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  Subjects -> HEALTH AND SAFETY (Total: 1342 journals)
    - CIVIL DEFENSE (23 journals)
    - DRUG ABUSE AND ALCOHOLISM (89 journals)
    - HEALTH AND SAFETY (555 journals)
    - HEALTH FACILITIES AND ADMINISTRATION (382 journals)
    - OCCUPATIONAL HEALTH AND SAFETY (107 journals)
    - PHYSICAL FITNESS AND HYGIENE (105 journals)
    - WOMEN'S HEALTH (81 journals)

HEALTH AND SAFETY (555 journals)                  1 2 3 | Last

Showing 1 - 200 of 203 Journals sorted alphabetically
16 de Abril     Open Access  
A Life in the Day     Hybrid Journal   (Followers: 12)
Acta Informatica Medica     Open Access   (Followers: 1)
Acta Scientiarum. Health Sciences     Open Access   (Followers: 1)
Adultspan Journal     Hybrid Journal   (Followers: 1)
Advances in Child Development and Behavior     Full-text available via subscription   (Followers: 10)
Advances in Public Health     Open Access   (Followers: 23)
African Health Sciences     Open Access   (Followers: 2)
African Journal for Physical, Health Education, Recreation and Dance     Full-text available via subscription   (Followers: 7)
African Journal of Health Professions Education     Open Access   (Followers: 6)
Afrimedic Journal     Open Access   (Followers: 2)
Ageing & Society     Hybrid Journal   (Followers: 38)
Air Quality, Atmosphere & Health     Hybrid Journal   (Followers: 4)
AJOB Primary Research     Partially Free   (Followers: 3)
American Journal of Family Therapy     Hybrid Journal   (Followers: 11)
American Journal of Health Economics     Full-text available via subscription   (Followers: 13)
American Journal of Health Education     Hybrid Journal   (Followers: 30)
American Journal of Health Promotion     Hybrid Journal   (Followers: 26)
American Journal of Health Sciences     Open Access   (Followers: 7)
American Journal of Health Studies     Full-text available via subscription   (Followers: 11)
American Journal of Preventive Medicine     Hybrid Journal   (Followers: 27)
American Journal of Public Health     Full-text available via subscription   (Followers: 201)
American Journal of Public Health Research     Open Access   (Followers: 27)
American Medical Writers Association Journal     Full-text available via subscription   (Followers: 5)
Analytic Methods in Accident Research     Hybrid Journal   (Followers: 5)
Annals of Health Law     Open Access   (Followers: 3)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 12)
Applied Biosafety     Hybrid Journal  
Applied Research In Health And Social Sciences : Interface And Interaction     Open Access   (Followers: 3)
Archive of Community Health     Open Access   (Followers: 1)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Arquivos de Ciências da Saúde     Open Access  
Asia Pacific Journal of Counselling and Psychotherapy     Hybrid Journal   (Followers: 9)
Asia Pacific Journal of Health Management     Full-text available via subscription   (Followers: 3)
Asia-Pacific Journal of Public Health     Hybrid Journal   (Followers: 8)
Asian Journal of Gambling Issues and Public Health     Open Access   (Followers: 3)
Atención Primaria     Open Access   (Followers: 1)
Australasian Journal of Paramedicine     Open Access   (Followers: 3)
Australian Advanced Aesthetics     Full-text available via subscription   (Followers: 4)
Australian Family Physician     Full-text available via subscription   (Followers: 3)
Australian Indigenous HealthBulletin     Free   (Followers: 6)
Autism & Developmental Language Impairments     Open Access   (Followers: 8)
Behavioral Healthcare     Full-text available via subscription   (Followers: 6)
Bijzijn     Hybrid Journal   (Followers: 2)
Bijzijn XL     Hybrid Journal   (Followers: 1)
Biomedical Safety & Standards     Full-text available via subscription   (Followers: 8)
BLDE University Journal of Health Sciences     Open Access  
BMC Oral Health     Open Access   (Followers: 6)
BMC Pregnancy and Childbirth     Open Access   (Followers: 21)
BMJ Simulation & Technology Enhanced Learning     Full-text available via subscription   (Followers: 10)
Brazilian Journal of Medicine and Human Health     Open Access  
Buletin Penelitian Kesehatan     Open Access   (Followers: 2)
Buletin Penelitian Sistem Kesehatan     Open Access  
Cadernos de Educação, Saúde e Fisioterapia     Open Access   (Followers: 1)
Cadernos Saúde Coletiva     Open Access   (Followers: 1)
Cambridge Quarterly of Healthcare Ethics     Hybrid Journal   (Followers: 11)
Canadian Family Physician     Partially Free   (Followers: 11)
Canadian Journal of Community Mental Health     Full-text available via subscription   (Followers: 9)
Canadian Journal of Human Sexuality     Hybrid Journal   (Followers: 2)
Canadian Journal of Public Health     Full-text available via subscription   (Followers: 19)
Case Reports in Women's Health     Open Access   (Followers: 3)
Case Studies in Fire Safety     Open Access   (Followers: 15)
Central Asian Journal of Global Health     Open Access   (Followers: 2)
CES Medicina     Open Access  
Child Abuse Research in South Africa     Full-text available via subscription   (Followers: 1)
Child's Nervous System     Hybrid Journal  
Childhood Obesity and Nutrition     Open Access   (Followers: 10)
Children     Open Access   (Followers: 2)
CHRISMED Journal of Health and Research     Open Access  
Christian Journal for Global Health     Open Access  
Ciência & Saúde Coletiva     Open Access   (Followers: 2)
Ciencia e Innovación en Salud     Open Access  
Ciencia y Cuidado     Open Access   (Followers: 1)
Ciencia, Tecnología y Salud     Open Access  
ClinicoEconomics and Outcomes Research     Open Access   (Followers: 2)
CME     Hybrid Journal   (Followers: 1)
CoDAS     Open Access  
Community Health     Open Access   (Followers: 3)
Conflict and Health     Open Access   (Followers: 7)
Contraception and Reproductive Medicine     Open Access  
Curare     Open Access  
Current Opinion in Behavioral Sciences     Hybrid Journal   (Followers: 4)
Day Surgery Australia     Full-text available via subscription   (Followers: 2)
Digital Health     Open Access   (Followers: 3)
Disaster Medicine and Public Health Preparedness     Hybrid Journal   (Followers: 11)
Dramatherapy     Hybrid Journal   (Followers: 2)
Drogues, santé et société     Full-text available via subscription  
Duazary     Open Access   (Followers: 1)
Düzce Üniversitesi Sağlık Bilimleri Enstitüsü Dergisi / Journal of Duzce University Health Sciences Institute     Open Access  
Early Childhood Research Quarterly     Hybrid Journal   (Followers: 17)
East African Journal of Public Health     Full-text available via subscription   (Followers: 3)
Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity     Hybrid Journal   (Followers: 19)
EcoHealth     Hybrid Journal   (Followers: 4)
Education for Health     Open Access   (Followers: 6)
electronic Journal of Health Informatics     Open Access   (Followers: 6)
ElectronicHealthcare     Full-text available via subscription   (Followers: 3)
Elsevier Ergonomics Book Series     Full-text available via subscription   (Followers: 4)
Emergency Services SA     Full-text available via subscription   (Followers: 2)
Ensaios e Ciência: Ciências Biológicas, Agrárias e da Saúde     Open Access  
Environmental Disease     Open Access   (Followers: 2)
Environmental Sciences Europe     Open Access   (Followers: 1)
Epidemics     Open Access   (Followers: 4)
Epidemiologic Perspectives & Innovations     Open Access   (Followers: 5)
Epidemiology, Biostatistics and Public Health     Open Access   (Followers: 18)
Ethics, Medicine and Public Health     Full-text available via subscription   (Followers: 4)
Ethiopian Journal of Health Development     Open Access   (Followers: 8)
Ethiopian Journal of Health Sciences     Open Access   (Followers: 7)
Ethnicity & Health     Hybrid Journal   (Followers: 13)
Eurasian Journal of Health Technology Assessment     Open Access  
European Journal of Investigation in Health, Psychology and Education     Open Access   (Followers: 2)
European Medical, Health and Pharmaceutical Journal     Open Access   (Followers: 1)
Evaluation & the Health Professions     Hybrid Journal   (Followers: 10)
Evidence-based Medicine & Public Health     Open Access   (Followers: 6)
Evidência - Ciência e Biotecnologia - Interdisciplinar     Open Access  
Expressa Extensão     Open Access  
Face à face     Open Access   (Followers: 1)
Families, Systems, & Health     Full-text available via subscription   (Followers: 8)
Family & Community Health     Partially Free   (Followers: 12)
Family Medicine and Community Health     Open Access   (Followers: 7)
Family Relations     Partially Free   (Followers: 11)
Fatigue : Biomedicine, Health & Behavior     Hybrid Journal   (Followers: 2)
Food and Public Health     Open Access   (Followers: 12)
Food Quality and Safety     Open Access  
Frontiers in Public Health     Open Access   (Followers: 6)
Gaceta Sanitaria     Open Access   (Followers: 3)
Galen Medical Journal     Open Access  
Gazi Sağlık Bilimleri Dergisi     Open Access  
Geospatial Health     Open Access  
Gesundheitsökonomie & Qualitätsmanagement     Hybrid Journal   (Followers: 9)
Giornale Italiano di Health Technology Assessment     Full-text available via subscription  
Global Health : Science and Practice     Open Access   (Followers: 6)
Global Health Promotion     Hybrid Journal   (Followers: 15)
Global Journal of Health Science     Open Access   (Followers: 10)
Global Journal of Public Health     Open Access   (Followers: 13)
Global Medical & Health Communication     Open Access   (Followers: 2)
Global Mental Health     Open Access   (Followers: 7)
Global Security : Health, Science and Policy     Open Access   (Followers: 1)
Globalization and Health     Open Access   (Followers: 5)
Hacia la Promoción de la Salud     Open Access  
Hastane Öncesi Dergisi     Open Access  
Hastings Center Report     Hybrid Journal   (Followers: 3)
HEADline     Hybrid Journal  
Health & Place     Hybrid Journal   (Followers: 15)
Health & Justice     Open Access   (Followers: 5)
Health : An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine     Hybrid Journal   (Followers: 7)
Health and Human Rights     Free   (Followers: 9)
Health and Social Care Chaplaincy     Hybrid Journal   (Followers: 7)
Health and Social Work     Hybrid Journal   (Followers: 55)
Health Behavior and Policy Review     Full-text available via subscription   (Followers: 3)
Health Care Analysis     Hybrid Journal   (Followers: 15)
Health Inform     Full-text available via subscription  
Health Information Management Journal     Hybrid Journal   (Followers: 17)
Health Issues     Full-text available via subscription   (Followers: 2)
Health Notions     Open Access  
Health Policy     Hybrid Journal   (Followers: 42)
Health Policy and Technology     Hybrid Journal   (Followers: 4)
Health Professional Student Journal     Open Access   (Followers: 2)
Health Promotion International     Hybrid Journal   (Followers: 21)
Health Promotion Journal of Australia : Official Journal of Australian Association of Health Promotion Professionals     Full-text available via subscription   (Followers: 8)
Health Promotion Practice     Hybrid Journal   (Followers: 16)
Health Prospect     Open Access   (Followers: 1)
Health Psychology     Full-text available via subscription   (Followers: 50)
Health Psychology Research     Open Access   (Followers: 19)
Health Psychology Review     Hybrid Journal   (Followers: 40)
Health Renaissance     Open Access  
Health Research Policy and Systems     Open Access   (Followers: 13)
Health SA Gesondheid     Open Access   (Followers: 2)
Health Science Reports     Open Access  
Health Sciences and Disease     Open Access   (Followers: 2)
Health Services Insights     Open Access   (Followers: 1)
Health Systems     Hybrid Journal   (Followers: 4)
Health Voices     Full-text available via subscription  
Health, Culture and Society     Open Access   (Followers: 12)
Health, Risk & Society     Hybrid Journal   (Followers: 13)
Health, Safety and Environment     Open Access   (Followers: 21)
Healthcare     Open Access   (Followers: 3)
Healthcare in Low-resource Settings     Open Access   (Followers: 1)
Healthcare Quarterly     Full-text available via subscription   (Followers: 8)
Healthcare Technology Letters     Open Access  
HERD : Health Environments Research & Design Journal     Full-text available via subscription  
Highland Medical Research Journal     Full-text available via subscription  
Hispanic Health Care International     Full-text available via subscription  
HIV & AIDS Review     Full-text available via subscription   (Followers: 12)
Home Health Care Services Quarterly     Hybrid Journal   (Followers: 6)
Hong Kong Journal of Social Work, The     Hybrid Journal   (Followers: 2)
Hospitals & Health Networks     Free   (Followers: 4)
IEEE Journal of Translational Engineering in Health and Medicine     Open Access   (Followers: 3)
IMTU Medical Journal     Full-text available via subscription  
Indian Journal of Health Sciences     Open Access   (Followers: 3)
Indonesian Journal for Health Sciences     Open Access   (Followers: 1)
Indonesian Journal of Public Health     Open Access  
Infodir : Revista de Información científica para la Dirección en Salud     Open Access  
Inmanencia. Revista del Hospital Interzonal General de Agudos (HIGA) Eva Perón     Open Access  
Innovative Journal of Medical and Health Sciences     Open Access  
Institute for Security Studies Papers     Full-text available via subscription   (Followers: 2)
interactive Journal of Medical Research     Open Access  
International Archives of Health Sciences     Open Access  
International Health     Hybrid Journal   (Followers: 5)
International Journal for Equity in Health     Open Access   (Followers: 6)
International Journal for Quality in Health Care     Hybrid Journal   (Followers: 34)

        1 2 3 | Last

Journal Cover
African Health Sciences
Journal Prestige (SJR): 0.446
Citation Impact (citeScore): 1
Number of Followers: 2  

  This is an Open Access Journal Open Access journal
ISSN (Print) 1680-6905
Published by African Journals Online Homepage  [264 journals]
  • Reproducibility of corneal, macular and retinal nerve fiber layer
           thickness measurements using the iVue-100 optical coherence tomography

    • Authors: Khathutshelo P Mashige
      Abstract: Purpose: To determine the intra-session and inter-session reproducibility of corneal, macular and retinal nerve fiber layer thickness (RNFL) measurements with the iVue-100 optical coherence tomography in normal eyes.
      Methods: These parameters were measured in the right eyes of 50 healthy participants with normal vision. Six scans each for corneal thickness, macular and optic nerve head were taken on one day (intra-session), followed by similar repeated measures on five separate days (inter-session). Reproducibility was computed using intra-class correlation coefficient (ICC), coefficient of variation (COV), and test-retest variability (TRV).
      Results: For intra-session reproducibility, the ICC, COV and TRV values for mean corneal thickness were 0.924, 2.82%, and 3.06 μm respectively. For the mean macular thickness, they were 0.978, 4.64% and 4.51 μm respectively, while for mean RNFL thickness they were 0.946, 3.19%, and 5.66 μm respectively. Inter-session values for mean corneal thickness were 0.926, 2.65% and 3.48 μm, and 0.916, 2.24% and 2.03 μm for mean macular thickness. For mean RNFL thickness, they were 0.962, 2.21%, and 4.72 μm respectively.
      Conclusion: There was good reproducibility of all measured parameters. However, mean RNFL thickness measurements were the most reproducible, suggesting that this may be the best parameter to use to determine measured changes over time.
      Keywords: Corneal thickness, macular thickness, retinal nerve fiber layer thickness, iVue-100, reproducibility
      PubDate: 2019-01-08
      Issue No: Vol. 17, No. 4 (2019)
       
  • Abnormalities of the external genitalia and groins among primary school
           boys in Bida, Nigeria

    • Authors: Adedeji O Adekanye, Samuel A Adefemi, Kayode A Onawola, John A James, Ibrahim T Adeleke, Mark Francis, Ezekiel U Sheshi, Moses E Atakere, Abdullahi D Jibril
      Abstract: Background: Abnormalities of the male external genitalia and groin, a set of lesions which may be congenital or acquired, are rather obscured to many kids and their parents and Nigerian health care system has no formal program to detect them.
      Objectives: To identify and determine the prevalence of abnormalities of external genitalia and groin among primary school boys in Bida, Nigeria.
      Methods: This was a cross-sectional study of primary school male pupils in Bida. A detailed clinical examination of the external genitalia and groin was performed on them.
      Results: Abnormalities were detected in 240 (36.20%) of the 663 boys, with 35 (5.28%) having more than one abnormality. The three most prevalent abnormalities were penile chordee (37, 5.58%), excessive removal of penile skin (37, 5.58%) and retractile testis (34, 5.13%). The prevalence of complications of circumcision was 15.40% and included excessive residual foreskin, excessive removal of skin, skin bridges and meatal stenosis. Undescended testes were seen in 6 (0.90%) boys, with median age of 9 years and 2 were bilateral. Also, micropenis was detected in 27 (4.07%) of the pupils.
      Conclusion: Inguino-penoscrotal abnormalities are common in our community (36.20%). Screening of pre-school and school children to  detect them should be introduced into the school health programs in Nigeria.
      Keywords: External genitalia, groin abnormalities, boys
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Common childhood kidney diseases in Uganda and their prevention

    • Authors: Amos Odiit
      Abstract: No Abstarct
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Idiopathic nephrotic syndrome in South African children.

    • Authors: Yassir Mahgoub Bakhiet, Abdullahi Mudi, Tholang Khumalo, Glenda Moonsamy, Cecil Levy
      Abstract: Background: Different histo-pathological types and treatment response patterns of Idiopathic nephrotic syndrome (INS) have been associated with differences in ethnicity and geographical location.
      Objective: To provide an update on the steroid response and renal histo-pathological pattern in children treated for INS.
      Method: Medical records of children with INS treated at the Charlotte Maxeke Johannesburg Academic Hospital were reviewed.
      Results: Mean age was 5.3 years ± 2.8. The majority (68.1%) of the 163 children were of the black racial group. The highest rate of INS was seen in the 2-6 year age group (71.2%). The black racial group had the highest rate (42/111; 37.8%) of focal segmental glomerulosclerosis (FSGS), and the white race had the highest rate (9/14; 64.3%) of minimal change disease (MCD). Ninety four (57.7%) patients were steroid sensitive (SSNS) while 69 patients (42.3%) were steroid resistant (SRNS). Minimal change disease was the most common histo-pathological type seen in SSNS (60%), while FSGS was the most common observed in patients who had SRNS (65.2%).
      Conclusion: There appears to be a higher rate of FSGS in all the racial groups, and also a higher rate of MCD in the black race group, when compared to previous reports.
      Keywords: Idiopathic, nephrotic syndrome, children.
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Long term effect of a school based intervention to prevent chronic
           diseases in Tunisia, 2009-2015

    • Authors: Rim Ghammam, Jihen Maatoug, Nawel Zammit, Raoudha Kebaili, Lamia Boughammoura, Mustafa Al’Absi, Harry Lando, Hassen Ghannem
      Abstract: Background & Objectives: We aimed to evaluate the long term effect of school based intervention to prevent non- communicable disease risk factors.
      Methods: It was a quasi experimental study conducted during the period of 2009-2015. We involved school children aged from 11 to 16 years old. For the assessment of the program’s effectiveness, subjects in both groups were examined at baseline, at the end of the 3-year intervention period and at the follow-up, one year after program’s cessation.
      Results: In the intervention group, the prevalence of school children who reported to be eating 5 fruits and vegetable sdaily increased significantly from 30.0% at pre-assessment to 33.2% at post-assessment, one year after (p=0.02, p=0.41 respectively). For the control group, this prevalence had significantly decreased from 40.2% at baseline to 35.0% at post-intervention, at the follow up, this proportion increased to 44.5%(p=0.001, p<10-3 respectively). Concerning smoking habits, we observed a decreasing trend in the intervention group from 5.7% at pre-assessment, to 4.8% at post-assessment and to 3.4% at the follow-up (p=0.19 and p=0.25 respectively). There was also a significant decrease in school children who did recommended physical activity in the same group.
      Conclusion: The present work showed that interventions promoting healthy lifestyles should be maintained. Developing countries should be encouraged and supported to design, conduct, and evaluate robust preventive interventions.
      Keywords: Schools, lifestyle, intervention.
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • The reality of every day communication for a deaf child using sign
           language in a developing country.

    • Authors: Zandile M Blose, Lavanithum N Joseph
      Abstract: Background: Research that focuses on the communication between deaf children and their hearing families is scarce despite the majority of deaf children being born into hearing families where a common communication mode needs to be forged.
      Objective: The aim of the study was to explore, describe and compare the nature of communication across typical daily contexts of a deaf child who uses South African Sign Language (SASL) and who is born into a hearing family with no prior experience of SASL.
      Methods: A case study design which included quantitative and qualitative components was used to observe a nine year old grade one child with profound hearing loss. Spontaneous communication was observed with 13 communication partners in the home context and these included the mother, a sibling and peers. Two educators and 11 peers were observed in the educational context. Surveillance cameras were used to obtain 27 hours of video-recording in the home and 19 hours at the school. Interviews were conducted with the mother, siblings, educators, and the deaf child.
      Results: It was observed that communication using SASL, albeit minimal, home signs, natural gestures and oral communication were used extensively. Due to a mismatch in the communication mode in the home context communication interactions were fewer and predominantly oral, impoverished and with frequent breakdowns whereas the communication interactions in the school were characterized by SASL, was meaningful and had fewer communication breakdowns.
      Conclusion: Communication for deaf children within the home is problematic as communication partners are not fluent in SASL.
      Keywords: Deaf child, sign language, developing country.
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Characteristics of astigmatism in Black South African high school
           children.

    • Authors: Samuel Otabor Wajuihian
      Abstract: Background: Astigmatism impairs vision at various distances and causes symptoms of asthenopia which negatively impacts reading efficiency.
      Objective: The aim of conducting this study was to determine the prevalence and distribution of astigmatism and its relationship to gender, age, school grade levels and spherical ametropia.
      Methods: Using a multi-stage random cluster sampling, 1589 children who included 635 (40%), males, and 954 (60%), females were selected from 13 out of a sample frame of 60 schools. Their ages ranged between 13 and 18 years with a mean of 15.81±1.56 years. The parameters evaluated included visual acuity using the LogMAR chart and refractive errors measured using an autorefractor and then refined subjectively. Axis of astigmatism was presented in the vector method where positive values of J0 indicated with-the-rule, negative values described against-the-rule and J45 represented oblique astigmatism.
      Results: The mean cylinder power was −0.09 ± 0.27 and mainly with-the-rule, J0 = 0.01 ± 0.11. The overall prevalence of clinically significant astigmatism (≤ − 0.75 cylinder) in the sample was 3.1% [(95% Confidence interval = 2.1-4.1%)]. Cylinder of at least − 0.25 power was considered to classify astigmatism types. Thus, the estimated distributions of types of astigmatism were: axis- 11.5%, sphero-astigmatism 10.1% and magnitude-astigmatism 11.2% while 67.2% had no cylinder of any magnitude.
      Conclusion: The prevalence of astigmatism is relatively low in this population studied. Older children and those in high school grade levels were more likely to have with-the-rule or against-the-rule astigmatism. The prevalence of astigmatism were comparable within but not across regions.
      Keywords: Astigmatism prevalence, school children, South Africa.
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Suicidal ideation and associated factors among school going adolescents in
           Swaziland.

    • Authors: Aseel M Almansour, Seter Siziya
      Abstract: Background and objective: Suicide among children has been a major issue and the statistics are considerably alarming. However, no studies have been conducted in Swaziland on suicidal ideation which is a starting point for committing suicide. The objective of the study was to determine the prevalence of suicidal ideation and its correlates.
      Methods: A secondary analysis of data was conducted using data collected in a Swaziland 2013 Global School-based Student Health Survey (GSHS). The survey assessed among other factors, mental health of the students using a self-administered questionnaire. We considered factors that have been reported to be associated with suicidal ideation in the literature. Unadjusted odds ratios (OR) and adjusted odds ratios (AOR) together with their 95 confidence intervals (CI) are reported.
      Results: The overall proportions of students who considered suicide were 18.3% of 1866 females and 15.6% of 1672 males. In bivariate models the risk factors for suicidal ideation were feeling lonely, anxiety, using drugs and smoking marijuana. In multivariate model to include age, gender, food security, close friends, truancy, bullied, attacked, physical fight, drugs, marijuana, parental understanding anxiety and loneliness, all the considered factors were significantly associated with suicide except close friends.
      Conclusion: The rate of suicidal ideation was high among adolescents in Swaziland and intervention considering violence, social support from friends and parents, and drug abuse should be designed to prevent suicidal thoughts.
      Keywords: Suicidal ideation, school going adolescents, Swaziland.
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Intestinal candidiasis and antibiotic usage in children: case study of
           Nsukka, South Eastern Nigeria.

    • Authors: Ifeoma M Ezeonu, Ntun W Ntun, Kenneth O Ugwu
      Abstract: Background: Overgrowth of candida results from factors that disrupt the intestinal microbial balance, such as the use of antibiotics. Unregulated antibiotic use and rampant practice of self-medication in Nigeria, is a cause for concern.
      Methods: A total of 314 stool specimens were collected from children <1 to 12 years of age in Nsukka, South Eastern Nigeria and screened for candida species using standard methods. Questionnaires were used to collect relevant information on the participants.
      Results: Out of the 314 participants, 31.2% had candidiasis, indicated by growth of ≥105 CFU/ml. Four different species of candida were identified. Candida albicans had the highest prevalence (59.0%), while Candida krusei had the least prevalence (6.0%). Of the 314 participants, 46.5% had diarrhoea, out of which 58.9% had intestinal candidiasis while only 14.3% of the non-diarrhoeic children had candidiasis. Of 208 participants who had taken antibiotics within three weeks of the study, 42.3% had candidiasis compared to 20.8% of those with no recent history of antibiotic use.
      Conclusion: The results of this study showed a high prevalence of intestinal candidiasis among children in Nsukka. Strong associations were observed between the presence of intestinal candidiasis and diarrhoea, age and use of antibiotics (p<0.001).
      Keywords: Intestinal candidiasis, children, antibiotic use, diarrhea
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Assessing regional variations in the effect of the removal of user fees on
           facility-based deliveries in rural Zambia

    • Authors: Chama-Chiliba Chitalu, Koch Steven
      Abstract: Background: Maternal health remains a concern in sub-Saharan Africa, where maternal mortality averages 680 per 100,000 live births and almost 50% of the approximately 350,000 annual maternal deaths occur. Improving access to skilled birth assistance is paramount to reducing this average, and user fee reductions could help.
      Objective. The aim of this research was to analyse the effect of user fee removal in rural areas of Zambia on the use of health facilities for childbirth. The analysis incorporates supply-side factors, including quantitative measures of service quality in the assessment.
      Method: The analysis uses quarterly longitudinal data covering 2003 (q1)-2008 (q4) and controls for unobserved heterogeneity, spatial dependence and quantitative supply-side factors within an Interrupted Time Series design.
      Results: User fee removal was found to initially increase aggregate facility-based deliveries. Drug availability, the presence of traditional birth attendants, social factors and cultural factors also influenced facility-based deliveries at the national level.
      Conclusion: Although user fees matter, to a degree, service quality is a relatively more important contributor to the promotion of facility-based deliveries. Thus, in the short-term, strengthening and improving community-based interventions could lead to further increases in facility-based deliveries.
      Keywords: Maternal care, facility based deliveries, user fees, rural, Zambia.
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • The market dynamics of selective serotonin re-uptake inhibitors: a private
           sector study in South Africa

    • Authors: Frasia Oosthuizen, Pariksha Jolene Kondiah, Hawa Bibi Moosa, Siddiqa Naroth, Nabeel Ismail Patel, Divashnee Reddy, Amanda Soobramoney
      Abstract: Objective: The objective of this study was to analyse the market share of generic vs originator selective serotonin re-uptake inhibitors (SSRIs), and also compare market share of different SSRIs in the private health care sector in South Africa, over a period of 4 years.
      Methodology: This was a retrospective, descriptive study that measured generic market volume as a percentage of the total private SSRI market volume. Retail private sector sales data for six SSRIs available in the private sector in South Africa was evaluated. Sales data were obtained from various stages in the pharmaceutical supply chain, June 2009 – May 2013.
      Results: Generics constituted 86% and originators 14% of the private sector market volume of SSRIs. The share of the market volume of generic medicines increased by 29.93% over this 4-year period, while an overall increase of 27.86% in the ratio of generics to originators was observed.
      Conclusion: In line with policies, generic SSRIs hold a larger volume of the market in the private sector in South Africa.
       Keywords: Selective serotonin, private sector, South Africa.
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • World Medical Association Declaration of Geneva

    • Authors: Anonymous Anonymous
      Abstract: No
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Changes in erythrocyte ATPase activity under different pathological
           conditions

    • Authors: Ali A Kherd, Nawal Helmi, Khadijah Saeed Balamash, Taha A Kumosani, Shareefa A AL-Ghamdi, Qari M, Etimad A Huwait, Soonham S Yaghmoor, Alaama Nabil, Maryam A AL-Ghamdi, Said S Moselhy
      Abstract: Background: Studies have shown that Na+-K+ ATPase activity was altered in disrupted red blood cell membranes and this enzyme is believed to be the site of active transport of Na+ and K+ in intact red blood cells. The enzyme is often referred to as Na+- K+ pump because it pumps Na+ out and K+ into the cell against gradients with the concomitant hydrolysis of intracellular ATP.
      Objective: The aim of this study was to find out the possibility of using Na+-K+-ATPase activity as a biomarker for the diagnosis of individuals with different physiological conditions.
      Materials and methods: The activity of Na+-K+ ATPase was determined in blood samples collected from different pathological and physiological conditions such as pregnancy, smoking, diabetes and renal dysfunction compared with healthy subjects matched for age and sex.
      Results: The Na+-K+ ATPase activity in pregnancy (0.094 ± 0.0051 μM Pi/min. mg protein), smoking (0.064 ± 0.0011 μM), diabetes (0.047 μM 0.002 μM) and kidney disease (0.069 ± 0.0014 μM) was higher compared to the measurements in healthy individuals (0.0081 ± 0.0031 μM).
      Conclusion: Na+- K+ATPase specific activity is a biomarker for the diagnosis of individuals with different physiological diseases.
      Keywords: Na+-K+ATPase, red blood cell, pregnancy, smoking, diabetes, kidney diseases.
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Neurocalcin-delta: a potential memory-related factor in hippocampus of
           obese rats induced by high-fat diet.

    • Authors: Wei-Wei Ma, Bing-Jie Ding, Lin-Hong Yuan, Lei Zhao, Huan-Ling Yu, Yuan-di Xi, Rong Xiao
      Abstract: Introduction: Aberrant protein expression within the hippocampus has recently been implicated in the pathogenesis of obesity- induced memory impairment.
      Objectives: The objective of the current study was to search for specific memory-related factors in the hippocampus in obese rats.
      Methods: Sprague-Dawley (SD) rats were fed either a high-fat (HF) diet or normal-fat (NF) diet for 10 weeks to obtain the control (CON), diet-induced obese rats (DIO) and diet-resistant (DR) rats. D-galactose was injected subcutaneously for 10 weeks to establish model (MOD) rats with learning and memory impairment. After the hippocampus of the rats sampling, the proteome analysis was conducted using two-dimensional get electrophoresis (2-DE) combined with peptide mass fingerprinting (PMF).
      Results: We found 15 differential proteins that expressed in the hippocampus in rats induced by HF diet from the 2-DE map. In addition, Neurocalcin-delta (NCALD) was nearly down-regulated in the DR rats compared with CON rats and MOD rats, which was further confirmed by Western blot, real-time PCR and ELISA results.
      Conclusion: Our data demonstrates that the differential memory-related proteins were a reflection of the HF diet, but not potential factors in obesity proneness or obesity resistance. Furthermore, NCALD is proved to be a potential hippocampus-memory related factor related to obesity.
      Keywords: Diet-induced obesity; diet-resistant; high fat diet; neurocalcin-delta; proteome
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Sub-clinical middle ear malfunctions in elderly patients; prevalence,
           pattern and predictors

    • Authors: Olusola Ayodele Sogebi, Taiwo Olugbemiga Adedeji, Olatundun Ogunbanwo, Emmanuel Abayomi Oyewole
      Abstract: Background: Little is known about functioning of the middle ear with advancing age.
      Objectives: To estimate the prevalence and describe tympanometric patterns of sub-clinical middle ear malfunctions,( S-MEM) in elderly patients. It also assessed clinical factors that could predict S-MEM.
      Methods: Cross-sectional, analytical study of patients aged ≥ 60 years in a tertiary hospital in Nigeria between 2011-2014. Pure tone audiometry (PTA), tympanometry and acoustic reflexes were recorded. S-MEM was based on audiometric and tympanometric evident abnormalities. Descriptive, univariate and multivariate analyses performed to detect independent clinical predictors of S-MEM at p-value of <0.05.
      Results: 121 patients , M: F of 1.1:1. Mean age was 70.1 ± 6.2 years, 77.7% were married. Prevalence of S-MEM was 21.5%. Abnormal tympanometric tracings were type AS>C>B>AD. The parameters that were statistically-significant on univariate analyses were subjected to logistic regression analysis which confirmed previous head injury, diabetes, osteoarthritis of knee joint, and absent acoustic reflex as clinical predictors for S-MEM.
      Conclusion: 21.5% of elderly Africans had subclinical abnormalities in their middle ear functioning, mostly with type AS tympanogram. Independent clinical predictors of S-MEM included previous head injury, diabetes, history of osteoarthritis of knee joints, and absent acoustic reflex.
      Keywords: Middle ear malfunctions, elderly patients.
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Bowel injury following gynecological laparoscopic surgery

    • Authors: Hassan M Elbiss, Fikri M Abu-Zidan
      Abstract: Background: Bowel injury remains a serious complication of gynecological laparoscopic surgery. We aimed to review the literature on this topic, combined with personal experiences, so as to give recommendations on how to avoid and manage this complication.
      Methods: We performed a narrative review on bowel injury following gynecological laparoscopic surgery using PubMed covering prevention, diagnosis, and management. Search terms used were laparoscopy, gynaecology, injury, bowel, prevention, treatment.
      Results: Important principles of prevention include proper pre-operative evaluation and increased laparoscopic surgical skills and knowledge. High clinical suspicion is crucial for early diagnosis. Diagnostic workup of suspected cases includes serial abdominal examination, measuring inflammatory markers, and performing imaging studies including abdominal ultrasound and CT scan. When bowel injury is recognized during the first laparoscopic procedure then laparoscopic primary suturing could be tried although laparotomy may be needed. When diagnosis is delayed, then laparotomy is the treatment of choice. The role of robotic surgery and three-dimensional laparoscopic gynecological surgery on bowel injury needs to be further assessed.
      Conclusion: Early recognition of bowel injury is crucial for a favorable clinical outcome. A combined collaboration between gynecologists and general surgeons is important for timely and proper decisions to be made.
      Keywords: Laparoscopy, gynaecology, injury, bowel, prevention, treatment
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • An erroneous opinion on a cause of death in a forensic autopsy: a case
           report

    • Authors: Meel Banwari
      Abstract: Background: The quality of autopsies is always questioned in courts, especially in developing countries. Wrong decisions or misjudgments are undesirable in medicine, but they are very dangerous in forensic medicine. If a wrong opinion is given, either a culprit can be acquitted or an innocent person can be sentenced. Therefore, an expert opinion is always required before the announcement of a judgment.
      Objective: To highlight the problem of accuracy in determining the cause of death in forensic autopsy.
      Case history: A 19- year old young adult male (Mr E), who had a history of alcohol abuse, was brought to a hospital casualty department by police, on an allegation of theft. He was unconscious and died within two hours of arrival. A post-mortem report was requested by a private attorney for an expert opinion. A post-mortem examination was conducted and multiple superficial injuries were recorded on his body. Head injury was given as a cause of death. The author seeks to critically analyze the post-mortem findings in relation to the cause and manner of death.
      Conclusion: An erroneous opinion was reached regarding cause and manner of death in this autopsy report.
      Keywords: Erroneous opinion, forensic autopsy.
      PubDate: 2018-01-08
      Issue No: Vol. 17, No. 4 (2018)
       
  • Editorial: HIV and NCDs: inevitable interaction in resource limited
           settings.

    • Authors: James K Tumwine
      Abstract: No
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • The effect of interrupted anti-retroviral treatment on the reconstitution
           of memory and naive T cells during tuberculosis treatment in HIV patients
           with active pulmonary tuberculosis

    • Authors: Sophie Nalukwago, Christina L Lancioni, Joy Baseke Oketcho, Dave H.e Canaday, W Henry Boom, Lonzy Ojok, Harriet Mayanja-Kizza
      Abstract: Background: The reconstitution of cellular immune components contributes to clinical outcome of HIV and Mycobacterium tuberculosis (MTB) infection. Interruption of anti-retroviral therapy (ART) could lead to perturbations in reconstitution of T cells in HIV/ tuberculosis (TB) patients. Objectives: To ascertain the effect of interrupted ART on reconstitution of CD4+ and CD8+ T sub-sets in TB patients.
      Methods: Participants with HIV (CD4>350 cells/μL) and TB were recruited under a larger phase 3 open label randomised controlled clinical trial. The CD45RO and CD62L markers were measured on CD4+ and CD8+ cells by flow cytometry. Samples were analysed at baseline, 3, 6, 12 months.
      Results: There was a significant increase of naive CD8+ cells (p = 0.003) and a decrease in effector CD8+ cells (p = 0.004) among participants in ART/TB treatment arm during the first 6 months. Withdrawing ART led to naive CD8+ cells reduction (p=0.02) to values close to baseline. An increase of naive CD8+ cells after 6 months of TB treatment in TB alone treatment arm (p=0.01) was observed. A trend towards increment of naive CD4+ sub sets in either treatment arms was observed.
      Conclusion: Interrupting ART alters CD8+ but not CD4+ sub-sets in patients with less advanced HIV infection and TB.
      Keywords: Interrupted anti-retroviral treatment, memory and naive T cells, HIV patients, active pulmonary tuberculosis.
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Prevalence and predictors of unknown HIV status among women delivering in
           Mulago National Referral Hospital, Kampala, Uganda.

    • Authors: Emily C Namara-Lugolobi, Gertrude Nakigozi, Zikulah Namukwaya, Dan K Kaye, Edith Nakku-Joloba
      Abstract: Introduction: Knowledge of a person’s HIV status during pregnancy is critical for prevention of mother to child transmission of HIV.
      Objectives: To determine the prevalence and factors associated with unknown HIV status among women delivering in Mulago Hospital.
      Methods: This was a cross-sectional study of women that had just delivered. The women’s demographic characteristics, health seeking behaviour, health system-related factors and knowledge on PMTCT were collected. Fisher’s exact test, Wilcoxon rank sum test and logistic regression were used to test associations.
      Results: The prevalence of unknown HIV status was 2.6% (10/382). Attending ANC at higher level facilities (OR =0.1 95% CI 0.0 – 0.4) and having been counselled for HIV testing during ANC (OR=0.1, 95% CI 0.0 - 0.4) were associated with likelihood of having a known HIV status. Out of the ten women with unknown HIV status, 4/6 who attended ANC in public/ government accredited health facilities “opted out” of HIV testing due to personal reasons. Among the four who attended ANC in private clinics, two were not offered HIV testing and one “opted out”.
      Conclusion: Most participants had a known HIV status at labour (97%). Private clinics need to be supported to provide free quality HCT services in ANC.
      Keywords: Unknown HIV status, women delivering, Mulago National Referral Hospital, Kampala, Uganda
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Low sero-prevalence of hepatitis delta antibodies in HIV/ hepatitis B
           co-infected patients attending an urban HIV clinic in Uganda

    • Authors: Elizabeth Katwesigye, Emmanuel Seremba, Fred Semitala, Ponsiano Ocama
      Abstract: Background: Co-infection with hepatitis B (HBV) and hepatitis D (HDV) is common among human immunodeficiency virus (HIV) infected individuals in developing countries and it aggressively accelerates progression of liver disease to cirrhosis and other complications. There is scarcity of data on HDV in sub-Saharan Africa .We investigated the sero-prevalence and factors associated with HDV antibody among HIV/HBV co-infected patients attending a large urban HIV clinic in Uganda.
      Methods: We screened 189 HIV/HBV co-infected individuals for anti-HDV immunoglobulin G (IgG) and performed logistic regression to determine the associated factors. Socio-demographic, clinical data, immunological status, and liver fibrosis (as determined by the Aspartate transaminase to platelet ratio index and transient elastography) were included.
      Results: Participants were predominately young and of sound immunologic status (median age 40 years, median CD4 440 cells/μl). 98% were on ART regimens containing anti-HBV active medications (95.2% were on TDF/3TC while 4.8% on 3TC containing regimen). Median duration on ART was 36 months (IQR 22-72). Anti-HDV was detected in 6/198, 3.2% (95% CI 1.14-6.92%), associated with male gender and a duration of more than 5 years since HIV diagnosis.
      Conclusions: The sero-prevalence of HDV antibodies among the HIV/HBV co-infected patients is low in a Ugandan urban cohort.
      Keywords: Co-infection in Uganda, hepatitis delta antibodies, hepatitis B virus, HIV.
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Angiotensin-converting enzyme insertion/deletion polymorphism and
           susceptibility to Kawasaki disease: a meta-analysis

    • Authors: Yan Pan, Hongzhu Lu
      Abstract: Background: The angiotensin-converting enzyme (ACE) I/D polymorphism has been reported to be associated with Kawasaki disease(KD) ,but studies to date present conflicting results.
      Objectives: The aim of this study is to derive a more precise estimation of the association between the ACE I/D polymorphism and KD risk.
      Methods: PubMed,EMBASE,CNKI and Wangfang databases were retrievaled to identify for relevant studies from inception to May 2017.Pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated using Stata 12.0 software.
      Results: A total of 6 case-control studies comprising 634 patients and 458 controls were included in the meta-analysis,and we found a significant association between the ACE I/D polymorphism and KD risk(D vs I:OR = 0.81, 95%CI = 0.31-2.11;DD vs II: OR = 1.03, 95%CI = 0.42-2.54; DI vs II: OR = 1.44, 95%CI = 1.09-1.90; dominant model: OR = 1.43, 95%CI = 1.11-1.85; recessive model: OR = 1.21, 95%CI = 0.44-3.29 ).When stratified by sample size>200, this polymorphism is associated with an increased the risk of KD.
      Conclusion: The I/D polymorphism in the ACE gene may be associated with susceptibility to KD.
      Key words: ACE,I/D polymorphism, Kawasaki disease.
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Prevalence of mecA gene among staphylococci from clinical samples of a
           tertiary hospital in Benin City, Nigeria

    • Authors: Ephraim Ehidiamen Ibadin, Idahosa Onaiwu Enabulele, Fowora Muinah
      Abstract: Background: The staphylococci have increasingly been associated with infections worldwide and anti-microbial resistance has  made these versatile pathogens more recalcitrant in the hospital setting.
      Objectives: This study sought to investigate the occurrence and distribution of Staphylococcus species as well as determine the prevalence of methicillin resistant Staphylococcus aureus (MRSA) and methicillin resistant coagulase negative staphylococci (MRCoNS) among clinical samples from University of Benin Teaching Hospital (UBTH) in Benin City.
      Methods: Ninety one (91) clinical isolates comprising S. aureus and Coagulase Negative staphylococci (CoNS) were recovered from routine clinical specimens and anti-microbial susceptibility tests were carried out. Polymerase Chain Reaction (PCR) was thereafter carried out on these isolates to detect mecA gene.
      Results: Staphylococcus species had its highest prevalence from infected wounds of patients (28.8%) while urine samples showed the least (5.4%). The highest level of resistance was to ceftazidime (S. aureus - 68%, CoNS - 75.6%) while the least resistance was observed for meropenem (S. aureus- 26%, CoNS- 46.3%). Using phenotypic method (with 1μg oxacillin antibiotic disc), the distribution of MRSA and MRCoNS was 44.0% and 46.3% respectively. PCR analysis showed that 38.0% of S. aureus and 41.5% of the CoNS had mecA gene respectively; wound swabs showed the highest prevalence with 30.5% of staphylococcal isolates being mecA gene positive. There was also no significant association between the Staphylococcal isolates and their isolation rate, isolation site and mecA gene distribution (p > 0.05).
      Conclusion: This study draws attention on the increase in the prevalence of mecA gene (39.6%) and an increase in multidrug resistant staphylococci when compared to previous studies in our country; it recommends laboratory guidance and periodic review to stem the tide of resistance.
      Keywords: Staphylococcus aureus (S. aureus), coagulase-negative staphylococci (CoNS), mecA gene, methicillin-resistance
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Evaluation and improvement of LAMP assays for detection of Escherichia
           coli serogroups O26, O45, O103, O111, O121, O145, and O157

    • Authors: Deguo Wang
      Abstract: : Escherichia coli serogroups O26, O45, O103, O111, O121, O145, and O157 are the causative agents of human diseases, and LAMP assays have been developed for detection of the seven leading STEC serogroups.
      Objective: To evaluate existing LAMP assays for detection of the seven STEC serogroups, if necessary, to improve these assays and to promote their practical application.
      Methods: Pure DNA extract from 23 strains reserved in our lab was used to evaluate the existing LAMP assays. The existing LAMP assays were modified via adding 1% tetramethylene sulfoxide and 5% dimethyl sulfoxide as well as optimizing reaction temperature.
      Results: The detection limit of the modified LAMP assays was 0.1-1 pg per reaction, equivalent to 25-250 cfu per reaction, the non-specific amplification can completely be eliminated with optimal amplifying temperature, and the modified LAMP assays can specifically and sensitivly amplify targeted O serogroup-specific gene (wzx or wzy) of any concerned Escherichia coli serogroup as commercial kit Isothermal Master Mix did.
      Conclusion: In conclusion, the LAMP assays were highly susceptible to non-specific amplification caused by primer dimers, and these modified methods were free of non-specific amplification and can rapidly and reliably detect the seven major Shiga toxin-producing E. coli serogroups.
      Keywords: Loop-mediated Isothermal Amplification (LAMP), toxin-producing Escherichia coli serogroups, non-specific amplification, tetramethylene sulfoxide, dimethyl sulfoxide.
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Seroprevalence of hepatitis E in swine abattoir workers.

    • Authors: Aquino Qouilazoni Ukuli, Kizito Kahoza Mugimba
      Abstract: Background: Hepatitis E (HE) caused by Hepatitis E virus (HEV) is an emerging global public health threat. It has been identified as potentially zoonotic and swine act as main reservoirs.
      Objectives: The objective of this study was to determine the seroprevalence and risk factors associated with HEV in swine abattoir workers.
      Methods: This was a cross-sectional study where 45 workers were sampled (N=50), serum collected and tested for presence of anti HEV IgM using ELISA.
      Results: A seroprevalence of 13.3% was obtained with the highest 50% among slaughterers and the lowest amongst sanitary cleaner, cloth cleaners and inspector. Those in direct contact with live pigs, their carcasses and tissues were at a higher risk compared to those in indirect contact. Seroprevalence was seen to increase with age, with the highest rate among those above 24 years.
      Conclusion: There is silent HE virus infection in abattoir workers at Wambizi as reflected by presence anti HEV IgM in 13% of the tested serum. However, no single case of HE has ever been reported in swine abattoir workers or general population in Kampala city. This silent maintenance of HEV infection amongst swine abattoir workers is an occupational risk that could challenge public health systems.
      Keywords: Hepatitis E, seroprevalence, swine abattoir workers
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Plasma ACTH concentration and pituitary gland histo-pathology in rats
           infected with

    • Authors: Charles Irungu Maina
      Abstract: Background: Human African trypanosomiasis is one of the neglected and re-emerging infectious diseases in Africa with over 60 million people being at risk of contracting the disease.
      Objective: To investigate the effects of Trypanosoma brucei brucei infection on secretion of adrenocorticotropic hormone (ACTH) and histology of the pituitary gland and paraventricular nucleus in rats.
      Methods: Rats were randomly divided into two groups, control and experimental. Experimental rats were injected intraperitonially with 0.2ml of blood containing 1.0 x 104 live T.b.brucei parasites. Tail blood samples were collected weekly for the determination of plasma concentration of ACTH. The pituitary gland and coronal section of brain were processed histologically and observed microscopically.
      Results: There was a significant difference (p = 0.0190) in plasma ACTH concentration between the control and experimental rats. Histological alterations were observed in both the pituitary and paraventricular nucleus of experimental rats.
      Conclusion: T.b.brucei infection causes histological changes in both the paraventricular nucleus and pituitary gland in rats. These histological changes could account for the decrease in corticotropin releasing hormone (CRH) and ACTH production in the infected rats.Keywords: Trypanosomiasis, paraventricular nucleus, pituitary gland, ACTH
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Breast cancer metastasis to thyroid: a retrospective analysis

    • Authors: Lingyan Zhou, Liyu Chen, Dong Xu, Qi Shao, Zhenying Guo, Minghua Ge
      Abstract: Background: Breast cancers metastasizing to thyroid gland are relatively uncommon in clinical practice.
      Objective: Retrospective analysis of data from breast cancer patients with thyroid metastasis (TM).
      Methods: The US suspected, fine-needle aspiration cytology (FNAC) confirmed TM in breast cancer patients, treated between 2005 and 2015 at our hospital, was retrospectively analyzed. The data were re-evaluated by the pathologist and radiologist who were blinded to the patients’ data.
      Results: FNAC and immunohistochemistry confirmed the ultrasonography (US) suspected TM in eight breast cancer patients. Clinically both unilateral and bilateral TM was seen, which were symptomless and metachronously (6-121 months) metastasized. Six of eight cases exhibited recurrence/distant metastasis and were treated with chemotherapy/ thyroidectomy of which two cases passed away. The remaining two patients had no recurrences/distant metastases and were treated with partial/total thyroidectomy. Post-chemotherapy US showed more homogenous thyroid parenchyma with gathering of calcification that reduced in size, revealing the sensitiveness of TM to chemotherapy.
      Conclusion: US was useful in screening TM in breast cancer patients. Both partial and total thyroidectomy was effective in disease free survival of isolated TM cases, with controlled primary condition. TM responded well to chemotherapy in most of the recurrent breast cancer cases with or without distant metastasis.
      Keywords: Thyroid, ultrasonography, breast cancer, metastasis.
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Mammographic classification of breast lesions amongst women in Enugu,
           South East Nigeria

    • Authors: Uchechukwu I Nwadike, Charles U Eze, Kelvin Agwuna, Chibuzo Mouka
      Abstract: Objectives: The study was to classify lesions identified on mammograms using Breast Imaging Reporting and Data System (BIRADS) grading method. This was in view of ascertaining the rate of occurrence of breast malignancy of the studied population.
      Methods: A retrospective cohort study of 416 mammographic reports of women was undertaken. The reports were written by consultant radiologists of 10 years’ experience and above. The reports were evaluated and characterised using Breast Imaging Reporting and Data system (BIRADS). Demographic data of patients were sourced from the request cards. The data was entered into a proforma and analysed using SPSS version 17. All request cards with incomplete data were excluded from the study.
      Results: Using the BI-RADS Classification, the mammographic reports shows that 29.57% of the lesions were benign, and 4.57% were suspicious and biopsy recommended, while 3.60% were highly suggestive of malignancy. The right breast was predominantly affected with 42.7% of the patients (P<0.05).
      Conclusion: Classification of breast lesion using BI-RADS grading system is a veritable tool in the diagnosis of the breast lesion. The present study shows that 3.6% of the population has a high index of malignancy.
      Keywords: Mammography, breast, lesion, BI-RADS classification
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Gastrointestinal malignancies at five regional referral hospitals in
           Uganda

    • Authors: Siraji Obayo, Luswa Lukwago, Jackson Orem, Ashley L Faulx, Christopher S Probert
      Abstract: Background: There is a paucity of published data regarding the trend and distribution of gastrointestinal malignancies in Uganda.
      Objectives: To study the trend and distribution of gastrointestinal malignancies over a 10 year period at five regional referral hospitals in Uganda.
      Methods: Patient’s charts with histologically confirmed diagnoses of gastrointestinal malignancies for the period 2002-2011 were identified. Case information, which included age at diagnosis, sex, and year of diagnosis, primary anatomic site of the tumour and hospitals attended, was retrospectively abstracted. Patient’s clinical and demographic features were compared.
      Results: Oesophageal cancer was the most common (28.8%) followed by liver (25.8%), stomach (18.4%) and colorectal (14.3%). The mean age at diagnosis for all the cancers was not significantly different in both sexes 54.1, (SD16.1) versus 53.6, (SD 14.7). The highest mean annual number of cases of oesophageal and stomach cancers was 21.8, (SD 15.5) and 16.6, (SD 13.0) respectively from Mbarara Hospital; Lacor had the highest mean annual number of liver cancer cases (21, SD 17.7) followed by Mbale (11.4,SD 8.3). The mean annual number of colorectal cancers was highest in Mbale Hospital (10.3, SD 8.1) followed by Lacor (4.9, SD 3.9). The distribution of oesophageal, liver, stomach and colorectal cancers diagnosed per year across the five referral hospitals was different, P<0.001.
      Conclusion: Oesophageal, liver, stomach and colorectal cancer remain the most common gastrointestinal malignancies and their rate is increasing in Uganda. There is a need for awareness, endoscopic and radiological assessment of symptomatic individuals and a need for screening of high index patients.
      Keywords: Gastrointestinal malignancies, Uganda Regional Referral Hospitals, 10-year trend.
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Analysis of SNPs of MC4R , GNB3 and FTO gene polymorphism in obese Saudi
           subjects

    • Authors: Said Salama Moselhy, Yasmeen A Alhetari, Archana Iyer, Etimad A Huwait, Maryam A AL-Ghamdi, Shareefa AL-Ghamdi, Khadijah Saeed Balamash, Ashraf A Basuni, Mohamed N Alama, Taha A Kumosani, Soonham Sami Yaghmoor
      Abstract: Background: The goal of this study was to analyze the association between the FTO rs17817449 (G>T), G protein beta3 subunit (GNB3) C825T and Melanocortin 4 receptor (MC4R) A822G single nucleotide  olymorphism (SNP) with obesity in Saudi subjects.
      Methods: The subjects were divided into 2 groups according to BMI: Obese (BMI> 29.9) and non- obese control (BMI<24.9). Genotyping of the target genes were determined by polymerase chain reaction (PCR) followed by restriction fragment length polymorphism analysis (RFLP).
      Results: We demonstrated the association of the FTO genotype TT with increased weight, BMI and leptin levels in both males and females. However, there was no association of genotype TT with fasting blood glucose, triglycerides and cholesterol levels. Regarding GNB3 rs5443 polymorphism, the likelihood of obesity was linked to the TT genotype which was also associated with increased leptin levels. On the other hand, the SNP of MC4R A822G did not exhibit any significant association with obesity among studied subjects and showed only the presence of homozygous AA genotype.
      Conclusion: The polymorphism of FTO gene rs17817449 and GNB3 gene rs5443 (C825T) may be a genetic determinant of obesity in Saudi population whereas impact of MC4R Asn274Ser change could not be detected.
      Keywords: Obesity, FTO gene-polymorphism.
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Cardiovascular risk factors in adult general out-patient clinics in
           Nigeria: a country analysis of the Africa and Middle East Cardiovascular
           Epidemiological (ACE) study.

    • Authors: Geoffrey C Onyemelukwe, Oluwagbenga Ogunfowokan, Amam Mbakwem, A Kayode Alao, Kodjo Soroh, Osahon Omorodion, Paula Abreu
      Abstract: Background: With globalization and rapid urbanization, demographic and epidemiologic transitions have become important determinants for the emergence of cardiovascular disease (CVD).
      Objective: To estimate the prevalence of CVD risk factors in adult out-patients attending general practice and non-specialist clinics in urban and rural Nigeria.
      Methods: As part of the Africa and Middle East Cardiovascular Epidemiological (ACE) study, a cross-sectional epidemiologic study was undertaken for the presence of hypertension, diabetes mellitus, dyslipidemia, obesity, smoking and abdominal obesity in Nigeria.
      Results: In total, 303 subjects from 8 out-patient general practice clinics were studied, 184 (60.7%) were female and 119 (39.3%) were male. Mean age was 42.7±13.1 years; 51.8% were aged <45 years; 4% ≥65 years. Over 90% of subjects had ≥1 of 6 selected modifiable cardiovascular risk factors: 138 (45.6%) had 1-2; 65 (21.5%) had 3; 60 (19.8%) had 4; and 11 (3.6%) had 5 concurrent risk factors. Screening identified 206 subjects (68.0%) with dyslipidemia who did not have a prior diagnosis.
      Conclusion: Cardiovascular risk factors are highly prevalent in Nigerian subjects attending out-patient clinics. Moreover, many subjects were undiagnosed and therefore unaware of their cardiovascular risk status. Opportunistic screening alongside intensive national, multisectoral education or risk factor education is needed, should be scaled up nationwide and rolled out in both urban and rural communities in Nigeria.
      Keywords: Nigeria, cardiovascular risk factors, screening programs, risk factor management, The Africa and Middle East Cardiovascular Epidemiological (ACE) study.
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Oral dysbacteriosis in type 2 diabetes and its role in the progression to
           cardiovascular disease.

    • Authors: Ziad Nabee, Rajesh Jeewon, Prity Pugo-Gunsam
      Abstract: Background: Salivary changes and proliferation of specific bacterial communities are known to result in oral disease which may adversely impact on systemic conditions like diabetes and cardiovascular diseases.
      Objectives: This study reports on the changes in oral ecology of healthy and diseased adults and the possible role in disease causation.
      Methods: The study comprised 150 participants divided into control (healthy), diabetic and cardiac groups. After dental examination for (Decayed Missing Filled Teeth (DMFT) and Oral Rating Index (ORI), stimulated saliva was sampled to determine flow rate and buffering capacity. Salivary microbial load of Streptococcus mutans and Lactobacilli were subsequently quantified.
      Results: DMFT, ORI, buffering capacity and flow rate were inferior for both diabetic and cardiac patients, who had higher bacterial counts (p<0.05). Long standing diabetics harboured a higher load of  treptococcus mutans. The microbial load of Streptococcus mutans in cardiac patients was double that of diabetics.
      Conclusion: Disruption in the salivary environment and changes in microbial ecology with increased load of cariogenic bacteria were found in diabetic and cardiac patients. This study brings forward new evidence of a markedly higher load of Streptococcus mutans in cardiac patients which may underlie the progression of diabetes to cardiovascular disease in this population.
      Keywords: Oral ecology, saliva, bacteria, dental caries, diabetes.
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • QTc prolongation in Black diabetic subjects with cardiac autonomic
           neuropathy

    • Authors: Ogba J Ukpabi, Basden JC Onwubere
      Abstract: Background: Prolonged corrected QT (QTc) has been identified as a risk factor for malignant arrhythmias and sudden cardiac death. Caucasian studies have shown a definite relationship between QTc prolongation and Cardiac Autonomic Neuropathy (CAN) in diabetic subjects.
      Objective: To determine the prevalence of prolonged QTc in Black diabetic individuals with CAN and to ascertain how prolonged QTc correlated with the severity of CAN among these patients.
      Methods: A total of 176 adult diabetic subjects were studied, 87 males and 89 females. There was a control group of non-diabetic individuals. Cardiac autonomic function was assessed using five cardiovascular autonomic function tests. CAN was diagnosed if 2 or more of these tests were abnormal. Severity of CAN was determined according to the number of abnormal tests. QTc > 0.440 was regarded as prolonged.
      Results: Fifty-one out of the 176 diabetic subjects (29%) had CAN. The prevalence of prolonged QTc in diabetic subjects with CAN was 12%. QTc was prolonged in 1.6% and 0.6% of diabetic individuals without CAN and controls respectively. Although QTc correlated strongly with cardiac autonomic function neuropathy, there was no definite relationship between QTc prolongation and severity of CAN.
      Conclusion: This study in a Black population is in agreement with the well-known relationship between QTc prolongation and CAN reported in Caucasian studies. In view of the wide variability of QTc in this study population, it is suggested that relative QTc increase may be a better indicator of CAN than a definite QTc prolongation of greater than 0.440.
      Keywords: QTc prolongation, Cardiac Autonomic Neuropathy, Black diabetics, sudden cardiac death.
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • Role of offending out-door aero-allergen and CD14 C(-159)T polymorphism in
           development and severity of asthma in a Kolkata patient population

    • Authors: Shampa Dutta, Priti Mondal, Nimai Chandra Saha, Saibal Moitra, Sanjoy Podder, Amlan Ghosh, Goutam Kumar Saha
      Abstract: Objective: Present study involved identification of offending out-door aero-allergens and associated genetic pathway in nasso-bronchial asthma among Kolkata population.
      Methods: Skin-prick test was done among 950 asthmatic patients against 11 common aero-allergens and total serum IgE concentration was measured. PCR-RFLP was done in patients and non-asthmatic control (n=220 in each) to characterize functional polymorphism, C(-159)T, of CD14, a positional candidate gene for allergy. Association of genetic polymorphisms was made with clinico-pathological conditions.
      Results: We identified Cocos nucifera as the most common aero-allergen sensitizer among atopic patients in Kolkata. Patients with childhood-onset asthma were significantly more sensitive towards aero-allergens and had significantly higher serum IgE level than those of adult-onset (p< 0.0001). No significant difference was found in distribution of SNP genotypes of CD14 among case and control (p=0.178). However among patients, frequency of C allele is significantly higher in childhood-onset group than
      that of adult-onset and concordantly in former CC genotype was associated with significant higher level of serum IgE than CT and TT.
      Conclusion: In Kolkata, pollen is a common out-door aero-allergen and Cocos nucifera is predominant among pollens. Childhood- onset and adult-onset of asthma showed significant difference in allergen sensitivity as well as genetic background with respect to CD14 polymorphism.Keywords: Asthma, aero-allergen, skin prick test, total IgE, CD14 gene polymorphism
      PubDate: 2018-01-05
      Issue No: Vol. 17, No. 4 (2018)
       
  • The association between client type and condom use with steady and
           unsteady partners among persons seeking HIV testing and counseling
           services in Kenya

    • Authors: Elizabeth Broel, Larissa Brunner Huber, Jan Warren-Findlow, Elizabeth Racine
      Abstract: Background: Approximately 70% of global HIV infections are located in sub-Saharan Africa, and the prevalence of HIV infection in Kenya remains high.
      Objectives: This study examined the association between client type (general population, commercial sex worker [CSW], or truck driver) and consistent condom use with steady and unsteady partners.
      Methods: Self-reported data included in the Kenyan Ministry of Health 2010-2011 National HIV Testing and Counseling Registry were used (n=11,567). Odds ratios (ORs) and 95% confidence intervals (CIs) were obtained using logistic regression.
      Results: After adjustment, CSWs and truck drivers had decreased odds of consistent condom use with steady partners compared to the general population (OR=0.52; 95% CI: 0.41-0.67 and OR=0.29; 95% CI: 0.13-0.63; respectively). CSWs had 1.95 times the odds of consistent condom use (95% CI: 1.58-2.42) and truck drivers had 0.64 times the odds of consistent condom use with unsteady partners (95% CI: 0.45-0.91) compared to the general population.
      Conclusion: Although CSWs consistently use condoms with their unsteady partners, truck drivers do not consistently use condoms with any partners. Future HIV prevention efforts should target CSWs and truck drivers to increase consistent condom use with all partners. Such efforts may decrease the prevalence of HIV in Kenya.
      Keywords: Client type, condom use, HIV testing, Kenya
      PubDate: 2017-01-05
      Issue No: Vol. 17, No. 4 (2017)
       
  • The prevalence of and factors associated with tobacco smoking behavior
           among long-distance drivers in Lagos, Nigeria.

    • Authors: Obianuju B Ozoh, Maxwell O Akanbi, Casmir E Amadi, William M Vollmer, Nigel G Bruce
      Abstract: Background: Factors associated with tobacco smoking are useful in designing tobacco control programs. Objectives: To estimate the prevalence of and factors associated with tobacco smoking among long-distance drivers.
      Methods: A cross-sectional study. Stratified cluster sampling approach was used to select drivers based on if they received annual health screening (AHS) or not (non-AHS). We used a structured questionnaire to obtain information and weighted the resulting observations to derive population based estimates. Association between tobacco smoking and socio-demographic factors was explored in multivariate models.
      Results: A total of 414 male drivers, with a mean age of 43.6 (standard error 0.6) years were studied. Population weighted prevalence of current smoking was 18.9% (95% CI: 14.3-23.4) all drivers, 6.5% (95% CI: 2.6-10.4) of AHS drivers and 19.5 (95% CI: 14.7-24.2) of non-AHS drivers (p<0.001). In multivariate models, having close friends that smoked (OR= 6.36, 95% CI= 2.49 - 16.20) cargo driving (OR= 2.58, 95% CI= 1.29 - 5.15) and lower education levels (OR for post-secondary education vs. Primary education or less= 0.17, 95% CI= 0.04 - 0.81) were associated with current smoking.
      Conclusion: Prevalence of tobacco smoking is higher among non-AHS compared to AHS drivers. Having close friends that smoked, cargo driving, and lower education levels were associated with current smoking.Keywords: Tobacco smoking behavior, long-distance drivers, Lagos, Nigeria.
      PubDate: 2017-01-05
      Issue No: Vol. 17, No. 4 (2017)
       
 
 
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