Oral Assessment and Nursing Interventions Among Nigerian Nurses-Knowledge,Practices and Educational Needs

Background

Assessment of oral condition, oral care, and informing the attending doctor of unusual oral findings for possible consultation or referral to a dentist are the advocated roles of hospital nurses. The objective of the study was thus to assess the roles of Nigerian nurses in the assessment of oral conditions of hospitalized patients.

Methods

This questionnaire-based cross-sectional survey of all nurses caring for hospitalized patients in the University of Benin Teaching Hospital was conducted in the first half of 2010.

Results

Of the 384 studied participants, 94.3% considered oral care as an important aspect of nursing care and 73.4% had oral health component in their nursing school curriculum. A total of 80.7% reported suspicious and abnormal findings in hospitalized patients to the attending doctor. Amongst the respondents, 38.0% reported ability to conduct good oral tissue examination. Only 28.1% demonstrated good knowledge of common oral diseases. Three-quarters (73.4%) thought that it is compulsory for nurses to assess the oral condition of hospitalized patients. The 67.7% and 21.9% of the respondents did the assessment on admission and discharge respectively. The majority (90.1%) desired training on oral care of hospitalized patients.

Conclusion

There is a need to improve the skill and competence of nurses in the assessment of oral condition to make them a substantive partner in the oral care of hospitalized patients.     

Endoparasites of Rodents and Their Zoonotic Importance in Germi,Dashte–Mogan,Ardabil Province,Iran

Background

In order to verify the infectivity of rodents with endoparasites in Germi (Dashte-Mogan, Ardabil Province) the current study was undertaken.

Methods

Using live traps, 177 rodents were trapped during 2005–2007. In field laboratory, all rodents were bled prior to autopsy, frozen at −20°C, and shipped to the School of Public Health, Tehran University of Medical Sciences, Iran. In parasitological laboratory, every rodent was dissected and its different organs were examined for the presence of any parasite. Blood thick and thin smears as well as impression smears of liver and spleen were stained with Geimsa and examined microscopically.

Results

Two species of rodents were trapped; Meriones persicus (90.4%) and Microtus socialis (9.6%). The species of parasites found in M. persicus and their prevalences were as follows: Hymenolepis diminuta (38.8%), Hymenolepis nana (2.5%), Trichuris sp.(40.6), Mesocestoides larva (=tetrathyridium) (3.1%), Capillaria hepatica (6.9%), Moniliformis moniliformis (11.3%), Syphacia obvelata (2.5%), Taenia endothoracicus larva (0.6%), Physaloptera sp. (0.6%), Dentostomella translucida (0.6%), Heligmosomum mixtum (0.6%), Strobilocercus fasciolaris (0.6%),and Aspiculuris tetraptera (0.6%). The species of parasites found in M. socialis and their prevalences were as follows: H. diminuta (17.6%), Trichuris sp. (5.9%), Mesocestoides larva (5.9%), S. obvelata (11.8%), S. syphacia (11.8%), H. mixtum (17.6%), and Aspiculuris tetraptera (11.8%). There were no statistical differences between male and female for infectivity with parasites in either M. persicus or M. socialis. No blood or tissue protozoan parasite was found in any of the rodents examined.

Conclusion

Among different species identified, some had zoonotic importance. Therefore, the potential health hazard of these species needs to be considered to prevent infectivity of humans.     

Post traumatic stress disorder among former child soldiers attending a rehabilitative service and primary school education in northern Uganda

Background

This study was prompted by the psychiatric hospitalization of 12 former child soldiers of the Lord''s Resistance Army (LRA) at a rehabilitation school in northern Uganda with a case of mass psychotic behavior.

Objectives

To report the prevalence of post-traumatic stress disorder, depressed mood, and associated risk factors.

Methods

Data on post-traumatic stress disorder, depressed mood, physical disabilities, socio-demographic variables, and the children''s war experiences were collected in face-to-face interviews using the Harvard Trauma Questionnaire (HTQ), a modified Hopkins Symptoms Check-List (HSCL), and a 15-item War Trauma Experience Check-list (WTECL-15). Data was analyzed with SPSS version 11.0.

Results

There were 58 girls and 44 boys. Eighty nine children (87.3%) reported having experienced ten or more war-related traumatic psychological events; 55.9% of the children suffered from symptoms of post-traumatic stress disorder, 88.2%, symptoms of depressed mood and 21.6% had various forms of physical disability. Nearly half of the children (42.2%) reported a positive family history of severe mental illness; 10.8%, a family history of suicide; 22.5%, a family history of suicide attempt; and 45.1%, a family history of alcohol abuse. Children who experienced 10 or more traumatic war events were more likely than the rest to experience depressed mood. Return through a reception center or through a cleansing ritual did not protect against depression.

Discussion

Post-traumatic stress disorder among former LRA child soldiers at a rehabilitation centre in northern Uganda is presented. The report highlights the huge unmet need for psychological services among former child soldiers of the LRA.     

Necrotizing granulomatosis of the breast

Summary We describe a case of necrotizing granulomatosis of Wegener's type involving the breasts of a 40-year-old man. There were no signs of generalized disease. Involvement of the breast is rare in Wegener's granulomatosis (WG). To date. 17 cases have been reported, and all were women. They predominantly presented with a unilateral breast mass, and mammary malignancy was the principal concern. In the majority of cases, breast lesions of WG have been a presenting sign of, or preceded, disseminated disease. Our patient is unusual in that the necrotizing granulomas developed as an isolated finding in a site remote from those usually affected by WG, and, as far as we are aware, represents the first case of Wegener's type granulomatosis involving the male breast.     

Antegrade catheterization of the superficial femoral artery

A simple method of selective catheterization of the superficial femoral artery (SFA) following antegrade puncture of the common femoral artery is described. The method entails using a Cope-type dilator introducer, which directs the guide wire from its side hole into the SFA while the tip is secured in the deep femoral artery.     

Footprint peak time and functional ambulation profile reflect the potential for hemiparetic gait recovery

Objective: Gait disturbances were monitored in patients with chronic stroke with a walkway built with pressure sensors in order to assess whether detailed gait and footprint information could provide verification for the potential for gait recovery.

Methods: Gait variables (footprint peak times, temporal and spatial parameters and Functional Ambulation Profile, FAP, scores), were first recorded in 25 patients with chronic stroke at their preferred speed and 10 healthy volunteers walking from very slow to very fast. Patients and controls were divided into four groups based on the velocity performance. Secondly, the effect of rehabilitation on the footprint peak times was evaluated in another group of 20 chronic stroke patients.

Results and conclusions: The footprint peak time behaviour of different patients with chronic stroke reflected their hemiparetic gait pattern. The slower patients had prolonged footprint peak times on the non-affected side (NS) and shorter values on the lateral footprint on the affected side (AS). The increased gait velocity and the FAP scores decreased the footprint peak times on both sides, especially on the NS. The rehabilitation increased the gait velocity with 18.2%, decreased the duration of the mid-foot and forefoot peak times on the NS and the lateral mid-foot peak times on the AS. A detailed analysis of the individual gait performance allows more accurate assessment of the potential for gait recovery.     

Use of monoclonal antibodies for the histopathological diagnosis of human malignancy

This paper describes the use of a panel of seven monoclonal antibodies (selected so as to include reagents reactive with both epithelial and lymphoid cells) for distinguishing between anaplastic carcinoma and high grade lymphoma. Details are given of the immunohistological reactions of these antibodies against a wide range of both normal and malignant tissues and of a number of practical instances in which use of the antibody panel enabled a diagnosis to be made when routine histological examination had been inconclusive.     

Anin vitro model for studying mechanisms underlying synoviocyte-mediated cartilage invasion in rheumatoid arthritis

Rheumatoid arthritis (RA) is a chronic inflammatory disease of joints involving the pathological development of an invasive and destructive pannus tissue which contributes to the loss of cartilage and bone. To further analyze the process of cartilage degradation and invasion, we have developed an in vitro model composed of cartilage matrix and synoviocytes (isolated from RA pannus tissue, as well as normal synovial membrane). The matrix is derived from pig articular cartilage and contains collagen type II and proteoglycans and is similar in composition to human cartilage. Data generated from this model reveal that synoviocytes isolated from RA pannus tissue invaded cartilage matrix in a manner which directly correlated with the severity of the disease. Analysis of mechanisms associated with the invasive process demonstrate that highly invasive RA synoviocytes maintain a round morphology during attachment and spreading on cartilage matrix, compared with their normal counterparts. Furthermore, the level of secretion of matrix metalloproteinase (MMP) activity was shown to correlate with the RA phenotype, which could be modulated with a novel MMP inhibitor. Normal synoviocytes could be "converted" to an RA phenotype by specific inflammatory cytokines, such that invasion of cartilage matrix was augmented by culturing these cells in the presence of 5 U/ml IL-1b or 18 U/ml TGFb. Invasion was inhibited by 150 U/ml TNFa, and unaffected by 100 ng/ml PDGF. In addition, synovial fluid from RA patients induced invasion of normal synoviocytes, in a concentration dependent manner, from 150% to 460%; however, synovial fluid from another inflammatory arthritidy (Crohn's) did not augment invasion to the same degree. Moreover, this "conversion effect" appears to be specific for synoviocytes, since similar effects could not be achieved with human skin fibroblasts. This in vitro model of synoviocyte-mediated cartilage invasion allows for further molecular characterization of the invasive properties of the synoviocyte which contribute to RA.