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   Table of Contents - Current issue
Coverpage
January-June 2020
Volume 8 | Issue 1
Page Nos. 1-63

Online since Friday, July 31, 2020

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ORIGINAL ARTICLES  

Phenotypic and genotypic detection of malaria parasite among patients attending Aminu Kano Teaching Hospital, Kano, Northwest Nigeria p. 1
Zainab Ali Adamu, Abdulrazak Muhammad Idris, Abdulsalami Yayo Manu, Kabir Mustapha Umar
DOI:10.4103/njecp.njecp_28_19  
Introduction: Malaria parasite (Plasmodium species) is one of the most important parasitic infections affecting people of all age groups throughout tropical countries wherever suitable hosts are found. The parasites are transmitted to man by the malaria vector, the female Anopheles mosquito during blood meals. Among all the members of the genus Plasmodium, Plasmodium falciparum is the most prevalent and common malaria species worldwide, especially in Africa and other developing countries. Aims and Objective: The present study aimed at the phenotypic and genotypic detection of malaria parasite among patients attending the General Outpatient Department of Aminu Kano Teaching Hospital, Kano, Northwest Nigeria. Material and Method: A total of 456 samples were collected from patients that voluntarily consent to participate in the study. Blood samples were randomly collected by trained personnel by vein puncture; and thick and thin smear was made on a clean glass slide and left to air dry. The smear was stained with Giemsa stain and observed under × 100 microscopic objective lens. A total of 41 (9.0%) positive malaria parasite smears were obtained with 0–9 years. Result: From 41 positive malaria parasite smears obtained by microscopic examination, 15 were randomly selected and confirmed by polymerase chain reaction (PCR) and ten were selected from negative microscopic smears. Eight (53.3%) out of the 15 positive smears and 3 (30.0%) from the negative smears were confirmed to be PCR positive. Conclusion: The finding of the study confirmed the presence of malaria parasite among the patient group in the study area using both phenotypic and genotypic detection techniques.
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Lactobacillus pentosus KCA1 Decreases Vaginal and Gut Microbiota Associated with Bacterial Vaginosis p. 6
Kingsley Chidozie Anukam, Nneka Regina Agbakoba, Chinwe E Ejike, Charlotte B Oguejiofor
DOI:10.4103/njecp.njecp_31_19  
Introduction: Bacterial vaginosis (BV) which affects 14%–50% of reproductive-aged women in Nigeria is misdiagnosed and underreported. Treatment option is antibiotics, which leads to recurrent infections. The objectives of this study are three folds: first, to determine effects of oral feeding of Lactobacillus pentosus KCA1 on the vaginal and gut microbiota of women diagnosed with BV; second, to measure the level of two pro-inflammatory cytokines interleukin-1 (IL-1)-beta and IL-6 before and after KCA1 consumption; and third, to determine the relative abundance of bacterial metabolic genes. Materials and Methods: Seven women diagnosed with BV by Nugent score (7–10) were recruited to provide vaginal and gut sample before and after 14-day oral intake of 3 g of L. pentosus KCA1. The DNA from the swabs was processed for 16S rRNA metagenomics using Illumina MiSeq platform. The paired-end sequence FASTQ reads were imported into Illumina Basespace pipeline for quality check. In addition, EzBioCloud pipeline was used for alpha- and beta-diversity estimation using PKSSU4.0 version and open reference UCLUST_MC2 for operational taxonomic units picking at 97% cutoff. Blood samples were analyzed using ELISA technique. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States was used to predict the metabolic functions from the 16S rRNA gene dataset. Results: On average, there was no significant difference at P = 0.05 in the alpha-indices typified by Shannon index. The beta-diversity showed different clustering positions with principal coordinate analysis. However, at individual taxonomic categories, there was a significant decrease in the relative abundance of some genera associated with BV after KCA1 feeding with a corresponding increase of Lactobacillus genus. Bacterial genes related to defense systems were upregulated in the vagina. There was a two-fold downregulation of IL-1-beta after consumption of KCA1. Conclusion: Our findings suggest that L. pentosus KCA1 taken orally lowers pro-inflammatory cytokine and IL-1-beta and decreases the relative abundance of BV-associated bacteria.
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Effect of Cymbopogon citratus aqueous extract on Areca catechu-Induced lesions in the liver of adult wistar rats p. 20
Gerald Ikechi Eze, Kevin Aiwanfoh Akonoafua
DOI:10.4103/njecp.njecp_14_20  
Background: Cymbopogon citratus has been reported to possess antimicrobial, antioxidant, antimutagenic, and anticarcinogenic properties, as well as the ability to modify gene transcription while the seeds of Areca catechu are known to contain carcinogenic compounds. Aim: This study evaluated the effects of aqueous extract of C. citratus on A. catechu-induced liver injury in adult Wistar rats. Materials and Methods: Thirty rats weighing between 180 g and 250 g were obtained from the laboratory animal facility of the Department of Anatomy, University of Benin. The animals were randomly divided into six groups of five animals each. Group A served as control and received distilled water only, Group B received A. catechu only, Group C received C. citratus only, Group D received A. catechu and low dose C. citratus, Group E received A. catechu and moderate dose C. citratus, while Group F received A. catechu and high dose C. citratus. The experimental animals were acclimatizing for 2 weeks, before the administration of extracts, which was through oral gavage, for 4 weeks. The rats were sacrificed after the 4th week. Liver function tests and appropriate histological procedures were carried out. Results: Significant increases (P < 0.05) of aspartate transaminase and alanine aminotransferase levels were recorded in the group that received A. catechu only, whereas the administration of C. citratus in various doses inhibited the rise in their levels. Conclusion: Histological analysis showed that A. catechu caused inflammation and distortion of the histoarchitecture of the liver, while C. citratus attenuated these effects.
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Prevalence of intestinal helminth infection among human immunodeficiency virus/acquired immune deficiency syndrome patients attending Aminu Kano teaching hospital p. 26
Abdulhadi Sale Kumurya, Fatima Salahu Ibrahim, Nura Muhammad Bunza
DOI:10.4103/njecp.njecp_26_19  
Background: Helminth and human immunodeficiency virus (HIV) infections have a major effect on the host immune system, and coinfection is widespread. About 17%–66% of the world populations are infected with helminth and approximately 24% of the world's population is infected with intestinal helminth. The majority of this infection occurs in resource-limited settings like sub-Saharan Africa which includes Nigeria. Materials and Methods: Stool samples were collected from 297 participants comprising 150 HIV/acquired immune deficiency syndrome (AIDS)-infected individuals as test group and 147 HIV/AIDS-uninfected individuals as control group attending Aminu Kano Teaching Hospital. The samples were examined using direct wet mount and formol-ether concentration techniques. Results: The overall prevalence of intestinal helminth infection was 18.0% for the test group and 2.7% for the control group. Hookworm was found to be the most prevalent intestinal helminth parasite detected with 7.07%, followed by Ascaris lumbricoides (2.69%) and Fasciola species (0.67%), respectively. Some protozoan parasites were also detected, namely Entamoeba coli (3.4%) and Entamoeba histolytica (2.7%). Six of the participants had multiple infections with hookworm and E. histolytica (3 [1.0%]), A. lumbricoides and E. coli (2 [0.7%]), and A. lumbricoides and E. histolytica (1 [0.3%]). A statistically significant association was observed between the type of toilet used, animal rearing, handwashing, and intestinal helminth infection (P 0.02, 0.003, and 0.000). No statistical association exists between sources of water, walking barefooted, and intestinal helminth infection (P 0.211 and 0.942). Conclusion: This study revealed an increased prevalence of intestinal helminth infection among the test group than the control group, as such stool examination should be part of the routine laboratory investigations for HIV/AIDS patients to have effective and proper management of the patients.
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Healthcare workers' knowledge, attitude and practice of HIV postexposure prophylaxis in a South-Eastern Nigerian tertiary hospital p. 32
Appolus C Mmeremikwu, Obinna I Ekwunife, Ekene S Mefoh, Chioma C Mmeremikwu, Chiedozie Kingsley Ojide
DOI:10.4103/njecp.njecp_27_19  
Background: HIV postexposure prophylaxis (PEP) is an integral aspect of preventive management of HIV/AIDS. Timely provision of HIV PEP after exposures to HIV risky conditions can reduce significantly the possibility of HIV transmission. Objective: To determine the knowledge, attitude and practice of HIV PEP among healthcare workers (HCWs) in a Nigerian tertiary health facility. Methods: Standardized questionnaires designed to assess knowledge, attitude and practice of HIV PEP were administered to 343 HCWs randomly selected from various clinical specialties in the hospital. Their responses were coded, collated and analyzed using SPSS version 24. Simple descriptive statistics was used in the overall analysis and Chi-square statistics for bivariate analysis. Results: Twenty eight (8.2%) of the 343 HCWs had adequate knowledge of HIV PEP. The uptake of HIV PEP among the eligible HCWs was 60% and the provision of HIV PEP to eligible victims of rape was 67.9%. The general attitude on the attitude index was 93.8%. Conclusion: The study revealed a very poor level of knowledge and poor practice of HIV PEP among the HCWs. The attitude towards the HIV PEP intervention was however generally positive.
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Liver function parameters of patients on antiretroviral therapy attending al-noury specialist hospital Kano, Nigeria p. 40
Abdulhadi Sale Kumurya, Sadiya Ashiru Auta
DOI:10.4103/njecp.njecp_25_19  
Context: The hallmark of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) infection is the depletion of CD4hearing cells, especially the T helper cells, resulting in impairment of cellular immune response. The introduction of antiretroviral (ARV) therapy which has changed HIV/AIDS infection into a clinically wieldy disease is a progression development. Aims: The aim of the study was to evaluate the liver function parameters of patients ARV therapy attending Al-Noury Specialist Hospital Kano, Nigeria. Settings and Design: The study is a cross-sectional prospective study. Subjects and Methods: This work evaluated the effect of fixed dose combination of stavudine, lamivudine, and nevirapine on CD4cell counts and liver function parameters of 150 adult patients with a mean age of 34 years for 1 year. The measurement of serum alkaline phosphates, billirubin, and aminotransferases was analyzed using the reflection machine. Statistical Analysis Used: Data generated were analyzed using SPSS version 20.0. Logistic regression analysis was used to identify the significant predictors. Results: Of the 150 patients enrolled for the study, only 120 (180%) of them consisting of 82 (68.3%) males and 38 (31.7%) females were consistent with respect to adherence to therapy and submission to laboratory assessment. The findings of this study showed that CD4T-Cells, bilirubin, and alkaline phosphates had statistically significant changes (P > 0.05). Conclusions: Although the treatment outcome of patients with ARV indicates good response, evidence points to severe hepatocellular damage which may become life-threatening, especially for long-term users. We therefore recommend regular livers enzyme profile assessment as part of the integrated management of HIV/AIDS patients on ARV therapy.
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A comparative study on the availability of postnatal care services in primary health-care facilities in urban and rural settlements in Kaduna State, Nigeria p. 44
Chinedu John-Camillus Igboanusi, Kabir Sabitu, Awawu Grace Nmadu, Istifanus Anekoson Joshua, Abdulrazaq Abdullahi Gobir
DOI:10.4103/njecp.njecp_3_20  
Background: The days and weeks following childbirth is a critical phase in the lives of mothers and newborn babies. Major changes occur during this period which determine the well-being of mothers and newborns. Most maternal and infant deaths occur during this time. The study aimed at assessing and comparing the availability of postnatal care (PNC) services between primary health-care (PHC) facilities in urban and rural settlements in Kaduna State, Nigeria. Materials and Methods: This was a comparative mixed-method community-based study carried out in Sabon Gari and Giwa local government areas (LGAs) of Zaria. A multistage sampling technique was used to select 410 households in two LGAs. Structured questionnaires were used to collect data and the data were analyzed using the Statistical Package for the Social Sciences software version 20.0. Results: PNC services were available in the PHC facilities in the study areas, however, in varying degrees. The rural and urban PHCs had 25% and 64.3% of the recommended workforce, respectively. The recommended essential equipment availabilities for PHCs were 26.3% and 38.2% in rural and urban PHCs, respectively. The rural PHCs had 35.4% of the recommended essential drugs, while the urban PHCs had 72.5%. Quantitative findings tallied with focus group discussions that services were better in urban than in rural PHCs. Conclusion: PNC services were inadequate in both urban and rural areas of Kaduna State but more in the rural area. The PHC facilities studied lacked the recommended minimum requirements in terms of human resources for health, basic equipment, and essential drugs, and this was more marked in the rural facilities. The state PHC development agency needs to address shortages of workforce, equipment, and essential medicines in the study areas.
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REVIEW ARTICLE Top

Does whole-body vibration and exercise training improve bone mineral density in postmenopausal women? A mini review p. 52
Chidiebere Emmanuel Okechukwu
DOI:10.4103/njecp.njecp_36_19  
Whole-body vibration (WBV) training has been projected as a feasible tactic for the prevention and treatment of osteoporosis, and possible therapy for improving bone mass and strength in postmenopausal women. Moreover, regular exercise training could improve bone mineral density (BMD) and bone formation in postmenopausal women. The aim of this review was to evaluate the effectiveness of WBV and exercise training in improving BMD in postmenopausal women, based on the findings from systematic reviews and meta-analyses. Relevant systematic reviews and meta-analyses that reported on the effects of WBV and exercise training on BMD in postmenopausal women from 1998 to 2019 were evaluated. PubMed database was utilized. The MeSH system was used to extract the relevant research studies from PubMed. Based on the findings from the systematic reviews and meta-analyses, WBV training and supervised exercise regimen consisting of aerobic and resistance training improved BMD among postmenopausal women, respectively.
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CASE REPORT Top

Short-Interval periodic transcranial direct current stimulations may induce long-term remission of symptoms in a patient with poststroke depression p. 59
Auwal Bello Hassan, Musa Sani Danazumi, Cornelius Mahdi Ishaku, Abdulsalam Mohammed Yakasai
DOI:10.4103/njecp.njecp_33_19  
Transcranial direct current stimulation (tDCS) has been shown to be effective in the management of patients with poststroke depression (PSD) but with a high relapse rate. We present a report of a patient with PSD who had long-term mood improvement upon receiving periodic tDCS sessions with short inter-session intervals following a relapse of symptoms at 3 weeks after improvement due to stimulations with long inter-sessions intervals. A 60-year-old patient presented with moderate PSD, having a Beck Depression Inventory (BDI) score of 25. She received anodal tDCS to the left dorsolateral prefrontal cortex using two different application protocols. Initially, a stimulation session of 2 mA intensity for 20 min was given every working day for 2 weeks. After 3 weeks, she then received seven sessions of periodic stimulations of 2 mA intensity for 13 min each with 20 min inter-sessions interval. BDI score was taken before the intervention, immediately after, and at 3 weeks and 6 months postintervention. Immediately following the last session of the initial protocol of stimulation, the BDI score reduced from 25 to 7. However, the symptoms relapsed at 3 weeks postintervention to the initial BDI score of 25. There was no change in the BDI score immediately after follow-up with short interval periodic stimulations. Nevertheless, the BDI score improved to 18 at 3 weeks and later to 7 at 6 months postintervention. Series of periodic tDCS with short-intersession intervals may be more effective in inducing long-term mood improvement in patients with PSD.
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