistical Package for the Social Sciences version 23 was used to analyse the data, and statistical significance was set at <0.05. RESULTS: A total of 354 participants were included in this report with a mean age of 21.2±3.5 years. The female: male ratio was 1.9:1. The mean ±standard deviation of PSQI, GAD-7 score and PHQ-9 were 2.2±1.1, 12.4±5.1 and 15.0±5.4 respectively. The following percentages of participants were found to be at low, intermediate, and high risk for OSA: 94.1%, 5.6%, and 0.3%, respectively. This study showed that age and GAD-7 score were independently associated with the PSQI score while age, body mass index, neck cuff size and PHQ-9 score for OSA score. CONCLUSION: There is a burden of OSA among this population of young people; and modifying anthropometric and psychosocial factors can help mitigate the risk of OSA outcomes.

CONTEXTE: Les troubles respiratoires du sommeil (TRS), en particulier l'apnée obstructive du sommeil (AOS), sont peu étudiés chez la population jeune. Cette étude visait à déterminer la prévalence de l'ASO et ses facteurs de risque associés chez les jeunes. MÉTHODES: Un schéma d'étude transversale a été utilisé, et les participants âgés de 16 à 35 ans ont été recrutés dans cinq institutions tertiaires à Ibadan, au sud-ouest du Nigeria. L'étude a utilisé un questionnaire structuré, une toise, une balance, un ruban à mesurer et un tensiomètre numérique pour collecter les données. Le questionnaire Patient Health Questionnaire (PHQ-9), le Generalized Anxiety Disorder-7 (GAD-7) et l'index de qualité du sommeil de Pittsburgh (PSQI) ont été utilisés pour évaluer la dépression, l'anxiété et la qualité du sommeil respectivement. Pour évaluer le risque d'AOS, nous avons utilisé à la fois le questionnaire STOP-Bang et le score NOSAS. Le logiciel Statistical Package for the Social Sciences version 23 a été utilisé pour analyser les données, et la signification statistique a été fixée à <0,05. RÉSULTATS: Un total de 354 participants ont été inclus dans cette étude avec un âge moyen de 21,2±3,5 ans. Le ratio femmes : hommes était de 1,9:1. Les moyennes ± écart-type du PSQI, du score GAD-7 et du PHQ-9 étaient respectivement de 2,2±1,1, 12,4±5,1 et 15,0±5,4. Les pourcentages suivants de participants étaient classés à faible, intermédiaire et haut risque d'AOS: 94,1 %, 5,6 % et 0,3 %, respectivement. Cette étude a montré que l'âge et le score GAD-7 étaient associés de manière indépendante au score PSQI, tandis que l'âge, l'indice de masse corporelle, la circonférence du cou et le score PHQ-9 étaient associés au score ASO. CONCLUSION: Il existe un fardeau de l'ASO parmi cette population de jeunes; et la modification des facteurs anthropométriques et psychosociaux peut aider à atténuer le risque de résultats d'ASO. MOTS-CLÉS: Apnée obstructive du sommeil; Troubles Respiratoires du Sommeil ; Épidémiologie ; Trouble du sommeil.

Retraction: Synthesis of a chiral dinuclear Cu(II)-benzothiazolamine complex: evidence of cuprophilic interaction in its structure and exploration of its electrochemical properties and catalytic performance.

Retraction of 'Synthesis of a chiral dinuclear Cu(II)-benzothiazolamine complex: evidence of cuprophilic interaction in its structure and exploration of its electrochemical properties and catalytic performance' by O. Stephen Ojo et al., Dalton Trans., 2024, https://doi.org/10.1039/d3dt02994h.

Atorvastatin improves sputum conversion and chest X-ray severity score.

BACKGROUND: We report the results of a phase IIB study investigating the safety and effectiveness of atorvastatin use with standard anti-TB drugs.METHODS: In this multicentre, open-labelled study, we recruited treatment-naÏve patients with uncomplicated pulmonary TB aged at least 18 years. Participants were randomly assigned to standard-of-care or standard-of-care plus oral dose of atorvastatin (40 mg) daily for 2 months. Primary end points were safety measured by the number of participants with severe adverse events and effectiveness measured by the number of participants with negative sputum culture. Secondary endpoint was chest X-ray (CXR) severity score.RESULTS: Of the 185 participants screened, 150 were enrolled and equally assigned to the standard-of-care and atorvastatin groups. Adverse event severity was similar in the two groups. There was increased frequency of muscle pain in the trial group (12/75, 16% vs. 4/75, 5%). For efficacy analysis, respectively 64 (97%) and 57 (85.1%) patients in the trial and control groups had culture-negative results (P = 0.02) and experienced a reduction in CXR severity score of respectively 37% and 22%, with a mean difference of 1.4-4.9%.CONCLUSION: Atorvastatin is safe and associated with improved microbiological and radiological outcomes in TB.

Impact of Anemia on The Quality of Life of Chronic Kidney Disease Patients: A Single Institution Experience.

BACKGROUND: Anemia is a common complication of chronic kidney disease (CKD) and has been shown to worsen as CKD advances. CKD negatively impacts patients' health-related quality of life. It is therefore necessary to determine the impact of anemia on the quality of life in patients with CKD. OBJECTIVES: We assessed the relationship between the severity of anemia and its impact on the quality of life of anemic CKD patients attending nephrology clinics. METHODOLOGY: A cross-sectional study of one hundred and sixty-three subjects which included 102 CKD patients with anemia and sixty-one CKD subjects without anemia, was done between April 2016 and January 2017. Karnofsky's structured questionnaire was used for the quality of life, while the packed cell volume was used to determine the severity of anemia. RESULTS: The prevalence of anemia among CKD subjects was 102(62.6%), and it significantly worsens as CKD advances, which ranged from 42.3% in stage 3 to 93% in stage 5 (p < 0.001). The mean physical performance score was significantly lower among anemic CKD subjects than among controls, which was 73.17 ± 12.95 and 84.59 ± 11.04 respectively (P < 0.001). Furthermore, the mean physical performance score decreases significantly with the advancing CKD among both study groups. CONCLUSION: This study showed that CKD patients with anemia had significant impairment in their physical ability than CKD patients without anemia.

CONTEXTE: L'anémie est une complication fréquente de la maladie rénale chronique (MRC) et a tendance à s'aggraver à mesure que la MRC progresse.La MRC a un impact négatif sur la qualité de vie liée à la santé des patients. Il est donc nécessaire de déterminer l'impact de l'anémie sur la qualité de vie des patients atteints de MRC. OBJECTIFS: Nous avons évalué la relation entre la gravité de l'anémie et son impact sur la qualité de vie des patients atteints de MRC anémiques fréquentant les cliniques de néphrologie. MÉTHODOLOGIE: Une étude transversale portant sur cent soixante-trois sujets, dont 102 patients atteints de MRC avec anémie et soixante et un sujets atteints de MRC sans anémie, a été réalisée entre avril 2016 et janvier 2017. Le questionnaire structuré de Karnofsky a été utilisé pour évaluer la qualité de vie, tandis que le volume globulaire a été utilisé pour déterminer la gravité de l'anémie. RÉSULTATS: La prévalence de l'anémie chez les sujets atteints de MRC était de 102 (62,6 %), et elle s'aggrave significativement à mesure que la MRC progresse, passant de 42,3 % au stade 3 à 93 % au stade 5 (p < 0,001). Le score moyen de performance physique était significativement plus bas chez les sujets atteints de MRC anémiques que chez les témoins, soit 73,17 ± 12,95 et 84,59 ± 11,04 respectivement (p < 0,001). De plus, le score moyen de performance physique diminue significativement avec la progression de la MRC dans les deux groupes d'étude. CONCLUSION: Cette étude a montré que les patients atteints de MRC avec anémie présentaient une altération significative de leur capacité physique par rapport aux patients atteints de MRC sans anémie. Mots-clés: MRC,Anémie, Qualité de vie (QdV), Hémoglobine (Hb).

Transforming Parkinson's Care in Africa (TraPCAf): protocol for a multimethodology National Institute for Health and Care Research Global Health Research Group project.

BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disorder and, according to the Global Burden of Disease estimates in 2015, was the fastest growing neurological disorder globally with respect to associated prevalence, disability, and deaths. Information regarding the awareness, diagnosis, phenotypic characteristics, epidemiology, prevalence, risk factors, treatment, economic impact and lived experiences of people with PD from the African perspective is relatively sparse in contrast to the developed world, and much remains to be learned from, and about, the continent. METHODS: Transforming Parkinson's Care in Africa (TraPCAf) is a multi-faceted, mixed-methods, multi-national research grant. The study design includes multiple sub-studies, combining observational (qualitative and quantitative) approaches for the epidemiological, clinical, risk factor and lived experience components, as appropriate, and interventional methods (clinical trial component). The aim of TraPCAf is to describe and gain a better understanding of the current situation of PD in Africa. The countries included in this National Institute for Health and Care Research (NIHR) Global Health Research Group (Egypt, Ethiopia, Ghana, Kenya, Nigeria, South Africa and Tanzania) represent diverse African geographies and genetic profiles, with differing resources, healthcare systems, health and social protection schemes, and policies. The research team is composed of experts in the field with vast experience in PD, jointly led by a UK-based and Africa-based investigator. DISCUSSION: Despite the increasing prevalence of PD globally, robust data on the disease from Africa are lacking. Existing data point towards the poor awareness of PD and other neurological disorders on the continent and subsequent challenges with stigma, and limited access to affordable services and medication. This multi-site study will be the first of its kind in Africa. The data collected across the proposed sub-studies will provide novel and conclusive insights into the situation of PD. The selected country sites will allow for useful comparisons and make results relevant to other low- and middle-income countries. This grant is timely, as global recognition of PD and the public health challenge it poses builds. The work will contribute to broader initiatives, including the World Health Organization's Intersectoral global action plan on epilepsy and other neurological disorders. TRIAL REGISTRATION: https://doi.org/10.1186/ISRCTN77014546 .

Synthesis of a chiral dinuclear Cu(II)-benzothiazolamine complex: evidence of cuprophilic interaction in its structure and exploration of its electrochemical properties and catalytic performance.

The synthesis of a chiral dinuclear [Cu(OAc)2(L1)]2 complex (A) and its analogues Cu(OAc)2(L1)2 (B), Cu(OAc)2(L1)PPh3 (C), CuBr(L1)PPh3 (D), and Cu(OAc)2(L2) (E) is described. The X-ray structure of A reveals a cuprophilic interaction (2.65 Å) and shows that L1 behaves as a monodentate ligand. The stereogenic centre in L1 aligns the NH group to form non-covalent interactions with the paddle-wheel acetate groups at variable distances (2.4-2.5 Å and 2.2-2.7 Å). Thermogravimetric analysis confirmed our hypothesis that two equivalents of L1 (B) or a combination of L1 and PPh3 (C) would disrupt the cuprophilic interaction. All complexes, except D, showed irreversible redox waves by cyclic voltammetry. Complexes C and E have lower oxidative peaks (at 10 V s-1) than complex A between +0.40 and +0.60 V. This highlights the influence of ligand(s) on the redox behaviour of Cu(II) complexes. The significance of this electrochemical behaviour was evident in the Chan-Lam (CL) coupling reaction, where 2.5 mol% of A successfully facilitated the formation of a C-N bond. This study showcased the structure, thermal stability, electrochemical properties and catalytic performance of a chiral dinuclear copper(II)-benzothiazolamine complex.

Double asymmetric synthesis: faster reactions are more selective and a model to estimate relative rate.

The catalysed reaction of an enantiopure substrate with formation of a new chirality element may result in higher diastereoselectivity with one enantiomer of a catalyst (matched pair) than with the other (mismatched pair). The hypothesis that the matched reaction is faster was investigated using literature examples of kinetic resolution procedures that result in the formation of a new stereogenic centre. With one exception from fifteen examples, the selectivity factor (s = kfast/kslow) = kmatched/kmismatched. A model to estimate the relative rate of a fast-matched reaction vs. the corresponding slow-mismatched reaction is proposed. This model also provides insight into the basis of the selectivity displayed in the kinetic resolution procedures studied.

Expeditious access to cis-ß-aryl, γ-alkyl disubstituted (±)-γ-butyrolactones via nickel-hydride catalysis.

The 1,4-reduction of ß- and γ-substituted butenolides using 5 mol% of NiCl2·6H2O and NaBH4 in MeOH for rapid access to cis-ß,γ-disubstituted γ-butyrolactones is described. The reaction was selective for cis-products, which were obtained in good to excellent yields. This study showcased the influence of steric hindrance and angle strain on the diastereoselectivity outcome of conjugate reductions facilitated by in situ generated nickel-hydride.

Evaluation of circulating microRNA profiles in blood as potential candidate biomarkers in a subacute ruminal acidosis cow model - a pilot study.

BACKGROUND: Subacute ruminal acidosis (SARA) is a metabolic disorder often observed in high-yielding dairy cows, that are fed diets high in concentrates. We hypothesized that circulating miRNAs in blood of cows could serve as potential candidate biomarkers to detect animals with metabolic dysbalances such as SARA. MicroRNAs (miRNAs) are a class of small non-coding RNAs, serving as regulators of a plethora of molecular processes. To test our hypothesis, we performed a pilot study with non-lactating Holstein-Friesian cows fed a forage diet (FD; 0% concentrate, n = 4) or a high-grain diet (HG; 65% concentrate, n = 4) to induce SARA. Comprehensive profiling of miRNA expression in plasma and leucocytes were performed by next generation sequencing (NGS). The success of our model to induce SARA was evaluated based on ruminal pH and was evidenced by increased time spent with a pH threshold of 5.8 for an average period of 320 min/d. RESULTS: A total of 520 and 730 miRNAs were found in plasma and leucocytes, respectively. From these, 498 miRNAs were shared by both plasma and leucocytes, with 22 miRNAs expressed exclusively in plasma and 232 miRNAs expressed exclusively in leucocytes. Differential expression analysis revealed 10 miRNAs that were up-regulated and 2 that were down-regulated in plasma of cows when fed the HG diet. A total of 63 circulating miRNAs were detected exclusively in the plasma of cows with SARA, indicating that these animals exhibited a higher number and diversity of circulating miRNAs. Considering the total read counts of miRNAs expressed when fed the HG diet, differentially expressed miRNAs ( log2 fold change) and known function, we have identified bta-miR-11982, bta-miR-1388-5p, bta-miR-12034, bta-miR-2285u, and bta-miR-30b-3p as potential candidates for SARA-biomarker in cows by NGS. These were further subjected to validation using small RNA RT-qPCR, confirming the promising role of bta-miR-30b-3p and bta-miR-2285. CONCLUSION: Our data demonstrate that dietary change impacts the release and expression of miRNAs in systemic circulation, which may modulate post-transcriptional gene expression in cows undergoing SARA. Particularly, bta-miR-30b-3p and bta-miR-2285 might serve as promising candidate biomarker predictive for SARA and should be further validated in larger cohorts.

An expedient copper-catalysed asymmetric synthesis of γ-lactones and γ-lactams. Application to the synthesis of lucidulactone A.

The parent Josiphos ligand gave excellent ee values (95-99%) and good yields (60-97%) in the copper-catalysed asymmetric conjugate reduction of ß-aryl α,ß-unsaturated lactones and lactams with PMHS. The substrates were obtained from stereospecific copper-catalysed addition of arylboronic acids to alkynoates followed by deprotection and cyclisation. The acyclic lactam precursors also underwent reduction with good ee values (83-85%) and yields (79-95%). Application of this asymmetric reduction methodology included the synthesis of natural product lucidulactone A.

Smartphone Ownership and the Willingness to receive Mobile Health Services among Patients with Hypertension in Nigeria.

BACKGROUND: There are traditional barriers to accessing quality hypertension care in sub-Saharan Africa. Mobile phone technology is increasingly being used to overcome these barriers. This study assessed smartphone ownership and the willingness to receive mobile health services among patients with hypertension in Nigeria. METHODS: Four hundred and twenty-seven (427) patients with hypertension were recruited from two tertiary health institutions in Ekiti State, Nigeria. Questionnaires were fed into the Open Data Kit form, which was used to take data on mobile phone ownership, the willingness to receive and the preferred type of mobile phone-based hypertension health care services. RESULTS: Males were 37.2%. Mean age was 60.6 ± 15.3 years. Of the participants, 48.7% owned smartphones, 21.1% had regular internet subscription on their phones, 94.8% were willing to receive and pay mobile health services. Phone calls (48.0%) and text messages (31.6%) were the most preferred modes of receiving hypertension-related health education. Age category of 45-64 years was the only predictor of willingness to receive mobile health services. CONCLUSION: All our participants owned mobile phones, with 48.7% being smartphones and almost all the participants were willing to receive and pay for mobile health services for prevention, treatment and information on hypertension. Middle age was the only predictor of willingness to receive mobile health, and the most preferred choices were through phone calls and text messages. The above information will guide in the design of favourable mHealth interventions that will be ideal for our study population.

CONTEXTE: Il existe des obstacles traditionnels à l'accès à dessoins de qualité pour l'hypertension en Afrique subsaharienne. La technologie de la téléphonie mobile est de plus en plus utilisée pour surmonter ces obstacles. Cette étude a évalué la possession d'un smartphone et la volonté de recevoir des services de santé mobiles chez les patients souffrant d'hypertension au Nigeria. MÉTHODES: Quatre cent vingt-sept (427) patients hypertendus ont été recrutés dans deux établissements de santé tertiaires de l'État d'Ekiti, au Nigeria. Des questionnaires ont été introduits dans le formulaire Open Data Kit, qui a été utilisé pour recueillir des données sur la possession d'un téléphone mobile, la volonté de recevoir et le type préféré de services de soins de santé contre l'hypertension basés sur le téléphone mobile. RÉSULTATS: Les hommes représentaient 37,2 %. L'âge moyen était de 60,6 ± 15,3 ans. Parmi les participants, 48,7 % possédaient des smartphones, 21,1 % avaient un abonnement Internet régulier sur leurs téléphones, 94,8 % étaient disposés à recevoir et à payer des services de santé mobiles. Les appels téléphoniques (48,0 %) et les SMS (31,6 %) étaient les modes les plus privilégiés pour recevoir une éducation à la santé liée à l'hypertension. La catégorie d'âge de 45 à 64 ans était le seul prédicteur de la volonté de recevoir des services de santé mobiles. CONCLUSION: Tous nos participants possédaient des téléphones portables, 48,7 % étant des smartphones et presque tous les participants étaient disposés à recevoir et à payer des services de santé mobiles pour la prévention, le traitement et l'information sur l'hypertension. L'âge moyen était le seul prédicteur de la volonté de recevoir des soins de santé mobiles, et les choix les plus préférés étaient les appels téléphoniques et les SMS. Les informations cidessus guideront la conception d'interventions mHealth favorables qui seront idéales pour notre population d'étude. Mots clés: Smartphones, Volonté, Santé mobile, Âge moyen, Hypertension, Nigeria.

Anti-atherogenic and cardio-protective properties of sweet melon (Cucumis melo. L. Inodorus) seed extract on high fat diet induced obesity in male wistar rats.

BACKGROUND: Cucumis melon is a medicinal plant with multiple pharmacological properties such as anti-inflammatory, antioxidant, and diuretic effects. An increasing body of scientific evidence established the anti-diabetic/anti-obesity effects of Cucumis melo in humans, mice, and hamster models. However, there are no tangible reports on its ability to prevent cardiovascular complications following diet-induced obesity. The anti-atherogenic and cardioprotective effects of the Methanolic extract of Cucumis melo. L. Inodorus seeds on a high-fat diet (HFD)-induced obese rats was assessed in this study.  METHODS: Forty male Wistar rats were randomly divided into five groups, (n = 8/group); i.e., Normal (N), HFD, HFD + 50 mg/kg b.w. of MCMs (Methanolic extract of Cucumis melon seeds), HFD + 100 mg/Kg b.w. of MCMs and HFD + 200 mg/kg b.w. of MCMs. The experimental animals were anaesthetized and sacrificed after 10 weeks, and blood samples and heart tissue were collected for further analysis. Using the Graph Pad Prism version 5.0, the results expressed as Mean ± SD was tested using the one-way ANOVA to show intergroup differences, followed by Bonferonni 's post hoc test. The level of significance was determined at P ≤ 0.05. RESULTS: MCMs significantly (P < 0.05) reduced body weight, adiposity index, total fat mass, low-density lipoprotein cholesterol (LDL-c), and total cholesterol (TC) compared with the HFD obese groups MCMs caused a significant reduction in the body weight, total fat mass, adiposity index, low-density lipoprotein cholesterol (LDL-c), and total cholesterol (TC) when compared to the animals in HFD obese groups. Also, the Atherogenic index of plasma (AIP), Castelli index and, malondialdehyde (MDA) significantly (P < 0.05) decreased in MCMs treated groups compared to the HFD obese group. The catalase, protein, and HDL levels were significantly increased in MCMs treated groups compared to HFD-obese animals. Expression of nitric oxide in the form of nitrite in the heart tissue significantly increased in the MCMs treated compared to the HFD-obese rats, with the majority of the positive results recorded at 100 mg/Kg b.w. of MCMs. CONCLUSIONS: MCMs have anti-atherogenic and Cardio-protective properties on High Fat Diet-Induced Obesity in Male rats via an antioxidant and nitric oxide-dependent mechanism. Further study is recommended to evaluate the molecular mechanisms to which these anti-atherogenic and cardio-protective actions can be attributed and exploit the GCMS result in the development of drug candidates.

Synergistic cardioprotective ability of co-administration of Moringa supplemented diets and acarbose in diabetic cardiomyopathy involves attenuation of cholinergic, purinergic, monoaminergic, renin-angiotensin system, and antioxidant pathways.

One of the major complications of diabetes mellitus (DM) is diabetic cardiomyopathy (DCM) due to the multifaceted therapy involved. Here, we evaluated the combinatorial effect of Moringa leaf (ML) and seed (MS) supplemented diets plus acarbose (ACA) on cardiac acetylcholinesterase (AChE), adenosine triphosphatase (ATPase), adenosine deaminase (ADA), monoamine oxidase (MAO), arginase, angiotensin-I converting enzyme (ACE), and lactate dehydrogenase (LDH) activities, thiobarbituric acid reactive species (TBARS), and thiols levels. The diets and ACA (25 mg/kg) were administered for 14 days. The fasting blood glucose level (FBGL), cardiac AChE, ATPase, ADA, MAO, arginase, ACE, LDH activities, and TBARS and thiol levels were determined. Relative to the normal rats, the biomarkers were significantly increased in DM rats but were suppressed significantly in the diets plus ACA-treated rats while improving antioxidant status, with the 4% Moringa plus ACA proving outstanding compared to individual ML/MS and ACA. In addition, ML-supplemented diets with/without ACA had better effects compared to MS with/without ACA, respectively. In conclusion, the combination of ML/MS supplemented diets and ACA synergistically modulates the tested biochemicals. However, the effect on blood vessels and the nerves that control the heart, stiffness of left ventricular (LV) hypertrophy, fibrosis, cell signaling abnormalities, related gene expression, clinical trials, and echocardiology studies should be further investigated to affirm this claim. PRACTICAL APPLICATIONS: Moringa oleifera has been a vocal appetite in mitigating cardiovascular disease induced by diabetes, but the formulation of a medicinal diet as an ameliorative route of attention to the pathology is fairly addressed, not talking of its combination with the synthetic antidiabetic drug, such as ACA. Based on this experiment, it is imperative to explore such an idea. This research shows that co-administration of moringa leaf/seed formulated diets plus ACA exhibits a synergistic effect in DCM management. However, further research is needed in this field of experiment.

Women in Neurosurgery: Historical Path to Self-Segregation and Proposal for an Integrated Future.

Despite the rising percentage of women accessing the medical profession over the last few decades, surgical specialties are still largely male-dominated; in particular, a remarkable gender disparity is evident in neurosurgery, where only 19% of practitioners are females. Although women may be reluctant to choose a challenging specialty like neurosurgery due to concerns around how to balance family and career, it must be admitted that prejudices against female neurosurgeons have been deeply rooted for long, prompting many to give up and switch track to less demanding subspecialties. Among those who have persisted, many, if not most, have experienced difficulties in career progression and received unequal treatment in comparison with their male counterparts. In 1989, a group of 8 female neurosurgeons founded Women in Neurosurgery (WINS), an organization that aimed to guarantee inclusivity in neurosurgery, encouraging a better and more egalitarian working environment. Thereafter, WINS sessions were regularly promoted at international conferences, offering female neurosurgeons a platform to report issues related to gender discrimination. Over recent years, the mission of WINS sessions in national and international conferences has taken an unexpected deviation; they have progressively become supplementary scientific sessions with only women neurosurgeons as speakers, thus paving the road to a form of self-segregation. This tendency has also resulted in the establishment of sections of only female neurosurgeons within some national societies. Although there remains a faction that fiercely supports the WINS mindset of reserved spaces for women, such segregation is an upsetting prospect for those who believe that science and professionalism have no gender; a growing part of the global neurosurgical community believes that the conception of a "female neurosurgery" and a "male neurosurgery" is misguided and counterproductive and consider the existence of the WINS as anachronistic and no longer necessary.

Efficacy of Hexetidine, Thymol and Hydrogen Peroxide-Containing Oral Antiseptics in Reducing Sars-Cov-2 Virus in the Oral Cavity: A Pilot Study.

BACKGROUND: Studies have demonstrated the role of sputum as a site of severe acute respiratory syndrome-coronavirus-2 (SARSCoV-2) transmission. However, there is limited literature on the virucidal efficacy of oral antiseptics against SARS-CoV-2 virus. This study investigated the virucidal efficacy of three oral-antiseptics compared to a placebo-control in the sputum of SARS-CoV-2 infected individuals. METHODOLOGY: A pilot study of adults with SARS-CoV-2 positive results, as determined by reverse transcription-polymerase chain reaction (RT-PCR) of <7 days. The oral antiseptics investigated were: Hexetidine (0.1% w/v); Thymol (0.063% w/v) and H2O2(1.5%) compared to de-mineralized sterile water (Placebo-control). The primary outcome measure was the proportion of negative RT-PCR results at 15-mins, 30-mins, 1-hour, 2-hours and 4-hours After Oral antiseptics Interventions (AOI) compared to the placebo-control. Statistical analysis was done using STATA 15.0 software with p-values of <0.05 considered statistically significant. RESULTS: Data from a total of 66 participants that were RT-PCR SARS-CoV-2 positive at baseline (0-min) was analysed. At 15-mins AOI, the highest proportion of negativation from sputum samples was observed in the Hexedine group, with 69.2% of the baseline PCR positive cases converting to negative compared to 46.7% in the placebo-control group. In addition, H2O2 demonstrated efficacy at 2-hours AOI compared to placebo-control (62.5% vs 37.5% respectively) and other oral-antiseptics. Across all time-points, the oral-antiseptic groups compared to the placebo-control group, there was no statistically significant difference in the proportion of sputum samples which converted to a negative status (p>0.05). CONCLUSION: The findings in this study suggest there was no significant difference in the proportion of participants who converted to a negative sputum status across the treatment groups at various time points. Future studies could compare the cycle threshold (ct) viral titre values of sputum samples to determine quantitative differences.

CONTEXTE: Des études ont démontré le rôle des expectorations comme un site de transmission du syndrome respiratoire aigu sévère-coronavirus- 2 (SRAS-CoV-2). Cependant, il existe peu de documentation sur l'efficacité virucide des antiseptiques oraux contre le virus du SRASCoV-2. Cette étude a examiné l'efficacité virucide de trois antiseptiques oraux par rapport à un contrôle placebo dans les expectorations de personnes infectées par le SRAS-CoV-2. MÉTHODOLOGIE: Une étude pilote menée auprès d'adultes dont les résultats sont positifs pour le SRAS-CoV-2, tels que déterminés par la réaction en chaîne de la polymérase par transcription inverse (RT-PCR) pendant 7 jours. Les antiseptiques oraux étudiés étaient : Hexetidine (0,1% p/v) ; Thymol (0,063% p/v) et H2O2 (1,5%) par rapport à l'eau stérile déminéralisée (Placebo-contrôle). Le principal critère d'évaluation était la proportion de résultats RT-PCR négatifs 15 minutes, 30 minutes, 1 heure, 2 heures et 4 heures après les interventions antiseptiques orales (AOI) par rapport au contrôle placebo. L'analyse statistique a été réalisée à l'aide du logiciel STATA 15.0, les valeurs p de <0,05 étant considérées comme statistiquement significatives. RÉSULTATS: Les données d'un total de 66 participants qui étaient positifs à la RT-PCR SARS-CoV-2 au départ (0 minute) ont été analysées. Au bout de 15 minutes, la plus forte proportion de négativation des échantillons d'expectoration a été observée dans le groupe Hexedine, 69,2 % des cas positifs au départ par PCR devenant négatifs, contre 46,7 % dans le groupe témoin placebo. En outre, l'H2O2 a démontré son efficacité à 2 heures après l'apparition de la maladie par rapport au groupe placebo (62,5 % contre 37,5 % respectivement) et aux autres antiseptiques oraux. Pour tous les points temporels, les groupes d'antiseptiques oraux comparés au groupe placebo n'ont pas présenté de différence statistiquement significative dans la proportion d'échantillons d'expectoration qui sont devenus négatifs (p>0,05). CONCLUSION: Les résultats de cette étude suggèrent qu'il n'y a pas de différence significative dans la proportion de participants qui sont passés à un statut négatif d'expectoration dans les groupes de traitement à différents moments. Les études futures pourraient comparer les valeurs du titre viral au seuil de cycle (ct) des échantillons d'expectoration afin de déterminer les différences quantitatives. MOTS CLÉS: SRAS-CoV-2, antiseptiques oraux, hexétidine, peroxyde d'hydrogène.

Paediatric Cardiac Anaesthesia at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria: The Hurdles, Struggles, and Successes.

BACKGROUND: Open-heart surgery started at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) Ile-Ife, Nigeria, 5 years ago through partnership with foreign partners. This paper reviewed the difficulties facing the development of paediatric cardiac anaesthesia, the pattern, and the outcome of cases managed. METHODS: A review of the infrastructure, equipment, manpower and operational setup for open-heart surgery at OAUTHC was done. A retrospective study of all patients that were operated on from April 2016 to March 2021 was performed. Extracted data were analysed with Statistical Packages for the Social Scientists using descriptive statistics. RESULTS: A total of 102 patients had open-heart surgeries during the period under review by the various teams in a shared facility of the hospital's main theatre. Challenges with manpower, infrastructure, and supplies were major limitations to service delivery. Most of the patients (75.5%) were aged < 5 years. The commonest procedures performed were ventricular septal defect closure (31.4%), total correction of tetralogy of Fallot (26.5%), and atrial septal defect closure (9.8%). Fast-tracked anaesthesia was used always except where it was contraindicated. Most (76.7%) of the cases were extubated within 24 hours after surgery; the mean (SD) duration of ventilation in the ICU was 0.99 (1.2) days and the average length of ICU stay was 3 days. The overall mortality rate was 20.6%. CONCLUSION: Numerous challenges confront the provision of sustainable paediatric cardiac anaesthesia services in resource-constrained settings like ours. Much can be achieved with appropriate investment in material and manpower, and partnership with experienced teams.

CONTEXTE: La chirurgie à cœur ouvert a commencé au complexe hospitalier universitaire Obafemi Awolowo (OAUTHC) Ile-Ife, au Nigeria, il y a 5 ans grâce à un partenariat avec des partenaires étrangers. Cet article a passé en revue les difficultés rencontrées dans le développement de l'anesthésie cardiaque pédiatrique, le schéma et l'issue des cas pris en charge. MÉTHODES: Un examen de l'infrastructure, de l'équipement, de la main-d'œuvre et de la configuration opérationnelle pour la chirurgie à cœur ouvert à l'OAUTHC a été effectué. Une étude rétrospective de tous les patients opérés d'avril 2016 à mars 2021 a été réalisée. Les données extraites ont été analysées avec des progiciels statistiques pour les spécialistes des sciences sociales à l'aide de statistiques descriptives. RÉSULTATS: Au total, 102 patients ont été opérés à cœur ouvert au cours de la période étudiée par les différentes équipes dans une salle commune du bloc opératoire principal de l'hôpital. Les défis liés à la main-d'œuvre, à l'infrastructure et aux fournitures constituaient des obstacles majeurs à la prestation de services. La plupart des patients (75.5%) étaient âgés de < 5 ans. Les gestes les plus fréquemment pratiqués étaient la fermeture de la communication interventriculaire (31.4%), la correction totale de la tétralogie de Fallot (26.5 %) et la fermeture de la communication interauriculaire (9.8%). L'anesthésie accélérée a toujours été utilisée sauf en cas de contre-indication. La plupart (76.7%) des cas ont été extubés dans les 24 heures suivant la chirurgie ; la durée moyenne (ET) de la ventilation en USI était de 0.99 (1.2) jours et la durée moyenne de séjour en USI était de 3 jours. Le taux de mortalité global était de 20.6%. CONCLUSION: De nombreux défis font face à la prestation de services durables d'anesthésie cardiaque pédiatrique dans des contextes aux ressources limitées comme le nôtre. Beaucoup peut être réalisé avec un investissement approprié en matériel et en main-d'œuvre, et un partenariat avec des équipes expérimentées. MOTS-CLÉS: Pédiatrie, Anesthésie, Chirurgie Cardiaque, Nigéria, Pays en Développement.

A multi-centre, randomized, double-blind, placebo-controlled clinical trial of the efficacy and safety of chloroquine phosphate, hydroxychloroquine sulphate and lopinavir/ritonavir for the treatment of COVID-19 in Lagos State: study protocol for a randomized controlled trial.

BACKGROUND: The coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that was first identified in Wuhan, Hubei, China, in December 2019. It was recognized as a pandemic by the World Health Organization on 11 March 2020. Outbreak forecasting and mathematical modelling suggest that these numbers will continue to rise. Early identification of effective remedies that can shorten the duration and severity of illness is critical for Lagos State, which is the epi-centre of the disease in Nigeria. METHODS: This is a multi-centre, randomized, double-blind placebo-controlled superiority trial. The study investigates the efficacy of chloroquine phosphate, hydroxychloroquine sulphate and lopinavir/ritonavir added on to standard of care compared to standard of care only in patients with COVID-19 disease. The primary outcome is the clinical status of patients measured using a 7-point ordinal scale at day 15. Research participants and clinicians will be blinded to the allocated intervention. Outcome measures will be directly assessed by clinicians. Statistical analysis will be done by a team blinded to the identity and allocation of research participants. Data analysis will follow intention-to-treat methods, using R software. DISCUSSION: The current study is of strategic importance for Lagos State in potentially curbing the health, social and economic burden of COVID-19 disease. Should the current study demonstrate that either of the three intervention drugs is more efficacious than standard therapy alone, the State Ministry of Health will develop an evidence-based guideline for the management of COVID-19 in Lagos State. The findings will also be shared nationally and with other states which may lead to a standardized national guideline for the treatment of COVID-19 in Nigeria. TRIAL REGISTRATION: Pan African Clinical Trials Register PACTR202004801273802 . Registered prospectively on April 2, 2020.

Detection of NDM-1 in Metallo-Beta-Lactamase-Producing Strains of Pseudomonas aeruginosa isolates from a Tertiary Hospital in Southwest Nigeria.

BACKGROUND: Metallo-beta-lactamase producingPseudomonas aeruginosa (MBL-PA) infections pose a major healthcare concern globally due to the associated extended morbidity, increased cost of treatment and high mortality. OBJECTIVES: This study aimed to determine the prevalence of circulating MBL-PA strains and evaluate probable risk factors associated with the carriage of MBL-PA among patients in a selected South-western tertiary hospital in Nigeria. METHODS: One hundred and forty-four isolates recovered from diverse clinical specimens were identified as Pseudomonas aeruginosa by conventional methods. Eight antibiotics were tested on the isolates using Kirby-Bauer disc diffusion technique. All carbapenem resistant isolates were phenotypically screened for MBL-production using the combined disc synergy test. The MBL-producing strains were evaluated for the presence of three MBL genes blaIMP, blaVIM-2 and blaNDM1 by Polymerase chain reaction (PCR). RESULTS: Fourteen (9.7%) isolates were positive for metallobeta-lactamase production by combined disc synergy test. The MBL-producing strains were more commonly resistant to all the tested antibiotics except to piperacillin tazobactam and imipenem compared with the non MBL producing strains (p<0.05). Antibiotic use and the occurrence of multidrug resistance phenotype were significantly associated with MBLcarriage (p<0.05). Four (28.6%) MBL-PA isolates carried NDM-1 gene, while IMP and VIM-2 genes were not detected in any of the isolates. CONCLUSION: The study demonstrated a low prevalence of NDM-1 in P. aeruginosa circulating among patients in this environment. This may be because carbapenems are seldom prescribed in our hospital or probably due to the existence of other MBL genes and non-enzymatic resistance mechanisms that we did not investigate. Studies that evaluate the level of carbapenem resistance via non-MBL production route could assist and improve future surveillance of these fast spreading genes.

CONTEXTE: Les infections à Pseudomonas aeruginosa producteur de métallo-bêta-lactamase (LBM-PA) constituent un problème de santé majeur à l'échelle mondiale en raison de la morbidité prolongée, du coût accru du traitement et de la mortalité élevée qui y sont associés. OBJECTIFS: Les objectifs de cette étude étaient de déterminer la prévalence des souches de MBL-PA en circulation et d'évaluer les facteurs de risque probables associés au portage de MBL-PA chez les patients d'un hôpital tertiaire du sud-ouest du Nigeria. MÉTHODES: Cent quarante-quatre isolats récupérés à partir de divers spécimens cliniques ont été identifiés comme étant des Pseudomonas aeruginosa par des méthodes conventionnelles. Huit antibiotiques ont été testés sur les isolats à l'aide de la technique de diffusion en disques de Kirby-Bauer. Tous les isolats résistants aux carbapénèmes ont fait l'objet d'un dépistage phénotypique de la production de LBM à l'aide du test de synergie à disques combinés. Les souches productrices de LBM ont été évaluées pour la présence des trois gènes de LBM blaIMP, blaVIM-2 et blaNDM1 par réaction en chaîne par polymérase (PCR). RÉSULTATS: Quatorze (9,7 %) isolats étaient positifs pour la production de métallobêta-lactamase par le test de synergie de disques combinés. Les souches productrices de MBL étaient plus fréquemment résistantes à tous les antibiotiques testés, à l'exception de la pipéracilline-tazobactam et de l'imipénème, que les souches non productrices de MBL (p<0,05). L'utilisation d'antibiotiques et la présence d'un phénotype multirésistant étaient significativement associées au portage de LBM (p<0,05). Quatre (28,6 %) isolats de LBM-PA étaient porteurs du gène NDM1, tandis que les gènes IMP et VIM-2 n'ont été détectés dans aucun des isolats. CONCLUSION: L'étude a démontré une faible prévalence de NDM-1 dans les P. aeruginosa en circulation chez les patients dans ce contexte. Cela peut être dû au fait que les carbapénèmes sont rarement prescrits dans notre hôpital ou probablement à l'existence d'autres gènes MBL et de mécanismes de résistance non enzymatique que nous n'avons pas étudiés. Les études qui évaluent le niveau de résistance aux carbapénèmes par des voies non-MBL pourraient aider et améliorer la surveillance future de ces gènes qui se répandent rapidement. MOTS CLÉS: MBL-PA, Metallo-beta-lactamase, VIM, NDM1, IMP.