Journal of Biomedical Investigation

INDUCIBLE MACROLIDE RESISTANCE PHENOTYPES AND GENOTYPES IN CLINICAL ISOLATES OF Staphylococcus aureus FROM NNAMDI AZIKIWE UNIVERSITY TEACHING HOSPITAL, NNEWI, SOUTH EAST, NIGERIA

2024-05-23T09:44:31+01:00

Background: The widespread use of macrolide, lincosamide, and streptogramins-B (MLS-B) to treat Staphylococcal infections has caused an increase in resistance to these types of antibiotics.

Aim: The aim of this study is to identify macrolide resistant phenotypes and detect erm genes associated with macrolide resistance in Staphylococcus aureus.

Methodology: A total of 304 Gram positive cocci isolated from different clinical samples received at the Medical Microbiology Laboratory of Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi were used for this study. Oxoid Staphytect agglutination test kits were used to confirm 185 of these isolates as Staphylococcus aureus. Antibiotic sensitivity testing was done on the 185 verified S. aureus isolates while the D-test was used to check for macrolide resistance. Twenty (20) of the D-test positive isolates were tested for the presence of erm A, B, and C genes using a multiplex PCR method.

Results: Results showed that the occurrence of inducible MLS-B phenotype was 23 out of 185 (12.4%) while 46 out of 185 (24.9%) of the isolates displayed the constitutive MLS-B phenotype. Out of the 20 resistant isolates tested for the presence of resistance genes, 8 (40%) tested positive for erm C, while none possessed either erm A or erm B genes. All 8 of the erm C positive isolates were resistant to methicillin (MRSA). The iMLS-B phenotypes were more frequently observed in isolates that tested positive for erm C compared to the cMLS-β phenotype.

Conclusion: This study stresses on the need to be aware that iMLSB and cMLSB phenotypes exist among clinical isolates of S. aureus and that resistant genes are found in some of these isolates. Such isolates should be sought for during routine laboratory investigations in order to avoid possible treatment failure.

DOMINANT BODY SOMATOTYPE AND GENDER DIFFERENCES IN HAND GRIP STRENGTH OF YOUNG ADULTS IN A NIGERIAN UNIVERSITY

2024-05-23T10:09:27+01:00

Background: Hand Grip Strength (HGS) is a measure of the grasping power of an individual and a known indicator of physical capability in males and female who evidently have different body compositions, and may be used to evaluate patient recovery progress throughout injury treatment and rehabilitation.

Aim/ Objective: To determine the influence of dominant body somatotype and gender on hand grip strength of young Adults in a Nigerian University. Material/Methods: This was an ex-post facto research which was carried out among 162 undergraduates in Southern Nigeria. An electronic handheld dynamometer was used to evaluate the handgrip strength while the Heath-Carter Instruction Manual was used to determine the anthropometric dominant body somatotype. Data collected was summarized using descriptive statistics of frequency, percentages, mean and standard deviation, and analyzed using inferential statistics of Pearson’s Product Moment Correlation, Two-way and one-way ANOVA at an alpha level of 0.05.

Result: Endomorphy was more predominant in the population than mesomorphy and ectomorphy (48.1%, 25.3% and 26.5%). A significant effect was found in dominant body somatotype on the left and right hand grip strength (t = 11.959, p = 0.001 and t = 9.817, p = 0.001) with mesomorphy having the strongest effect on HGS, Furthermore, differences between genders and dominant body somatotypes in the left and right HGS was not significant statistically (F2 = 0.821, p = 0.442) and (F2 = 0.553, p = 0.576) but there was a significant main effect for dominant somatotype (F1 = 149.188, p = 0.001) and (F1 = 135.552, p = 0.001). Mesomorphic males were seen to have greater HGS. Result also revealed significant correlations between height and weight and HGS of both left and right hands (r = 0.453, p = 0.001), (r = 0.408, p = 0.001 and r = 0.420, p = 0.001).

Conclusion: Dominant body somatotypes as well as gender differences had a very significant influence on handgrip strength.

KNOWLEDGE, ATTITUDE AND PRACTICE OF HEALTH PROMOTION AMONG PHYSIOTHERAPISTS IN SELECTED TERTIARY HOSPITALS IN SOUTH EAST, NIGERIA

2024-05-23T10:16:29+01:00

Background: Health promotion involves multiple strategies that can be employed to improve the individual's life condition generally, and the physiotherapy profession has been shown to be highly relevant in health promotion activities.

Aim: The aim of this study was to determine the level of knowledge, attitude and practice of health promotion among physiotherapists in South-East Nigeria.

Method: One hundred and five (105) participants involving 56 males and 49 females in selected tertiary hospitals in the South-East Nigeria were recruited through a consecutive sampling technique. The study utilized a 19- item self-reported questionnaire adapted from a previously validated instrument utilized in Nigeria. Obtained data were summarized using descriptive Statistics presented in frequency distribution tables.

Results: A total of 105 physiotherapists responded with majority demonstrating a good knowledge of health promotion (97%). Most of the respondents (72.4%) agreed that their training offered lots of opportunity to explore health promotion. About 73.3% disagree that health promotion is less important than other aspects of the physiotherapist's role. Also 96.2% believe that health promotion is a fundamental part of physiotherapy. About 50.5% usually actively incorporate aspects of health promotion into delivery of care to clients, while 43.8% of them have good attitude towards health promotion.

Conclusion: The outcome of this study showed that the participants have good knowledge, a fair attitude and possess good practice of health promotion.

EFFECT OF ORAL ADMINISTRATION OF BITTER EXTRA ON THE HISTOMORPHOLOGY OF THE CEREBELLUM

2024-05-23T10:23:16+01:00

Background: Bitter Extra is a brand of herbal product adjudged to be efficacious in the treatment of various ailments.

Aim: This study is aimed at investigating the effect of Bitter Extra on the histomorphology of the cerebellum.

Method: Sixteen adult male Wistar Rats with weight between 158-230g were used for this study and were divided into four groups (1,2,3 and 4) with four (4) rats in each group. Group 1 served as the control while groups 2, 3 and 4 were taken as the test groups. Group 2 was administered 1.35ml/kg (low dose), group 3 was administered 2.7ml/kg (Medium dose), Group 4 was administered 5.4ml/kg (High dose) of Bitter Extra through an orogastric tube for a period of four weeks while group 1 was given water and feed only. The rats were fed and administered these amounts of drugs daily with their weights recorded after a week interval for four weeks.

Results: There were no significant changes (P>0.05) in the mean body weights of the rats in the test groups administered with Bitter Extra. However, in the histology of the cerebellum, rats in Group 4 showed increased proliferation of the Purkinje cell bodies into the molecular layer. Group 3 showed focal increase in Purkinje cell proliferation and hypertrophy of the Purkinje cell layer with pushing of the molecular layer, while Group 2 showed increased hypertrophy of Purkinje cell bodies and hyperplasia of cells in the granular layer.

Conclusion: These finding suggest that consumption of Bitter Extra does not in any way affect the body weight. High dosage consumption of Bitter Extra may cause hyperplasia, hypertrophy of the cells of the cerebellum which may lead to observable cerebellar dysfunction features.

KNOWLEDGE AND AWARENESS OF LIFESTYLE MODIFICATIONS AS A MEASURE INFLUENCING THE MANAGEMENT OF HYPERTENSION AMONG HYPERTENSIVE PATIENTS AT THE DELTA STATE UNIVERSITY TEACHING HOSPITAL, OGHARA

2024-05-23T10:38:22+01:00

Background: Millions of people suffer from hypertension; and considering that it poses a significant risk for a number of serious health-related problems (such as stroke, kidney, and heart diseases), lifestyle modifications activities like exercise, healthier diet, and stress reduction has been shown to effectively control hypertension and lower the risk of problems.

Aim: This study examined the knowledge and awareness of the predisposing factors to hypertension as a measure of lifestyle modification influencing the management of hypertension among hypertensive patients.

Materials and Methods: One hundred and fifty (150) hypertensive patients attending Delta State University Teaching Hospital Oghara, Delta State, Nigeria were recruited using a descriptive cross-sectional research design. Data was collected using a questionnaire designed by the researchers. A face-to-face administration of the questionnaire was used. Data was summarized using frequencies and percentages and analysed using the spearman’s rank order correlation at p-value significant at < 0.05 level.

Results: This study revealed that most participants were knowledgeable about the causes of hypertension and considered stroke as a complication of hypertension. Most participants were aware that a person with hypertension should practice a healthy diet, reduction of chronic stress level and should participate in aerobic exercise, while adopting cessation of smoking as measure for the control hypertension complications. Similarly, most of the respondents accepted the following factors are the influence of lifestyle modifications in the management of hypertension: having enough rest, mild to moderate exercise, low consumption of low salt diet, and high consumption of fruits and vegetables.

Conclusion: Most of the participants were knowledgeable about hypertension and the associated causative factors; and aware of various positive lifestyle modification strategies in the management of hypertension. However, the level of awareness of the respondents still needs to be increased, as it would improve the lifestyle modifications.

COMPARATIVE ASSESSMENT OF URINE LIPOARABINOMANNAN ASSAY AND ZIEHL NEELSEN SPUTUM SMEAR MICROSCOPY AS TUBERCULOSIS DIAGNOSTIC TOOLS IN NNEWI, NIGERIA

2024-05-23T11:32:26+01:00

Introduction. Tuberculosis (TB) remains a major public health issue worldwide, with about 8.0 million new cases and 2.0 million deaths yearly, the burden being more in the developing countries partly due to missed or improper diagnosis. Most available methods for TB diagnosis have one shortcoming or the other. The current detection rate of TB is far below set target, making it imperative for diagnostic tests that are rapid and accurate.

Aim: To assess the accuracy of urinary lipoarabinomannan (LAM) antigen and ZN microscopy assays in detecting MTB using Gene Xpert MTB/RIF as the gold standard.

Methodology: A total of 200 participants, 109 males and 91 females, accessing care at the TB (DOTS) Center of Nnamdi Azikiwe University Teaching Hospital, Nnewi were tested for TB using urinary LAM ELISA, ZN sputum microscopy and Xpert MTB/RIF. All the participants were recruited sequentially as they presented at the DOTS clinic. This is an experimental cross sectional study and all the data obtained were analysed using SPSS (statistical package for social sciences), version 20.

Results: ZN microscopy with a sensitivity of 80.0%, specificity of 91.1%, positive predictive value of 90.0%, negative predictive value of 82.2%, and diagnostic accuracy of 85.6% was found to be comparatively superior to LAM ELISA which had sensitivity of 13.3 %, specificity of 71.1%, positive predictive value of 31.6%, negative predictive value of 45.1 and diagnostic accuracy of 42.2%. Positivity rate with LAM ELISA was higher in HIV-positive patients (30.8 %) than in the HIV negative patients (20.0%).

Conclusion: LAM antigen assay does not appear to be very useful as a stand-alone test for TB due to its variable sensitivity and specificity compared to the gold standard in TB diagnosis which is smear microscopy. Smear microscopy should be optimized for enhanced performance in view of its superiority over LAM ELISA as noted in this study.

COMPARATIVE EFFECTS OF MAGNESIUM SULPHATE IONTOPHORESIS ON POST-STROKE ELBOW FLEXORS SPASTICITY

2024-05-23T11:46:00+01:00

Background: Controversy continues to trail the best physiotherapeutic approach to adopt in effectively managing hypertonicity in stroke patients. Magnesium sulphate is a muscle relaxant whose efficacy is relatively unexplored, and is unknown if it will be more effective than conventional cryotherapy.

Aim: The aim of this study was to compare the effects of cryotherapy, magnesium sulphate iontophoresis and the combination of both on the spastic elbow flexor muscles of stroke survivors.

Material and methods: Fifty-two stroke survivors were purposively recruited for the pre and post experimental study. They were randomly assigned to three groups, and the interventions were cryotherapy alone, magnesium sulphate iontophoresis (40 mA- mins) only and combination of both. The interventions were administered twice a week for six weeks for each group. The Modified Ashworth scale was used to grade the spasticity at baseline, 3rd and 6th week. Descriptive and Inferential statistics of Kruskal Wallis and Friedman tests were used to analyze the data obtained at p<0.05.

Results: Cyotherapy and Magnesium sulphate iontophoresis significantly (p = 0.003 and p = 0.02 respectively) reduced elbow flexors spasticity at 6th week. However, there were no significant differences (p > 0.05) when the three interventions were compared.

Conclusion: The three interventions were effective in alleviating spasticity of the elbow flexors of stroke survivors but none was superior over the other.

Curcuma longa AND Moringa oleifera ARE SYNERGISTICALLY ANTIPROLIFERATIVE BY DOWNREGULATING p63 GENE IN TESTOSTERONE-INDUCED BENIGN PROSTATE HYPERPLASIA IN RATS

2024-05-23T11:58:34+01:00

Background: Although many drugs exist for Benign Prostate Hyperplasia (BPH) today, it remains the most common prostatic disease affecting older men. Herbal medicine has become more common as an affordable alternative therapy for curing and preventing tissue-related pathologies in hopes of overcoming the side effects of existing synthetic pharmaceutical products and surgical procedures.

Aim: This study evaluated the effects of single and combined ethanolic extract of Curcuma longa and Moringa oleifera on testosterone-induced BPH, urothelial, and testicular toxicity in albino rats.

Method: In this experimental study BHP was induced in albino rats and treated with C. longa, M. oleifera, C. longa/M. oleifera, and Tamsulosin hydrochloride. Serum prostate-specific antigen (PSA) and tissue p63 expression were estimated by the ELISA and Avidin-Biotin Complex (immunohistochemistry) methods. Differences in PSA levels among the Groups were assessed using ANOVA and significance set at p< 0.05.

Result: Biochemical findings showed significantly increased serum PSA levels in BPH induced group (0.59 ± 0.07 nmol/L) without treatment compared with BPH-induced group treated with a single extract of C. longa, M. oleifera, combined extracts of C. longa and M. oleifera and standard drug (0.12 ± 0.06 nmol/L, 0.16 ± 0.04 nmol/L, 0.11 ± 0.02 nmol/L, and 0.20 ± 0.04 nmol/L, respectively) at p< 0.05. Histology revealed giant cell formation in the BPH-induced group without treatment. Combined administration of a mixture of C. longa and M. oleifera showed an observable reduction of the p63 protein expression in urothelial cells when compared with the single use of either of the plants.

Conclusion: This study revealed that combining both C. longa root and M. oleifera seed extracts has curative potential on experimentally induced BPH. It suggests that standardized herbal medicine could be used as an alternative to orthodox medicine, especially in low-resource settings.

UTILIZATION OF DIAGNOSTIC EFFICACY OF Α-METHYLACYL COA RACEMASE (AMACR) AND P63 IN DIFFERENTIAL DIAGNOSIS OF PROSTATE CANCER AND BENIGN PROSTATIC HYPERPLASIA

2024-05-23T14:40:56+01:00

Background: Diagnosis of prostatic tumours, especially the suspicious cases of precancerous lesions are usually subjective, using conventional morphology in Haematoxylin and Eosin stained tissue section. This method is also prone to diagnostic errors or misdiagnosis both in benign and malignant cases. Morphological investigation via light microscopy remains the gold standard for the diagnosis of prostatic carcinoma. Intra-observer variability in diagnosis and difficult cases may benefit from immunohistochemical staining using panel of markers.

Aim: The potentials of p63 and α‑methylacyl CoA racemase (AMACR) in differentiating cases of benign prostatic hyperplasia (BPH) from prostate cancer was studied.

Method: Eighty-five previously diagnosed archived prostate tumour tissues comprising of 41 malignant and 44 benign lesions were retrieved for the Histopathology Laboratory of a tertiary healthcare facility. The samples were reviewed and processed for immunostaining (IHC) using p63 and AMACR monoclonal antibodies.

Results: There was 85.9% (73) agreement between morphological diagnosis using conventional Haematoxylin and Eosin technique and IHC, and 14.10% (12) discordance. Of this discordance, 4 (33.30%) were found in cancer of the prostate and 8 (66.70%) were found in benign prostatic hyperplasia; 37 (90.2%) of previously H&E diagnosed CAP showed strong (3+) immunoreactivity for AMACR while 4(9.8%) were positive for p63. Similarly, previously H&E diagnosed BPH showed 36(81.8%) strong immunoreactivity for p63 and 8(18.2%) for AMACR. Grade V cancers occurred highest with 41% while grade II was the lowest with 5% occurrence. The Gleason’s scores ranges for 4+4 to 5+5, while the age of patients ranges from 48 to 86 years with mean age of 68.3 years.

Conclusion: Whereas morphological method remains the gold standard for diagnosis of prostatic lesions, it is not devoid of diagnostic errors. Therefore, p63 and AMACR biomarkers may be of great value in definitive diagnosis and confirming small foci of adenocarcinoma, resolving suspicious lesions and excluding benign mimickers.

IMPACT OF FUSARIUM SOLANI ON BRAIN, LIVER AND SPLEEN OF MOUSE INFECTION MODELS

2024-05-23T15:07:00+01:00

Background: Fusarium species infection is on the increase leading to morbidity and mortality in immunocompromised hosts. There have been several reports of disseminated infection of Fusarium species in immunosuppressed patients over the last 25-30 years.

Aim: The study aimed to determine the histopathological impact of the isolated Fusarium solani on the histomorphology of brain, liver and spleen tissue of albino mice.

Material and Methods: Isolates of Fusarium solani from humans and plants were obtained from clinical samples of patients and different plant products respectively. All the samples collected, were cultured immediately on Sabouraud Dextrose Agar slant containing 50 mg/l of chloramphenicol and 5 mg/l of gentamicin. Identification of isolates was carried out macroscopically and microscopically using standard mycological methods. Test mice were challenged with isolated conidia of Fusarium solani while the control mice were unexposed. After 30 days, randomly chosen surviving test mice and control were sacrificed. The brain, liver and spleen of the animals were aseptically excised for tissue burden estimation and further histological processing for light microscopical examination.

Result: In vivo virulence studies of Fusarium solani on mice brain, liver and spleen organs revealed disseminated infection of multiple organs and mortality. The presence of fungal propagules was detected in all organs, with the highest concentration found in the spleen. There were intense inflammations of the internal organs especially excretory organs compared to the control where there was no inflammation seen. Histopathological findings on the brain showed extensive oedemas with blurring of the white and grey matter junction and extensive destruction of the Purkinje cells. Splenic tissues also revealed complete destruction of the splenic bulb and presence of extensive destructive granulomas with many Langhans giant cells formed. There was also evidence of infections in the liver tissue ranging from intense hepatocyte swelling with hyperchromatic nuclei to intense periportal mononuclear cell infiltrates arising from diffuse toxic hepatic injury.

Conclusion: This study showed strong evidence of Fusarium solani pathogenicity in mice from various pathological manifestations and physical signs observed.

EFFECTS OF MALARIA INFECTION ON THE HAEMATOLOGICAL AND BIOCHEMICAL PARAMETERS OF PREGNANT WOMEN IN ONITSHA, ANAMBRA STATE, NIGERIA

2024-05-23T15:20:33+01:00

Background: Malaria remains a major public health problem in sub-Saharan Africa especially among pregnant women and unborn infants.

Aim: The effects of malaria infection on the haematological and biochemical parameters of pregnant women were investigated in Onitsha, Anambra State, Nigeria.

Materials and Methods: Venous blood samples were collected from 1500 pregnant women who attended antenatal clinic, in Onitsha, Anambra State, Nigeria. The haematological and biochemical parameters of the malaria positive samples were analysed using automated analysers and Giemsa stained blood films. Data was analysed using Chi-square analysis at level of significance of p<0.05.

Results: A total of 423 were positive for malaria. Haemoglobin and White blood cell (total and differential) counts were significantly associated with malaria infection (P<0.05). A total of 28 pregnant women (6.6%) who had malaria were found to be anaemic with highest prevalence of anaemia observed: among those less than 20years old (43.3%; p<0.05), in first trimester (20.0%; p<0.05), and among Secundigravidae (7.8%; p<0.05). Case wise, there were 68.3% leucocytosis and 1.4% leucopenia. Decreased platelet count was observed among malaria infected women, with 16(3.8%) having thrombocytosis while 24(5.7%) had thrombocytopenia. The biochemical parameters showed a significant difference between pregnant women with normal values and those with abnormal values (p<0.05). A total of 24(5.7%) of them had elevated ALT, 19(4.5%) had elevated AST, 15(3.6%) had elevated ALP and 32(7.6%) had elevated total bilirubin. Pregnant women less than twenty years old had the highest prevalence 9(30.0%) of elevated ALT, 7(23.3%) of elevated AST, 6(20%) of elevated ALP and 11(36.7%) of elevated total bilirubin.

Conclusion: Malaria in pregnancy is a major public health problem affecting women. Pregnant women below 20 years of age are particularly vulnerable to the disease and its associated morbidities including decreased haemoglobin (Hb), platelets counts, full blood counts, resulting in increased risk for anaemia.

AQUEOUS EXTRACT OF SOLANUM NIGRUM LEAF REVERSED REPRODUCTIVE DYSFUNCTIONS ASSOCIATED WITH ANASTROZOLE-INDUCED POLYCYSTIC OVARIAN SYNDROME IN RATS

2024-05-23T15:51:51+01:00

Background: Polycystic Ovarian Syndrome (PCOS), also referred to as Stein-Leventhal syndrome, is a common endocrine disorder that impacts 12-21% of women in their reproductive years.

Aim: The aqueous extract of Solanum nigrum leaves (AEoSNL) was investigated for its therapeutic effects on reproductive dysfunctions associated with anastrozole-induced PCOS in Wistar rats.

Method: Sixteen female Wistar rats (160.46 ± 4.11 g) were divided into four groups (A-D): group A were not induced into PCOS, while those in groups B, C and D were induced into PCOS by oral administration of 0.5 mg/kg body weight of anastrozole dissolved in 1% CMC (2 mL/kg) daily for 21 days. Animals in groups A and B both received 0.5 mL of distilled water, C and D received 0.5 ml co-administration of metformin (7.14mg/kg/day) and clomiphene citrate (2mg/kg/day) metformin, and 200 mg/kg body weight (bw) of AEoSNL once daily for fourteen days post-induction. Vaginal cytology, ovarian histology and levels of some reproductive hormones in the serum were determined.

Result: Anastrozole administration resulted in disrupted oestrous cyclicity, ovarian cyst formation and altered hormonal levels thereby replicating PCOS-like symptoms. The administration of 200mg/kg (bw) AEoSNL to PCOS rats significantly decreased (P≤ 0.05) serum testosterone, follicle stimulating hormone, progesterone and luteinizing hormone (LH) concentration but there was no significance difference (P≥0.05) in the prolactin level when compared with the control. The AEoSNL reversed the hyperandrogenemia, LH hypersecretion and irregular estrous cycle in PCOS-induced rats.

Conclusion: This study suggests that, 200 mg/kg(bwt) of AEoSNL exhibit therapeutic functions in anastrozole-induced PCOS in rats and can be explored in an anti-PCOS drug design subject to further experimentation.