Assessment of the compliance of Nigerian dentists with infection control: a preliminary study.

OBJECTIVE: To assess the compliance of a group of Nigerian dentists with standard infection control practices. METHOD: A confidential self-administered questionnaire survey was conducted among dentists engaged in active clinical practices in public hospitals in Lagos, Nigeria (n = 185). RESULTS: One hundred forty-six questionnaires were returned (response rate, 78.9%). Most (70.6%) of the dentists always wore gloves when treating patients, whereas 29.4% sometimes did. Regarding facemasks, 45.9% always wore them, 52.7% sometimes wore them, and 1.4% never wore them. Protective eye wear was always worn by 4.8% of the dentists, sometimes worn by 52.7%, and never worn by 42.5%. Approximately half (50.7%) of the respondents had received hepatitis B vaccination. Sterilization was performed using a combination of methods, including autoclaving (84.1%), boiling (19.3%), dry heat (17.5%), and chemicals (29.7%). Nonavailability of materials was the major reason for noncompliance with infection control practices. CONCLUSIONS: Nigerian dentists need continuous education regarding infection control. Also, Nigerian hospitals urgently need adequate funding for up-to-date and functional equipment and materials.     

Minimum practicable and acceptable infection control recommendations for dental practice in Nigeria

The advent of HIV/aids has led to a renewed interest in infection control and occupational safety in dentistry. The full implementation of "Universal Precautions" to prevent cross-infection of HIV, hepatitis B, and other blood borne pathogens would have a heavy financial implication on developing countries like Nigeria which are faced with the arduous problem of coping with scarce resources. Dentistry is bound to cost more when effective infection control is practised. This paper therefore proposes recommendations for minimum, practicable and acceptable infection control standards which are not only cost effective but also attainable.     

Plasma volume in normal pregnant Nigerian primigravidae

Plasma volume was measured in 10 non-pregnant, healthy nulliparous Nigerian and 30 normal primigravid Nigerians at various times of gestation by the Evans blue dye dilution technique. The mean plasma volume of 2098 ml for the non-pregnant Nigerians was statistically different (P less than 0.001) from values in non-pregnant caucasian primigravidae of comparable status. A mean maximum plasma volume increase of 1387 ml above non-pregnant value was found. Essentially, pregnancy imposed a much higher physiological load on Nigerian primigravidae compared to caucasian primigravidae. There was a significant negative correlation between plasma volume and packed cell volume (PCV) in pregnancy (r = -0.51, P less than 0.001), which may be related to excessive hemodilution in the primigravid Nigerian. Differences found may be due to geographical and/or racial factors.     

Orchidectomy attenuates high‐salt diet‐induced increases in blood pressure,renovascular resistance,and hind limb vascular dysfunction: role of testosterone

Sex hormone‐dependent vascular reactivity is an underlying factor contributing to sex differences in salt‐dependent hypertension. This study evaluated the role of androgens (testosterone) in high salt‐induced increase in blood pressure (BP) and altered vascular reactivity in renal blood flow and perfused hind limb preparation. Weanling male rats (8 weeks old, 180–200 g) were bilaterally orchidectomised or sham operated with or without testosterone replacement (Sustanon 250, 10 mg/kg intramuscularly once in 3 weeks) and placed on a normal (0.3%) or high (4.0%) NaCl diet for 6 weeks. The high‐salt diet (HSD) increased arterial BP, renal vascular resistance (RVR) and positive fluid balance (FB). These changes were accompanied by decreased plasma nitric oxide levels. The increased BP, RVR and FB observed in the rats fed a HSD were reversed by orchidectomy while testosterone replacement prevented the reversal. Phenylephrine (PE)‐induced increased vascular resistance in the perfused hind limb vascular bed was enhanced by HSD, the enhanced vascular resistance was prevented by orchidectomy and testosterone replacement reversed orchidectomy effect. Vasorelaxation responses to acetylcholine (ACh) and sodium nitroprusside (SNP) were impaired in HSD groups, orchidectomy attenuated the impairment, while testosterone replacement prevented the orchidectomy attenuation. These data suggested that eNOS‐dependent and independently‐mediated pathways were equally affected by HSD in vascular function impairment and this effect is testosterone‐dependent in male Sprague‐Dawley rats.     

Quantifying the economic burden of malaria in Nigeria using the willingness to pay approach

Background

Osteoporosis creates brittle bones susceptible to fracture, with resulting high levels of morbidity and mortality. Poor access to bone densitometry services for the residents of North Wales led to the Welsh Assembly Government offering capital to purchase a dual-energy X-ray absorptiometry (DXA) scanner, used to diagnose osteoporosis, for the region. The commissioning question for the six Local Health Boards across North Wales was where to site the new scanner. This decision needed to reflect current inequalities in access to services and concerns over inappropriate prescribing relative to Welsh norms.

Methods

Epidemiological, corporate and comparative healthcare needs assessments were performed. In addition, two cross-sectional surveys were conducted to determine the views of general practices and users of bone densitometry services resident in North Wales. An option appraisal and sensitivity analysis of 13 costed options for DXA scanning was conducted.

Results

We estimated that only 31% of the people in North Wales who met national guidelines were receiving DXA scans. There was definite inequity of access to the current service provided by area of residence. There was also evidence of inequity of access by age and sex. The most suitable option identified in the option appraisal was a bone densitometry service based in the central location of Llandudno.

Conclusion

The assessment identified significant unmet need for DXA scanning. A recommendation was made to improve access through the introduction of a new bone densitometry service based at Llandudno. This would double scanning provision provided and reduce travel costs and time for many North Wales residents. This recommendation was adopted by a joint commissioning group established by the six Local Health Boards in North Wales at the end of 2004 – evidence based commissioning in practice.     

Exosomes from marrow stromal cells expressing miR-146b inhibit glioma growth

Exosomes are 30–150 nm vesicles secreted by a wide range of mammalian cells that can contain microRNA (miRNA). To test if marrow stromal cell (MSC) exosomes could be used as a vehicle for delivery of anti-tumor miRNAs, we transfected MSCs with a miR-146b expression plasmid, and harvested exosomes released by the MSCs. Intra-tumor injection of exosomes derived from miR-146-expressing MSCs significantly reduced glioma xenograft growth in a rat model of primary brain tumor.     

Reflex inotropic responses of the heart from lung inflation in anaesthetized dogs

In anaesthetized dogs a tracheal divider was inserted to allow inflation of one lung with various pressures. Left ventricular inotropic responses were assessed by measuring the maximum rate of change of left ventricular pressure (dP/dt max) using a preparation in which aortic pressure, carotid sinus pressure and heart rate were held constant.Heart responses to lung inflation were variable. In five dogs there was a consistent tachycardia, in three bradycardia and in six there was no change. In the dogs in which heart rate increased, inflation of one lung with pressures between 0.5 and 2.0 kPa (5 and 20 cm H₂O) resulted in no significant change in dP/dt max. In the remaining dogs there was a decrease in dP/dt max which was more pronounced at the higher inflation pressures. The negative inotropic response was shown to be a reflex with afferent nerve endings in the lung and with the efferent pathway in the sympathetic nerves.