Journal of Biomedical Investigation

ANTIMICROBIAL ACTIVITIES OF AQUEOUS EXTRACT OF RIPE ANNONA MURICATA LINN. (SOURSOP) FRUIT PULP ON CLINICAL ISOLATES

Benedictta C. OKEKE-NWOLISA — 2023-03-31

Introduction: Antimicrobial resistance poses a great challenge and so is of great public health concern. Traditional healers employ a variety of medicinal plants, including Annona muricata Linn., to treat infectious diseases, especially those caused by multidrug resistant microorganisms.

Aim: To assess the antimicrobial properties of ripe Annona muricata Linn. fruit pulp against some clinical isolates.

Materials and Methods: Ripe Annona muricata Linn. fruit pulp, distilled water, and clinical isolates were used in this study. Annona muricata fruits was obtained from Nnewi, Anambra State, Nigeria. The in-vitro antibacterial and anti-fungal activities of aqueous extracts of ripe Annona muricata Linn. fruit pulp was determined using the agar disc diffusion technique. This investigation relied on use of both bacterial and fungal isolates. The organisms were collected from Nnamdi Azikiwe University Teaching Hospital Nnewi's stock culture. Cultures were transported to the laboratory by resuscitating them in peptone water, then sub culturing them into a nutrient agar medium and incubating them at 37^oc for 24 hours. Data was presented using frequency counts.

Results: Aqueous extracts of ripe Annona muricata fruit pulp showed antibacterial and anti-fungal activity, with zones of inhibition diameter as large as 36mm for Staphylococcus aureus and 30mm for Proteus spp., Klebsiella spp. (33mm), Pseudomonas aeruginosa (20mm), E. coli (24mm), Candida albicans (30mm) and Aspergillus spp. (30mm) all demonstrated considerable susceptibility to the ripe Annona muricata Linn. fruit pulp extracts.

Conclusion: The study concluded that the aqueous extracts of ripe Annona muricata Linn. fruit pulp exhibited some antimicrobial activity to both clinical bacterial and fungal isolates, which may explain why it is used locally to treat diarrhoea and other illnesses.

ASSESSMENT OF BIOMARKERS OF RENAL FUNCTION IN LEPROSY PATIENTS IN OSSIOMO – OGAN, EDO STATE, NIGERIA

Babatunde Ishola Gabriel ADEJUMO — 2023-03-31

Background of study: Parameters such as blood-urea nitrogen, creatinine, uric acid, and electrolytes are good biomarkers of renal function, which could be considered as suitable prognostic indicators of renal diseases.

Aim: This study aimed at assessing the renal biomarkers of renal function in leprosy patients at Ossiomo-Ogan,Edo State, Nigeria.

Materials and methods: The study was conducted at the Leprosy Rehabilitation Centre, Ossiomo-Ogan, in Edo State, Nigeria, between April and December 2021. This study included 108 people between the ages of 18 and 60 (57 leprosy patients and 51 controls). Parameters such as urea, creatinine, chloride, potassium, sodium, and bicarbonate were assayed using standard methods. The data obtained were summarized using the mean and standard deviation. Comparative analysis was done using an independent sample t-test, while correlation tests were done using Pearson's bivariate correlation test.The level ofsignificance wasset at p 0.05.

Results: Serum levels of potassium and chloride were significantly elevated in leprosy patients compared with the controls (p<0.05). However, no significant differences were observed in sodium and bicarbonate between leprosy patients and controls (p > 0.05). Findings also indicated no significant differences in serum levels of urea (p = 0.292) and creatinine (p = 0.790) between leprosy patients and control subjects. Age, BMI, blood pressure parameters, urea, creatinine, and electrolytes in both leprosy patients and controls also indicated no significant correlation.

Conclusion: No significant difference in renal function was observed between leprosy patients and non leprosy-affected individuals. However, the levels of serum urea and creatinine are high, which indicate renal involvement among the leprosy patients. There is a need to analyze renal biomarkers (urea, creatinine electrolytes) as part of routine medical examinations among leprosy patients to prevent renal failure.

ATTITUDE, PERCEPTION AND PRACTICE AND BARRIERS OF PHYSIOTHERAPISTS TOWARDS THE ASSESSMENT AND MANAGEMENT OF RISK FACTORS OF LIFESTYLE-RELATED DISEASES: A CROSS-SECTIONAL SURVEY

U.A.C. OKAFOR — 2023-03-31

Background of the study: Prevention and management of lifestyle-related diseases (LRDs) are deemed a priority in contemporary physiotherapy. However, questions subsist in developing countries like Nigeria on the place of physiotherapy practice in the assessment and management of risk factors of LRDs.

Aim of the study: This study provide insights into the attitude, perception and practice of physiotherapists towards the assessment and management of risk factors of LRDs during patient care.

Materials and Method: A total of 110 physiotherapists were recruited from public and private hospitals in Lagos State, Nigeria. Participants completed an adapted questionnaire. The questionnaire consisted of 10 sections that assessed demographic and physical characteristics, risk factors and management of LRDs, and attitudes of participants in the assessment and management of LRDs. Data was summarized using frequencies and percentages.

Results: Respondents always assessed risk factors of LRDs in the descending order of: blood pressure 68 (61.8%), alcohol use 41 (37.3%), exercise 41 (37.3%), level of activity 40 (36.4%), tobacco use 37 (33.6%), and diet 31 (28.2%). Regarding respondents' management options for 20% overweight or more, 58 (52.7%) always use exercise regularly, 57 (51.8%) always use decreasing calore intake, 49 (44.6%) always use decreasing dietary fats, 45 (40.9%) always perform specific exercises, whereas 28 (25.5%) advises patients to quit smoking. Also, respondents' reported as 'very effective' the use of exercise (64, 58.2%), healthy diet (61, 55.5%) and weight reduction (57, 51.8%) for changing patients behaviour.

Conclusions: Blood pressure was the most assessed risk factors of LRDs by physiotherapists in Lagos. Physiotherapists in Lagos always advise individuals with LRDs on dieting, weight reduction, cessation of smoking and alcohol intake. Management options of exercise, healthy diet and weight reduction are very effective for changing patients' behaviour.

BACTERIAL CONTAMINATION AND ANTIBIOGRAM OF ISOLATES FROM THE HANDS OF UNDERGRADUATE STUDENTS AND FOMITES AT NNAMDI AZIKIWE UNIVERSITY NNEWI CAMPUS ANAMBRA STATE

Chioma Maureen OBI — 2023-03-31

Background: Health professionals are at high risk of acquiring bacterial contamination and are potential sources of health-acquired infections as well as community acquired infections. This study determined the bacterial contamination and antibiogram of isolates from the hands of undergraduate students and fomites at Nnamdi Azikiwe University, Nnewi Campus, Nnewi Anambra State.

Methods: A cross-sectional study was conducted between April and July 2022 in different Departments of Faculty of Health Sciences and Technology. A total of 112 swab samples from hands of students of health profession and 20 seats were swabbed using a simple-rinse method. The isolated Bacterial colonies were counted and species were identified using standard bacteriological techniques. Antibiotic susceptibility testing was performed using a disk diffusion technique. Chi-square test was done to ascertain the association between variables.

Results: The proportion of E.coli was found to be 17.9%, followed by klebsiella pneumonia with prevalence of 11.9%, while Salmonella and Proteus spp were 10.3% and 8.3% respectively. The relationship between the number of bacterial isolated from hands and seat was significant (P=0.01), (X2=8.7). The overall multidrug-resistant rates among E.coli, Klebsiella pneumonia, Proteus species, Salmonella species were 50%, 43%, 43%, 43% and 35% respectively.

Conclusion: There is low prevalence of pathogenic enteric bacteria among students in the study area.

ELEVATED INTER-ARM BLOOD PRESSURE DIFFERENCE: LEVELS AND CORRELATES AMONG STROKE SURVIVORS

Obinna Chinedu OKEZUE — 2023-03-31

Background: Differences could exist in blood pressure measurement obtained from both arms, and it is deemed abnormal when it is equal to/ greater than 10mmHg. The elevated interarm blood pressure differences (IABPDs) have been associated with an increased risk for cardiovascular dysfunction.

Objectives: This study aimed at determining the levels and correlates of elevated IABPDs in systolic and/or diastolic values of stroke survivors.

Methods: Sixty-one stroke survivors (27 males and 34 females) were recruited from the stroke unit of the Physiotherapy Clinic at the University of Port Harcourt Teaching Hospital, Nigeria. BP values were measured in both arms with the patient in a sitting position. An interval of 5 minutes was observed before measuring from the other arm. Data obtained were analyzed and summarized, using descriptive statistics of frequency and percentage. Inferential statistics of Chi-Square was used to determine significant differences between variables. Level of significance was set at p < 0.05.

Results: Findings revealed elevated IABPDs in 82% of the participants; with the greatest difference noted to be 30mmHg. There was an association between IABPDs and Gender (p=036), BMI (p=041), and affected arm (0.017) respectively.

Conclusions: Elevated IABPDs was common among the stroke survivors; with discrete higher systolic and diastolic BP values that elicited such IABPDs derived from both arms. Females had twice as much elevated IABPDs than the male participants. Such elevated IABPDs shows an increased risk for cardiovascular diseases hence it is vital to observe it among patients with diseases like stroke which can reoccur. Overall, this measure will help all health care professionals to optimally monitor and care for stroke survivors.

MOLECULAR DETECTION OF CEFOTAXIMASE MUNICH (CTX-M) RESISTANT ACINETOBATER BAUMANNII IN A TERTIARYCARE HOSPITAL IN SOUTHEAST NIGERIA

Akachukwu Egwu OKORO — 2023-03-31

Background: Acinetobacter baumannii (A. baumannii) is one of the numerous organisms responsible for multidrug resistant, hospital acquired infections in many tertiary health care institutions worldwide.

Aim: To detect the presence of cefotaximase (CTX) resistant A. baumannii in NAUTH Nnewi, Southeast, Nigeria.

Materials and Methods: Clinical isolates of Gram-negative bacilli (n=210) were obtained from several clinical specimens. All isolates were phenotypically identified in the laboratory using standard cultural methods. Antimicrobial susceptibility tests were performed on all A. baumannii species detected using the Kirby Bauer disc diffusion technique. Isolates resistant to any of the 3rd generation Cephalosporins were screened for ESBL activity using the Double disc synergy test. Polymerase Chain Reaction wasthen used to detect the presence of CTX gene from the ESBL positive isolates.

Results: Out of the 210 Gram-negative bacilli, 20 (9.5%) were Acinetobacter species. The organisms were most resistant to amoxicillin-clavulanic acid and the 3rd generation cephalosporins. Cefotaximase (CTX) gene was observed in 3/20 (5%) of the Acinetobacter species.

Conclusion: Multidrug resistant Acinetobacter baumannii was prevalent in the study area, although the rate of CTX production was relatively low. Consequently strict application of good infection prevention and control measures in the hospital setting is necessary to curb the menace associated with this organism.

SOCIO-ECONOMIC STATUS OF STROKE SURVIVORS AND PEOPLE LIVING WITH OSTEOARTHRITIS IN PORT HARCOURT METROPOLIS, RIVERS STATE

Ifeanyi Kalu OTI — 2023-03-31

Background: Socio-economic status (SES) is an important determinant of health, and one of the major factors that determine treatment and rehabilitation outcomes of debilitating chronic conditions such as stroke and osteoarthritis (OA).

Aim of the Study: This study determined and compared SES of stroke survivors and people living with osteoarthritis (PLWOA) in Port Harcourt Metropolis, Rivers State.

Material and Methods: The study design was comparative cross-sectional. A multistage sampling technique was used to select 78 stroke survivors and 186 PLWOA from the two strata making up Port Harcourt Metropolis – Port Harcourt City Local Government Area (PHALGA) and Obio-Akpor Local Government Area (OBALGA). Kuppuswamy's socio-economic scale was used to measure the current SES of the two groups from June 2019 to January 2020. Data were analyzed using the IBM SPSS version 24. Chi-square test statistic was used to compare the proportion of stroke survivors with low, middle and high SES and that of PLWOA. P-value ≤ 0.05 was considered statistically significant.

Results: Results revealed that majority of stroke survivors and PLWOA were males, 55 (70.5%) and 106 (57%) respectively and within 51-60 years of age. The proportions of stroke survivors with low, middle and high SES were 26.1%, 56.5% and 17.4% compared to 41.7%, 49.7% and 8.1% respectively of those of PLWOA. The difference observed between these proportions was statistically significant (Chi-square = 10.272, P-value = 0.006).

Conclusion: The study concluded that most stroke survivors and PLWOA in Port Harcourt metropolis were of middle SES, and that low SES was higher in PLWOA than in stroke survivors.

THE PREVALENCE OF INTESTESTINAL PARASITES AND IMPACT OF CRYPTOSPORIDIUM INFECTION AMONG DIARRHOEAL - INFECTED HIV PATIENTS VISITING THE SPECIALIST HOSPITAL, BENIN-CITY, EDO STATE, NIGERIA

Fidelis Ohiremen OYAKHIRE — 2023-03-31

Background of the study: Diarrhea is one of the world's worst health problems, especially in immuno compromised persons.

Aim: The study's main goal was to determine the prevalence ofintestinal parasites and the clinical impact of Cryptosporidium parvum in HIV-positive diarrhea patients at the Specialist Hospital in Benin City, Edo State, South-Central Nigeria.

Materials and methods: Stool concentration and modified Zehl-Neilson staining was used to evaluate 196 stool samples for intestinal parasites.

Results: A total of 196 HIV/AIDS-related diarrhea patients (116 women and 80 men) were examined for intestinal parasites. The overall parasite prevalence, density, and age prevalence among diarrhea-infected HIV/AIDS patients were 21.35% and 5.0%, respectively, with Ascaris lumbricodes (5.6%), Cryptosporidium parvum (5.1%), and Entamoeba histolytica (5.1%) being the second most frequent intestinal parasites surveyed. HIV-infected people of all ages had 5.0% Cryptosporidium-related diarrhea. Patients aged 46–55 years had 2.5% of all cases, whereas those aged 6–15 years, 16–25 years, and 56–60 years had 0%. Cryptosporidium was more common in women (4.0%vs.1.0%) than in men. Both groups showed a statistical difference (P 0.05). Regimen 1A had the most cryptosporidium (3.1%). HIV-related diarrhea was more common among patients with CD4 levels below 350 (4.1% vs. 1.0%, respectively) compared with CD4+ > 350 (136 individuals), who made up the bulk of those tested with a statistical difference between groups. HIV patients with only bloody diarrhea had a 3.1% prevalence of cryptosporidium, compared to 0% in those with bloody diarrhea and mucus or only mucus; the odd ratio (OR) was 1.06 (95% CI 0.20–85.27) with P> 0.05. Cryptosporidium oocysts have been found in HIV-infected patients' feces at the Specialist Hospital in Benin City, Edo State, suggesting a relation to HIV diarrhea, particularly in the late stages of illness. It causes 5.0% of diarrhea in this population.

Conclusion: Cryptosporidiosis is frequent in HIV-infected diarrhea patients. Thus, HIV and immuno suppressed patients' diarrhea treatments should incorporate this study's findings.

THE USE OF GENE XPERT MTB/MTB RIF ASSAY IN THE DIAGNOSIS OF EXTRA-PULMONARY TUBERCULOSIS AT NAUTH, NNEWI

Arthur Ebelenna ANYABOLU — 2023-03-31

Introduction: About 15–20% of active tuberculosis cases may spread outside the lungs to affect other parts of the body causing what is known as extra pulmonary tuberculosis (EPTB). Cases of Extra Pulmonary Tuberculosis are equally prevalent in all the Tuberculosis high burden zones. Information on Extra pulmonary Tuberculosis is scarce in Nigeria despite being high burden TB country. Existing tests for diagnosis of extra pulmonary Tuberculosis are limited in accuracy and turn-around time and often require invasive procedures and special expertise.

Aim: This study aimed to assess the utility of the Gene Xpert MTB/RIF in the diagnosis of extra pulmonary Tuberculosis and document the burden of Extra Pulmonary TB in NAUTH, Nnewi, Nigeria.

Materials and Methods: Extra pulmonary samples (comprising pleural aspirates, ascetic fluids, cerebrospinal fluids, gastric lavage, pus, pleural fluids, scrotal aspirates, hydrocele fluids and biopsy materials) taken from 288 patients accessing the Nnamdi Azikiwe University Teaching Hospital, Nnewi were examined using Ziehl Neelsen smear microscopy and Xpert MTB/RIF assay.

Results: Gene Xpert MTB/RIF assay detected MTB in 18 (6.3%) of 288 EPTB suspects against 8 (2.8%) of 288 detected by Ziehl Nelseen AFB microscopy.

Conclusion: The inclusion of Gene Xpert MTB/RIF assay method in routine diagnostic protocol for EPTB is a welcome development due to its faster turnaround time and higher sensitivity compared to smear microscopy.

KNOWLEDGE AND PERCEPTION OF PRE-AND POST-OPERATIVE PHYSIOTHERAPY INTERVENTIONS AMONG MEDICAL DOCTORS IN TERTIARY HOSPITALS IN ANAMBRA STATE

Martha Chukwuemeka Uchechukwu — 2023-03-31

Background: Physiotherapy interventions reduce the length of hospital stay and also exert beneficial effects on physical fitness and post-operative outcomes across various surgical fields.

Aim:To determine the knowledge and perception of medical doctors on pre-and post-operative physiotherapy intervention, and the influence of age, gender, place of basic training/primary medical practice, and present career status on the variables.

Methods: 102 medical doctors (29 females and 73 males) working in the two tertiary hospitalsin Anambra State, who gave their consent were consecutively recruited. Each of the participants responded to the self-reported questionnaire. Obtained data were summarized using the descriptive statistics of mean and standard deviation. Alpha level was set at >0.05.

Results: Mean knowledge of pre-and post-operative physiotherapy interventions was found to be 8.87 ± 1.66 and a perception score of 5.30 ± 1.72. Knowledge of pre-and post-operative physiotherapy had no significant correlation with their perception (p=0.629). The study also showed participants from institutions that trained physiotherapists had a significantly higher knowledge of the pre-and post-operative physiotherapy referrals than their counterparts that trained in institutions without physiotherapy (p =0.025).

Conclusion: Medical doctors in this study had good knowledge of pre-and post-operative physiotherapy interventions but a poor perception of pre-and post-operative physiotherapy interventions. Participants from institutions that trained physiotherapists had a significantly better knowledge of the pre-and post-operative physiotherapy.

JOB SATISFACTION AMONG NURSES IN TERTIARY HEALTH INSTITUTIONS IN EDO STATE NIGERIA

Sunday F NDUBUISI — 2023-03-31

Background: There is a likelihood of ineffective health care services with insufficient nurses having job dissatisfaction as a result of the recent increase in emigration among health workers, particularly nurses.

Aim: To ascertain the level of job satisfaction, and the influence of selected demographic variables on job satisfaction among nurses in Edo State, Nigeria.

Material and methods: A cross-sectional study design was employed. An adapted self-administered questionnaire was utilized to obtain information from 326 nurses who were consecutively sampled from the tertiary hospitals in Edo State, Nigeria. Mann-Whitney U test, Kruskal-Wallis, and Spearman's rank order correlation tests were used to analyze data, with level of significance set at < 0.05.

Results: The results revealed mean score of participants = 30.36, i.e. they were neither dissatisfied nor satisfied with their jobs. There was no significant correlation between job satisfaction and demographic data (institution, age, gender, marital status, spouse's residence, and year of service), although cadre (p=0.05), academic qualification (p= 0.05) were potent predictors of job satisfaction.

Conclusion: There is neither job satisfaction nor dissatisfaction among nurses in tertiary hospitals Edo State, with only cadre and academic qualifications possibly correlating with job satisfaction.