Journal of Biomedical Investigation

EFFECTS OF BRIEF-INTENSE MODE AND ACUPUNCTURE-LIKE TENS IN THE RELIEF OF CHRONIC LOW BACK PAIN

2024-01-13T13:12:45+01:00

Background: Transcutaneous electrical nerve stimulation (TENS) is a physical modality used in the management of pain using various treatment modes. However, the optimal mode of application for the treatment of chronic low back pain appeared not to be well studied.

Aim: The study aimed to determine and compare the effects of Brief-intense mode and Acupuncture-like TENS in the relief of chronic low back pain.

Materials and Methods: Twenty-seven (27) participants were recruited using a consecutive sampling technique. Participants were randomly allocated into three groups (Brief-intense, Acupuncture-like TENS and Control group) using simple balloting. Participants in brief-intense group and acupuncture-like TENS group received TENS treatment using different current intensities, pulse duration and frequency in addition to conventional physiotherapy treatment for low back pain. However, participants in control group received only conventional physiotherapy treatment for low back pain. Each group received treatment two times a week for six weeks. Outcome measures assessed were pain intensity and functional disability using Numerical Pain Rating Scale (NPRS) and Roland Morris Questionnaire (RMQ) respectively. Data collected at baseline, week three and six were analyzed using using one-way ANOVA and independent Ttest. Alpha level was set at < 0.05.

Results: There was a significant reduction in pain intensity and functional disability in the three groups across the three time frame for measurement (p < 0.05). However, there was no significant difference between the effects of Brief-intense mode and Acupuncture-like TENS on pain intensity and functional disability (p > 0.05).

Conclusion: Both modes of TENS (brief-intense group, acupuncture-like TENS) produced a significant effect in the reduction of pain as well in the improvement of functional disability in all participants with chronic low back pain. However, no one seems to be more effective than the other in the treatment of chronic low back pain.

ELEVATED PRE-TREATMENT NEUTROPHIL-TO-LYMPHOCYTE AND NEUTROPHIL-TO-LYMPHOCYTE-PLATELET RATIOS ARE ASSOCIATED WITH A HIGH RISK OF IN-HOSPITAL DEATH AMONG PATIENTS WITH PROSTATE CANCER IN SOUTHEASTERN NIGERIA

2024-01-13T13:25:56+01:00

Background: There is an increasing mortality rate among patients diagnosed with prostate cancer (PCa) in West Africa. To identify the causes of the high mortality rate, this study analyzed the occurrence of high-grade tumours and presence of BRCA2 gene loss. It also assessed the utility of systemic inflammatory indices as prognostic tools in low-resource settings.

Methods: This study included 72 cases of PCa diagnosed from Jan. 2017 to Dec. 2020. The neutrophilto-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), platelets- neutrophils-to-lymphocytes ratio (PNLR), and neutrophils-to-lymphocytes platelets ratio (NLPR) were assessed and analyzed accordingly. Significance was set at p< 0.05.

Results: The prevalence of Gleason grades (G) 1 to 5 was 9.3%, 16.3%, 16.3%, 25.6, and 32.6%, respectively. There was a high frequency of BRCA2 loss (58.3%) and frequency was higher among patients with G4/5 tumours (59.5%) than in patients with G1-G3 tumours (46.7%) at p= 0.347. A high frequency of G4/5 tumours was observed among patients within the age group of 50-59 years (n= 7/8; 87.5%) and patients with castration-resistant PCa (n= 12/17; 70.6%). The pre-treatment PLR and calcium concentration were higher among patients with G4/5 tumours compared to patients with G1-G3 tumours (p= 0.046 and < 0.001, respectively.) There were direct relationships between BRCA2 expression and age (p= 0.019), tumour grade and calcium (p= 0.000), BRCA2 and calcium expression (p= 0.027), unemployment and G4/5 (p< 0.001), and education status and G4/5 (p= 0.020). The pre-treatment NLR and NLPR were 2.0 and 4.7 times higher in in-hospital deaths than in stable discharges at p= 0.005 and 0.001, respectively.

Conclusion: This study revealed high frequencies of BRCA2 loss and high-grade PCa in Southeastern Nigeria. It also revealed elevated pre-treatment NLR and NLPR in cases of in-hospital death. It suggests that pre-treatment PLR could be used to identify patients with G4/5.

DEVELOPMENT AND ANALYTICAL VALIDATION OF AN ENZYME–LINKED IMMUNOSORBENT ASSAY FOR THE MEASUREMENT OF SERUM S100A12 AND SERUM CALPROTECTIN IN INFLAMMATORY BOWEL DISEASE

2024-01-13T13:35:33+01:00

Background: Inflammatory bowel disease (IBD) is characterized by prolonged symptomatic episodes of risk of relapse and remission. Current diagnosis of IBD rely heavily on use of faecal biomarkers such as faecal calprotectin (fCAL) which has been noted to have certain limitations. Quantitative determination of levels of fCAL through the application of enzyme–linked immunosorbent assay (ELISA) technique is well–established.

Aim: The primary goal of this study was to develop and validate S100A12 ELISA (ImmunodiagnostikTM AG, Stubenwald–Allee 8a, D–64625 Bensheim, Germany) for the determination of S100A12 in serum (sA12), and to validate MRP8/14 Calprotectin S100A8/A9 ELISA (Bühlmann Laboratories AG, Baselstrasse 55, CH–4124 Schönenbuch, Switzerland) and IDK® Calprotectin ELISA (ImmunodiagnostikTM AG, Stubenwald–Allee 8a, D–64625 Bensheim, Germany) for the determination of calprotectin in serum (sCAL).

Method: The assay was validated by determining sensitivity, linearity, recovery, imprecision, carry over, analytical interference and stability. A two–site sandwich enzyme–linked immunosorbent assay (ELISA) was developed and analytically validated using faecal and
serum samples from healthy controls and patients presenting with inflammatory bowel disease directed against commercially available ELISA kits manufactured by Bühlmann Laboratories AG, Schönenbuch, Switzerland and ImmunodiagnostikTM AG, Bensheim,
Germany. To accomplish this goal, a two–site sandwich ELISA for serum S100A12 and faecal calprotectin was set up and validated by evaluating faecal S100A12 ELISA assay for use with serum S100A12 samples, and faecal calprotectin ELISA assay for use with serum calprotectin samples.

Results: Linearity versus recovery data for BMN^®-Cp (100.8 vs. 82.1%), IDK^®-Cp (98.4 vs. 89.5%) and IDK^®-A12 (103.7% vs. 107.8%) are within the target of between 80–120% acceptance criteria for immunoassays. %CV for intra–assay versus inter–assay variability for BMN^®-Cp (3.1 vs. 3.2), IDK^®-Cp (2.9 vs. 4.7) and IDK^®-A12 (7.0 vs. 3.8) are <20% acceptable criteria for imprecision study.ULMR for BMN®-Cp, IDK^®-Cp and IDK^®-A12 were 2.4x106, 2.5x104 and 5.4x102 ng/mL respectively. LoB versus LLoD were 577 vs. 597, 0.673 vs. 1.119 and 1.145 vs. 1.633 ng/mL for BMN^®-Cp, IDK^®-Cp and IDK^®-A12 respectively. LoQ was 3615, 2880 and 522 ng/mL for BMN^®-Cp, IDK^®-Cp and IDK^®-A12 respectively. No significant assay drift, carry over or instability was observed for the assays.

Conclusion: The assays described are sufficiently sensitive, linear, accurate, precise and `reproducible for routine clinical laboratory application. Further studies to evaluate the clinical utility of the assays in assessing IBD are needed.

KNOWLEDGE OF THE MANAGEMENT OF EXTRAPYRAMIDAL SYNDROMES OF NEUROLEPTIC DRUGS AMONG NURSES IN NEUROPSYCHIATRIC HOSPITALS OF ANAMBRA AND ENUGU STATES

2024-01-13T13:49:34+01:00

Background: Many patients on antipsychotic medication have reported experiencing Extrapyramidal Syndrome (EPS). Due to high rate of EPS developed in patients, antipsychotic medication guideline and rating scale were developed for the management of EPS while caring for patients on antipsychotic drugs.

Aim: The aim of this study was to determine the knowledge and management of Extrapyramidal syndrome of Neuroleptic Drugs among Nurses in Neuropsychiatric Hospitals of Anambra and Enugu State.

Materials and methods: A descriptive cross-sectional survey was carried out among 221 Nurses from Neuropsychiatric Hospital in Anambra State and Federal Neuropsychiatric Hospital in Enugu state. Data was collected using questionnaire adopted from a similar study. The data was summarized frequencies, percentages and Chi-square with level of significance set at < 0.05.

Results: More than half of the nurses in Federal Neuropsychiatric Hospital Enugu 164 (83.25%) had good knowledge of EPS, while 14 (66.67%) of Nurses in Neuropsychiatric Hospital Anambra State also had good knowledge of EPS and its management. While 197 (100%) and 21 (100%) in Federal Neuropsychiatric Hospital Enugu and Neuropsychiatric Hospital Nawfia Anambra respectively agreed that their hospitals had no policy/guideline for EPS management. There was a significant association between years of working as a registered nurse (p=<0.001), current grade level (p=0.001) and knowledge of EPS among nurses.

Conclusion: Most of the participants had good knowledge of Extrapyramidal Syndrome; none of them used American Association guideline and rating scale in management of EPS.

Recommendation: As EPS continues to pose problem to psychiatric patients, nurses who are the ones administrating these medications need to adopt the standard guidelines stated for management of EPS to ensure its reduction.

KNOWLEDGE OF THE APPROACHES TOWARDS CANCER PAIN MANAGEMENT IN PATIENTS CARE AMONG NURSES IN SELECTED HOSPITALS IN AKWA IBOM STATE

2024-01-13T13:57:47+01:00

Background: Cancer-related pain can be acute or chronic and related to tumour, treatment, or both. Cancer pain has a debilitating effect and, if left untreated or poorly managed, can have a significant impact on a patient's physical, emotional, and mental well-being, thus impairing the patient's quality of life. Immediately a comprehensive assessment of a patient's pain is concluded, different treatment approaches should be considered before treatment planning is developed.

Aim: This study examined knowledge and approaches used in managing cancer pain in cancer patients among nurses in selected hospitals in Akwa Ibom State, Nigeria.

Materials and methods: A cross-sectional descriptive survey was carried out among 88 registered nurses purposely recruited from selected hospitals in Akwa Ibom State. Data was collected using Observational checklist and revised Nurses Knowledge and Attitudes Survey Regarding Pain (NKASRP) questionnaire. The obtained data were summarized using frequencies, Percentages and chi-square.

Results: More than half of the nurses 64 (73.70%) had adequate knowledge about cancer pain management while only 3 out of 10 cancer pain management approach was satisfactorily utilized by the participants in the care of cancer patient aimed at relieving pain.

Conclusions: Although more of the nurses had adequate knowledge on cancer pain management, the approach used was sub-optimal.

CROSS-CULTURAL ADAPTATION, RELIABILITY, AND VALIDATION OF THE INTERNATIONAL PHYSICAL ACTIVITY QUESTIONNAIRE SHORT FORM IN LANGUAGES IN AFRICA: A SYSTEMATIC REVIEW

2024-01-13T14:04:40+01:00

Background: The African population consists of diverse cultures and languages whose first language is not English. To address the challenges of using the English version of the International Physical Activity Short Form (IPAQ-SF), encourage physical activity (PA) participation/research, and curb non-communicable diseases (NCDs) in developing countries in Africa, there is a need for cultural adaptation of the questionnaire.

Aim of the study: This study aimed to conduct a Systematic Review on cultural adaptation, reliability and validation of the IPAQ-SF into African languages and to proffer probable reasons for differences between the versions.

Materials and Methods: We searched PubMed, Google Scholar, and AJO from inception to August 14, 2022. Studies were recruited if they conducted a cultural adaptation, validation and reliability of IPAQ-SF into the African language. The data analysis included descriptive statistics, ANOVA, and Student’s t test using SPSS version 23, and a p<0.05 was used as the level of significance.

Results: A total of 453 healthy adult subjects (Hausa, n = 102 & Yoruba, n = 351) who met the inclusion criteria were documented. The mean age and BMI were 29.3±6.255 years and 24.1±4.335 (kg/m2), respectively. Majority of the subjects were male (n = 293) and single (n = 375) than married (n = 74) and female (n = 160). The reliability and concurrent validity of the Yoruba and Hausa IPAQ were acceptable. The total scores obtained from the concurrent validity in the males in the Hausa (r = 0.844) IPAQ-SF were significant (r = 0.022) and more than that of the Yoruba (r = 0.640) version. The ICC total and female was significantly higher in the Hausa than the Yoruba IPAQ-SF.

Conclusions: Overall, not many studies reported the cultural adaptation of English IPAQ-SF into African languages. Both Hausa and Yoruba IPAQ-SF have acceptable concurrent validity and test-retest reliability for assessing PA. The total score for the concurrent validity male, ICC total and female were significantly higher in the Hausa than the Yoruba IPAQ-SF. We recommend that the English IPAQ-SF be culturally adapted to the Africa languages such as Igbo, pidgin, Swahili, Ajagam, Boki, and Effik.

ANTIOXIDANT MICRONUTRIENTS AND PHENOL FRACTION OF PIPER GUINEENSE EXTRACT EXHIBITS DIFFERENTIAL CD68 CEREBELLAR EXPRESSION ON AZT INDUCED-NEUROINFLAMMATION

2024-01-13T14:13:31+01:00

Background of the study: Exposure to HAART regimen especially Azidothymidine (AZT) therapy has neurotoxic adverse effects like neuroinflammation.

Aim: We assessed the role of Phenol extract of P.guineense leaf and antioxidants on the Azidothymidine challenge.

Material and Methods: Thirty-six adult Wistar rats were randomized into nine groups of 4 rats each. Azidothymidine (AZT) was administered to all groups except the control which received 0.1mL saline. Others received 100 mg/kg of AZT for 8 days, 100 mg/kg of AZT+100 mg/kg of P.guineense, 100 mg/kg of AZT+ 200 mg/kg of P.guineense, 100 mg/kg of AZT + 400 mg/kg of P.guineense, 100 mg/kg of AZT+ Zinc, 100 mg/kg of AZT+ 3mg/kg of Melatonin, 100 mg/kg of AZT+ 1000mg/kg Cellgivity, and 100 mg/kg of AZT+ 50 mg/kg of Selenium for 14 days respectively. Cerebellar amoeboid microglia expression was by identified by CD68 marker.

Result: AZT induces reactive microgliosis, and the P.guineense extract exhibited dose-dependent pleiotropic microglia retraction. The antioxidants: Zinc, melatonin, selenium and cellgevity deferentially mitigate the AZT effect by providing neuroprotection. The high dose of P.guineense, selenium, and cellgevity had a pronounced reversal effect on the microglia.

Conclusion: The effective dose of phenol extract P.guineense was beneficial in halting the neuroinflammatory effect of AZT in the cerebellum.

ESTABLISHMENT OF LOCAL DIAGNOSTIC REFERENCE LEVELS (LDRL) FOR ADULT CHEST COMPUTED TOMOGRAPHY EXAMINATION IN A SOUTH-EASTERN STATE OF NIGERIA

2024-01-13T14:31:38+01:00

Background: Diagnostic reference levels (DRLs) are indispensable tools and a sub-principle in optimization of radiation dose in the field of Radiography and radiological sciences. It is intended to identify and reduce unnecessary high ionizing radiation dose to patients during radiological examinations such as Chest Computed Tomography (CT) examination.

Objective: To determine local Chest Computed Tomography dose index (CTDIvol) and Dose length product (DLP) in the selected CT centers, estimate the Effective dose (ED) for Chest CT examination and compare our results with both stated Nigerian national and international standards.

Materials and Methods: A total of 240 adult subjects referred for chest CT examination from the four considered CT radiodiagnostic centers were surveyed within a period of six months. Data were obtained from different models of CT scanners which included Toshiba Alexium, Brightspeed multidetector CT scanner and Siemens Somerton respectively. Radiation dose were generated from Computed Tomography Dose Index (CTDIvol) and Dose Length Product (DLP) from where the effective dose (E) was calculated using the product of chest DLP and the normalized coefficient found in the European guideline. Data were analyzed using SPSS version 20 Chicago software. The mean values for each CT centre were calculated at 75th percentile of DLP and CTDIvol chosen as the basis for DRLs.

Results: The 75th percentile of CTDIvol and DLP were 22 mGy and 800 mGy.cm. The effective dose was 13. 6mSv.

Conclusion: Radiation dose variations across the four CT centres surveyed have revealed the need for urgent dose optimization to narrow down centre-specific and composite DRL values to national and international best practice.

SYSTEMATIC REVIEW ON EPIDEMIOLOGICAL STUDIES OF SCHISTOSOMIASIS IN SOKOTO STATE, NIGERIA

2024-01-13T14:42:59+01:00

Background of the study: Schistosomiasis has been as one of the dangerous neglected tropical diseases that cause huge socioeconomic health problems in many parts of Nigeria including Sokoto State. However, there is a dearth of information on the disease distribution, intensity and risk factors associated with the illness in the state.

Aim of the Study: The present study was conducted to systematically review the prevalence, intensity and risk factors causing schistosomiasis infection in Sokoto state, Nigeria.

Methodology: Information from more than five hundred (500) research articles at ResearchGate, ScienceDirect, PubMed, Google Scholar and World Health Organization (WHO) were gathered. However, only manuscripts that were found with relevant information needed for the sake of the present research were highly considered, articles that contained information on the prevalence, intensity, or risk factors associated with the schistosomiasis were given much emphasis, only articles in which at least their abstract was written in English language were considered.

Results: Results from the available article showed that; the overall schistosomiasis infection rate across the state ranged from 2.9% to 61.8, and the overall intensity of the disease in the state was between 499.0 to 1.75. Identified risk factors in the State were: occupation, education, age group, personal habits socioeconomic status, personal hygiene and residence location.

Conclusion: It was concluded that there is a high prevalence and intensity of schistosomiasis in Sokoto state, Nigeria as a result of many risk factors such as environmental, socioeconomic and demographic.

Recommendation: It was recommended that further research should focus on investigating the antigenic factors responsible for the persistence of the parasite in the state to allow for best preventive and control measures.

PATTERN AND PREVALENCE OF WORK-RELATED MUSCULOSKELETAL DISORDERS AND ITS ASSOCIATION WITH QUALITY OF SLEEP AMONG FOOD VENDORS IN OGBOMOSHO, NIGERIA

2024-01-13T14:52:06+01:00

Background: Food vendors are at risk of musculoskeletal disorders due to the awkward postures they attain while cooking and serving the food. The pain that results from musculoskeletal disorders could impact their sleep.

Objective: This study investigated the prevalence of work-related musculoskeletal disorders (WMSDs) on food vendors' sleep quality.
Method: This cross-sectional study was conducted on food vendors in selected food outlets in Ogbomosho, Nigeria. Data was collected on participants’ socio-demographics, prevalence of work-related musculoskeletal disorders using the Nordic Musculoskeletal Questionnaire and quality of sleep using the Pittsburgh Sleep Quality Index. Descriptive statistics and Chi-square were used to analyze the data. The alpha level was set at p≤0.05.

Result: There were 82 participants [19 males (23.2%) and 63 females (76.8%)]. The mean age was 31.5±9.592 years. The average number of weekly working hours for participants was 69.95±17.318 hours. The majority of the participants (83%) reported having pain in one or more parts of the body in the last 12 months, with the low back (53.7%) and knees (51.2%) reported as the most affected regions. There was a significant association between WMSDs and participants' sleep quality (p = 0.003). Also, there was a significant association between sleep quality and the number of participants' work hours (p = 0.025).

Conclusion: The study revealed a high prevalence of WMSDs among food vendors in Ogbomosho which was significantly associated with quality of sleep. Hence, proper education and awareness programmes on WMSDs and their prevention should be done for food vendors.

RISK PROFILE, KNOWLEDGE OF FALL AND PRACTICE OF SAFE BEHAVIOUR AMONG COMMUNITY-DWELLING ADULTS IN KANO METROPOLIS, NIGERIA

2024-01-13T15:04:03+01:00

Background: People who grow older may increasingly be at risk for fall and are susceptible to injuries from fall. Fall-related injuries are associated with serious psychological and behavioural consequences including fear of recurrent fall and isolation. It is doubtful if knowledge of fall will be associated with the fall risk profile and safe behavioural practices among elderly.

Objective: The objective of this study is to determine if there is any association between knowledge of fall, fall risk profile and safe behaviour among community dwelling adults in Kano metropolis.

Methods: A cross-sectional survey of community-dwelling adults (n= 287) was carried out using Fall Knowledge Assessment Questionnaire, Desmond Fall Risk Questionnaire and Fall Behaviour Scale for the Older Persons. A snow balling sampling technique was used to recruit volunteers regardless of their education, gender, socio-economic status and irrespective of walking with aid or not.

Results: The results of this study showed that there was a weak significant correlation between the knowledge of fall and fall risk (r = - 0.219, p < 0.05) and no significant correlation was observed between knowledge of fall and behaviour (r = 0.030, p < 0.05) and behaviour and fall risk (r = 0.090, p < 0.05).

Conclusion: From the outcome of this study, it was concluded that there was a reciprocal relationship between knowledge of fall and fall risk among this cohort of elderly participants in Kano metropolis.

SOCIAL DETERMINANTS OF OBESITY IN THE UNITED KINGDOM: A SYSTEMATIC REVIEW OF THE LITERATURE

2024-01-13T15:12:48+01:00

Background: Obesity is a global public health problem. The increasing prevalence arise from complex and multifaceted determinants that relate to individual lifestyles, choices people make and the influence of social circumstances of the wider society in which they live. There is a worldwide phenomenon that obesity follows a social gradient that makes it possible for higher obesity risk to reflect lower level of socioeconomic profile (SEP) or socioeconomic status (SES). The levels of SEP or SES define the conditions of daily living which, are in turn shaped by the broader political, economic, social and cultural environment.

Aim: The aim of this study was to conduct a systematic review of published literature over a timeframe of 2000 to 2018 on lifestyle factors, economic conditions, environmental and socio–cultural issues as they constitute social determinants of obesity in the UK.

Methods: Based on the modified PRISMA protocol, a literature search was conducted for the social determinants of obesity in the UK across four generalisable themes or search areas: living environment, behaviour/psychology, biology/physiology and economic drivers of food production and consumption. The systematic review identified published works done in the UK from 2000 to 2018 using ten databases. Only studies characterised by empirical evaluations of causality of obesity predicated on four generalisable themes and which, met the inclusion criteria were considered in this review.

Results: A total of 14 articles met the inclusion criteria and were reviewed in this study. The majority of the determinants related to living environment and economic drivers for food production and consumption, rather than behaviour/psychology or biology/physiology. This review found living environment and economic drivers for food production and consumption to be demonstrably having the most influence on obesity as a public health problem in the UK.

Conclusion: The living environment and economic drivers for food production and consumption were the two key determinants of obesity in the UK as shown in this review. Many limitations are noteworthy and should be considered when interpreting the findings highlighted here. Future studies on causalities of obesity would benefit from pursuing two vital paths of inquiry recommended in this review.