Physical Activity among Healthcare Workers in a Major Tertiary Hospital, Southeast Nigeria.

BACKGROUND: Physical inactivity (PIA) is the fourth leading risk factor in an estimated global death of 3.2 million annually. To reverse this negative impact of PIA, there is a need to increase physical activity (PA). This could be achieved through creation of awareness, promotion, and good practice of PA by healthcare workers. OBJECTIVE: To evaluate physical activity among healthcare workers (HCW) in a major tertiary hospital, southeast Nigeria. METHODS: The Global Physical Activity Questionnaire (GPAQ) was researcher-administered to investigate PA level among consenting HCW who met the inclusion criteria. Participants were recruited from their workstations in the hospital. The questionnaire recorded age, anthropometrics, demographics, and physical activity. Data were summarized with descriptive statistics of frequency and percentages. The spearman rank correlation test was used to assess for the relationship between PA and socio-demographic factors. RESULTS: There were 209 participants with 93 (44.5%) males and 116 (55.5%) females. The mean age was 34.32±9.88 years. Amongst different professions, Nurses were 53(25.3%), Doctors, 31 (14.8%), and Dietitians, 21 (10%), Accountants, 19 (9.1%). The majority of the participants 100 (47.8%) had physical activity level that was high (extra sufficient), 31 (14.8%) had a moderate PA level while 78 (37.3%) had a low physical activity level. There was a significant negative relationship between PA and age, marital status, number of children, and other dependents respectively, whereas there was no significant relationship between PA and gender, income, and family type. CONCLUSION: HCWs have the minimum required PA in a week. About 63% met the minimum required PA in a week. Age, marital status, and having children or dependents reduce participation in PA. However, there is a need for conscious awareness and practice of PA among HCW in the hospital.

CONTEXTE: L'inactivité physique (AIP) est le quatrième facteurde risque dans une mortalité mondiale estimée à 3,2 millions de personnes par an. Pour inverser cet impact négatif du PIA, il est nécessaire d'augmenter l'activité physique (AP). Cela pourrait être réalisé par la sensibilisation, la promotion et les bonnes pratiques de l'AP par les travailleurs de la santé. OBJECTIFS: Évaluer l'activité physique chez les travailleurs de la santé (HCW) dans un grand hôpital tertiaire, au sud-est du Nigeria. METHODES: Le questionnaire global sur l'activité physique (GPAQ) a été administré par des chercheurs pour étudier le niveau d'activité physique chez les travailleurs de la santé consentants qui répondaient aux critères d'inclusion. Ils ont été recrutés à partir de leurs postes de travail à l'hôpital. Le questionnaire enregistrait l'âge, l'anthropométrie, la démographie et l'activité physique. Les données ont été résumées avec des statistiques descriptives de fréquence et de pourcentages. Lacorrélation du rang de lanceur pour le test de la relation entre l'AP et les facteurs sociodémographiques. RESULTATS: Il y avait 209 participants avec 93 (44,5 %) hommes et 116 (55,5 %) femmes. L'âge moyen était de 34,32 ± 9,88 ans. Parmi les différentes professions, les infirmières étaient 53 (25,3%), les médecins, 31 (14,8%), et les diététiciens, 21 (10%), les comptables, 19 (9,1%) etc. La majorité des participants 100 (47,8%) avaient des problèmes physiques niveau d'activité élevé (extra suffisant), 31 (14,8%) avaient un niveau d'AP modéré tandis que 78 (37,3 %) avaient un niveau d'activité physique faible. Il y avait une relation négative significative entre l'AP et l'âge, l'état matrimonial, le nombre d'enfants et d'autres personnes à charge, respectivement, alors qu'il n'y avait pas de relation significative entre l'AP et le sexe, le revenu et le type de famille, respectivement. CONCLUSION: les travailleurs de la santé ont l'AP minimale requise en une semaine. 62,6 % ont atteint l'AP minimale requise en une semaine. L'âge, l'état matrimonial et le fait d'avoir des enfants ou des personnes à charge réduisent la participation à l'AP. Cependant, il existe un besoin de sensibilisation consciente et de pratique de l'AP parmi les travailleurs de la santé à l'hôpital. Mots-clés: Inactivité physique, Facteurs de risque, Nigéria, Questionnaire global sur l'activité physique, Équivalent métabolique.

Comparison of fluconazole pharmacokinetics in serum, aqueous humor, vitreous humor, and cerebrospinal fluid following a single dose and at steady state.

The objective of this study was to characterize the pharmacokinetic parameters and penetration of fluconazole following a single dose in the serum, aqueous humor, vitreous humor and cerebrospinal fluid (CSF) of non pigmented rabbits using serial sampling techniques and to determine if the pharmacokinetic parameters in the eye and CSF are similar. Twenty healthy male rabbits received intravenous fluconazole 20 mg/kg as a single dose or 20 mg/kg every 12 hours for 4 doses. Serum, aqueous humor, vitreous humor and CSF samples were taken 15 minutes after the initial intravenous injection and hourly thereafter for six hours. Fluconazole concentrations were determined by microbiological assay. Pharmacokinetic analyses were performed using a nonlinear least-square regression program. Fluconazole's penetration in all anatomical compartments was > 70% than in the serum. Similar elimination half-lives and time to reach maximum concentrations were noted in all compartments. While mean concentrations in each anatomical compartment were similar in animals receiving a single dose or among those at serum steady state, the mean concentrations achieved in the serum, aqueous and vitreous humors and CSF were between 1.82 and 2.17 times higher at serum steady state than following a single dose. At serum concentrations that are comparable to those in humans, the penetration of fluconazole into the noninflamed aqueous and vitreous humors and CSF were > or = 70%. The CSF and ocular pharmacokinetic parameters closely resembled each other, so that either could be used as a surrogate for the other.

Productivity potentials and nutritional values of semi-arid zone earthworm (Hyperiodrilus euryaulos; Clausen, 1967) cultured in organic wastes as fish meal supplement.

In the present study 60 Adult Earthworms (H. euryaulos) of weight and length range 1.7-3.0 g (mean-2.34 +/- 0.91 g) and 13.0-28.0 cm (mean-21.5 +/- 5.8 cm), respectively were cultured for 12 weeks. The productivity potential and nutrient composition of earthworm (H. euryaulos) cultured in two rearing substrata (Cellulose Substrate (Control)--Coded Hs1 and Dry Neem and leaves and soil Substrate--Coded Hs2) were assessed using six wooden boxes stocked in triplicates at the rate of 92.7 g earthworms per box. The higher total final weight, weekly weight gain, relative growth rate, specific growth rate and survival of 400.6 g kg(-1) of substrate, 25.7 g/week/substrate, 332.5, 0.76/day and 99.0% while the lower of 367.5 g kg(-1) of substrate, 22.9 g/week, 296.4, 0.71/day and 98.0% were recorded in earthworm cultured in cellulose substrate and the soil substrate respectively. The proximate analyses, mineral compositions and amino acids indices were comparable to those of conventional fish meal. Based on the results of this study, the utilization of cellulose substrate is recommended for the culture of earthworm and the inclusion of the earthworm meal is guarantee as a reliable and nutritional dependable fish meal supplement.

Fleroxacin pharmacokinetics in aqueous and vitreous humors determined by using complete concentration-time data from individual rabbits.

Although composite data from separate subjects can be used to generate single-subject estimates, intersubject variation precludes rigorous ocular pharmacokinetic analysis. Therefore, a rabbit model in which sequential aqueous and vitreous humor samples were obtained following the administration of the quinolone fleroxacin was developed. Mean data from individual animals were used for pharmacokinetic analysis. Following direct intravitreal or systemic drug administration, sequential paracenteses did not alter pharmacokinetic constants or ocular penetration and were not associated with an increase in ocular protein; contamination of vitreous humor with blood was minimal (less than 0.1%). Following direct injection or intravenous administration, vitreous humor concentration-time data were best described by one- and two-compartment models, respectively. The maximum concentration and the penetration into the aqueous and vitreous humors were 1.54 and 0.5 micrograms/ml and 27 and 10%, respectively. Elimination rates from aqueous and vitreous humors and serum were similar following parenteral drug administration. Drug elimination following direct injection was rapid, and the elimination rate from the vitreous humor was not prolonged by the coadministration of probenecid. Our animal model provides a new approach to the rigorous examination of the ocular pharmacokinetics of quinolone antimicrobial agents in the eye.

Sequential parenteral and oral ciprofloxacin regimen versus parenteral therapy for bacteremia: a pharmacoeconomic analysis.

OBJECTIVE: To compare, in patients with gram-negative bacteremia, a course of parenteral antibiotic therapy alone with initial parenteral therapy followed by oral ciprofloxacin in terms of the length of hospitalization, clinical effectiveness, toxicity, and cost. DESIGN: A prospective, controlled, randomized, open trial in select hospitalized patients. SETTING: Large metropolitan teaching hospital. PATIENTS: Fifty hospitalized patients with proven gram-negative bacteremia were randomized to receive either oral ciprofloxacin (group 1) following a 72-hour initial intravenous antibiotic regimen or to continue parenteral therapy alone (group 2). To compare the length of hospitalization, an additional group of 50 hospitalized patients with bacteremia (not enrolled in the study, group 3) were analyzed. INTERVENTION: Parenteral antibiotics for 72 hours followed by continuation of a parenteral regimen or oral ciprofloxacin 750 mg bid. MAIN OUTCOME MEASURES: Clinical response, toxicity, and length of hospitalization. RESULTS: Clinical resolution was comparable in the 24 group 1 patients receiving intravenous antibiotics followed by oral ciprofloxacin (83%), the 26 group 2 patients receiving parenteral therapy alone (77%), and the 50 comparison patients (76%). There was little toxicity noted in any group, and the initial parenteral antibiotic regimens were similar. The mean numbers of hospital days on antibiotics were 9.1, 11.2, and 10.6 days in groups 1,2, and 3, respectively (p < 0.05 for group 1 vs. group 2 or 3), and the lengths of hospitalization were 9.8, 15.7, and 12.1 days, respectively (p < 0.05 for group 1 vs. group 2 or 3). Shortening the length of hospitalization and days of antibiotic therapy was associated with a cost savings of up to $78 000 for group 1 patients. CONCLUSIONS: Parenteral therapy for 72 hours followed by oral ciprofloxacin significantly shortened both the number of hospital days taking antibiotics and the length of stay compared with parenteral therapy alone. Both regimens were equally effective and safe in the therapy of gram-negative bacteremia, and initial parenteral therapy followed by oral ciprofloxacin was cost-effective.

Definition of the supraclavicular and infraclavicular nodes: implications for three-dimensional CT-based conformal radiation therapy.

PURPOSE: To delineate with computed tomography (CT) the anatomic regions containing the supraclavicular (SCV) and infraclavicular (IFV) nodal groups, to define the course of the brachial plexus, to estimate the actual radiation dose received by these regions in a series of patients treated in the traditional manner, and to compare these doses to those received with an optimized dosimetric technique. MATERIALS AND METHODS: Twenty patients underwent contrast material-enhanced CT for the purpose of radiation therapy planning. CT scans were used to study the location of the SCV and IFV nodal regions by using outlining of readily identifiable anatomic structures that define the nodal groups. The brachial plexus was also outlined by using similar methods. Radiation therapy doses to the SCV and IFV were then estimated by using traditional dose calculations and optimized planning. A repeated measures analysis of covariance was used to compare the SCV and IFV depths and to compare the doses achieved with the traditional and optimized methods. RESULTS: Coverage by the 90% isodose surface was significantly decreased with traditional planning versus conformal planning as the depth to the SCV nodes increased (P < .001). Significantly decreased coverage by using the 90% isodose surface was demonstrated for traditional planning versus conformal planning with increasing IFV depth (P = .015). A linear correlation was found between brachial plexus depth and SCV depth up to 7 cm. CONCLUSION: Conformal optimized planning provided improved dosimetric coverage compared with standard techniques.

Pharmacokinetics of ofloxacin in serum and vitreous humor of albino and pigmented rabbits.

The purpose of this study was to evaluate the pharmacokinetics of ofloxacin in serum and vitreous humor samples from albino and pigmented rabbits by using a recently described animal model which permits robust estimation of parameter values. The drug was administered to rabbits intravenously, multiple vitreous humor and serum samples were taken from each rabbit, and the vitreous humor and serum samples were assayed by high-pressure liquid chromatography. The pharmacokinetic parameters were determined with RSTRIP, an iterative, nonlinear, weighted, least-squares regression program. Eight New Zealand White rabbits and eight Dutch Belted rabbits (split into single-dose and multiple-dose groups) were investigated in this study. The value of penetration into the vitreous humor of albino rabbits (n = 6) was 32.6% +/- 2.12%, with terminal-elimination half-life values of 3.21 and 2.39 h, respectively, for vitreous humor and serum. In pigmented rabbits after a single dose (n = 3) and with a steady-state concentration of drug in serum (n = 4), penetration values were similar, at 30.4% +/- 2.98% and 30.0% +/- 4.12%, respectively (P > 0.10). Following a single dose of ofloxacin, pigmented animals had elimination half-life values from serum and vitreous humor of 2.64 and 4.32 h, respectively. After steady state was achieved, half-life values for serum and vitreous humor were 3.12 and 6.05 h, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Determination of robust ocular pharmacokinetic parameters in serum and vitreous humor of albino rabbits following systemic administration of ciprofloxacin from sparse data sets by using IT2S, a population pharmacokinetic modeling program.

Robust determination of the concentration-time profile of anti-infective agents in certain specialized compartments is often limited by the inability to obtain more than a single sample from such a site in any one subject. Vitreous humor and cerebrospinal fluid are obvious examples for which the determination of concentrations of anti-infective agents is limited. Advances in pharmacodynamics have pointed out the importance of understanding the profiles of drugs in the plasma and in specialized compartments in order to dose the drugs to obtain the best patient outcomes. Advances in population pharmacokinetic modeling hold the promise of allowing proper estimation of drug penetration into the vitreous (or other specialized compartment) with only a single vitreous sample, in conjunction with plasma sampling. We have developed a rabbit model which allows multiple samples of vitreous to be obtained without breaking down the blood-vitreous barrier. We have employed this model to test the hypothesis that robust estimates of vitreous penetration by the fluoroquinolone ciprofloxacin can be obtained from a traditional intensive plasma sampling set plus a single vitreous sample. We studied 33 rabbits which were receiving 40 mg of ciprofloxacin per kg of body weight intravenously as short infusions and from which multiple plasma and vitreous samples were obtained and assayed for ciprofloxacin content by high-performance liquid chromatography. Data were analyzed by the iterative two-stage population modeling technique (IT2S), employing the iterative two-stage program of Forrest et al. (Antimicrob. Agents Chemother. 37:1065-1072, 1993). Two data sets were analyzed: all plasma and vitreous samples versus all plasma samples and the initially obtained single vitreous sample. The pharmacokinetic parameter values identified were used to calculate the percent vitreous penetration as the ratio of the area under the concentration-time curve for the vitreous to that for the plasma. The values identified, 4% penetration for the full data set versus 3% penetration for the single vitreous sample data set, and their corresponding estimates were not statistically significantly different. We conclude that population modeling holds promise for the analysis of penetration of antimicrobiol agents into specialized spaces from which only single samples can be obtained, particularly for patients with whom robust plasma sampling can be performed.

Aqueous and vitreous penetration of ciprofloxacin following different modes of systemic administration.

The overall importance of the peak or the mean serum concentrations as predictors of ocular drug penetration is unknown. To address this fundamental question with an agent which shows promise as adjunctive therapy in the treatment of endophthalmitis, we studied the penetration of ciprofloxacin into the aqueous and vitreous humors following three different modes of systemic administration. New Zealand white rabbits received either a single bolus dose (40 mg kg-1), three intermittent doses of 13.33 mg kg-1 evenly spaced over an 8 hr period, or a continuous infusion of 40 mg kg-1 over an 8 hr period. Pharmacokinetic analysis was performed using RSTRIP II, a non-linear, least square regression model analysis program. The serum area under the concentration-time curve (AUC) values for each mode of drug administration were similar: 32.9 micrograms hr ml-1 for single dose, 31.9 micrograms hr ml-1 for intermittent dose, and 33.8 micrograms hr ml-1 for continuous infusion modes. The percentage penetration into the aqueous and vitreous were also similar; 30.5% and 6.5% for a single dose, 31.6% and 7.4% for intermittent doses and 30.0% and 7.5% for continuous infusion. The penetration into the aqueous and vitreous humors was not influenced by mode of administration. As with other quinolones we have studied, elimination rates were similar for the central and peripheral compartments in the post-distributive phase. Vitreous humor ciprofloxacin concentrations achieved were below that which inhibits most Staphylococcus epidermidis, the most common isolate in patients with post-operative endophthalmitis.