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   Table of Contents - Current issue
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January-June 2019
Volume 7 | Issue 1
Page Nos. 1-62

Online since Friday, September 13, 2019

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ORIGINAL ARTICLES  

Phenotypic determination of methicillin-resistant Staphylococcus aureus in Aminu Kano Teaching Hospital, Kano, Nigeria p. 1
Abdulrazak Muhammad Idris, Abdulhadi Sale Kumurya, Yusuf Mohammed, Huda Munir Mustapha
DOI:10.4103/njecp.njecp_20_18  
Background: Phenotypic detection of methicillin-resistant Staphylococcus aureus(MRSA) has been problematic ever since its discovery in the early 1960s. The emergence of low-level resistant MRSA clones acquired in the community has only added to these difficulties. In 2005, the Clinical and Laboratory Standards Institute (CLSI) published zone diameter (10), breakpoint guidelines for cefoxitin. However, a number of technical issues remain regarding the use of cefoxitin as a predictor for methicillin resistance. Materials and Methods: In these studies, 252 nonduplicate samples of staphylococcal isolates were collected from various clinical samples obtained from patients attending Aminu Kano Teaching Hospital. The isolates were subcultured and identified using standard bacteriological procedure according to CLSI (13). Antibiotic susceptibility testing was done using a modified form of the Kirby–Bauer method. Methicillin resistance was screened using disk-diffusion method with cefoxitin 30 μg and oxacillin 1 μg. Results: High percentage of the isolates were recovered from patients of age groups of 1–9 years and <1 year with 45.2% and 23.4%, respectively. About 77% isolates were obtained from blood culture followed by wound (11.5%) and ear swab (6.7%). MRSA prevalence of 20.6% and 25.8% was obtained in this study using cefoxitin (30 μg) and oxacillin (1 μg), respectively. High prevalence of MRSA was obtained from people of the old age group which may be due to used and misused of antibiotics. From the 252 isolates obtained in this study, 84.1%, 77.4%, and 77.0% were found to be susceptible to ciprofloxacin, gentamicin, and clindamycin, respectively. The least susceptible was found 49.2%, 52.0%, and 62.7% in erythromycin, co-trimoxazole, and tetracycline, respectively. Conclusion: The study revealed that routine phenotypic screening of MRSA gives a better result when both oxacillin and cefoxitin were used, especially in resource-limited areas where molecular analysis is not available.
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Factors associated with the dietary habits and nutritional status of undergraduate students in a private university in Southern Nigeria p. 7
Kingsley Omage, Vivian O Omuemu
DOI:10.4103/njecp.njecp_1_19  
Purpose: The purpose of this study was conducted to determine the factors associated with the dietary habits and nutritional status of undergraduate students in Igbinedion University, Okada. Methodology: A total of 800 undergraduate students who participated in the study were selected using a multistage sampling method. The study applied a cross-sectional, descriptive study design, and data were collected using a pretested, structured self-administered questionnaire. Data were analyzed using the SPSS statistical package (version 22.0), and the level of significance was set at P < 0.05. Results: The mean age of respondents was 23.5 ± 2.4 years, with the highest proportion of 41.0% within the 19–21 years age group. The proportion of respondents who snacked was significantly higher among those who had an average monthly allowance of ≥₦11,000 (440). A higher proportion of those who had one sibling (30.8%) and three siblings (62.7%) had a medium dietary diversity and high Dietary Diversity Score (DDS), respectively. The difference in DDS observed with increasing average monthly allowance was statistically significant. Over three-quarters of the fathers of the respondents (85.0%) and two-thirds of the respondents' mothers (74.5%) had tertiary level of education. All married respondents (100.0%) ate 3 main meals per day and a significantly higher proportion of single respondents (55.3%) ate <3 main meals per day. The proportion of overweight respondents was higher among those who were ≥28 years old 8 (22.2%) and 100 (83.3%) of those in the 16–18 years age group had a normal body mass index. Conclusion: The factors, which affect the dietary habits and nutritional status of undergraduate students of Igbinedion University, Okada, include age, sex, number of siblings, marital status, monthly allowance, and level of education of parents.
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Maternal consumption of sucrose during lactation may program metabolic dysfunction in young offspring p. 17
Nkiru A Katchy, Pearl A Okeke, Eghosa E Iyare
DOI:10.4103/njecp.njecp_2_19  
Background: It is well established that the consumption of sugars by both young and old, males and females, has tremendously increased over the past decades. This increased consumption is without prejudice to the physiological state of the body. There is evidence to suggest a correlation between the excessive consumption of these sugars and their adverse metabolic effects. Aim: The aim of this study was carried out to investigate the effect of maternal consumption of sucrose during lactation on some metabolic indices in young offspring of the rat. Methods: Fourteen female albino Wistar rats weighing were used for this study and were randomly assigned into two groups (sucrose group and control group) at delivery. Water and 30% (w/v) sucrose solutions from plastic bottles were made with tap water and administered during lactation until weaning. At postnatal day 42, offspring of sucrose-fed rats showed a statistically significant decrease (P < 0.05) in body weight and food intake when compared with control. The female offspring showed a statistically significant increase (P < 0.05) in liver weight index, total cholesterol, and triglycerides and a significant decrease in high-density lipoprotein (HDL) and insulin values (P < 0.05) when compared with control. The male offspring showed a statistically significant increase (P < 0.05) in the oral glucose tolerance test, total cholesterol, triglycerides, low-density lipoprotein values and a significant decrease in pancreatic weight, HDL, and insulin concentration when compared with control. Conclusion: This study suggests that maternal consumption of sucrose during lactation may contribute to the onset of metabolic dysfunction in the young adult offspring.
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Effect of core stability and treadmill walk exercises on the functional status of postlumbar - Surgical patients with low back pain: A pilot study p. 23
Farida Garba Sumaila, Ganiyu O Sokunbi
DOI:10.4103/njecp.njecp_9_19  
Background: Low back pain (LBP) is one of the most common musculoskeletal disorders for which patients consult medical care. It is also the most important cause of disability and absenteeism with increasing prevalence leading to a major socioeconomic impact on society. These facts highlight the importance of finding effective and validated treatments for this disabling condition. Stabilization Exercises and Treadmill Walk Exercise are widely reported to be effective in the management of LBP. However, their effects on Post -Surgical LBP have not been widely reported. Materials and Methods: The study was a pre test- post test quasi-experimental research design undertaken as a pilot study prior to a large randomized controlled trial. Eleven (11) Participants met the study criteria and therefore participated in the study via consecutive sampling, they received Core stability exercises and Treadmill walk exercises (Bruce protocol) three times in a week for a period of six 6 weeks. Assessment of Pain intensity, Functional Disability, Quality of Life and Fear avoidance belief was carried out. Data obtained was summarized using descriptive statistics and analysed using t-test and Wilcoxon sign rank test. Results: Mean age (years) was 51.91 ± 12.44 and mean body mass index (kg/m2) was 23.56 ± 2.52. A statistically significant decrease in pain and functional disability was found among the participants (P < 0.05) with a large effect size. Significant improvement was found in the quality of life and fear avoidance (P < 0.05) with large effect size. Conclusion: It is concluded that Core stability exercises and Treadmill walk training are effective in the reduction of pain and improvement of functional ability, quality of life and fear avoidance of individuals with Post-surgical LBP.
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Preconception sex determination: Maternal demographic variables as a predictive “tool” p. 30
Oshiozokhai Eboetse Yama, Ibukun N Adeyemo, Taiwo Olabisi Kusemiju, Olufunke O Dosumu, Stella Chinwe Gbotolorun, Ohunene Makoju Avidime, Timothy Danboyi
DOI:10.4103/njecp.njecp_20_19  
Background: The unending attempt targeted at having a particular sex has led to unplanned increase in family sizes, especially in the developing world. Most published studies on sex selection did not consider the effects of maternal variables. Objective: The main objective of the study is to investigate the effects of maternal variables: age, date of the last menstrual period (LMP), blood group, and genotype on the sex of a baby. Materials and Methods: One hundred and twenty-seven case files of women who attended the Antenatal and Postnatal Clinics at the Lagos University Teaching Hospital, Idi-Araba, Lagos, between 2013 and 2015 were randomly selected. They comprised women between the ages of 18 and 40 years. Data extracted were maternal age, LMP, blood groups, and genotypes of mothers and sexes of their babies. Results: The percentages of boy (38.4%) to girl (9%) child born to mothers with LMP occurring in 1st week (day 1–7) of the month were significant (P < 0.05) compared to 2nd, 3rd, and 4th week, with male-to-female percentages of 12.3%–25.9%, 15.1%–24.1%, and 34.3%–33.3% (P > 0.05), respectively. There was no association between genotype and blood groups of the mothers and the sex of the baby (P > 0.05). Conclusion: The study showed correlations between the sex of the infants and the week of the month of LMP supporting maternal involvement in sex determination.
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Antiproliferative potential of methanolic extracts of Ageratum conyzoides linnaeus via downregulation of ki-67 and upregulation of p53 protein expression in hepatic tissue of rats p. 35
Dayo Rotimi Omotoso, Gerald Ikechi Eze
DOI:10.4103/njecp.njecp_21_19  
Background: Hepatic tissue is susceptible to toxicity induced by hepatotoxins, leading to lesions, necrosis, fibrosis, tumor, or carcinoma. However, it is self-regenerating which can actively proliferate to recover lost segments. During tissue proliferation, molecular markers such as Ki-67 and p53 proteins usually play opposing roles. In this study, we aimed at assessing the antiproliferative potential of methanolic extracts of Ageratum conyzoides Linn using the expression of these markers of proliferation in hepatic tissues of adult male Wistar rats. Materials and Methods: Twenty animals used for this study were divided equally into four groups (1–4) as follows: Group 1 represented control, whereas Groups 2–4 were, respectively, treated with extracts at dosage of 100, 300, and 500 mg/kg (body weight) orally for 28 days. Afterward, the animals were sacrificed; their hepatic tissues were harvested, were processed into tissue sections, were histologically stained using hematoxylin and eosin technique, and were immunostained for Ki-67 and p53 proteins using horseradish peroxidase-3, 3-Diaminobenzidine technique (with monoclonal anti-Ki67 and anti-p53 antibodies). Stained sections were examined and quantified using Image-J software. Data obtained were statistically analyzed using IBM-SPSS (version 20) and compared using t- test. Results: The tissue histology showed densely packed hepatocytes in treated groups. The immunostaining revealed statistically significant (P < 0.05) upregulation of the Ki-67 expression only among the treated Group 4 animals, whereas the p53 protein expression was statistically significantly (P < 0.05) upregulated in all the treated groups. Conclusions: The findings of this study implied that only higher dose of extracts could trigger increase in the rate of hepatic cell proliferation even the inhibitory signal of proliferation becomes activated. Hence, the exposure of methanolic leaf extracts of A. conyzoides L. may cause dose-dependent antiproliferative activity.
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REVIEW ARTICLES Top

Prenatal exposure and fetal programming of schizophrenia Highly accessed article p. 41
Chidiebere Emmanuel Okechukwu
DOI:10.4103/njecp.njecp_12_19  
Schizophrenia (SCZ) is a neurodevelopmental disorder, which results to cognitive dysfunction and memory decline. Maternal undernutrition during fetal development alters epigenomic programming, and this might result to SCZ in offspring later in life because of the disruption of fetal brain development and synaptogenesis. Maternal stress, exposure to teratogens and neurotoxic agent, hypoxia, and viral infection alters fetal neurodevelopmental mechanisms because of an increase in inflammatory proteins. Interleukin 8 and tumor necrosis factor released due to stress and infection increase the risk of offspring developing SCZ later in life. Having infections linked to Toxoplasma gondii, Chlamydia, and some pathogens seropositivity during pregnancy or the period preceding childbirth are high-risk factors for offspring to develop SCZ later in life. This review was conducted by extracting papers using key terms indicating Schizophrenia, fetal programming of neurodevelopmental disorders, maternal undernutrition, maternal immune activation, and genome-wide studies through PubMed, Science Direct, PsychINFO, Medline, Web of Science, and Google Scholar. Maternal Stress was found to induce hypermethylation resulting to poor expression of reelin, which causes a reduction in GABAergic neurons in animal models. In vivo animal experimentation indicated that poor maternal care, unfavorable environmental factors, and conditions produce aberrant deoxyribonucleic acid methylation patterns at various gene loci in the medial prefrontal cortex of the brain, thus altering and modifying the network of genes involved in mental activities. However, the epigenomic mechanisms behind the fetal programming of SCZ have not been fully understood; more facts could be unraveled in the future.
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Role of exercise in the treatment of gambling disorder p. 50
Chidiebere Emmanuel Okechukwu
DOI:10.4103/njecp.njecp_11_19  
Gambling disorder(GD)is a behavioral addiction recognized by the Diagnostic and Statistical Manual for Mental Disorders 5th version and the International Statistical Classification of Diseases 10th version (ICD-10). GD according to the ICD-10 is characterized by maladaptive and recurrent pattern of gambling behavior that persists despite the negative consequences for the individual and his family. GD is a rising global health issue, and its consequences are family problems, substance abuse, suicide ideation, suicide attempts, suicide, and criminal behaviors such as theft and drug trafficking to raise money for gambling activities. Mood disorders such as major depressive disorder, anxiety, obsessions, and personality disorders are comorbid with GD. Papers were searched using key terms indicating addiction, exercise, physical activity, and GD on PubMed, Science Direct, Psych INFO, Medline, and Google Scholar database. Exercise is effective in the prevention and treatment of depression in addition to psychotherapy and antidepressant drug therapies. Pathological gamblers who are not physically active are expected to have poor cardiovascular and mental health, lack of physical fitness, and low quality of life compared to healthy controls who exercise regularly. There is a need to include a standard exercise program in support of psychotherapeutic and pharmacological treatment of GD because of the benefits of regular exercise in the improvement of cardiovascular and mental health, lifestyle modification, and in the primary and secondary prevention of chronic diseases. Exercise was found to be effective as an adjunctive therapy in the treatment of GD and co-occurring psychiatric disorders.
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Effectiveness of core stability exercises in patients with chronic non-specific low back pain: A review of randomized controlled trials p. 55
Fatima Kachalla Gujba, Nicky Lambon, Sokunbi Ganiyu, Mamman Ali Masta, Muhammad Ali Usman
DOI:10.4103/njecp.njecp_17_18  
Individual studies have shown that core stability exercise (CSE) program is effective at improving pain and function in patients with chronic nonspecific low back pain (LBP) and the use of this intervention has become increasingly popular. However, there is still a further need for systematic review to infer the precise efficacy of CSEs for chronic nonspecific LBP (CNLBP). The aim of this study was to systematically review randomized controlled trials (RCTs) evaluating the effectiveness of CSEs in patients with CNLBP. A systematic review of RCTs was done using published articles. Recognized databases such as CINAHL, AMED, MEDLINE, PEDro, and The Cochrane Library were used to search for RCTs published between 2010 and 2015 in which pain and disability were evaluated as outcomes. Methodological quality was assessed using the PEDro scale. Six studies met the criteria for this review. The included studies randomised participants into two different exercise groups. All studies had PEDro scores of >5/10. Five out of the six studies showed benefits of CSEs over other intervention or control for pain and disability while the other study shows both CSEs and traditional trunk exercises to be effective. The result of this review supports the effectiveness of CSEs at improving pain and disability in patients with CNLBP. Further studies with robust methodology are warranted to assess the longterm effects of this intervention in patients with CNLBP.
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