Structural studies of substrate and product complexes of 5-aminolaevulinic acid dehydratase from humans, Escherichia coli and the hyperthermophile Pyrobaculum calidifontis.

A number of X-ray analyses of an enzyme involved in a key early stage of tetrapyrrole biosynthesis are reported. Two structures of human 5-aminolaevulinate dehydratase (ALAD), native and recombinant, have been determined at 2.8 Šresolution, showing that the enzyme adopts an octameric quaternary structure in accord with previously published analyses of the enzyme from a range of other species. However, this is in contrast to the finding that a disease-related F12L mutant of the human enzyme uniquely forms hexamers [Breinig et al. (2003), Nature Struct. Biol. 10, 757-763]. Monomers of all ALADs adopt the TIM-barrel fold; the subunit conformation that assembles into the octamer includes the N-terminal tail of one monomer curled around the (α/ß)8 barrel of a neighbouring monomer. Both crystal forms of the human enzyme possess two monomers per asymmetric unit, termed A and B. In the native enzyme there are a number of distinct structural differences between the A and B monomers, with the latter exhibiting greater disorder in a number of loop regions and in the active site. In contrast, the second monomer of the recombinant enzyme appears to be better defined and the active site of both monomers clearly possesses a zinc ion which is bound by three conserved cysteine residues. In native human ALAD, the A monomer also has a ligand resembling the substrate ALA which is covalently bound by a Schiff base to one of the active-site lysines (Lys252) and is held in place by an ordered active-site loop. In contrast, these features of the active-site structure are disordered or absent in the B subunit of the native human enzyme. The octameric structure of the zinc-dependent ALAD from the hyperthermophile Pyrobaculum calidifontis is also reported at a somewhat lower resolution of 3.5 Å. Finally, the details are presented of a high-resolution structure of the Escherichia coli ALAD enzyme co-crystallized with a noncovalently bound moiety of the product, porphobilinogen (PBG). This structure reveals that the pyrrole side-chain amino group is datively bound to the active-site zinc ion and that the PBG carboxylates interact with the enzyme via hydrogen bonds and salt bridges with invariant residues. A number of hydrogen-bond interactions that were previously observed in the structure of yeast ALAD with a cyclic intermediate resembling the product PBG appear to be weaker in the new structure, suggesting that these interactions are only optimal in the transition state.

Extension of resolution and oligomerization-state studies of 2,4'-dihydroxyacetophenone dioxygenase from Alcaligenes sp. 4HAP.

The enzyme 2,4'-dihydroxyacetophenone dioxygenase (DAD) catalyses the conversion of 2,4'-dihydroxyacetophenone to 4-hydroxybenzoic acid and formic acid. This enzyme is a very unusual dioxygenase in that it cleaves a C-C bond in a substituent of the aromatic ring rather than within the ring itself. Whilst it has been shown that DAD is a tetramer in solution, the recently solved crystal structure of the Alcaligenes sp. 4HAP enzyme was in fact dimeric rather than tetrameric. Since the use of limited chymotrypsinolysis, which apparently results in removal of the first 20 or so N-terminal residues of DAD, was necessary for crystallization of the protein, it was investigated whether this was responsible for the change in its oligomerization state. Gel-filtration and analytical ultracentrifugation studies were conducted, which confirmed that chymotrypsinolysed DAD has an apparent molecular weight of around 40 kDa, corresponding to a dimer. In contrast, the native enzyme has a molecular weight in the 70-80 kDa region, as expected for the tetramer. The structural basis for tetramerization has been investigated by the use of several docking servers, and the results are remarkably consistent with the tetrameric structure of a homologous cupin protein from Ralstonia eutropha (PDB entry 3ebr).

Characterization of Clostridium Species from Food Commodities and Faecal Specimens in Lagos State, Nigeria.

BACKGROUND: Food-borne pathogens are a major public health challenge worldwide. These organisms' cause illnesses leading to time loss in the work place and reduced productivity.Clostridium species cause infections through the production of powerful toxins which are responsible for diarrhoea and cramping. Diarrhoeal diseases due to Clostridia are one of the commonest worldwide but have hardly been reported in Nigeria. OBJECTIVE: This study characterized Clostridium species from food commodities and human faeces in Lagos State MATERIALS AND METHODS: Four hundred and twenty samples comprising food (220) and faecal (200) specimens in Lagos state were included in this study. Isolates obtained were identified using API 20-A and confirmed by Polymerase Chain Reaction assay and 16S rRNA sequencing. The food samples included meat and meat products, ready to drink traditionally prepared milk products, fresh vegetables, canned foods and local honey. RESULTS: Seventy (16.7%) Clostridium species were identified, 50 from food and 20 from faeces. Majority of the isolates were obtained from vegetables (56%) and meat products (34%). Of the 70 Clostridial species, 38 (54.3%) were C. perfringens, 5 (7.1%) were C. difficile and 2 (2.9%) were C. botulinum. All 38 (100%) strains of C. perfringens possessed alpha (cpa) toxin gene. CONCLUSION: Clostridium species are present in our environment and contaminate food products posing potential risks to consumers. There is therefore a need for these traditionally made street vended foods to be monitored because they are potential sources of food borne pathogens.

Burnout among doctors in residency training in a tertiary hospital.

The mental health of doctors is an issue of growing concern all over the world as it frequently interplays with their professional trainings and responsibilities. This study was done to determine the pattern and correlates of burnout among 204 doctors undergoing residency training. Eligible participants were interviewed using designed questionnaire, General Health Questionnaire (GHQ-12) and Maslach Burnout Inventory (MBI). The mean age of participants was 33.44±4.50. Ninety-three (45.6%) respondents reported burnout in the dimension of emotional exhaustion (EE), 118 (57.8%) in the dimension of depersonalization (D), and 126 (61.8%) in the dimension of reduced personal accomplishment (RPA). Factors that were significantly associated with all the dimensions of burnout were perceived heavy workload and presence of emotional distress (based on GHQ score of ≥3). The perception of call duty as being not stressful was negatively predictive of burnout in the emotional exhaustion subscale (odds ratio [OR]=0.52; 95%confidence interval [CI]=0.29-0.97; p=0.03), while emotional distress was a positive predictor (OR=6.97; 95%CI=3.28-14.81; p<0.001]. Absence of doctor-to-doctor conflict negatively predicted burnout in the depersonalization subscale (OR=0.36; 95%CI=0.17-0.76); p<0.01), while older age (OR=0.66; 95%CI=0.47-0.95; p=0.03) and adequate support from the management (OR=0.45; 95%CI=0.22-0.90; p=0.02) constituted negative predictors of burnout in the reduced personal accomplishment subscale. Burnout is highly prevalent among resident doctors. Evolvement of comprehensive mental health services, training supports, conflict de-escalation/resolution mechanisms, and periodic assessment are indicated to mitigate work related distress with burn out among resident doctors, while improving their productivity.

Structural evidence for the partially oxidized dipyrromethene and dipyrromethanone forms of the cofactor of porphobilinogen deaminase: structures of the Bacillus megaterium enzyme at near-atomic resolution.

The enzyme porphobilinogen deaminase (PBGD; hydroxymethylbilane synthase; EC 2.5.1.61) catalyses an early step of the tetrapyrrole-biosynthesis pathway in which four molecules of the monopyrrole porphobilinogen are condensed to form a linear tetrapyrrole. The enzyme possesses a dipyrromethane cofactor, which is covalently linked by a thioether bridge to an invariant cysteine residue (Cys241 in the Bacillus megaterium enzyme). The cofactor is extended during the reaction by the sequential addition of the four substrate molecules, which are released as a linear tetrapyrrole product. Expression in Escherichia coli of a His-tagged form of B. megaterium PBGD has permitted the X-ray analysis of the enzyme from this species at high resolution, showing that the cofactor becomes progressively oxidized to the dipyrromethene and dipyrromethanone forms. In previously solved PBGD structures, the oxidized cofactor is in the dipyromethenone form, in which both pyrrole rings are approximately coplanar. In contrast, the oxidized cofactor in the B. megaterium enzyme appears to be in the dipyrromethanone form, in which the C atom at the bridging α-position of the outer pyrrole ring is very clearly in a tetrahedral configuration. It is suggested that the pink colour of the freshly purified protein is owing to the presence of the dipyrromethene form of the cofactor which, in the structure reported here, adopts the same conformation as the fully reduced dipyrromethane form.

Dengue virus serotype-2 impairs proliferation of healthy donors' T lymphocytes.

OBJECTIVES: T lymphocytes are not infected by dengue virus (DENV), nevertheless it is possible that exposure to DENV may affect their function. T lymphocytes from DENV-infected individuals are impaired in their proliferative capacity, although this effect has been attributed to altered function of antigen-presenting cells rather than to an intrinsic defect on T lymphocytes. Here we analyzed whether T lymphocytes from healthy donors became impaired in their proliferative capacity following in vitro exposure to DENV serotype-2 (DENV-2), as well as the possible mechanisms for this. METHODS: Isolated CD4+ and CD8+ T lymphocytes from healthy donors were in vitro exposed to DENV-2, before polyclonal activation, cell proliferation, IL-2 synthesis. IL-2Rα expression, nuclear translocation of NF-AT and NF-κB, and intracellular calcium flux were assessed. RESULTS: In vitro exposure of both CD4+ and CD8+ T lymphocytes from healthy donors to DENV-2 impairs cell proliferation, IL-2 synthesis, and IL-2Rα (CD25) cell membrane expression. Signalling wise, exposure to DENV-2 impairs the nuclear translocation of NF-AT, downstream of intracellular calcium mobilization, as well as that of NF-κB. CONCLUSION: In the course of a dengue infection, direct exposure of T lymphocytes to DENV could affect cell-mediated immune responses.

Arcobacter, an emerging opportunistic food borne pathogen--A review.

BACKGROUND: Arcobacters, emerging aetiologic agents of food-borne diarrhoeal illness in humans and animals are more frequently isolated in meat, especially poultry meat, pork and beef. Though human infection may exist, it has not been documented in Nigeria. AIM: This review presents an update of scientific information in Nigeria on arcobacters as an emerging food-borne pathogen of public health significance in Nigeria. METHODS: A comprehensive reviews of literatures was adopted to give an update on scientific findings on the disease in Nigeria. RESULTS AND CONCLUSIONS: The review revealed scientific evidences attributing the cause of human and animal illness to Arcobacter spp. It also highlights efforts towards the development of animal models where in virulence and pathogenicity of primarily A. butzleri and A. cryaerophilus isolated from human diarrhoeal stool samples were tested. This in turn elucidated the public health significance of this emerging food-borne pathogen. The review canvases for more investigation as to the role of arcobacters in food contamination and unrecognised food-borne disease in Nigeria.

Are we discussing SUDEP?--A retrospective case note analysis.

PURPOSE: Sudden unexplained death in epilepsy (SUDEP) is uncommon. Discussing the risk of SUDEP can be difficult, particularly in those where the risk is considered low, and previous studies have suggested that clinical practice varies widely. The Scottish Intercollegiate Guidelines Network (SIGN) suggest information on SUDEP is "essential" and National Institute of Clinical Excellence (NICE) recommend that "tailored information on the person's relative risk of SUDEP should be part of the counselling process…". The study aimed to evaluate if discussion of SUDEP risk is being documented in clinical records and to determine if there is an association between documented discussion and risk factors for SUDEP. METHODS: A retrospective case note review was undertaken in those with an established diagnosis of epilepsy attending clinic between 1st January 2009 and 30th June 2009. RESULTS: Overall, a documented SUDEP discussion was noted in 14/345 (4%) cases. Patients were statistically more likely to have a documented SUDEP discussion if they had ongoing generalised tonic-clonic seizures, with a trend also towards informing those non-compliant with medication. CONCLUSION: Patients were more likely to be informed of SUDEP if they had potentially modifiable risk factors identified. There was, however, no documented evidence to suggest that SUDEP is being discussed in the majority of cases.

An analysis of subdomain orientation, conformational change and disorder in relation to crystal packing of aspartic proteinases.

The analysis reported here describes detailed structural studies of endothiapepsin (the aspartic proteinase from Endothia parasitica), with and without bound inhibitors, and human pepsin 3b. Comparison of multiple crystal structures of members of the aspartic proteinase family has revealed small but significant differences in domain orientation in different crystal forms. In this paper, it is shown that these differences in domain orientation do not necessarily correlate with the presence or absence of bound inhibitors, but appear to stem at least partly from crystal contacts mediated by sulfate ions. However, since the same inherent flexibility of the structure is observed for other enzymes in this family such as human pepsin, the native structure of which is also reported here, the observed domain movements may well have implications for the mechanism of catalysis.

Silencing of the polyamine catabolic key enzyme SSAT prevents CDK inhibitor-induced apoptosis in Caco-2 colon cancer cells.

Roscovitine and purvalanol are purine derivative cyclin-dependent kinase (CDK) inhibitors that induce apoptosis in various types of cancer cells. However, their impact on the apoptotic cell death mechanism requires further elucidation. Natural polyamines putrescine, spermidine and spermine play essential roles in the regulation of cell growth and proliferation. Increased levels of polyamines in cells are considered to be involved in cancer progression. Intracellular polyamine levels are under the control of several catabolic enzymes, such as spermidine/spermine-N-acetyl transferase (SSAT), acetylpolyamine oxidase (APAO) and spermine oxidase (SMO), which could be altered by several therapeutic drugs. However, the possible role of polyamines in drug-induced apoptosis has yet to be clarified. In the present study, our aim was to determine the modulation of the polyamine catabolic pathway related to CDK inhibitor-induced apoptosis in Caco-2 cells. We found that roscovitine and purvalanol (each 20 µM) induced apoptosis by activating caspase-9 and -3, and inhibiting the mitochondrial membrane potential in Caco-2 cells. CDK inhibitors decreased the intracellular putrescine and spermine levels without affecting spermidine levels. Although both roscovitine and purvalanol induced SSAT expression, they did not exert a significant effect on the APAO expression profile. SSAT transient silencing prevented roscovitine-induced apoptosis compared to parental cells. Thus, we concluded that roscovitine and purvalanol significantly induce apoptosis in Caco-2 cells by modulating the polyamine catabolism, and that SSAT could be an important target in evaluating the potential role of polyamines in apoptotic cell death.

Lack of association between IL-6 gene polymorphisms and rheumatoid arthritis in Turkish population.

Inflammatory cytokines play an important role in the pathogenesis of rheumatoid arthritis (RA). One of candidate genes is interleukin-6 (IL-6), and single-nucleotide polymorphisms in the promoter region of IL-6 were found to be associated with RA. The aim of this study was to determine the association between IL-6 promoter polymorphisms (-174, -572, -597) and RA in Turkish population. A total of 425 subjects were recruited into the study (247 healthy controls and 178 RA). The promoter region of IL-6 gene was amplified by PCR using DNAs from patients and the controls, and their PCR products were digested by suitable enzymes. No significant association was found between RA and -174 genotype distribution (P = 0.535) and allele frequency (P = 0.230). There was also no relationship between -572 (P = 0.150) and -597 (P = 0.912) gene polymorphism and RA. Our results suggested that IL-6 gene promoter polymorphisms have no association with RA in Turkish population.

Serum biochemistry and heamatological changes associated with graded doses of experimental Arcobacter infection in rats.

UNLABELLED: BACKGROUND; Arcobacters have unusually wide range of habitats, and some species can be human and animal pathogens OBJECTIVE: This study was designed to assess the haematological and biochemical changes associated with experimental Arcobacter infection in adult albino rat. METHODS: The pathogenicity of Arcobacterbutzleri and A.cryerophilus, isolated from the caecal content of healthy chicken and confirmed by multiplex PCR was tested in albino rats (Rattusnovegicus). Seventy-five healthy adult male rats, subdivided into 5 rats per group, challenged orally with a single dose of 10⁻³ - 10⁻9 cfu/ml of bacterial strains and another group of five uninfected rats served as control. RESULTS: Experimental infection resulted in diarrhoea,electrolyte imbalance and alteration of heamatological values. The packed cell volume (PCV), platelets, neutrophils and lymphocytes of the experimentally infected albino rats were significantly higher than those of the control group. CONCLUSION: This study showed that Arcobacter could be a potential pathogen in albino rats while the selected haematological and electrolyte parameters may be good diagnostic indicators of the animal response to the bacterial infections.

Isolation and molecular identification of Fusobacterium nucleatum from Nigerian patients with oro-facial infections.

BACKGROUND: Fusobacterium nucleatum is one of the most common anaerobic bacteria present in the oral cavity and is often isolated from infections involving other body sites. OBJECTIVE: To characterise F. nucleatum strains from patients attending a teaching hospital in Nigeria in order to provide information on the methods for accurate identification of anaerobes in clinical specimen. METHODS: Fusobacterium nucleatum specie from 50 patients presenting with oro-facial infections were studied by culture on Fusobacterium selective agar and fastidious anaerobe agar. The isolates were characterised based on colonial morphology, microscopy, lipase production, susceptibility to kanamycin and colistin and resistance to vancomycin. Biochemical tests were performed using a commercial test kit. The identity of the isolates was confirmed based on molecular characterization performed using polymerase chain reaction (PCR) analysis. RESULTS: Forty-eight (96%) F. nucleatum isolates were obtained from the 50 patients by culture and all the isolates were identified by colonial appearance and microscopy based on their unique spindle shape with tapered ends. Only 26 (54.2%) of the 48 isolates were identified by commercial API 20A test kit while PCR confirmed the identity of all the isolates. CONCLUSION: Anaerobes are involved in human infections and their study is quite cumbersome due to tedious nature and high cost of the techniques involved. Cultural method is reliable in the isolation and identification of F. nucleatum species. PCR is a rapid and simple method that can complement the phenotypic identification of anaerobes and would assist in their full identification.

Delayed diagnosis of intersex state: surgical outcome of cases seen and review of current concepts.

BACKGROUND: Sexual ambiguity is said to occur when the gender of the baby cannot be determined at birth. The gender of an individual is in question because the genitals do not appear clearly as that of male or female. It is traumatizing to the family. It also causes confusion and problems in determining the sex, in which a child would be reared. The abnormality is relatively uncommon. Disorders of sexual differentiation can arise from abnormalities in chromosomes, gonadal development or hormonal production or activity. The orderly development process may also be affected by various environmental factors. Some of these factors may ultimately lead to the development of ambiguous external genitalia. CASE PRESENTATIONS AND MANAGEMENT: Three of such patients with ambiguous genitalia are presented, in which the initial diagnosis proved to be incorrect. The various investigations that were carried out and surgical management are discussed. CONCLUSION: Arguments which led to the ultimate choice of the sex of a child ranged from strict medical, to psychosocial and even cultural considerations. Expert examination shortly after birth would allow an early and definite decision, avoiding more serious problems with sexual ambiguity in later life.

Prevalence of multiple drug resistance and screening of enterotoxin (stn) gene in Salmonella enterica serovars from water sources in Lagos, Nigeria.

OBJECTIVE: To determine the prevalence, antibiotic resistance and carriage of enterotoxin (stn) gene among strains of Salmonella isolated from water sources in Lagos. STUDY DESIGN: A total of 200 samples (60 well water, 60 pipe-borne water and 80 different brands of sachet water) were collected at random from various locations in Lagos. METHODS: The samples were evaluated bacteriologically using standard methods. The identified isolates were subjected to antimicrobial susceptibility tests and were further screened for the presence of stn gene using standard procedures. RESULTS: Thirty-seven of the samples analysed were positive for Salmonella isolates. Seven serotypes were found -Salmonella typhi (n = 3, 8.1%), Salmonella typhimurium (n = 8, 21.6%), Salmonella choleraesuis (n = 5, 13.5%), Salmonella enteritidis (n = 9, 24.3%), Salmonella paratyphi (n = 8, 21.6%) and Salmonella arizonae (n = 4, 10.8%) - with at least one serotype present in all water sources. Over 60% of Salmonella isolates carried stn gene and the risk was higher in pipe-borne water. There was no relationship (P > 0.05) between enterotoxin-producing gene and antibiotic resistance in Salmonella isolates. Thirteen resistance patterns were exhibited by the isolates, with Str. Amp.Tet.Chl.Amo.Gen, Str. Amp.Tet.Amo.Chl.Amo.Nal.Nit, Str.Tet and Str. Amp.Tet.Chl.Amo being the most notable resistance patterns observed. Isolates that carried stn gene developed resistance to more antibiotics. Although reduced susceptibility to ciproflocacin was observed in two strains, none of the isolates developed resistance to ofloxacin. CONCLUSION: Emerging multidrug-resistant Salmonella serotypes with stn gene were found in the water samples, which may pose a threat to public health. Constant monitoring of pipe leakages, the quality of various wells and the quality of sachet water is advocated to avoid possible future outbreaks of salmonellosis due to consumption of contaminated water.

Raman micro-spectroscopic analysis of cultured HCT116 colon cancer cells in the presence of roscovitine.

Raman micro-spectroscopic analysis of cultured HCT116 colon cancer cells in the presence of roscovitine, [seliciclib, 2-(1-ethyl-2-hydroxy-ethylamino)-6-benzylamino-9-isopropylpurine], a promising drug candidate in cancer therapy, has been performed for the first time. The aim of this study was to investigate modulations in colon cancer cells induced by roscovitine. Raman spectra of the cultured HCT116 colon cancer cells treated with roscovitine at different concentrations (0, 5, 10, 25 and 50 µM) were recorded in the range 400-1850 cm(-1). It was shown that the second derivative profile of the experimental spectrum gives valuable information about the wavenumbers and band widths of the vibrational modes of cell components, and it eliminates the appearance of false peaks arising from incorrect baseline corrections. In samples containing roscovitine, significant spectral changes were observed in the intensities of characteristic protein and DNA bands, which indicate roscovitine-induced apoptosis. Roscovitine-induced apoptosis was also assessed by flow cytometry analysis, and analysis of propidium iodide staining. We observed some modifications in amide I and III bands, which arise from alterations in the secondary structure of cell proteins caused by the presence of roscovitine.

Detection of Arcobacter in feces of healthy chickens in Osogbo, Nigeria.

Isolation of arcobacters in foods, with the highest prevalence reported in poultry, has underscored its importance as a potential food safety problem in recent years. To estimate its prevalence in live birds, fresh stool samples from healthy chickens were screened by enrichment and plating on Arcobacter selective medium containing cefoperazone, amphotericin B, and teicoplanin. Of 150 fecal samples, only 2 (1.3%) yielded Arcobacter. Species were identified with fluorescence resonance energy transfer PCR. Isolate no. 21 from a local flock shared 99% identity with the complete genome of A. butzleri RM4018 (CP000361.1). Isolate no. 4 from a layer hen shared 100% identity with a partial 16S rRNA gene sequence of A. cryaerophilus (EF064151.1). The low prevalence of Arcobacter in the fecal samples of healthy chickens concurs with earlier studies suggesting that Arcobacter appears to be a transient colonizer of poultry intestines and therefore might not be the major source of chicken carcass contamination.

Lack of association between IL-1 and IL-6 gene polymorphisms and myocardial infarction in Turkish population.

Inflammation and genetics play a key role in the pathogenesis of atherosclerosis and its clinical result myocardial infarction (MI). Proinflammatory cytokines, IL-1 and IL-6, have been shown to play essential roles in developmental stages of coronary artery plaque formation. The aim of this study was to determine the association between IL-1 [IL-1RN, IL-1ß (-511, +3953)], IL-6 [-174, -572, -597] gene polymorphisms and MI in Turkish population. A total of 402 people were participated; 235 healthy control subjects and 167 MI patients (MI<40, n: 72; MI>40, n: 95). Polymerase chain reaction (PCR) was used to determine the genotype of IL-1RN, whereas the genotypes of IL-1ß (-511, +3953) and IL-6 (-174, -572, -597) were determined using PCR followed with restriction digestion analysis. There was no significant difference between MI and controls for IL-1RN, IL-1ß-511, +3953 (P: 0.875, 0.608, 0.442) and IL-6 -174, -572, -597 (P: 0.977, 0.632, 0.584) gene polymorphisms. Lack of association was observed between MI at younger age (MI<40) and either IL-1RN VNTR, IL-1ß-511, +3953 (P: 0.878, 0.732, 0.978) or IL-6 -174, -572, -597 (P: 0.313, 0.654, 0.552) gene polymorphisms. This study demonstrated that there was not any association between IL-1, IL-6 gene variants and MI in Turkish population. In addition, IL-1 and IL-6 gene polymorphisms did not affect MI at younger age (MI<40) or older age (MI>40). Thus, IL-1 and IL-6 single nucleotide polymorphisms may not be a risk factor for susceptibility to MI in Turkish population.

A study on job satisfaction among clinical and non-clinical hospital staff in a teaching hospital in Lagos, Nigeria.

OBJECTIVES: Previous studies had demonstrated that continuous and effective productivity of hospital staff are linked to job satisfaction and only those who are satisfied with their job can be maximally effective and productive. This cross-sectional descriptive survey was designed to determine the levels of job satisfaction among various groups of health care professionals working in a teaching hospital in Lagos, Nigeria. METHODS: Two hundred clinical and non-clinical hospital staff were invited to take part in the study. They completed a sociodemographic questionnaire and the Job Descriptive Index (JDI). RESULTS: The results indicated that majority clinical and non-clinical staff were satisfied with their jobs as regards the parameters of the JDI compared with those not satisfied with their jobs. CONCLUSION: The government and health policy makers should continue to pay attention to boost job morale and satisfaction of medical health workers to continue to make them to be satisfied with their job.

Does the tumor localization in advanced pancreatic cancer have an influence on the management of symptoms and pain?

PURPOSE: The symptoms and survival of patients with advanced pancreatic cancer show great variability according to tumor localization. The main purpose of this study was to see for any differences between the intensity of symptoms, mainly pain, and the need for analgesic treatment in advanced pancreatic cancer patients with different (head vs. body-tail) tumor localizations. METHODS: Ninety-six patients with histologically confirmed pancreatic cancer were enrolled in the study. The patients were divided into 2 subgroups according to tumor localization: group 1 (n=50) with head tumors and group 2 (n=46) with body and tail tumors. The demographic features of the patients as well as disease stages, onset of symptoms and necessity and consumption of analgesics were recorded. Patients were followed-up until death, and survival data was also analysed. RESULTS: At the time of diagnosis, patients with body and tail tumors had more advanced disease stages compared to head tumors (p=0.006). While jaundice was the most common initial symptom in head tumors (p<0.0001), it was pain in body and tail tumors (p<0.001). Patients with body and tail tumors had more analgesics consumption as compared to those with head tumors (p=0.009). No statistically significant difference in survival was detected between the 2 groups (p>0.05). CONCLUSION: We believe that pancreatic cancer should be accepted as two diverse disease types according to tumor localization, and pain and symptom management should be organized based on this fact.