Metabolic syndrome and its components among HIV/AIDS patients on Antiretroviral Therapy and ART-Naïve Patients at the University of Calabar Teaching Hospital, Calabar, Nigeria

Background: Although an increasing access to ART in sub-Saharan Africa has made it possible for HIV/AIDS patients to live longer, clinicians managing such patients are faced with the challenge of drug-related metabolic complications. Methods: A cross -sectional study was carried out at the University of Calabar Teaching Hospital, Nigeria, on three groups of participants; namely HIV patients on ART, ART-naïve patients and HIV negative subjects (n =75). Demographic and anthropometric data were collected using a well-structured questionnaire while biochemical parameters were measured using colorimetric methods. Results: The highest prevalence of MS was associated with the HIV/AIDS patients on ART (i.e. 32.0 %, and 50.3% for NCEP-ATP III and IDF criteria respectively). Patients on ART had significant increases (p< 0.05) in waist to hip ratio, FPG, serum TG and LDL-c; and a significantly higher (p< 0.05) prevalence of hypertension, diabetes, low HDL-c and hypertriglyceridemia compared to the ART-naïve patients. Low serum HDL-c was the most prevalent form of dyslipidemia in all three groups and the most prevalent component of MS in HIV patients. Conclusion: ART increases the risk of MS and CVD. HIV/AIDS patients on ART should be advised on lifestyle modifications and undertake regular assessment of their cardiovascular risk factors

Socio-demographic characteristics of HIV patients diagnosed at immunization centres in Calabar, South -south, Calabar, Nigeria

Introduction: The World Health Organization (WHO) estimated that 3.2 million children were living with Human Immunodeficiency Virus (HIV) at the end of 2013, mostly in sub- Saharan Africa. Socio- economic and demographic factors do not only affect viral transmission but also the success of preventive strategies and treatment.Objective: To determine the socio -demographic characteristics of mothers, and the relationship between maternal and HIV status of their infants attending immunization clinics in Calabar.Methods: Using multistage sampling method, 330 subjects were enrolled and screened from 63 immunization centres. The sociodemographic characteristic of each infant's mother was documented. The results of Rapid test for mothers and Dried Blood Spots (DBS) results for infants were compared. Results: Of the 330 subjects recruited, 173 (52.4%) were males while 157(47.6%) were females. Mean age of the infants was 9.20 ± 3.1 weeks. Twenty four mothers and infants tested positive for HIV antibodies. After confirmatory tests using HIV Deoxyribosenucleic acid (DNA PCR), 14(58.3%) out of 24 antibody seropositive infants were infected. The transmission rate after confirmation was 58.3%. Conclusion: Parental education, social class and low maternal Antiretroviral drug (ARV) use were responsible for transmission. It is therefore recommended that health education on ARV use during antenatal period and HIV status of mother baby pair be done at immunization centres. HIV positive mothers and babies should be promptly referred for therapy

Utilization of banked blood in pediatric surgical procedures in Calabar, Nigeria

Background: Performing major surgery in a child demands that blood is cross-matched and saved to be transfused as indicated. Because the cost of cross-matching and donation of blood can be enormous and may equal or surpass the cost of surgery in our setting; it is pertinent to evaluate its utilization. The aim of this study was to determine how banked blood meant for pediatric surgical procedures was utilized with the hope of streamlining our blood requisition policy. This may be useful to pediatric and other surgeons involved in the operative care of children in similar settings. Materials and Methods: This was a prospective study of all children who had ELECTIVE or EMERGENCY surgical procedures between January 2009 and June 2010. The age; sex; nature of surgery; blood loss; banked units of blood and amount transfused were collected and analyzed. Results: Eighty two patients had 81 units of blood banked for them. Forty - eight and half units (59.9) of the banked blood were for the emergency group but only 18 units (22.2) were actually transfused at the end (P = 0.044) leading to inadequate use of the product. Conclusion: Banking large quantities of blood but utilizing only little is tantamount to inadequate use and delays surgical intervention. Indirectly; it increases cost of surgery. There is need to rationalize our blood ordering habits without causing harm to patients

Influence of Gender and Age on Psychosocial Adjustment of People Living with HIV/AIDS in Calabar; Nigeria

Purpose: Health and adjustment to chronic health conditions are often affected by various sociodemographic variables. This study assessed the influence of gender and age on the psychological; social and spiritual adjustment of people living with HIV/AIDS in Calabar; Cross River State; Nigeria. Materials and methods: A comparative descriptive research design was adopted to study 280subjects selected from two health facilities within the study area. A validated adjustment questionnaire was the instrument for data collection while stratified random sampling involving balloting with replacement was used for sample selection. Results: Results showed a significant influence of gender on the respondents' psychological; social and spiritual adjustment (Cal.t=7.89; 4.05; 3.78 Crit.t=1.96). The males adjusted better than the females. Similarly; age of respondents exerted significant influence on psychological adjustment (Cal.F=5.54 Crit.F.=2.37) but not on social and spiritual adjustment (Cal.F=1.67; 0.56 Crit.F

Malaria: knowledge and prevention practices among school adolescents in a coastal community in Calabar, Nigeria

Background: Malaria prevention and treatment constitute an unbearable economic burden to most African countries, especially south of the Sahara, where about 500 million cases occur annually. The problem of malaria among adolescents has largely been overshadowed by the huge burden of the disease among young children. Attention to malaria among adolescents has also been diverted by the huge burden of HIV/AIDS among adolescents. Some surveys reveal a lack of knowledge and many misconceptions about the transmission and treatment of malaria, which could adversely affect malaria control measures and antimalarial therapy. Such a knowledge gap could have an adverse effect on school children, who could be used as change agents and as role models for their siblings and peers in the malaria control strategy. Objectives: To determine the malaria prevention practices of school adolescents in the coastal community of Calabar, Nigeria. Method: This was a cross-sectional survey involving secondary schools in southern Calabar. Four hundred adolescents were randomly selected from the 4565 learners in 5 out of 17 secondary schools in southern Calabar, Cross River State, Nigeria. A self-administered, semi-structured questionnaire was administered to the respondents. Results: Most respondents (77.5%) were aware that the vector transmits the malaria parasite through biting. Fewer respondents would prevent malaria attacks by clearing the vegetation in the peri-domestic environment (13.5%), filling up potholes (16.9%), opening up drainage (11%), using insecticide-treated nets (25.7%) or using antimalarial drugs (11.2%). Less than one-tenth (8%) would use various other methods such as not accepting unscreened blood, while only 11% obtained the information from their teachers. Conclusion: The study identified knowledge gaps among school children. There is a need to empower teachers with information about the cause of malaria and prevention strategies

Footcare practices among Nigerian diabetic patients presenting with foot gangrene

Diabetic foot ulceration and gangrene is a major cause of morbidity andmortality. This study has examined potential preventive footcare practices in a cohort of diabetic patients presenting with foot gangrene. One hundred and two (102) diabetic emergencies presented during the study period. Diabetic foot gangrene accounted for 27 (26%) of these cases. There were 18 males and 9 females (M:F = 2:1), with a mean age of 52+13 years. The mean duration of ulceration was 4±3 weeks and mean ulcer­gangrene interval was 1.2±0.5 weeks. Only 9 patients (33%) had been exposed to any form of footcare education, 15 patients (55%) treated their ulcers by unorthodox means, and 63% of the patients practiced no significant footcare. More widespread education and awareness is needed to prevent the continuing and serious problem of diabetic foot gangrene and consequent lower limb amputation

Biologically active components of Physostigma venenosum.

Physostigmine is a major alkaloid found in the seeds of the fabaceous plant Physostigma venenosum. It is a powerful and reversible acetylcholine esterase inhibitor which effectively increases the concentration of acetylcholine at the sites of cholinergic transmission. It exerts its cholinesterase inhibitor effect in both the periphery and central nervous system. Many studies on physostigmine have involved the reliance on techniques that extract and quantify physostigmine in biological samples. This paper presents an overview of the currently applied methodologies for the determination of physostigmine and its metabolites in various biological samples. Papers published from January 1980 to December 2003 were taken into consideration for the discussion of the metabolism and analytical method of physostigmine. HPLC methods have been discussed and used in most of the references cited in this review. A few CE and RIA methods that have been recently reported are also mentioned in this paper. Basic information about the sample assayed, sample preparation, chromatographic column, mobile phase, detection mode and validation data are summarized in a table.

Efficient formal total synthesis of physostigmine and physovenine: conformational analysis of key intermediates.

An efficient route for the formal total synthesis of physostigmine (1) and physovenine (2), alkaloids from 5-methoxyindole-3-acetonitrile, through a Grignard reagent 1,4-addition, is described. 2-Hydroxyindolenine 5, the key advanced intermediate for the synthetic targets, was converted either to esermethole (12) via a high-yielding (28%) seven-step sequence or to the C-ring oxygenated analogue 15 in a five-step sequence and 23% overall yield. (1)H NMR and molecular modeling analyses of esermethole (12) and the furoindolines 13 and 15 were used to deconvolute weighted time-average vicinal coupling constants to provide definite solution-state conformational preferences in CD(2)Cl(2) solvent.

De Phosphoricum acidum a Phytollaca / From Phosphoricum acidum to Phytollaca

La plupart des donnees que contient cette matiere medicale homeopathique sont inedites. Elles ont ete deduites ou calculees a partir des provings originaux de l'Encyclopedie de Matiere medicale pure, du... (AU)