Mercury hygiene and biomedical waste management practices among dental health-care personnel in public hospitals in Lagos State,Nigeria

BackgroundIndiscriminate disposal of hospital wastes including mercury/amalgam wastes pose a serious threat to life and environment. There is a growing concern about biomedical waste (BMW) management among health care workers, however there are limited reports on BMW management by dental personnel in developing countries.ObjectivesThis study investigated the level of knowledge of BMW, observance of proper mercury hygiene and BMW management practice among public dental personnel in Lagos State, Nigeria.MethodsA cross-sectional study regarding BMW management across public hospitals in Lagos State, Nigeria was conducted following institutional ethics committee approval. A self-administered questionnaire was utilized to obtain data from different facilities selected by purposive and simple random sampling techniques as applicable. The questionnaires were distributed among 437 respondents by convenience sampling. The resulting data were statistically tested using Chi-square and G-test with p-value < 0.05 indicating significant level.ResultsAmongst 437 respondents, majority were females (62.5%) and the highest proportion fell within the age range of 25–34 years (44.4%). Only 17.2% of the respondents had good knowledge of BMW management/legislation and 4.1% had good BMW practice. Less than half (49.4%) of respondents disposed mercury-contaminated materials inside the trash and majority (92.2%) did not observe proper mercury hygiene. Significantly better mercury hygiene practices were observed in secondary facilities (p=0.040).ConclusionA minor proportion of public dental personnel had good knowledge and practice of proper mercury hygiene and BMW management. This shows there is an urgent need for training of health personnel on proper BMW handling and disposal in developing countries like Nigeria.     

尼日利亚Gwagwalada原发性开角型青光眼患者的社会人口学和临床特征

目的：探讨比较尼日利亚Gwagwalada原发性开角型青光眼(POAG)与非青光眼患者的临床社会人口学特征。

方法：横断面对比研究。共调查235例成年患者,其中96例POAG及139例非青光眼。记录患者年龄、性别、教育程度、职业、种族、青光眼家族史、眼痒、糖尿病和高血压情况。眼部检查包括视力、中央视野、杯盘比、前房角评估和眼压。

结果：平均年龄为49.88±13.75岁,其中男114例(48.5%)。POAG患者包括42个种族,其中伊博人(24/96,25.0%)和约鲁巴人(20/96,20.8%)最为常见。大多数POAG(74/96,77.1%)年龄在40-69岁之间。POAG(73/96,76.0%)有不同程度的视力障碍。POAG组与非青光眼组的对比如下：青光眼阳性家族史(34/96,35.4%)vs(25/139,18.0%; P=0.012); 糖尿病史(8/96,8.3%)vs(6/139,4.3%); 高血压病史(24/96,25.0%)vs(28/139,20.1%); 糖尿病合并高血压病史(1/96,1.0%)vs(4/139,2.9%; P=0.268); 使用抗糖尿病药物者(5/96,5.2%)vs(7/139,5.0%); 使用降压药者(24/96,25.0%)vs(23/139,16.5%); 联合使用抗糖尿病和抗高血压药物者(4/96,4.2%)vs(5/139,3.6%; P=0.328); 有眼痒症状者(18/96,18.7%)vs(37/139,26.6%; P=0.328); 视力障碍\〖右眼(RE)：51/96,53.1%; 左眼(LE)：60/96,62.5%\〗vs(RE：40/139,28.7%; LE：37/139,26.6%; P=0.000); 垂直杯盘比>0.4(RE：96/96,100%; LE：96/96,100%)vs(RE：131/139,94.2%; LE：124/139,89.2%)(RE：P=0.307; LE：P=0.006); 眼压>22 mmHg(RE：17/96,17.7%; LE：22/96,22.9%)vs(RE：2/139,1.4%; LE：2/139,1.4%; P=0.006)。大多数POAG患者(60/96,62.5%)正在服用抗青光眼药物,(23/96,24.0%)尚未开始用药,P=0.000。许多POAG(32/96,33.3%)正在服用β受体阻滞剂、前列腺素抑制剂和碳酸酐酶抑制剂的联合抗青光眼药物。

结论：青光眼具有与其他眼部疾病不同的临床社会人口学特征。许多参与者肯定了青光眼的家族史,大多数青光眼参与者正在接受抗青光眼治疗。包括失明在内的视力障碍与青光眼显著相关。该研究证实,开角型青光眼与高杯盘比和高眼内压有关。     

Mechanism of Viral Suppression among HIV Elite Controllers and Long-Term Nonprogressors in Nigeria and South Africa

A subgroup among people living with HIV (PLHIV) experience viral suppression, sometimes to an undetectable level in the blood and/or are able to maintain a healthy CD4+ T-cell count without the influence of antiretroviral (ARV) therapy. One out of three hundred PLHIV fall into this category, and a large sample of this group can be found in areas with a high prevalence of HIV infection such as Nigeria and South Africa. Understanding the mechanism underpinning the nonprogressive phenotype in this subgroup may provide insights into the control of the global HIV epidemic. This work provides mechanisms of the elite control and nonprogressive phenotype among PLHIV in Nigeria and South Africa and identifies research gaps that will contribute to a better understanding on HIV controllers among PLHIV.     

Infection Prevention and Evaluation of Fever After Laparoscopic Hysterectomy

Background:

Surgical site infection (SSI) is a common complication of hysterectomy. Minimally invasive hysterectomy has lower infection rates than abdominal hysterectomy. The lower SSI rates reflect the role and benefit in infection control of having minimal incisions, rather than a large anterior abdominal wall incision. Despite the lower rates, SSI after laparoscopic hysterectomy is not uncommon. In this article, we review pre-, intra-, and postoperative risk factors for infection. Rates of postoperative fever after laparoscopic hysterectomy and when evaluation for infection is warranted in a febrile patient are also reviewed.

Database:

PubMed was searched for English-only articles using National Library of Medicine Medical Subject Headings (MESH) terms and keywords including but not limited to “postoperative,” “surgical site,” “infection,” “fever,” “laparoscopic,” “laparoscopy,” and “hysterectomy.”

Conclusions:

Reducing hospital-acquired infections such as SSI is one of the more effective ways of improving patient safety. Knowledge and understanding of risk factors for infection following laparoscopic hysterectomy enable the gynecologic surgeon or hospital to implement targeted preventive measures.     

Endomyometritis after cesarean delivery in the era of antibiotic prophylaxis: incidence and risk factors

Purpose: To identify the rate of postpartum endomyometritis (PPE) after cesarean delivery (CD) in the era of antibiotic prophylaxis and determine risk factors.

Methods: A single institution retrospective study was performed in women undergoing CD. Data regarding obstetrical and surgical variables were collected. Diagnosis of PPE was made clinically.

Results: Among 2419 patients, the rate of PPE was 1.6% (n?=?38) and was associated with lower age (27.0 versus 31.0; p?p?p?=?.0081). There was no difference in PPE for cefazolin 2?g versus 1?g (OR: 1.91; p?=?.17) or 3?g versus 1?g (OR: 3.69; p?=?.29), gentamicin/clindamycin versus cefazolin (OR: 5.60; p?p?=?.001), sexually transmitted infection during the pregnancy (OR: 4.197; p?=?.02) or blood transfusion (OR: 9.50; p?Conclusions: While the overall rate of PPE was low, several risk factors were identified. Preoperative diagnosis of chorioamnionitits is associated with a higher rate of PPE. Further studies are needed to identify optimal regimens for antimicrobial prophylaxis in women undergoing CD.     

Electronic brachytherapy for postsurgical adjuvant vaginal cuff irradiation therapy in endometrial and cervical cancer: A retrospective study

PurposeA new platform for brachytherapy called electronic brachytherapy (EBT) has been developed, which uses a miniature X-ray source to generate low-energy radiation. A retrospective study of adverse events and clinical outcomes in patients treated with EBT to the vaginal cuff, either as monotherapy or in combination with external beam radiation therapy (EBRT), was conducted.Methods and MaterialsMedical records were reviewed from 16 patients treated with postoperative EBT for endometrial (n = 13) or cervical cancer (n = 3) between February 2009 and November 2010. Patients received either intracavitary vaginal EBT alone or EBT in combination with EBRT. The radiobiologic effectiveness of EBT was assumed to be one.ResultsMedian follow-up was 20.5 months (range, 7–36 months). When EBT was used alone (n = 5), the median dose per fraction, number of fractions, and total dose delivered were: 6 Gy (range, 5.5–6.2 Gy), 5 fractions (range, 5–6), and 30 Gy (range, 30–34 Gy), respectively. When EBT was combined with EBRT, the EBT component median dose per fraction, number of fractions, and total dose delivered were: 5 Gy (range, 4.5–7 Gy), 2 fractions (range, 2–4), and 14 Gy (range, 9–20 Gy), respectively. The median EBRT dose was 45 Gy (range, 45–49.2 Gy). Our local control rate, locoregional (pelvic) control rate, and overall survival rate were 94%, 94%, and 88%, respectively. Of the 16 patients, 4 patients reported Grade 2 or greater toxicity (25%); however, there were no Grade 4–5 adverse events. Gynecologic, genitourinary, and gastrointestinal adverse events accounted for 57% (n = 4), 43% (n = 3), and 0% (n = 0) of all Grade 2 or greater side effects. No Grade 2 or higher toxicities were noted in patients treated with EBT alone.ConclusionEBT is an acceptable means of delivering postoperative vaginal brachytherapy and appears comparable with other methods; as the sole method of treatment, the toxicity rates of EBT are low.     

Prevalence of Cytomegalovirus IgG Antibodies among Pregnant Women Visiting Antenatal Clinic,LAUTECH Teaching Hospital in Osogbo,Osun State,Nigeria

Cytomegalovirus (CMV) is one of the predominant viral infections that lead to congenital diseases and teratogenic risks during the perinatal stage. There is paucity of seroepidemiological data on anti-CMV IgG antibody in pregnant women in Osogbo, Osun State, Nigeria. This study was aimed at determining the seroprevalence of Cytomegalovirus IgG antibody among pregnant women visiting antenatal clinic, LAUTECH Teaching Hospital, Osogbo, Nigeria. One hundred and seventy-four sera from the pregnant women were screened by Enzyme linked Immunosorbent Assay (ELISA) for cytomegalovirus (CMV) IgG antibody. Data analysis was done using SPSS software. In this study, 105 of the 174 pregnant women were seropositive for CMV IgG antibodies giving an antibody prevalence of 60%. There was no association found between CMV IgG seropositivity and the subjects’ demographic characteristics, however, the 60.0% prevalence of CMV-IgG antibody observed amongst pregnant women in this study demands for vaccines and regular testing for the presence of CMV and its related risk factors in antenatal clinic.