Prevalence of Soil-transmitted Helminths in Primary School Playgrounds in Edo State, Southern Nigeria.

Schoolchildren in primary schools are mostly at risk of acquiring soil-transmitted helminths (STHs) infections due to their habits (geophagy, onychophagy and playing with barefoot). Profiling soil parasites on school playgrounds is expected to provide an insight to an array of parasites schoolchildren are constantly at risk of acquiring; and this information could guide on intervention programmes. Soil samples from sixteen primary school playgrounds in Edo State (South-South, Nigeria) were collected over a six-month period both in the dry (January, February and March) and wet (May, June and July) seasons in 2018 and early 2019. Samples were processed and analysed following standard parasitological procedures. Of the 576 soil samples collected, 318(55.2 %) were positive with one or more soil parasites. Generally, the predominant parasites recovered from the total number of soil samples collected were: Ascaris 127(22 %), Strongyloides 111(19.27 %) and hookworm 50(8.68 %). Ascaris was most preponderant in the dry season, while Strongyloides was the most occurring in the wet season. The mean differences in the parasite load for Ascaris and hookworm between dry and wet seasons were not significant; while for Strongyloides it was higher in the wet than dry season. These results could be a consequence of observed poor state of toilet/sanitary facilities as well as the lack or poor state of basic infrastructure like proper drainage and waste disposal systems in the host communities. There is therefore urgent need to interrupt the STHs transmission cycles in the environment and possibly in schoolchildren by instituting sustainable intervention programmes within schools located in STHs endemic regions like southern Nigeria.

A report of heat stroke in two Nigerian siblings.

Infants and children are at higher risk of heat stroke for several reasons. We report these cases to highlight the danger of leaving children unsupervised in vehicles, aid prompt diagnosis, and management of heat stroke. Two Nigerian siblings aged ranges 5 and 3 years old, were trapped inside an unlocked vehicle and subsequently developed heat stroke. Both children presented with hyperthermia, severe dehydration, convulsions, and loss of consciousness. One of them also had hematuria. They were treated by spraying water onto their bodies to bring down the temperature, intravenous fluid resuscitation, oxygen therapy, and anticonvulsants. Both eventually recovered and were discharged with no obvious neurologic sequalae, but are being followed-up.

Exploring the inhibitory potential of phytochemicals from Vernonia glaberrima leaves against snake venom toxins through computational simulation and experimental validation.

Phospholipase A2 (PLA2) is an enzyme present in appreciable quantity in snake venoms which catalyze the hydrolysis of glycerophospholipids at sn-2 position and promote the release of lysophospholipids and fatty acids. 5-methylcoumarin-4-ß-glucoside (5MC4BG) and lupeol were previously isolated from the leaves of V. glaberrima. The aim of this research was to evaluate effect of these compounds as potential inhibitors of snake venom toxins of Naja nigricollis using an in vitro and in silico studies. Antisnake venom studies was conducted using acidimetry while the molecular docking analysis against PLA2 enzyme from N. nigricollis was performed using Auto Dock Vina and ADME-Tox analysis was evaluated using swissADME and ProTox-II online servers. The two compounds (5MC4BG and Lupeol) were able to inhibit the hydrolytic actions of PLA2 enzyme with percentage inhibition ranging from 23.99 to 72.36 % and 21.97-24.82 % at 0.0625-1.00 mg/mL respectively while the standard ASV had 82.63 % at 1.00 mg/mL after 10 min incubation at 37 °C. Similar effects were observed after 30 min incubation, although there was significant increase in percentage inhibition of 5MC4BG and lupeol ranging from 66.51 to 83.73 % and 54.87-59.60 % at similar concentrations. Furthermore, the compounds were able to bind to the active site of PLA2 enzyme with high affinity (-7.7 to -6.3 kcal/mol); the standard ligand, Varespladib had a docking score of -6.9 kcal/mol and they exhibited favorable drug-likeness and pharmacokinetic properties and according to toxicity predictions, the two compounds are toxic. In conclusion, the leaf of V. glaberrima contains phytoconstituents with antisnake activity and thus, validates the hypothesis that, the phytoconstituents of V. glaberrima leaves has antisnake venom activity against N. nigricollis venom and thus, should be studied further for the development as antisnake venom agents.

Calabash pregnancy: a malingering response to infertility complicated by domestic violence.

This is a case report of a 20-year old para 0+0 who presented with an 11-month pregnancy. On evaluation, the pregnancy was found to be a fake made-up 'calabash pregnancy'. There were no pregnancy symptoms and she had just menstruated three weeks prior to presentation. This was a deliberate event in response to delayed pregnancy attainment complicated by domestic violence. Domestic violence was in the form of verbal and physical abuse and later was on a monthly basis precipitated by onset of her menstrual flow. The patient's age, monogamous union and the fact that she is an orphan made her vulnerable to domestic violence.

Disseminated cutaneous leishmaniasis in HIV positive patient--a case report.

Disseminated cutaneous leishmaniasis and HIV dual-infection is seldom reported. Leishmaniasis and HIV co-infection may intensify the immune defect and is the chief reason for atypical presentation and widespread progression of cutaneous leishmaniasis and its defiance to conventional therapy. Here we report a 38-year-old HIV-positive lady who presented with a 6-month history of a progressive papule and nodular eruptions of leishmaniasis on face, trunk and extremities that was recalcitrant to treatment.

A metalloproteomic analysis of interactions between plasma proteins and zinc: elevated fatty acid levels affect zinc distribution.

Serum albumin is a highly abundant plasma protein associated with the transport of metal ions, pharmaceuticals, fatty acids and a variety of small molecules in the blood. Once thought of as a molecular 'sponge', mounting evidence suggests that the albumin-facilitated transport of chemically diverse entities is not independent. One such example is the transport of Zn2+ ions and non-esterified 'free' fatty acids (FFAs) by albumin, both of which bind at high affinity sites located in close proximity. Our previous research suggests that their transport in blood plasma is linked via an allosteric mechanism on serum albumin. In direct competition, albumin-bound FFAs significantly decrease the binding capacity of albumin for Zn2+, with one of the predicted consequences being a change in plasma/serum zinc speciation. Using liquid chromatography (LC), ICP-MS and fluorescence assays, our work provides a quantitative assessment of this phenomenon, and finds that in the presence of high FFA concentrations encountered in various physiological conditions, a significant proportion of albumin-bound Zn2+ is re-distributed amongst plasma/serum proteins. Using peptide mass fingerprinting and immunodetection, we identify candidate acceptor proteins for Zn2+ liberated from albumin. These include histidine-rich glycoprotein (HRG), a multifunctional protein associated with the regulation of blood coagulation, and members of the complement system involved in the innate immune response. Our findings highlight how FFA-mediated changes in extracellular metal speciation might contribute to the progression of certain pathological conditions.

Determinants of patient waiting time in the general outpatient department of a tertiary health institution in north Western Nigeria.

BACKGROUND: The amount of time a patient waits to be seen is one factor which affects utilization of healthcare services. Patients perceive long waiting times as barrier to actually obtaining services and keeping patients waiting unnecessarily can be a cause of stress for both patient and doctor. AIM: This study was aimed at assessing the determinants of patients' waiting time in the general outpatient department (GOPD) of a tertiary health institution in northern Nigeria. SUBJECTS AND METHODS: This descriptive cross-sectional study was carried out among new patients attending the GOPD of the Usmanu Danfodiyo University Teaching Hospital, Sokoto, North Western Nigeria. A structured questionnaire was used to elicit information from 100 patients who were recruited into the study using a convenience sampling method. Data collected were entered and analyzed using Statistical Package for Social Sciences version 17; Chi-square test was used to compare differences between proportions with the level of statistical significance set at 5% (P < 0.05). RESULTS: Sixty-one percent (59/96) of the respondents waited for 90-180 min in the clinic, whereas 36.1% (35/96) of the patients spent less than 5 min with the doctor in the consulting room. The commonest reason for the long waiting time in the GOPD was the large number of patients with few healthcare workers. CONCLUSION: There is an urgent need to increase the number of health workers in the GOPDs which serves as the gate way to the hospital if the aims of the Millennium Development Goals are to be realized.

Knowledge, Attitude and Practice of Breast Self Examination among Female Students of a Tertiary Institution in Sokoto, North-West Nigeria.

Background: Breast cancer is the most common cancer in women worldwide. Early detection and prompt treatment offers the greatest chance of survival. We described the knowledge, attitude and practice of breast self examination among female students of a tertiary institution in Sokoto, northwest Nigeria. Methods: A set of semi structured self administered questionnaire was used to seek information on respondents’ knowledge, attitude and practice of breast self examination. A total of 80 female students were selected using stratified sampling technique, with a response rate of 100%. The data were analysed using the Statistical Package for Social Sciences (SPSS) version 20 and Microsoft Excel 2007. Results: The mean age of respondents was 21 years ±SD1.83, with 48.8% of them being Hausa. They are predominantly Muslims and 85% are single. About 19% of the respondents have family history of breast cancer. Up to 96% of them have heard about breast cancer and 86.3% were aware of BSE, however, only 46% of them had adequate knowledge of BSE. Majority (96%) of the respondents had positive attitude towards BSE as 92.5% of them think BSE is necessary and a further 97.5% would like to know more about it. This study showed poor level of BSE practice with only 17.5% showing good practice out of the 45% of respondents that have ever practiced BSE. Conclusion: Most of the respondents have heard about BSE but only 46.3% had adequate knowledge. Majority of respondents demonstrated a positive attitude towards BSE; however, the practice was low.

Patient Satisfaction with Services at a General Outpatient Clinic of a Tertiary Hospital in Nigeria.

Aims: To determine the factors influencing patient satisfaction with services at the general outpatient clinic of a tertiary hospital in Nigeria. Study Design: A descriptive cross sectional study. Place and Duration of Study: We carried out the study between February and July 2011, in the General Outpatient Department of Usmanu Danfodiyo University Teaching Hospital Sokoto, Ni. Methodology: One hundred respondents were sampled using systematic sampling technique. We developed a structured questionnaire, which sought information on sociodemographic characteristics of patients, registration/wait times and patients’ satisfaction. We analyzed the data using the Statistical Package for Social Sciences (SPSS) version 17.0. Results: Out of the 100 patients sampled, 4 opted out, thus giving a response rate of 96%. Their ages ranged between 15-70 years with mean of 32±13 years. Students constituted 28.4% of the participants, followed by full term housewives (27%). Those participants having up to tertiary education accounted for 36.1%. Up to 62.5% of participants were females and majority of them were from urban areas (88.5%). Registration time ranged between 1-132 minutes (mean = 76±22.7 minutes) whereas clinic wait time ranged between 10-167minutes (mean = 83.7±38.6 minutes). Sixty five percent of them expressed satisfaction with neatness of the clinic environment, 48.5% expressed satisfaction with communication with the doctors while 65% expressed satisfaction with the explanations offered concerning their ailments. The overall satisfaction with services at the clinic was 52%. Determinants of satisfaction were total clinic wait time (P=.001, r=-0.4), clinic wait time (P=.007, r=-0.25) and age (P=.001, r=0.31). Conclusion: The overall satisfaction with services at the clinic was above average, patients expressed dissatisfaction with registration time, wait time and condition of consulting room. Health care managers should commence appointment system to reduce the number of patients who turn out at the same time. They should also address provider-related factors that cause dissatisfaction.

Prevalence of Obesity, Diabetes Type 2 and Hypertension among a Sampled Population from Sokoto Metropolis-Nigeria.

Aims: To determine the prevalence of obesity and its relationship with hypertension and diabetes among dwellers of Sokoto metropolis. Study Design: A descriptive cross sectional study. Place and Duration of Study: We conducted the study in March 2012, within Sokoto metropolis to mark the world kidney day. Methodology: We enrolled 300 participants using a convenience sampling technique. An interviewer administered questionnaire was used to obtain the biodata and past medical history. Blood pressure and anthropometric parameters were measured while blood and urine samples were taken for RBS estimation and urine analysis respectively. We analyzed the data obtained using the Statistical Package for Social Sciences (SPSS) version 17. Results: Out of the 300 participants that came for screening, two opted out, thus leaving 298 participants. There were 50.3% males and 49.7% females. Their mean age was 42±31 years. The BMI ranged between 14-48 kg/m2 with mean of 24.24 kg/2 ±5. Mean SBP and RBS were 130mmhg (±25) and 7.34±4 mmol-1 respectively. About 13.9% of the participants were found to be obese. Obesity was significantly associated with SBP (p<0.001) and RBS level (p=0.002). Conclusion: Obesity is quite common in our environment and it contributes to the occurrence of hypertension and elevated blood sugar. Screening for obesity markers should be encouraged at every contact with healthcare provider. Physical activity for at least 30 minutes/day should be encouraged in order to reduce the risk of obesity, hypertension and diabetes mellitus.

Calabash pregnancy: a malingering response to infertility complicated by domestic violence / Embarazo de calabaza: una respuesta de fingimiento a la infertilidad complicada con violencia doméstica

This is a case report of a 20-year old para 0+0 who presented with an 11-month pregnancy. On evaluation, the pregnancy was found to be a fake made-up 'calabash pregnancy There were no pregnancy symptoms and she had just menstruated three weeks prior to presentation. This was a deliberate event in response to delayed pregnancy attainment complicated by domestic violence. Domestic violence was in the form of verbal and physical abuse and later was on a monthly basis precipitated by onset of her menstrual flow. The patient's age, monogamous union and the fact that she is an orphan made her vulnerable to domestic violence.

Éste es un reporte de caso de una para 0 + 0 de 20 anos de edad, que se presentó con un embarazo de 11 meses. En la evaluación, se encontró que se trataba de un embarazo de calabaza, es decir, inventado, fingido. En realidad, no había ningún síntoma de embarazo, y había tenido la menstruación tres semanas antes de presentarse. Se trataba de un acontecimiento deliberadamente construido, en respuesta a una largamente demorada expectativa de lograr un embarazo, complicada con violencia doméstica. La violencia doméstica seproducía enforma de abuso verbalyfísico, precipitándose luego mensualmente con la aparición de cadaflujo menstrual. La edad de los pacientes, la unión monógama, y el hecho de que era huérfana, la hacía vulnerable a la violencia doméstica.