The Relationship between Adolescents' Family Background, Perceived Self-Concept and Health Seeking Behaviour in an Urban City of South-Western Nigeria.

BACKGROUND AND OBJECTIVES: The understanding of adolescents about themselves affects their choices and actions when their health is concerned. This study assessed the relationship between family background, perceived self-concept and health seeking behaviour of adolescents. METHODS: This was a prospective cross-sectional study involving three secondary schools in Ekiti State, South-western Nigeria. A total of 352 students were recruited through multistage random sampling technique. The Personal Self-Concept Questionnaire (PSC) was used to assess the adolescents' personal self-concept while the health seeking behaviour was adapted from the Botsha Bophelo Adolescent Health Study (BBAHS) adapted questionnaire. The family background was sought from the respondents. Demographic variables were described as means and standard deviations. Categorical variables were reported as frequency distribution and proportions with the Pearson correlation test used to assess the relationship of relevant variables with self-concept. RESULTS: There was negative correlation between the adolescents' family social class and their autonomy self-concept (r = -0.117; p<0.029). Out of the 42% who had any form of ill-health, 29.6% had sought for medical attention, 8.5% were sexually exposed, 4% and 4.8% were screened for HIV and the use of contraception respectively. Having been hospitalized in the past six months related with their general self-concept (r = -0.124; p<0.02) and sense of fulfillment (r = -0.118; p<0.027). Use of cannabis negatively correlated with general self-concept (r = -0.132; p<0.013) and honesty self-concept (r = -0.127; p<0.017). Sexual exposure correlated negatively with emotional self-concept (r = -0.116; p<0.03). CONCLUSION: From this study, the socioeconomic class of the family of the adolescents affected their individuality. In addition, adolescents with high self-concept will not easily seek for appropriate medical attention.

CONTEXTE ET OBJECTIFS: La compréhension que les adolescents ont d'eux-mêmes affecte leurs choix et leurs actions lorsqu'il s'agit de leur santé. Cette étude vise à évaluer la relation entre le milieu familial, la perception de soi et le comportement des adolescents en matière de santé. MÉTHODES: Il s'agit d'une étude prospective transversale portant sur trois écoles secondaires de l'État d'Ekiti, au sud-ouest du Nigeria. Un total de 352 étudiants a été recruté par une technique d'échantillonnage aléatoire à plusieurs degrés dans les écoles sélectionnées. Le Personal Self-Concept Questionnaire (PSC) a été utilisé pour évaluer le concept de soi des adolescents, tandis que le comportement en matière de santé a été adapté à partir du questionnaire adapté de la Botsha Bophelo Adolescent Health Study (BBAHS). Le contexte familial a été demandé aux répondants. Les variables démographiques ont été décrites sous forme de moyennes et d'écarts types. Les variables catégorielles ont été rapportées sous forme de distribution de fréquence et de proportions. Le test de corrélation de Pearson a été utilisé pour évaluer la relation entre les variables pertinentes et le concept de soi. RÉSULTATS: Il existe une corrélation négative entre la classe sociale familiale des adolescents et leur concept d'autonomie (r = -0.117 ; p<0.029). Sur les 42% qui présentaient une forme quelconque de mauvaise santé, 29,6% avaient consulté un médecin, 8,5% étaient sexuellement exposés, 4% et 4,8% étaient respectivement dépistés pour le VIH et l'utilisation de la contraception. Le fait d'avoir été hospitalisé au cours des six derniers mois était lié à l'image générale de soi (r = -0,124 ; p<0,02) et au sentiment d'accomplissement (r = -0,118 ; p<0,027). La consommation de cannabis est corrélée négativement avec le concept général de soi (r = -0,132 ; p<0,013) et le concept d'honnêteté (r = -0,127 ; p<0,017). L'exposition sexuelle est corrélée négativement avec le concept de soi émotionnel (r = - 0,116 ; p<0,03). CONCLUSION: D'après cette étude, la classe socio-économique de la famille des adolescents a affecté leur individualité. De plus, les adolescents ayant un concept de soi élevé ne chercheront pas facilement à obtenir des soins médicaux appropriés. Mots clés: Adolescents, concept personnel de soi, contexte familial, comportement de recherche de santé.

Clinical neglect of aspergillosis in pulmonary tuberculosis co-infection: a case report of avoidable mortality in a resource-constrained setting

Background: Pulmonary aspergillosis (PA) is common among patients with tuberculosis (TB). With both infections presenting with similar clinical and radiologic features, diagnosis of PA is often made too late or missed completely due to lack of clinical suspicion and poor diagnostic laboratory capacity for mycotic infections prevalent in our settings. We present a case of preventable mortality caused by delayed diagnosis and treatment of PA in a patient with pulmonary TB (PTB). Case presentation: A 13-year-old female was diagnosed and treated for PTB, having received anti-TB regimen for 8 months in a mission hospital from where she was referred due to worsening cough, chest pain and progressive breathlessness. The patient was re-assessed and investigated, with GeneXpert detecting Mycobacterium tuberculosis, susceptible to rifampicin. Diagnosis of pulmonary tuberculosis complicated by right pneumothorax was made indicating an emergency thoracotomy and chest tube insertion and continuation of the first line anti-TB regimen. At about 2 weeks into admission, patients had features of superimposed acute bacterial sepsis with fever becoming high grade, marked neutrophilia with toxic granulation and elevated sepsis biomarker, and this necessitated empiric antibiotic treatment with parenteral meropenem and vancomycin. However, the patient only had mild clinical improvement following which there was progressively worsening respiratory symptoms and massive haemoptysis. Result of sputum fungal study was available on admission day 20 and revealed a growth of Aspergillus flavus. Treatment with intravenous voriconazole was however commenced rather late when the fungal respiratory disease could no longer be remedied. The patient died on admission day 23. Conclusion: Diagnosis of PA in patients with background TB is often made too late to guarantee timely and effective antifungal treatment with negative consequences on patients' outcomes. Improving clinical and laboratory capacities is essential to reducing mortality from PA in healthcare facilities.

Dual-targeted therapeutic strategy combining CSC-DC-based vaccine and cisplatin overcomes chemo-resistance in experimental mice model.

BACKGROUND AND PURPOSE: Emerging evidence suggests that one of the main reasons of chemotherapy treatment failure is the development of multi-drug resistance (MDR) associated with cancer stem cells (CSCs). Our aim is to identify a therapeutic strategy based on MDR-reversing agents. MATERIALS AND METHODS: CSC-enriched Ehrlich carcinoma (EC) cell cultures were prepared by drug-resistant selection method using different concentrations of cisplatin (CIS). Cell cultures following drug exposure were analyzed by flow cytometry for CSC surface markers CD44+/CD24-. We isolated murine bone marrow-derived dendritic cells (DCs) and then used them to prepare CSC-DC vaccine by pulsation with CSC-enriched lysate. DCs were examined by flow cytometry for phenotypic markers. Solid Ehrlich carcinoma bearing mice were injected with the CSC-DC vaccine in conjunction with repeated low doses of CIS. Tumor growth inhibition was evaluated and tumor tissues were excised and analyzed by real-time PCR to determine the relative gene expression levels of MDR and Bcl-2. Histopathological features of tumor tissues excised were examined. RESULTS AND CONCLUSION: Co-treatment with CSC-DC and CIS resulted in a significant tumor growth inhibition. Furthermore, the greatest response of downregulation of MDR and Bcl-2 relative gene expression were achieved in the same group. In parallel, the histopathological observations demonstrated enhanced apoptosis and absence of mitotic figures in tumor tissues of the co-treatment group. Dual targeting of resistant cancer cells using CSC-DC vaccine along with cisplatin represents a promising therapeutic strategy that could suppress tumor growth, circumvent MDR, and increase the efficacy of conventional chemotherapies.

Risk factors for pterygium recurrence after surgical excision with combined conjunctival autograft (CAG) and intraoperative antimetabolite use.

BACKGROUND: To identify the determinants of recurrence following primary pterygium excision combined with conjunctival autograft (CAG) and intraoperative use of Mitomycin C (MMC) or 5-Fluorouracil (5-FU). METHODS: A randomized controlled clinical trial comparing 5-FU (50 mg/ml) plus CAG versus MMC (0.01%) plus CAG in preventing recurrence of primary pterygium following excision. RESULTS: A total of 80 eyes of 80 subjects were studied, with 46 eyes in the 5-FU group and 34 eyes in the MMC group. The mean age was 50.7 +/- 13.1 years with a male: female ratio of 0.95:1. Mean follow up period was 35.2 +/- 29.1 weeks. The overall recurrence rate was 10%, with a rate of 8.7% in the 5-FU group and 11.8% in the MMC group. The mean age of the patients who had a recurrence was 38.1 +/- 13.3 years compared to 52.1 +/- 12.4 years in those without a recurrence (p = 0.003). The median size of the pterygium in patients who had a recurrence was 3.2mm, while the median size in patients who did not have a recurrence was 3.0mm (p = 0.8). Five (12.8%) males had a recurrence compared to three (7.3%) females (p = 0.48); while 10.5% of fleshy pterygia recurred compared to none (0%) of the non-fleshy pterygia (p = 1.00). CONCLUSION: Younger age remains a risk factor for recurrence when both CAG and antimetabolites are combined in the treatment of pterygium, while the effect of gender, size and morphology of the pterygium may be diminished by such combination.

A study on bluetongue virus infection in Saudi Arabia using sentinel ruminants.

Four sentinel herds comprising cattle, sheep and goats were established at various localities in Saudi Arabia. Maternal bluetongue antibodies were detected in all four sentinel herds but disappeared in 4-6 months, immediately followed by seroconversion in all. Serological results indicated that the animals were recently exposed to BT virus serotypes 10, 12, 15 and 20. The epidemiology of the disease in Saudi Arabia is discussed.

Clinico-pathological observations on naturally occurring contagious ecthyma in lambs in Saudi Arabia.

Typical lesions of contagious ecthyma were diagnosed in lambs four months old and infection has been confirmed by viral isolation and identification. The lambs had lower total serum protein values, haemoglobin concentration, erythrocyte counts and packed cell volume, but higher blood leukocyte counts and increased serum transaminase activity when compared to apparently healthy animals. The disease is believed to be transmitted from newly introduced goats which showed evidence of infection.