This study determined the Indoor and Outdoor background radiation of the Computed Tomography Scanners (CT) rooms in some selected hospitals within the Federal Capital Territory, Abuja, Nigeria. The measurements were done with the survey meters held in the CT room while the CT machine is switched off and around the department or unit outside the CT room. The data measured was read on the display screen of the survey meters. The average dose of the ten readings taken in a hospital was recorded under the area code assigned to that Hospital. The Results showed that the CT indoor doses ranged from 0.141µSv/hr ± 0.02 to 0.213µSv ± 0.03, with a mean value of 0.171µSv/hr ± 0.03. And the CT outdoor doses ranged from 0.165 µSv/hr ± 0.02 to 0.250 µSv/hr ± 0.04, with a mean value of 0.208 µSv/hr ± 0.0.03. Also, the Mean dose values for CT indoor and Outdoor were 0.171µSv/hr± 0.03 and 0.208µSv/hr± 0.03 respectively. The mean background radiation values gotten for CT indoor and outdoor doses are all within the acceptable limits for natural background radiation levels for indoor and outdoor when the machine was in operation. When the indoor and outdoor doses were added, it is about 1.56mSv per year from CT scanners when added to estimated 2mSv from radon gas. The background radiation will be 3.56mSv per year for Federal Capital Territory, Abuja, Nigeria.

Background: The major goal of this research is to fill in the gap of articles with insufficient theoretical support regarding the SDL and strategy of co-creation of values provided by medical and healthcare organizations. Approaching from the perspective of healthcare consumers, it examines relationships among interaction, willingness, competence, and value co-creation. Methods: The research is a cross-sectional study, with people seeking healthcare services in major hospitals in Taiwan as objects, Questionnaires were used as method for investigation and data collection. Results: The affecting factors of the co-creation of healthcare are education, occupation, with or without commercial insurance, willingness, competence, and interaction, reaching significant statistic standard (p <0.05). Conclusion: The co-creation of values cannot only rely on the efforts of the medical professionals, it also requires the cooperation and efforts of patients and their families.

It is well known that the type and quantity of used disinfectant and the disinfection procedures is directly related to the effects of their use. The aim of this study was to review of the use of antiseptics and disinfectants in the region of Eastern Macedonia over five years period. The data were collected from hospitals in the region of eastern Macedonia (Strumica, Veles, Stip and Kavadarci). The results of microbiological testing conducted by the public health institutes in the cities were also collected and used knowing that the routine testing period for microbiological controls in hospitals was 15 days. The results indicated that the number of conditionally pathogenic bacteria is reduced starting from 2011. The reduction of the quantity of disinfectant used is also noted from 2011. The results obtained in all hospitals examined show similar situation in the region of eastern Macedonia. We will present the results obtained from Clinical Centre - Stip as the center of this region. The amount of disinfectants and antiseptics consumed comparing with the microbiological data indicates their rational utilization starting from 2011. Use of disinfectants according to the standardized procedures established by the IHI times allows current daily care. The knowledge about the current situation permits the staff to take proper precautions. It is pointed out the role of IHI times in the hospitals, as well as the role of hospital pharmacists.

Background: It is often difficult to predict which newborn with HIE will develop neurological sequlae so there is an urgent need for predictors for adverse neurological outcomes in these infants. Aim of Study: To evaluate the serum levels of serum amyloid A (SAA) protein in newborns with HIE during the first week of life and after 3 and 6 months of follow up to assess its correlation with degree of HIE neurological sequlee. Patients and Methods; This case-control study was conducted on 72 infants; group (1) included 36 full term neonates diagnosed as HIE and group (2)included 36 age and sex matched, infants as a control group, Serum amyloid A by ELIZA technique was measured at post natal age of 1 and 7 days, CT scan was done in justified cases .with follow up at age of 3 and 6 months for neurological sequlee. Results: SAA protein level was elevated in the asphyxiated group in comparison to the control group at day 1 and day 7, SAA level was significantly correlated to the Sarnat scoring system of HIE. SAA level significantly differ on follow up of developmental milestone at age of 3 and 6 months. ROC curve for validity of SAA for severity of HIE at cut off point > 25µg/ml at day 1 and at cut off point > 20 µg/ml at day 7 of HIE diagnosis reported sensitivity 100% and specificity 100% .Conclusion: SAA correlates with the severity of HIE and higher SAA expression is a prognostic marker for morbidity in these infants.

Background: The widespread use of antibiotics has resulted in emergence of community-acquired antibiotic resistance among uropathogens in outpatient’s population. This constitutes an impediment in the management of urinary tract infection (UTI) in both community and hospital settings. Objective: The aim of this study was to determine the current antibiotic resistance trends, extended spectrum beta-lactamase (ESBL) production and plasmid profile of uropathogens from outpatients. Methods: A total of 370 mid-stream urine samples were collected and cultured by standard methods. Isolated uropathogens were identified using appropriate biochemical methods. The modified Kirby Bauer disk method was used for antibiotic susceptibility test. The ESBL-producing uropathogens were identified and their plasmid DNA extraction and curing were carried out by standard methods. Results: About 35.7% and 32.7% of uropathogens were multi-drug resistant and ESBL-producing respectively. There was higher prevalence of ESBL-production among isolates from female patients (62.5%) when compared to that from male patients (37.5%). The isolated uropathogens were most resistant to Cefotaxime, and most sensitive to Imipenem. Resistance to antibiotics by ESBL-producing uropathogens was found to be plasmid-mediated. Conclusion: Community acquired Uropathogens from outpatients were multidrug resistant due to ESBL production localized on plasmids, a probable cause of treatment failures experienced in Uyo.

BACKGROUND: Nasopharyngeal carcinoma is encountered regularly in otolaryngological practice in Nigeria. However, it is often misdiagnosed due to varied presenting symptoms, hence the need to describe the pattern of presentation and the challenges of treatment of the patients that presented to our centre with nasopharyngeal carcinoma. METHODS: The pathology and clinical records were retrieved for all histologically confirmed cases of nasopharyngeal carcinoma from the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC) cancer registry. The epidemiological data, symptoms and stage at presentation, type of treatment, outcome and challenges encountered were obtained from the records. RESULTS: A total of 384 histologically confirmed head and neck malignancies were seen over the review period, and nasopharyngeal carcinoma constituted 32 (8.33%). There were 24(75.0%) male and 8(25.0%) female. The age ranged from 17 - 80 years with a mean of 54.5 + 12.2 years. All the patients presented with neck swelling, Nasal obstruction 14(43.75), Epistaxis 11(37.5%), Trismus 2(6.25%), and proptosis 2(6.25%). Twenty-four (75%) presented with stage four tumour. Treatment was primarily radiotherapy. Fifteen (46.88%) completed radiotherapy. Two (6.25%) patients had chemo-radiation and 15(46.88%) defaulted at different stages of treatment mainly due to financial constraints, others include beliefs and breakdown of radiotherapy machines. Prognosis was very poor with 1-year survival of 21.9% and five-year survival of 9.25%. Conclusion: Neck swelling, Epistaxis and nasal blockade are the most common presenting symptoms. Patients present late leading to poor prognosis. Financing treatment out of pocket is a major reason for presenting late and defaulting during management.

Background: There is a global raise in the rate of fall among older adult, often than not, this fall result in severe effect such as hip fracture. Despite effort to rehabilitate this age group after hip fracture, about 50% hardly regain their pre-fracture functional state thereby impairing activity of daily living and their quality of life. Aim: This review aims at evaluating the effectiveness of different strategies of rehabilitation in the promotion of functional gait recovery after hip fracture among older adults. Data Sources: Literature searches were conducted on CINAHL, MEDLINE, SportDiscus and web of science in addition to manual search. Study Selection: Studies were selected based on the inclusion criteria by two independent reviewers. Data Extraction: Data were extracted presented on a spread sheet. Thematic approach was used in analysing the findings because of the heterogeneity of the studies. Result: It was found that 12 weeks intervention as a follow up to usual care comprising of twice a week exercise regimen conducted at home and as out-patient centre each lasting 40 to 90 minutes per session was found to be a promising strategy in rehabilitation after hip fracture among older adults. The strategy was found to improve mobility, balance and muscles strength and power. Furthermore, compliance to treatment regimen was found to be improved in short term interventional studies supervised by a trained physiotherapist. Conclusion: Based on findings, it could be concluded that outcomes were improved with the interventions. However, there is need to verify this claims in relation to appropriate exercise suitable for different cultures.

In order to meet the needs of the real-time monitoring for the elderly bed-wetting and night sweats, we designed a new alarm device. In this device, conductive wire array sensor, made by ourselves, is applied to sense body fluid and urine of the elderly. And the single-chip is used to simultaneously realize mobile phone alarm and bedside alarm. Furthermore, nurses and relatives can be informed in the first time by this device and make corresponding treatment. Therefore, the device has the advantages of low cost, convenient use, strong practicality and so on.

Background: HUS is a life-threatening multisystem disease caused by uncontrolled complement activation. About 25 % of patients have CNS (Central nervous system) involvement, often leading to serious long-term disabilities in young children. Eculizumab, a humanized monoclonal antibody that targets the complement protein C5, has shown to improve the disease course in children with better neurological outcomes. Early use in disease course showed much better results and its potential use as a prophylactic therapy has been indicated. Scoring systems have been developed for prediction of CNS complications, which may help identify potential candidates for prophylactic Eculizumab therapy. Presentation: We present a 3 year old child who presented with Shiga-Toxin Producing E coli Hemolytic-Uremic Syndrome (STEC-HUS) and seizures. One week into hospitalization he suddenly became unresponsive besides withdrawal to pain. Brain MRI revealed multifocal infarcts involving bilateral basal ganglia, thalami, dorsal brainstem, and cerebellar white matter with microhemorrhages. He was started on Eculizumab in an attempt to halt neurological decline. In spite of starting Eculizumab therapy, our patient succumbed to a fatal cardiac arrest. Based on the SCWP ( sodium, CSR, white count and protein) scoring system our patient was at very high risk for developing neurological sequelae even at initial presentation. His therapy was not started until very late in the course of the disease which may have led to the unfavorable outcome Conclusion: Ecluzimab therapy should be initiated early in HUS patients with CNS involvement. Scoring systems may help identify at risk patients and potentially start prophylactic Eculizumab therapy to achieve improved neurological outcomes in children.

Resistance to antimicrobials by pathogenic microorganisms has raised serious global clinical concerns in recent times. The present study aimed at detection of ß-lactam resistance genes in S. aureus isolates from women with symptomatic and asymptomatic cases of urinary tract infections in Nasarawa state, Nigeria. A total of 200 non-repetitive midstream urinal samples were analysed and 50 (29%) bacterial isolates were identified as S. aureus. The susceptibility profile of the bacterial isolates to tested antibiotics was Nitrofurantoin (74.1%), Gentamicin (72.4%), Ciprofloxacin (65.5%), Ofloxacin (56.9), Augmentin (36.2%), Cotrimozazole (29.3%), Ampicillin (27.6%), Erythromycin (25.8%), Ceftazidine (20.7%) and Cefurozime (10.3%). Thirteen bacterial isolates were found to be resistant to all ß-lactam antibiotics tested, out of which 7 were confirmed ß-lactamase producers using the acidometric and iodometric methods. The detection of ß-lactamase genes (blaZ, blaI and blaR1) was carried out and only five of the isolates were found to be expressing the blaI genes. This research finding suggests that ß-lactam resistance by S. aureus may not be dependent only on the blaZ, blaI and blaR1 genes.

Background: The incidence of cancers is increasing worldwide, particularly in the developing countries as shown by recent cancer stastics from the WHO. It is even anticipated that with the increase in life expentancy, consequent upon inproved standard of living and globalization, the burden of cancers will increase within this millenium. With respective to cancer of the prostate, it is the most common type of cancer in urology. In developing countries, diagnostic is done at a late stage of evolution. In Cameroon, data on prostate cancer are scanty whereas the incidence of this disease is increasing. Objective: This article is designed to describe the epidemiological features of prostate cancer at the General Hospital of Yaoundé. Patients and methods: A 4-year retrospective study of patients seen with the diagnosis of cancer at the Medical Oncology unit of the Yaoundé General Hospital between January 2012 and December 2015. The demographic pattern (age of patients, socio professional activity, marital status), clinical features (cancer diagnosis), treatment modalities and outcome were studied. Main results: Of the 7 775 patients enrolled in the Medical Oncology Service over the study period, 1.4% (n = 108) cases of prostate cancer were seen. The prevalence over the study period was 1.38% and a relatively large annual growth of cases with an annual average of 27 cases was noted. The average age of patients was 67.82 years with a range of 34-83 years. The commonest presenting symptoms were the urinary frequency (54.63%) whereas the least common were fatigue (05.5%) and straining (03.70%). PSA was obtained in 49 patients, representing about 45.4% of all patients. Only 14 (01.26%) had biopsy reports. Conclusion: Prostate cancer is a major problem facing the aging male, and inadequate facilities make early detection difficult. Therefore, treatment is mainly palliative because of late diagnosis.

Background: Behavioral health conditions are prevalent among patients in inpatient medical settings and when not adequately treated contribute to diminished treatment outcomes and quality of life. Substantial evidence has demonstrated the effectiveness of psychological interventions in addressing behavioral health conditions in a range of settings but, to a lesser extent with psychologically-based interventions delivered in inpatient medical settings. Purpose: The purpose of this paper is to increase attention on psychological interventions being delivered to patients across a broad spectrum of medical specialties in inpatient medical settings to support the implementation of interventions to address increasing patient needs. Methods: This selected, brief review of the literature sought to describe published psychologically-based interventions delivered in inpatient medical settings. A search for studies catalogued on PubMed from 2007 to 2016 was examined and studies were included in the review if they were delivered within inpatient medical settings. Two reviewers independently assessed relevant studies for criteria. Results: A total of ten articles met the inclusion criteria with interventions targeting outcomes across four primary domains: 1) pain and fatigue; 2) cognition; 3) affective/emotional and; 4) self-harm. Several articles support interventions grounded in Cognitive-Behavioral Therapy and brief psychological interventions. Most studies reported favorable outcomes for the interventions relative to controls. Conclusions: Psychologically-based interventions, especially those that integrate components of cognitive-behavioral therapy and a multidisciplinary approach, can be implemented in inpatient medical settings and may promote improved patient outcomes. However, the quality of this evidence requires formal assessment, requiring more comprehensive reviews are needed to replicate findings and clarify effectiveness of interventions.

The paper discussed iron homeostasis and anaemia in pulmonary tuberculosis. Iron (Fe) is one of the most abundant elements in the earth’s crust and an essential nutrient for almost all known organisms. It is able to receive and release electrons during conversion from Fe (II) to Fe (III) and plays a major role in DNA production and in energy generation. A system of highly regulated mechanisms is in place to control iron homeostasis. Regulation occurs at both the systemic and cellular levels and influences a number of iron-associated proteins. The iron regulatory protein, hepcidin, plays an important role in the mechanisms responsible for AI and the inflammation-mediated alteration of iron homeostasis. Specifically, hepcidin binds to and degrades the iron export protein ferroportin and down-regulates expression of the iron importer DMT1.Since hepcidin transcription is induced by the pro-inflammatory cytokine, interleukin-6 (IL-6), inflammation leads to a reduction in iron absorption and causes iron to be sequestered in macrophages and enterocytes.The inflammatory cytokines that are released upon innate recognition of a pathogen induce changes in plasma concentrations of other proteins. This phenomenon is referred to as the acute phase response (APR) and the affected proteins are considered acute phase proteins (APPs). The iron homeostasis proteins ferritin, transferrin and hepcidin are considered APPs, as are C-reactive protein (CRP) and alpha-1-antichymotrypsin (ACT), both of which are often utilized in studies as markers of inflammation. In the context of infection, iron’s limited availability within the human body and its physiological importance to both hosts and microbes make it a valuable commodity. Many microbes depend on host-acquired iron and, in response; hosts use their complex system of iron regulation to modify their iron metabolism and restrict iron availability. Evidence links iron with PTB pathogenesis both from the perspective of the pathogen and the host. Upon infection, host immune recognition of Mtb induces a pro-inflammatory reaction that restricts iron access. Most strikingly, a pattern of altered host iron status characterized by high ferritin, low transferrin, and low hemoglobin has been identified as a risk factor for progression to PTB. Decreasing iron availability (regardless of the mechanism) reduces Mtb growth, and addition of iron to Mtb almost always enhances growth.

Background: Sexual health is one aspect of daily life that becomes affected after an individual suffers from coronary artery diseases. Sexual health assessment is an important aspect in assessing general health of patients with coronary artery diseases. Patients often express their concern about sexual well-being after coronary artery diseases but they rarely receive sexual health-related information. Purpose: The aim of this study was to assess Jordanian patients with coronary artery diseases toward sexual health and resuming sexual health activities. Methods: A descriptive, correlational and longitudinal design was used. A convenience sample of 90 patients with coronary artery diseases was enrolled. The study was conducted at one university-affiliated hospital and one public hospital in Amman. Patients’ knowledge about sexual health was assessed using Sex after Myocardial Infarction Knowledge Test- Cardiac version. Results: The majority of patients (65.6%) were diagnosed with MI, male (76.7%) and above 45 years (78.9%). Most patients (72.2%) had a CAD for five years or less. Patients acknowledged the importance of sexual health assessment but they rarely receive sexual health information. The results revealed that patients’ knowledge was limited regarding certain aspects of sexual health (M=13.74, SD= 3.26) at phase one and most patients (55.6%) had moderate knowledge. The results indicated that patients’ knowledge had significantly improved at second phase. Conclusions: Sexual health is an important concern for patients with coronary artery diseases that need to be addressed after recovery. Results of the study showed that sexual health remains an important issue for both patients with coronary artery disease and their health care providers. Continuing education for nurses and health education for patients regarding sexual health should be considered in health institutions.

Background: This study explored the relationship between work stress, workload, and quality of life (QOL) among rehabilitation professionals. Methods: This study applied a cross-sectional design. A questionnaire was distributed to rehabilitation professionals—comprising physicians in the rehabilitation department, occupational therapists, physical therapists, speech-language pathologists, and audiologists—working in teaching hospitals. A total of 152 valid responses were collected, yielding a valid response rate of 93.8%. Results: For female respondents, factors affecting the QOL were educational level, type of professional license, length of service, average leisure hours per week, expense on leisure per week, work stress, and workload (all p < .01). For male respondents, no factor reached statistical significance (p > .001). Conclusion: This study provides the following suggestions to hospital administrators: establishing a stress-relief helpline, evaluating employees’ workload, regularly arranging stress management training courses, implementing employee health promotion programs, and promoting proactive strategies to improve employee physical and mental health.

Background: E-cigarette use has grown in popularity, especially as the devices have been touted as smoking cessation tools. In an exploratory study, we sought to compare dual users (i.e., users of both combustible tobacco and e-cigarettes) to e-cigarette only users. Methods: The Electronic Cigarette Opinion Survey (ECOS) was employed to assess users’ (n=78) perceptions and consumption of e-cigarettes and combustible cigarettes. Quantity of e-juice and nicotine used and time of initial nicotine exposure were assessed. Multivariable logistic regression was used to evaluate the association between e-cigarette use behaviors and being an e-cigarette only user compared to a dual user. Results: Compared to dual users, e-cigarette only users consumed higher levels of nicotine in e-juice (p=0.0009) and more nicotine per month (p=0.03). For dual users, the time of first nicotine exposure after waking was significantly earlier than for e-cigarette only users (mean= 9.6 minutes (SD= 8.0) and mean= 26.6 minutes (SD= 22.0), respectively; p=0.0056). Results from the regression models suggest the amount of e-juice consumed and time of first nicotine exposure after waking are significantly associated with being an e-cigarette only user. Conclusions: These findings shed light on the perceptions and use patterns of e-cigarette only users compared to dual users. As regulation of e-cigarettes is considered, understanding the impact of e-cigarettes and dual use is imperative. Despite frequent marketing claims that e-cigarettes are completely safe, health campaigns need to convey emerging and mixed findings on safety as well as current scientific uncertainty to the public.

Polymeric Nanoparticles of Rifampicin were prepared by emulsion solvent evaporation technique using poly methyl methacrylate as polymer matrix and Poly vinyl alcohol as surfactant. Drug entrapped free flowing nanoparticles of Rifampicin were obtained after optimization using 32 factorial design and characterized for entrapment efficiency, particle size distribution, differential scanning calorimetry (DSC), X-ray diffraction (XRD), scanning electron microscopy (SEM) and in vitro and stability studies. The PMMA nanoparticles had a small size (213 ± 0.72 nm), uniform size distribution. The effects of dependent variables drug-polymer ratio and surfactant concentration on particle size and encapsulation efficiency were studied. The drug and polymer were not interacting with each other. SEM studies revealed the spherical shape of nanoparticles and in vitro release studies showed sustained drug release. RIF-polymeric nanoparticles drug delivery system proved to be promising for anti-tubercular therapy.

The issue of medical aliteracy has drawn both scholars and medical practitioners’ attention in the recent years. The negative cost of medical aliteracy has continued to constitute major threats to health related issue which has resulted in high mortality rate, high medical expenditure and medical underperformance among others. On this premise the study examined the influence of medical aliteracy among senior medical personnel. The study employed descriptive research design and Chi-Square to test the research hypotheses. A total number of 50 questionnaires were designed to collect information from the sampled population through a random sampling. From the result of the analysis it was revealed that factors such as ineffective supervision of medical personnel, low patient literacy level, lack of personnel-patients engagement could lead to medical aliteracy among senior medical personnel. Senior medical personnel have the knowledge of medical aliteracy and its implications on for medical personnel and the public. Medical aliteracy has an implication on health sector performance which includes increase in mortality rate, increase health expenditure, widening of the gap between patients – medical personnel communication among others. Perception of medical aliteracy has significant influence on medical personnel performance. The study concluded that, medical aliteracy is prevalent among medical personnel and patients and is associated with many poor medical outcomes in the health sector. It was however recommended that medical literacy training, schemes and programmes should be designed according to the needs of the different medical personnel and should therefore be included in medical professional training programs.

A survey was developed and distributed to adult pharmacy customers in Pristina, Kosovo to explore the extent and reasons for self-medication and knowledge regarding antibiotic use. The survey was distributed via-email to a convenience sample of pharmacy customers (n=693). Four hundred and nineteen (n=419, 63.2% response rate) completed surveys were returned. Most respondents (56%, n=235) were between 25-45 years old, almost 80% (79.62%, n=332) held a university degree, 59.43% were females, and 12.05% (n=50) were unemployed. Sore throats (44.47%, n=185) were the most common reason for self-medicating with antibiotics followed by other – unspecified (28.61%, n=119), cough (7.21%, n=30) and pain (6.49%, n=27). Amoxicillin was the most frequently self-administered antibiotic (41.1%, n=175). It was concluded that self-medication with antibiotics in this sample is a problem and controlling antibiotic use is an important public health effort.

The effects of co-administration of Azadirachta indica and Gongronema latifolium on the liver of Plasmodium beighei infected Swiss albino mice was evaluated. Thirty mice divided into 6 groups of 5 animals each were used for this study. Healthy control group was not infected with. Other group was infected by intraperitoneal injection of P. beighei. Once parasitaemia was confirmed, treatment groups were assigned; Group A received distilled water at 10ml/kg body weight. Group B was not given any extracts. Groups C was given G.latifolium extract at 500mg/kg body weight. Groups D was given A. indica extract at 500 mg/kg body weight. Group E received both extracts at 500 mg/kg each. Group F received Artemether at 1.6mg/kg body weight intraperitoneally. The extracts were administered orally for 5 days. The animals were sacrificed after blood was obtained for serum liver enzymes estimation. The liver were processed for histological study using H and E. Histology of the liver showed sinusoidal congestion and hepatocyte necrosis in the diseased control and steatosis, loss of normal sinusoidal architecture, necrosis of hepatocytes and portal tract inflammation in the A. indica only group. The groups administered G. latifolium, both singly and in combination with A. indica had normal liver histology. The liver enzyme ALT was significantly (p<0.05) raised in A. indica treated group while it was normal in the G. latifolium groups. It will thus appear that G. latifolium ameliorated the hepatotoxicity of A. indica in Plasmodium beighei infected mice.

Dengue Fever, a major global Vector-Borne public health concern, is considered a major threat for mortality and morbidity of human-population. As no public-health vaccine is not still available, for prevention of the disease different Vector Control methods are still the prime means. The key to success lies on analysis of geo-climatic, socio-cultural, politico-legal and economic condition of the area, seasonal variation, as well as the spatial spread of the disease. Among different cities of India, Kolkata, an important Metropolis, has been subjected to this study, where the spatial spread of dengue has been found to have some important characteristics. The authors of the present work, who have been working on Vector Borne Diseases and have effectively forecasted models of Urban Malaria for Kolkata, have attempted a baseline study on Spatial Clustering of Dengue Fever in the same City, based on a large survey data, conducted by the Kolkata Municipal Corporation. In this pursuit, Moran scatter-plot, Hot-Spot Map and Heat Map using LISA Tools were derived for consecutive two years, so that the possible spatial effects on Dengue incidences can be derived after Spatial Analytic techniques. Disease Control methods can only be derived following the detailed Statistical Analysis of the Spatial Clustering data.

Introduction: This review discusses the molecular mechanisms responsible for the normalization of otherwise raised intraocular pressure (IOP) in patients of glaucoma when they are administered statin therapy. Material and Methods: Literature published between 1990 and 2016 on the pathophysiology of glaucoma and the action of statins has been reviewed. Data Synthesis: A decrease in resistance to aqueous humor flow through trabecular meshwork (TM) in the eye tissue results in lessening of the raised intraocular pressure. KATP channels have been discovered in the eye tissue recently. Activation of KATP channels facilitates the flow of aqueous humor through the TM. This presumption is strengthened by the action of statins. Statins activate these KATP channels and, thereby, facilitate the aqueous flow through TM leading to relief in IOP. Statins interfere in the cholesterol biosynthesis pathway leading to decreased cholesterol synthesis. However, a simultaneous decrease in the level of ubiquinone leads to activation of KATP channels. Further, accumulation of LC Acetyl CoAs also activates these KATP channels. Expert Opinion: Statins decrease the elevated intraocular pressure in glaucoma by activating KATP channels. KATP channels are recently discovered therapeutic targets which may be exploited in the treatment of glaucoma.

Objective: The aim of this study was to evaluate the approach of parents to fever of children and related factors. Methods: In this survey study, A 26-question survey was conducted the parents whose children were under 15 years of age and admitted to the department of Emergency at Ministry of Health Okmeydani Training and Research Hospital between November 2014 and April 2015 due to fever. The survey questions included the presence of a thermometer at home, their manner of taking temperature, mother’s knowledge level about fever, methods applied for reducing fever, antipyretic use and their concerns as well as the demographic characteristics. Results: In the study, 250 parents who were parents of 132 boys and 128 girls enrolled and the mean age of mothers, fathers and children who participated in the study were 25, 29.3 and 3.6 years, respectively. Most of the families (81.2 %) were nuclear family which consists of mother, father and children. It was recorded that 3.2% of parents with the score 0; 19.2% of parents with the score 10; and 86.4% of parents with the score 5 according to fever concern scale rated from 0 to 10. Conclusion: Parents should be informed correctly about fever in children to prevent fever phobia that causes an excessive number of unnecessary applications to the emergency department, high health care cost, and labor loss at hospitals by physicians and public informative publications.

Introduction and Aim: Transition from being a student nurse to a full time registered nurse is a difficult phase in the lives of intern nurses. During this phase they face many challenges which influence their professional lives as well as their transitional experience. This study aimed to identify the transitional challenges experienced by intern nurses at Labasa Hospital, Fiji. Methodology: This qualitative study was conducted using a phenomenological approach. Data collection through semi structured in-depth interviews commenced after ethical approval was obtained. Each interview lasted between 40 to 60 minutes. The 22 participants were intern nurses of Labasa Hospital, Fiji who were either current intern nurses and had worked for more than 6 months or had completed internship within the past 5 years at Labasa Hospital and currently working as registered nurses within various units in the facility. Written consent was obtained from intern nurses who were willing to participate before the commencement of the interview on a one to one basis. The interview data was transcribed verbatim and interpreted thematically. Results: The intern nurses participating in the study were between the ages of 22 and 26 years old. Only one participant was 46 years old. 10 were current intern nurses while the remaining 12 had completed their internship and working as registered nurses. Reality shock is one of the challenges identified as a subtheme through thematic analysis in this study. The categories identifies under reality shock are role ambiguity, self-doubt, and work environment. Conclusion: The findings of the study identified reality shock as one of the many challenges experienced by intern nurses of today. There is an immediate need for healthcare providers and nursing leaders to recognize and address the reality shock in order to facilitate better transitional experiences for intern nurses. Easing the burden of reality shock will promote a healthy working environment as well as initiate better clinical outcomes.

Objective: The aim of the study was to identify level of stress among nurses according to their job status. Background: Stress is highly associated with nursing profession. This stress is caused by several factors both personal and organizational such as educational level, gender, nature of work environment and work overload etc. These factors directly or indirectly expose nurses to a considerable level of stress. If a nurse works at two places, their stress level will predictably be much higher than that of those who work at a single place. Methodology: Quantitative analytical cross-sectional study design was applied in a private tertiary care hospital at Peshawar, Pakistan. Study population included all nurses working in the mentioned hospital. Universal sampling technique was used for double jobber nurses, while convenient sampling technique was used for single jobber nurses. An adopted questionnaire was used for data collection. Chi-square test was applied to analyze the data. Result: Among double jobber nurses, 23.33% had severe, 63.34% had moderate, and 13.33% had mild level of stress. On the other hand, there was no severe level of stress among single jobbers; only 20% had moderate and 80% had mild level of stress. Conclusion: The current study identified that level of stress was higher in double jobber nurses as compared to single jobber nurses. The study would have been more generalizable if more tertiary care hospitals were included for data collection.

Aim: of the study was to conduct a comparative analysis of inflammatory markers in patients with coronary heart disease of stable and unstable flow. Methods: 78 patients aged 36 to 75 years were enrolled in this study (mean age 58.2±12.6 years). Laboratory and instrumental data were obtained and assessed. IL-6, TNF-a in blood plasma was carried out by the method of enzyme immunoassay on a solid-phase analyzer «Humareader Single». Statistical processing of the obtained results was carried out using vibrational statistics methods recommended for biomedical research on the IBM PC AT Pentium IV. Results: In patients with unstable angina (UA), the frequency of elevated levels of CRP, TNF-a, and leukocytes was statistically significantly higher than in the group with stable ischemic heart disease (P<0.05). The mean levels of these markers were statistically significantly higher in patients with UA compared with patients with stable form of coronary heart disease (CHD, P<0.05): CRP (4.3 ± 2.4 and 2.9 ± 2.3 mg / L, p <0.05, respectively), TNF-a (10.5 ± 2.5 and 7.7 ± 3.4 pg / ml, p <0.05) and leukocytes (9.2 ± 2.5 6.9 ± 2.3x109 / l, p <0.05). The level of interleukin-6 in patients with UA was higher in comparison with patients with stable angina (SA, 3.4 ± 1.7 and 2.9 ± 0.5 pg/ml), but the difference was statistically not significant (p> 0.05 ). There were no significant differences in the level of fibrinogen and ESR between patients with UA and SA. Conclusion: It was noted that the signs of inflammation are detected both in patients with unstable forms and in patients with stable form of CHD, but the degree of inflammation in patients with UA (level of TNF-a, CRP and leukocytes) is higher than in patients with stable ischemic heart disease.

Malaria infection during pregnancy is a major public health problem- especially in tropical and sub-tropical regions; with substantial risks for the mother, her foetus and the new-born, Pregnant women are particularly susceptible to malaria, and in low transmission settings they have a greater risk of severe Plasmodium falciparum malaria. This study aimed at investigating the rate of parasitaemia amongst pregnant and none pregnant women was conducted among people attending clinics at the University of Calabar Teaching Hospital, Mambo hospital, Nosam medical laboratory services in Calabar Cross River state. They fall within the age group 18 to 60 years. They were pregnant women who came for Antenatal clinic, controls were sampled from patients who came to request for medical examination and blood donors. Thick and thin blood smears were made from finger prick samples of 400 candidates attending Antenatal clinics 200 of them were from established pregnant women and the other 200 were from non-pregnant women to serve as control. The blood films were dried and fixed in absolute methanol dried and stained with 2% Giemsa stain for 30 min. it was then rinse in clean water and allowed to dry in a draining rack. Dried slides were viewed using x100 oil immersion objective. Result revealed a parasitic rate of 132 (55.9 %) among pregnant women and104 (44.1%) parasitaemia among none pregnant women. The difference between pregnant women and none pegnant women were significantly different at p < 0.05. Similarly, the mean parasite density of the pregnant women was higher 28.9 against 14.2 of control none pregnant women. In conclusion there was a significant density of malaria parasitaemia amongst pregnant women in this study.

Background of study: There is emerging evidence that human immunodeficiency virus (HIV) infection, even in the absence of anti-retroviral therapy (ART) toxicity and other cofactors, may have a direct impact on liver pathogenesis. Aim: Based on this premise, our study determined the impact of HIV infection on liver enzymes as markers of hepatic function. Methods: the case-control study comprised of a total of 60 participants (30 males and 30 females) aged 18-60 years. The study compared aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), cluster of differentiation (CD4+) cells among ART-naïve HIV patients (n=20), follow-up HIV patients who were on highly active ART (n=20) and apparently healthy controls (n=20). Results: a significant (P<0.05) change was observed in the liver enzymes and CD4+ cells among the study groups compared. Specific changes showed that serum AST, ALP levels of ART-naïve patients were significantly (P<0.05) higher than that of follow-up and controls. Serum ALT levels of controls were significantly (P<0.01) lower than that of ART-naïve and follow-up patients. The CD4+ cell count of ART-naïve patients was significantly (P=0.000) lower than that of follow-up and control groups. Conclusion: Liver enzyme abnormalities were observed in ART naïve HIV infected patients. Consequently, there is a need to monitor liver enzyme levels before and after initiation of therapy.

Malaria infection during pregnancy is a major public health problem- especially in tropical and sub-tropical regions; with substantial risks for the mother, her foetus and the new-born, Pregnant women are particularly susceptible to malaria, and in low transmission settings they have a greater risk of severe Plasmodium falciparum malaria. This study aimed at investigating the rate of parasitaemia amongst pregnant and none pregnant women was conducted among people attending clinics at the University of Calabar Teaching Hospital, Mambo hospital, Nosam medical laboratory services in Calabar Cross River state. They fall within the age group 18 to 60 years. They were pregnant women who came for Antenatal clinic, controls were sampled from patients who came to request for medical examination and blood donors. Thick and thin blood smears were made from finger prick samples of 400 candidates attending Antenatal clinics 200 of them were from established pregnant women and the other 200 were from non-pregnant women to serve as control. The blood films were dried and fixed in absolute methanol dried and stained with 2% Giemsa stain for 30 min. it was then rinse in clean water and allowed to dry in a draining rack. Dried slides were viewed using x100 oil immersion objective. Result revealed a parasitic rate of 132 (55.9 %) among pregnant women and104 (44.1%) parasitaemia among none pregnant women. The difference between pregnant women and none pegnant women were significantly different at p < 0.05. Similarly, the mean parasite density of the pregnant women was higher 28.9 against 14.2 of control none pregnant women. In conclusion there was a significant density of malaria parasitaemia amongst pregnant women in this study.

Background of study: There is emerging evidence that human immunodeficiency virus (HIV) infection, even in the absence of anti-retroviral therapy (ART) toxicity and other cofactors, may have a direct impact on liver pathogenesis. Aim: Based on this premise, our study determined the impact of HIV infection on liver enzymes as markers of hepatic function. Methods: the case-control study comprised of a total of 60 participants (30 males and 30 females) aged 18-60 years. The study compared aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), cluster of differentiation (CD4+) cells among ART-naïve HIV patients (n=20), follow-up HIV patients who were on highly active ART (n=20) and apparently healthy controls (n=20). Results: a significant (P<0.05) change was observed in the liver enzymes and CD4+ cells among the study groups compared. Specific changes showed that serum AST, ALP levels of ART-naïve patients were significantly (P<0.05) higher than that of follow-up and controls. Serum ALT levels of controls were significantly (P<0.01) lower than that of ART-naïve and follow-up patients. The CD4+ cell count of ART-naïve patients was significantly (P=0.000) lower than that of follow-up and control groups. Conclusion: Liver enzyme abnormalities were observed in ART naïve HIV infected patients. Consequently, there is a need to monitor liver enzyme levels before and after initiation of therapy.