Knowledge and indulgence in substsance abuse among adolescents in Anambra state,South-East Nigeria

BackgroundSubstance abuse is a growing societal problem with adolescents being at increased risk. The few studies in Nigerian adolescents have not factored in their knowledge base with regard to the concept of substance abuse.ObjectivesThis study determined the indulgence in and knowledge of substance abuse and associated factors among adolescents.MethodsThis was a questionnaire based study involving 10 to 19year olds recruited from an adolescent summer camp in Anambra state, South-East Nigeria.ResultsThe data of 276adolescents was analyzed, male–91, 33%, M: F = 1: 2. Mean age was 16.4 ± 1.4years. 13.8% (38) accepted they had abused substances in the past; 74.3% (205) had the correct knowledge of the meaning of substance abuse; 10.1% (28) admitted taking substances for pleasure. The substances taken included Alcohol (67.9%), Cigarette (25.0%), Tramadol (10.7%), Cocaine (7.1%), among others. Multiple substances were taken 28.6% of the time.Age category had no significant association with the abuse of substances (X2–2.656, p = 0.282). Stratified by age category, gender had a significant association with substance abuse in Late adolescence (n = 11; M–9, 81.8%; F–2, 18.2%; X2 = 6.893, p = 0.016) but not Mid-adolescence (n = 27; M – 10, 37.0%; F – 17, 63.0%; X2 = 0.749, p = 0.500).ConclusionAn unacceptable proportion of the adolescents were already exposed to substances/drugs in spite of having suboptimal knowledge. Adolescents need to be educated on substance abuse and its dangers in order to curb this in the society.     

Physical activity across adulthood and subjective cognitive function in older men

Low subjective cognitive function (SCF), which is associated with APOE4 genotype, adversely impacts quality of life and has predicted clinical dementia. We examined whether physical activity during early adulthood or mid-to-late life is associated with late-life SCF. We followed 28,481 US male health professionals aged 40–75 years who reported their physical activity in 1986 and biennially thereafter. SCF was reported in 2008 and 2012. The SCF score was averaged for the 2008 and 2012 assessments and categorized as “good”, “moderate”, and “poor”. Men in the highest versus lowest quintile of mid-to-late life physical activity in 1986 had 38% lower odds of poor versus good SCF score (multivariable-adjusted odds ratio (OR) 0.62; 95% CI 0.53, 0.72; P for trend < 0.0001). Being physically active in early adulthood was also associated with a 23% lower odds of poor SCF, independent of later activity, and being active both in early and mid-to-late adulthood was associated with a 48% lower odds of poor SCF score compared with those who were always sedentary (OR 0.52; 95% CI 0.38, 0.71). Our results suggest that being physically active during early adulthood and mid-to-late life independently contribute to prevention of poor subjective cognitive function in late-life.     

Antihyperglycaemic and antioxidant potentials of Cussonia arborea in alloxan-induced diabetic rats

This study was to evaluate the anti-hyperglycaemic potential of the methanolic stem bark extract of Cussonia arborea in alloxan-induced diabetic rat model. C. arborea extract was well tolerated by the rats at the highest dose of 3,200 mg/kg. The extract at the dose of 500 mg/kg body weight significantly (p?<?0.05) reduced the blood glucose levels of diabetic rats from 16.9?±?4.7 to 5.1?±?1.8 (72.4?±?2.9 % reduction) 6 h post-extract administration. Upon screening of the four fractions obtained after chromatographic techniques, fraction 2 showed the highest anti-hyperglycaemic activity (75.2?±?2.1 % reduction). Further phytochemical studies on fraction 2 revealed that it contains mainly saponin. Fraction 2 showed concentration-dependent antioxidant scavenging activity in 1,1-diphenyl-2-picrynyl phenyl hydrazyl photometric assay. The optimum percentage antioxidant activity was 55 % at the concentration of 400 μg/ml. Ferric reducing antioxidant power (FRAP) value (1.6 μm) of the fraction at 400 μg/ml was statistically comparable to that of 2 μm ascobic acid (reference standard).). It was concluded that the anti-hyperglycaemic property of the extract is attributable to fraction 2. The anti-hyperglycaemic activities of C. arborea could also be attributed to its antioxidant potentials.     

Kidney Health for Everyone Everywhere—From Prevention to Detection and Equitable Access to Care

The global burden of chronic kidney disease (CKD) is increasing with a projection of becoming the fifth leading cause of years of life lost globally by 2040. CKD is a major cause of catastrophic health expenditure. The costs of dialysis and transplantation consume up to 3% of the entire annual healthcare budget in high‐income countries. Crucially, however, both the onset and progression of CKD is potentially preventable. In 2020, the World Kidney Day campaign highlights the importance of preventive interventions—be it primary, i.e. to prevent de novo CKD, or secondary or tertiary, i.e. prevention of worsening early CKD or progression of more advanced CKD to end‐stage kidney disease, respectively. Primary prevention should focus on the modification of CKD risk factors and address the structural abnormalities of the kidney and urinary tracts, and exposure to environmental risk factors and nephrotoxins. In persons with pre‐existing kidney disease, secondary prevention, including blood pressure optimization, glycemic control and avoiding high‐protein high‐sodium diet should be the main goal of education and clinical interventions. In patients with moderate to advanced CKD, the management of comorbidities such as uremia and cardiovascular disease along with low‐protein diet are among the recommended preventative interventions to avoid or delay dialysis or kidney transplantation. Whereas national policies and strategies for noncommunicable diseases may exist in a country, specific policies directed toward education and awareness about CKD screening, prevention and treatment are often lacking. There is an urgent need to increase awareness for preventive measures throughout populations, professionals and policy makers.     

FREQUENCY,URINALYSIS AND SUSCEPTIBILITY PROFILE OF PATHOGENS CAUSING URINARY TRACT INFECTIONS IN ENUGU STATE,SOUTHEAST NIGERIA

Objective: This study was designed to determine the frequency and causative agent(s) of urinary tract infections (UTIs) in individuals with symptoms of urinary tract infections in Enugu State of Southeast Nigeria, and to determine the antibiotic susceptibility pattern of microbial agents isolated from urine culture. Methods: The study involved 211 individuals (149 females and 62 males) clinically suspected for UTI. Urine samples were collected by the mid-stream ‘clean catch’ method and tested using standard procedures. Antibiotic susceptibility of the isolated pathogens was tested using the Kirby-Bauer technique according to the Clinical and Laboratory Standards Institute (CLSI) guidelines. Results: Microscopy of centrifuged urine samples showed 16 patients had pyuria while 54 had pus cells. Calcium oxalate crystals were found in 14 samples. Urinalysis performed with urine samples showed 17 had protein; seven were nitrite positive and three had moderate to high glucose concentration. Fifty-four urine samples (36.2%) from females and 12 (19.4%) from males showed significant growth upon culture. Gram stain and biochemical tests identified nine different organisms with Escherichia coli as the most common isolated species. Forty three randomly selected strains were further tested for their susceptibility against a panel of antibiotics. Thirty isolates (81.08%) were resistant to four or more antibiotics with the highest resistance shown by E. coli (76.67%). All the Gram- negative isolates were resistant to Ampicilox, Cefuroxime and Amoxicillin. Conclusion: Urinary tract infections were found more in females in the area under study. As found in other studies, E. coli was the most predominant isolate, although other organisms seem to be on the increase.     

Pilot study of omega-3 fatty acid supplements in sickle cell disease

In a previous retrospective study, it was observed that the greater the amounts of the omega-3 fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in the blood, the lesser the number of complications of sickle cell disease (SCD) and the higher the steady state haemoglobin level. SCD causes ischaemia-reperfusion injury and inflammation; which can be ameliorated by a metabolite of DHA that down-regulates expression of pro-inflammatory genes. The objectives of this prospective pilot study were to evaluate the effects of DHA and EPA supplements in SCD, and test the hypothesis that these effects are mediated partly by reducing inflammation. Oral DHA and EPA supplements were given to 16 SCD patients for 6 months. We then compared pre- and post-supplementation values of number of crisis, steady state Hb, plasma unconjugated bilirubin and three indices of inflammation: plasma interleukin-6, blood neutrophil and platelet counts. There was a significant reduction in the plasma level of unconjugated bilirubin, and the number of sickle cell crisis; but not in the markers of inflammation. The pilot data suggest that DHA and EPA supplements reduce the number of crisis and steady state haemolysis in SCD; but provide no evidence that these effects are mediated by reducing inflammation.     

Isolation and molecular characterization of Candida africana from Jos, Nigeria

During a survey of the prevalence of Candida spp. in Jos, Plateau State, Nigeria, two atypical C. albicans isolates were recovered. These two yeasts were germ tube positive, chlamydospore-negative and gave a green color on CHROMagar Candida. Molecular analysis performed by amplification of the hwp1 gene showed that these two isolates belonged to C. africana, a newly proposed Candida species closely related to C. albicans. Based on the presence or absence of an intron in DNA sequences encoding rRNA, the two C. africana, including all C. albicans isolates examined, were found to belong to genotype A and no other genotypes or species such as C. dubliniensis were found. To our knowledge, this is the first isolation of C. africana in Nigeria.     

Effects of pyrimethamine versus proguanil in malarial chemoprophylaxis in children with sickle cell disease: a randomized, placebo-controlled, open-label study

Background

Malarial chemoprophylaxis is essential for patients with homozygous sickle cell disease (SCD) who live in areas where malaria is endemic. Endemic regions include most sub-Saharan African countries and Southeast Asia.

Objective

This study compared the efficacy and tolerability of pyrimethamine with that of proguanil and placebo in the prevention of malaria and the complications of Plasmodium falciparum infection (hepatomegaly, splenomegaly, bone pain crisis, hemolytic crisis) in children with SCD.

Methods

In this single-center, open-label study conducted in Nigeria, children aged 1 to 16 years with SCD were randomly assigned to receive tablets of pyrimethamine (0.5 mg/kg·wk), proguanil (1.5 mg/kg·d), or placebo (vitamin C, 7 mg/kg·d) for 9 months as prophylaxis from February to December (which includes the rainy season), the period of greatest malarial transmission. The clinical and laboratory features of malaria (presence of parasitemia, parasite count and density, hepatomegaly and/or splenomegaly, symptomatic malarial infection [fever, rigors], bone pain crises, and hemolytic crises) were assessed.

Results

A total of 97 patients completed the study (49 boys, 48 girls; mean [SD] age, 7.8 [4.3] years). The pyrimethamine group comprised 36 patients (mean [SD] age, 8.1 [4.3] years; range, 2-16 years); the proguanil group, 32 patients (mean [SD] age, 9.5 [3.7] years; range, 3-16 years); and the placebo group, 29 patients (mean age, 5.9 years; range, 1-14 years). The male:female ratio was 1.1:1 in the pyrimethamine group, 1:1.7 in the proguanil group, and 1.6:1 in the placebo group. Parasitemia was noted in 7 patients (19.4%) in the pyrimethamine group, 6 (18.8%) in the proguanil group, and 7 (24.1%) in the placebo group at the start of the study. P falciparum was the only isolate. The mean parasite density over the 9-month period was significantly lower with proguanil compared with pyrimethamine (P = 0.045) and placebo (P<0.05). The incidence of splenomegaly was least with pyrimethamine, but this group had the most patients clinically diagnosed with malaria. Hospitalizations and episodes of bone pain and hemolytic crisis occurred most frequently with placebo. One patient in the placebo group died of septicemia.

Conclusions

Proguanil and pyrimethamine both reduced parasitemia; however, proguanil significantly decreased mean parasite density more effectively than pyrimethamine. Pyrimethamine and proguanil may protect children with SCD from the complications of P falciparum infection despite persistent parasitemia. Proguanil may be more useful than pyrimethamine in the prevention of bone pain crises among patients with SCD.