Atypical presentation of mpox in Irrua environs: a case report.

BACKGROUND: Mpox, previously known as monkeypox, -is an orthopoxvirus infection of the skin and previously a public health emergency of international concern. It reemerged in Nigeria over 5 years ago and has since spread to other parts of the world. This is a case report of a confirmed patient who was managed at Irrua Specialist Teaching Hospital, Irrua, Edo State, Nigeria before the global surge. This report shows peculiar differences from previous patients managed at the same center in terms of the relatively prolonged eruptive phase, possible seasonal occurrence of mpox in the community, and some traditional care for mpox and skin rashes. It also corroborates previous reports of possible sexual transmission of mpox in Nigeria before the report from the global outbreak. CASE PRESENTATION: The patient is a 30-year-old Nigerian male artisan with a 2-month history of raised rashes on the body that started on the genitals then involved other parts of the body. There was history of sore throat and unprotected sex with a female partner with similar rash whose other sexual history could not be ascertained. There was also history of "seasonal" rash in his village for about 7 years prior to his symptoms. Examination showed multiple vesicles and some nodules (ulcerating, healing, and healed) on the face, trunk, limbs, gluteal region, scrotum, palms, and sole, an almost circumferential penile ulcer, and lymphadenopathy. Polymerase chain reaction skin samples sent for mpox returned positive, while retroviral and coronavirus disease 2019 screenings were negative. He was managed in isolation while contact tracing in the affected community was initiated. CONCLUSION: Atypical presentations of mpox, as managed in Irrua before the global surge, emphasize the varied spectrum of presentations (typical and atypical) in Nigeria. Therefore, there is a need for a higher index of suspicion for the uncommon presentations which will strengthen case recognition, case management, and community-based interventions as well as surveillance in the prevention and control of mpox in Irrua, its environs, Nigeria, and the world.

Bacteriological Profile and Antibiotic Sensitivity Patterns in Clinical Isolates from the Out-Patient Departments of a Tertiary Hospital in Nigeria.

BACKGROUND: Antimicrobial resistance (AMR) is a rising global public health threat. Knowledge of the circulating pathogens in a particular area and their antibiotic resistance profile is essential to direct clinicians on rational antibiotic prescribing. AIM: The study was conducted to determine the microbial isolates and antibiotic susceptibility profiles of pathogens from a range of clinical samples in a tertiary hospital in Edo Central Senatorial District in Edo State, Nigeria. SETTINGS AND DESIGN: The study was a retrospective analysis of microbiological isolates from clinical specimens collected between January 2016 and December 2019, using standard techniques from outpatient clinic attendees. Chi-square test was used to compare the association of the type of bacterial isolates with patients' sex and level of significance P set as < 0.05. Prevalence rates of bacterial isolates and resistance rates were calculated for each antibiotic used in the microbiological culture. RESULTS: Of the 3,247 clinical specimens processed, 994 (30.6%) showed microbial growth with 436 (43.9%) as gram-positive and 558 (56.1%) as gram-negative bacterial isolates. Escherichia coli (E. coli) made up 286 (28.8%) of all the isolates. Resistance to cotrimoxazole, tetracycline and cloxacilin for gram-poisitive pathogens was 93.1%, 86.4% and 72.5% respectively. For gram-negative pathogens, resistance to amoxycilin, cloxacilin and erythromycin was 100%, 96.9% and 95.6% respectively. Sensitivity to carbapenems, nitrofurantoin, and cefixime was high for gram-negative bacteria (100.0 %,76.8 % and 82.5 % respectively). Gram-positive bacteria exhibited high sensitivity to carbapenems ceftriaxone and cefixime. CONCLUSION: High rates of resistance to common antibiotics were observed for gram-positive and gram-negative isolates. Hospital pharmacies and treatment guidelines should be made to reflect the current patterns of resistance to available antibiotics.

Antibiotic Self-Medication among Adult Out-patient Clinic Attendees in Nigeria.

BACKGROUND AND OBJECTIVES: The study was conducted to determine the prevalence and pattern of antibiotic selfmedication and associated risk factors among out-patients clinic attendees in Edo state, Nigeria. METHODS: A cross-sectional study was conducted among 800 consenting adult attendees at the general out -patient department of five secondary and one tertiary health facilities. Data were analyzed using Statistical Package for Social Sciences. Chi-square test was used for bivariate analysis, and significant variables analyzed with multivariate logistic regression. Statistical significance p was set at < 0.05. RESULTS: Three hundred and seventy four (46.8%) of 800 respondents had self-medicated with antibiotics 6 months preceding the study with commonly used drugs as Ampicillin/Cloxacillin (31.3%) and Amoxycillin (24.8%). Respiratory tract conditions were the most common reasons for taking antibiotics, 100 (27.2%). Primary reasons for self-medication was the availability of the drug at the local drug store. Being divorced or widowered (AOR 0.302, 95% CI 0.117-0.781, p = 0.01) and age > 70 years (AOR 0.18, 95% CI 0.04-0.84, p = 0.03) were significantly negatively associated with antibiotic self-medication. CONCLUSION: The practice of self-medication with antibiotics was high among adult out-patients in the study area, and primarily due to the ease with which antibiotics can be brought across the counter. Restrictions on over-the-counter sale of antibiotics and sensitization of drug sellers is an urgently required intervention to stem the tide. Public enlightenment on dangers of self-medication especially targeting at risk groups identified by the study is also required.

Engaging Market Traders in Lassa Fever Campaign: Assessment of Knowledge and Risk Behaviour.

BACKGROUND: Markets provide a forum for reaching a large adult population with information on Lassa fever, and therefore understanding the food handling practices of traders may provide the foundation for an effective campaign against Lassa fever. This study was undertaken to provide baseline information on knowledge and food handling practices of traders in local markets in a Lassa fever endemic state of Nigeria. STUDY DESIGN: A structured questionnaire was used to obtain food handling habits that facilitate the transmission of Lassa virus from a cross sectional study involving 385 traders in three major markets in Edo state and data analyzed using SPSS version 15. RESULTS: Two hundred and ninety three (76.1%) had ever heard of Lassa fever, 27 (9.2%) had good knowledge. Good knowledge was significantly associated with higher educational status (p < 0.00) and male gender (p=0.03). Thirty seven (12.6%) respondents sun-dried their food frequently, 105 (35.8%) stored utensils in rodent proof containers, and 136 (46.4%) had the habit of eating garri soaked in water. One hundred and ninety (49.4%) respondents had food hygiene practices that were favorable for spread of Lassa fever. CONCLUSION: The observed gaps in knowledge of Lassa fever and food hygiene may be addressed through tailored health messages. In this way, market campaigns will be effective in increasing knowledge of Lassa fever, and traders can themselves become peer educators.

Knowledge of Secondary School Children in Edo State on Lassa Fever and its Implications for Prevention and Control.

BACKGROUND: Seasonal outbreaks of Lassa fever in West Africa cause significant morbidity and mortality across all ages. In addition to present efforts to raise awareness, school children can be targeted to become peer and family health educators. The study was carried out to determine the knowledge of Lassa fever among secondary school children, and household practices that increase risk of the infection. STUDY DESIGN: In a cross sectional survey, 561 secondary school students randomly selected from schools in Edo State were interviewed by means of a self - administered questionnaire that sought information on knowledge of Lassa fever and practices within the home that favour rodent contact . Data were analyzed using Statistical Package for Social Sciences version 15. RESULTS: Knowledge of Lassa fever was poor among 259 (49.4%) respondents, fair in 216 (41.2%) and good in 49 (9.4%). Female gender (< 0.01), monogamous family structure (p < 0.04) , and being in senior secondary class ( p=0.01) were predictors of high knowledge score. Self- reported Lassa fever risk conditions were found to be of low prevalence in 311(55.4%) and high in 250 (44.6%) homes, and associated with educational status of mother ( p=0.00) and father, (p =0.00). CONCLUSION: School children in endemic communities lack good knowledge of Lassa fever, but when properly guided, have the potential to become peer and family educators.

Prevalence of urinary schistosomiasis among school children in a rural community in South-South, Nigeria.

BACKGROUND: Schistosomiasis is a major health problems in tropical Africa with school age children being most affected. The study aimed to assess the prevalence of the disease among primary and secondary school children in a rural community in Edo State. STUDY DESIGN: A cross sectional study was carried out in a rural community in Etsako West local government area of Edo state. Respondents included all primary and secondary school students in the community. A structured administered questionnaire and urine microscopy were used for data collection. RESULTS AND CONCLUSION: Twenty-four percent of subjects reported passing blood in urine out of which 10.9% had ever sought medical attention for the haematuria. The overall prevalence of urinary Schistosomiasis, as confirmed by the presence of eggs of Schistosoma haematobium was 10.7% with males being almost 3 times as many as the affected females; 32 (74.4%) versus 11(25.6%). Prevalence of microhaematuria was 4.96 %, and protenuria 7.94% . There is need for an urgent mapping of communities served by the infested stream, as well as enlightenment campaigns to educate the rural populace on the disease and it's complications.

Knowledge; Attitude and Practices of Adolescent Secondary School Students in Uvwie Local Government Area of Delta State of HIV/AIDS

INTRODUCTION: Adolescents have a tendency to engage in high risk sexual and drug-use behaviour; and with a poor health-seeking behaviour; they continue to present the highest number of new cases of HIV reported in Africa.OBJECTIVE: To assess the knowledge; attitude and practise of adolescent secondary school students towards AIDS.METHOD: A cross sectional study was carried out on 358 senior secondary students selected by multistage sampling. A researcher administered semi-structured questionnaire was used for data collection.RESULTS: All had heard of AIDS; of which 40cited the media as source of information. Seventy four percent knew the cause to be a virus; 63could differentiate between AIDS and HIV; over 85knew of transmission through sex; mother to child; contaminated blood; and contaminated needles; 59cited kissing. Weight loss was the most common symptom (85) mentioned. Over 76knew AIDS to be untreatable. Over 75knew methods to prevent spread of which 23cited sex with a virgin; 61did not know anyone infected with the virus; 58felt infected persons should not be allowed to stay in the community; 61agreed to continue a relationship with an infected friend; 83agreed to care for an infected relative. Of 22who agreed they were sexually active; 66and 12had one and multiple partners respectively. Regarding protection; 30used condom always; 48sometimes and 23never. Twenty-one percent had ever had sex under influence of alcohol or marijuana. 55were willing to be tested; however none had been tested.CONCLUSION: Senior secondary school students in Uvwie have a fairly good knowledge of AIDS; and poor attitude towards people living with AIDS. Few are sexually active and are engaged in unsafe sex

Anatomical organization of primate visual cortex area VII.

The Golgi Rapid and Kopsch techniques have been used to provide material for an examination of the internal neuronal organization of cortical area VII of the Macaca monkey. The afferent and efferent relationships of area VII, as shown by axoplasmic transport tracing techniques in our own material and in previous studies in other laboratories, are reviewed. Comparison is made between the internal organisation of VI and VII cortex in terms of (1) the marked different in spiny and nonspiny neurons populations of granular layer 4, (2) the difference in relationship of lamina 6 pyramidal neurons to the overlying layers with a shift away from any relationship to granular layer 4 in VII, and (3) differences in the organization of VI lamina 4B and VII lamina 3B--both similarly placed, fiber-rich bands in the two cortical areas. The extrinsic relationships of VI and VII with the lateral geniculate nucleus, superior colliculus, pulvinar, peristriate cortex, cortical area STS, and with each other are compared in terms of laminar locations of efferent neurons and afferent axon terminal fields. It is hoped that this anatomical survey will provide a better foundation for physiological explorations of the region.

Biological effectiveness, in goldfish, of some p-substituted acetanilides alone and in the presence of poloxamers.

The death times of goldfish have been measured in aqueous solutions containing different concentrations of p-substituted acetanilides alone or in the presence of poloxamers. Plots of reciprocal death time versus concentration were linear with a positive concentration intercept, the minimum effective concentration (MEC). The MEC values were directly related to the pi value (hydrophobic-lipophilic constant) of the functional group on the acetanilide indicating that activity is directly related to lipophilicity. Slopes of reciprocal death time versus drug concentration were linearly related to pi values but there was no direct dependence. The presence of poloxamers in aqueous acetanilide solutions reduced the goldfish death time. The effect of the poloxamers is believed to be one of rendering the goldfish membrane more permeable to drugs.

Relationships between poloxamer structure and the solubilization of some para-substituted acetanilides.

Saturation solubilities of several para-substituted acetanilides have been measured at 37 degrees C in aqueous solutions of structurally related polyoxyethylene-polyoxypropylene block copolymers-poloxamers L62, L63, L64, P65 and F68. These poloxamers differ only in the amount of ethylene oxide in the hydrophil. Solubilities increased with increasing poloxamer concentration. As the oxyethylene chain length of the poloxamer increased, then the solubilizing capacity per equivalent of oxyethylene decreased. The moles of acetanilide derivative solubilized per mole of poloxamer increased with poloxamer oxyethylene content in the case of the less hydrophobic acetanilides but was invariant in the more hydrophobic ones. The solubilizing capacities have been discussed in terms of the inter-relationships between the hydrophobic nature of the solubilizate and solubilizer and the site of solubilization on the poloxamer molecule.