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Study’s Novelty/Excerpt • This study assesses heavy metal concentrations in traditional medicinal herbs consumed in Kano State, Nigeria, providing critical insights into their relative safety and potential health risks. • By analyzing ten powdered herbal samples using Atomic Absorption Spectrometry, the research identifies concerning levels of lead, chromium, cadmium, and mercury, with lead concentrations in one sample exceeding the WHO's safety limits. • The findings highlight significant variability in heavy metal content among different herbs, underscoring the need for stringent quality control and regulatory measures to ensure consumer safety. Full Abstract Herbs are extensively consumed in Nigeria, for their medicinal properties and availability. This study aimed at determining the concentration of heavy metals residues in some selected traditional medicinal herbs consumed in Kano State, Nigeria. This is to assess their relative safety and potential health risks to local inhabitants based on the World Health Organization standard limit. A total of ten (10) powdered samples of medicinal preparations were purchased from local markets in Kano metropolis and analyzed for the presence of lead, chromium, cadmium, and mercury contents. The samples underwent digestion, and heavy metal concentrations were determined using Atomic Absorption Spectrometry (AAS). The metals found to be present varied in different concentrations in the herbal samples. The presence of heavy metal ranges as follows: 0.6-6.5mg/kg for chromium, 3.10-22.10mg/kg for lead, 0.08-0.60mg/kg for cadmium, and 0.09-0.30mg/kg for mercury. However, mercury content was not detected in some samples. The study's findings conclude that the lead (Pb) values were found to be the highest in concentration, exceeding the W.H.O limits in sample J, which is used as a remedy for cough. This indicates that the sample is highly contaminated compared to others. Mercury was not detected in four of the samples, and when present, it was below the limits set by the World Health Organization, making all the samples free from mercury contamination.

Epidemic meningococcal meningitis is a major public health problem still affecting tropical countries, particularly in Sub-Saharan Africa, which lies within African meningitis belt. Repeated large scale epidemics of CSM have been reported in northern Nigeria for the past four decades. It is one of the important causes of morbidity and mortality in these regions. Mortality from the CSM remains high despite advances in treatment modalities. Neisseria meningitidis serogroup A have been the major cause of large scale epidemics in tropical countries, while serogroups B, C, Y and W-135 are responsible for most of invasive disease in America and other developed countries. Objective: To determine the pattern of epidemic CSM in children at Federal Medical Centre, Gusau. Method: The study was a retrospective one carried out in children aged six months to 12 years admitted into Emergency Paediatrics Unit (EPU) with a diagnosis of CSM within the period January to May, 2009. Results: Seventy- seven children with epidemic CSM were admitted and managed in EPU from January- May 2009. Conclusion: Neisseria meningitidis serogroup A CSM is becoming the disease of young infants, and stresses the need for inclusion of CSM vaccine in early infancy in routine immunization policy, in areas within the meningitis belt in Sub-Saharan Africa.

Omalhassan Amir Abdelkarim,1 Usman Abubakar,2 Mohamed A Hussain,3 Abd Elrahman Babiker Abadi,1 Ahmed Osman Mohamed,3 Wadah Osman,4,5 Asmaa E Sherif,4,6 Sara Altayep Ebrahim,1 Asmaa Hussein Ahmed,1 Marwa Omer Ahmed,1 Ahmed Ashour4,6 1Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan; 2Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, Qatar; 3Department of Pharmaceutical Microbiology, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan; 4Department of Pharmacognosy, Faculty of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-KharJ, Saudi Arabia; 5Department of Pharmacognosy, Faculty of Pharmacy, University of Khartoum, Khartoum, Sudan; 6Department of Pharmacognosy, Faculty of Pharmacy, Mansoura University, Mansoura, EgyptCorrespondence: Omalhassan Amir Abdelkarim, Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, International University of Africa, Khartoum, PO Box 2469, Sudan, Email dromal409@gmail.comBackground: Adequate training in infectious diseases and antibiotic resistance is crucial for pharmacy students to participate in antibiotic stewardship programs and understand microbiology careers.Aim: The study was carried out to assess the knowledge and self-reported confidence in antibiotic resistance, antibiotic therapy, and antimicrobial stewardship (AMS) among final-year undergraduate pharmacy students in Sudan.Methods: A cross-sectional study was conducted in three universities using a 57-item online questionnaire between April and May 2022.Results: A total of 109 students (response rate 36%) participated and showed average knowledge scores of 5.6± 1.7 (out of 10.0) for antibiotic resistance, 4.9± 2.0 (out of 5.0) for appropriate antibiotic therapy, and 3.1± 1.4 (out of 5.0) for AMS. No significant differences were observed among schools. Some students reported poor knowledge about antibiotic therapy and the consequences of resistance. One-third of students lacked confidence in interpreting microbiological results. Knowledge of antibiotic resistance among students’ practice area after graduation was higher (p=0.017) and those interested in ID careers (5.8 vs 4.8) (p=0.037). Male students (5.6 vs 4.5) and those interested in ID careers (4.3 vs 3.4) (p< 0.001) had higher scores of appropriate antibiotic therapy. Students attended antibiotic resistance courses (51.5 vs 45.2), and those interested in ID significantly had higher self-confidence (55.3 vs 45.8) (p=0.008).Conclusion: Pharmacy students in Sudan have substantial knowledge of AMS and antibiotic resistance with poor knowledge of antibiotic therapy. Adequate training about infectious diseases and related topics is recommended to improve pharmacy students’ understanding of microbiological findings, other competencies, and skills to incorporate in antimicrobial stewardship.Keywords: antibiotic resistance, antimicrobial stewardship, antimicrobial therapy, Sudan, pharmacy students

Omalhassan Amir Abdelkarim,1 Usman Abubakar,2 Lubna Osman Taha,1 Sondos Ahmed Ashour,1 Wiaam Yousif Abass,1 Eslam Mohamed Osman,1 Mustafa Shith Muslih1 1Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, International University of Africa, Khartoum, Sudan; 2Department of Clinical Pharmacy and Practice, College of Pharmacy, QU Health, Qatar University, Doha, QatarCorrespondence: Omalhassan Amir Abdelkarim, Department of Pharmacy Practice and Clinical Pharmacy, Faculty of Pharmacy, International University of Africa, Madani St, P.O Box 2469, Al Khartoum, Khartoum, 12223, Sudan, Tel +249912325691, Email dromal409@gmail.comBackground: Intensive Care Unit (ICU) is a specialized ward where critically ill patients are admitted to provide intensive health care Inappropriate antimicrobial therapy (AMT) and high mortality rates were documented in the ICU. The influence of irrational use of empiric antibiotics on clinical outcomes in ICU patients is not well studied in Sudan.Aim: This study aims to determine the rational use of antibiotics and its impact on clinical outcomes among ICU patients.Methods: Using data collection form, a retrospective longitudinal study was conducted among ICU patients at Omdurman Military Hospital, Khartoum State. Patients admitted from January 2019 to December 2019 were included in the study. Patients who stayed in ICU < 48 hr were excluded. Appropriateness of AMT is assessed using culture sensitivity test (CST) and the American Society of Infectious Diseases (IDSA) guideline.Results: Among 102 patients, 54.9% male, one-third of patients developed nosocomial infections, 80.4% received empiric therapy with broad-spectrum antibiotics. The CST is done in 19%, and 43% patients are prescribed inappropriate AMT. Inappropriate AMT is associated with recurrent infections 38.4% (p=0.028) and high mortality 33.8% (p=0.014). Overall mortality rate 63.7% ICU patients. Elevated mortality in nosocomial 57.8%, decreased with inappropriate AMT in 21.6% patients. Significantly higher mortality rates 90.7% among uncontrolled infections (p< 0.001), 80.6% nosocomial infections (p=0.001), and 76.7% renal compromised (p=0.002).Conclusion: Empirical AMT reduces the frequency of nosocomial infections, which has an impact on mortality. Inappropriate AMT is significantly associated with uncontrolled infections and lower mortality. Implementing a restrictive infectious control system and effective stewardship programs in hospital ICU wards is recommended.Keywords: rational use of antibiotics, mortality rate, intensive care unit, clinical outcomes, appropriate antibiotic therapy

Abdulsalam M Halboup,1,2 Karem H Alzoubi,3,4 Omar F Khabour,5 Mahmoud A Alomari,6 Moath Refat,7 Abdulrazzaq Y Al-Khazzan,1 Ammar Ali Saleh Jaber,8 Usman Abubakar9 1Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, Yemen; 2Discipline of Clinical Pharmacy, University Sains Malaysia, Penang, Malaysia; 3Department of Pharmacy Practice and Pharmacotherapeutics, University of Sharjah, Sharjah, United Arab Emirates; 4Department of Clinical Pharmacy, Jordan University of Science and Technology, Irbid, Jordan; 5Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid, Jordan; 6Department of Rehabilitation, Jordan University of Science and Technology, Irbid, Jordan; 7Department of Biochemistry and Molecular Biology, Xi’an Jiaotong, University, Xi’an, China; 8Department of Clinical Pharmacy & Pharmacotherapeutics, Dubai Pharmacy College for Girls, Dubai, United Arab Emirates; 9Department of Clinical Pharmacy and Practice, Qatar University, Doha, QatarCorrespondence: Abdulsalam M Halboup, Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana’a, Yemen, Tel +967774960247, Email a_halboob@yahoo.com; a.halboup@student.usm.myBackground: Following the coronavirus disease (COVID-19) declaration as a pandemic, Yemen has started applying preventive measures to prevent its spread. This study aims to identify the perception regarding the nature of the COVID-19 disease, susceptibility to severe forms of the disease, and its relationship to seasonal influenza among the population of Yemen.Methods: This was a cross-sectional study of the public in Yemen. The relationship between participants’ sociodemographic factors and their responses was assessed by the chi-square test.Results: A total of 748 participants agreed to participate in the study. Regarding the nature of the diseases, nearly half of the participants (48.8%, n=352) believed that COVID-19 is a naturally occurring human virus that is a serious and fatal disease (61.2%, n=448). The majority (74.9%; n=518) did not agree that bacteria cause COVID-19. More than half of the participants (57.5%, n=423) believed this disease is transmitted to humans through a host animal. Regarding the vulnerable groups to develop severe COVID-19 infection, most of the participants pointed out that the elderly (94.3%, n=705), people with chronic diseases (89.9%, n=669), and pregnant women (53%, n=365) were more susceptible to severe diseases. Regarding symptoms, the majority (61.9%, n=458) of the participants agreed that the symptoms of COVID-19 are similar to those of seasonal influenza. Additionally, the majority (81.9%, n=579) agreed that some individuals develop more severe symptoms than seasonal influenza, particularly those with chronic illness. Gender, age, and education were found to be associated with participants’ perceptions regarding the nature of the virus and susceptibility to severe disease.Conclusion: Participants demonstrate a good understanding of the nature and susceptibility to complications associated with COVID-19 disease and its relationship to influenza. However, the respondents with a lower level of education might require additional educational campaigns to improve their awareness of the disease.Keywords: public perception, COVID-19, susceptibility, complications, Yemen

Inflammation is a physiological event that protects tissues from infection and injury. Chronic inflammation causes immune cell over activation and sustained release of inflammatory cytokines and chemokines cause pathologic conditions including autoimmune diseases. Heavy metals exposure affects innate and adaptive immune systems through triggering inflammatory responses. It seems that extended inflammatory responses could accelerate heavy metal-induced autoimmunity. In the present review we discuss the exposure route and toxicity of Cadmium (Cd), Lead (Pb), Mercury (Hg), Vanadium (V) and Platinum (Pt) and their effects on inflammatory responses by innate and adaptive immune system and autoimmunity.

In the present article, our main goal is to study the new extended beta, Gauss and confluent hypergeometric functions defined by using the two Fox-Wright functions as their kernel. Some applications of the new extended beta function to distribution theory are also discussed. [ABSTRACT FROM AUTHOR]

In this article, generalized pathway integral operator with the classical Gauss hypergeometric function kernel and the fractional differential operators are used to studied new extended hypergeometric function. Furthermore, extended fractional kinetic equation involving new extended hypergeometric function that contained two Fox-Wright function as regularizer is investigated using Sumudu transform and Wiman's function. [ABSTRACT FROM AUTHOR]

In this article, authors introduced the new (p, q; v)-extended Bessel-Wright function ..., some properties related to Marichev-Saigo-Maede fractional integral and derivative operators, and Caputo-type Marichev-Saigo-Maede fractional integral and derivative operators which are applied to the (p, q; v)-extended Bessel-Wright function. Some special cases such as Saigo, Riemann-Liouville and Erdeyi-Kober fractional integrals and derivative operators are obtained. In addition, applications of the new (p, q; v)-extended Bessel-Wright function ... to the fractional kinetic equations is also discussed. [ABSTRACT FROM AUTHOR]

Inflammation is a physiological event that protects tissues from infection and injury. Chronic inflammation causes immune cell over activation and sustained release of inflammatory cytokines and chemokines cause pathologic conditions including autoimmune diseases. Heavy metals exposure affects innate and adaptive immune systems through triggering inflammatory responses. It seems that extended inflammatory responses could accelerate heavy metal-induced autoimmunity. In the present review we discuss the exposure route and toxicity of Cadmium (Cd), Lead (Pb), Mercury (Hg), Vanadium (V) and Platinum (Pt) and their effects on inflammatory responses by innate and adaptive immune system and autoimmunity. [ABSTRACT FROM AUTHOR]

Brucellosis is a disease that causes significant reproductive failure in ruminants and has been reported to be a disease of major zoonotic importance. The aim of this study was to determine the seroprevalence and risk factors for Brucella melitensis infection in goats slaughtered in the Abattoir section of the Livestock Market Gwagwalada Area Council, Anagada, Abuja Nigeria. A total of 240 blood samples were collected in plain tubes without anti-coagulant at point of slaughter for the harvesting of serum samples. Serum Agglutination Test with EDTA (SAT-EDTA) and Lateral Flow Assay (LFA) were used to test for exposure to Brucella infection. Chi square was used to test for association between catergorical variables as with level of significance set at 0.05. Overall seroprevalence rates using SAT-EDTA and LFA were 7.11% and 6.67% respectively. Based on risk factors, seroprevalence rate was higher in does (6.62% vs 6.68%), goats = 1 year of age (7.45% vs 7.45%) and the Sahel breed of goats (9.80% vs 7.69%) by SAT-EDTA and LFA respectively. There was no significant difference between all variables p > 0.05. Highest prevalence rates were obtained in does, goats = 1 year and the Sahel breed of goats. As a pathogen of public health significance to in-contact abattoir workers, it is imperative that these workers be educated on the nature of the disease and on how to minimize its risk of transmission via contacted with infected animals and their products. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) and neonatal tetanus infections remain endemic in Nigeria despite the availability of safe, effective vaccines. We aimed to determine health facilities' capacity for hepatitis B vaccine birth dose (HepB-BD) and maternal tetanus-diphtheria (Td) vaccination and to assess knowledge, attitudes, and practices of HepB-BD and maternal Td vaccine administration among health facility staff in Nigeria., Materials and Methods: This was a cross-sectional study assessing public primary and secondary health facilities in Adamawa and Enugu States. A multistage sampling approach was used to select 40 facilities and 79 health-care workers (HCWs) from each state. A structured facility assessment tool and standardized questionnaire evaluated facility characteristics and HCW knowledge, attitudes, and practices related to HepB-BD and maternal Td vaccination. Frequencies and proportions were reported as descriptive statistics., Results: The survey of 80 facilities revealed that 73.8% implemented HepB-BD and maternal Td vaccination policies. HepB-BD was administered within 24 h of birth at 61.3% of facilities and at all times at 57.5%. However, administration seldom occurred in labor and delivery (35%) or maternity wards (16.3%). Nearly half of the facilities (46.3%) had HCWs believing there were contraindications to HepB-BD vaccination. Among 158 HCWs, 26.5% believed tetanus could be transmitted through unprotected sex, prevented by vaccination at birth (46.1%), or by avoiding sharing food and utensils. 65% of HCWs knew HBV infection had the worst outcome for newborns., Conclusions: The limited implementation of national policies on HepB-BD and maternal Td vaccination, coupled with knowledge gaps among HCWs, pose significant challenges to timely vaccination, necessitating interventions to address these gaps., (Copyright © 2024 Copyright: © 2024 Annals of African Medicine.)

Information regarding the radiation risk posed by radioactive emissions from the petrologic units in North eastern Nigeria is extremely limited. Consequently, there has been little research conducted on the environmental impact of radiation exposure from different petrologic units in this region. Hence, the 13 petrologic components of the area that comprises of the migmatites-gneiss (MG), banded gneiss (BG), biotite-hornblende granites (OGe), porphyritic biotite-hornblende granites (OGp), charnockytes (Ch), ignimbrites (JYG), basalts (bb), Keri-Keri Formation (KK), Gombe Sandstones (GS), Pindiga Formation (PS), Yolde Formation (YL), Bima Sandstones (BS), and alluvium (AL) deposits were assessed using aero-radiometric data (equivalent uranium, equivalent thorium, and percentage potassium radio-elements) acquired by Nigerian geological survey agency (NGSA) in 2009. The objective of this study is to compute the amount of radiation across the various rock units of the study area, and examine their radiation risk parameters. The results of this study showed variable levels of radiation across the various rock units examined. The average total activity concentration values recorded ranges from 261.67 ± 447.12 Bq/Kg across KK rock unit to 1482.02 ± 447.12 Bq/Kg across OGp/OGe rock types of the study area. Moreover, the average radium equivalent (Rn eq ), absorbed dose rates ( D ) estimated ranges from 113.83±461.3 3 Bq/Kg to 305.19 ± 58.51 Bq/Kg, and 51.88 ± 29.65 nGyh -1 to 144.94 ± 29.65 nGyh -1 along KK Formation, OGp, and same KK Formation, and OGp respectively. The average environmental radiation hazard parameters of the annual effective dose rate (AEDE), activity utilization index (AUI), respiratory dysfunction parameters (RH in , RH out ), annual gonad dose equivalent (AGDE), and excess life cancer risk (ELCR) measured across all rock units were found to be within or above their respective acceptable limits of 1 mSv/y, 300 μSv/y, and 0.29 × 10 -3 . Additionally, based on the conspicuously higher hazardous radiation ( D , Rn eq , AEDE AGDE, RH in , RH out, and ELCR) emissions estimated from the OGp, OGe, MG, BG, and Ch petrologic units, the inhabitants of these localities should therefore limit themselves from excessive exposure to these rocks. Therefore, periodic monitoring of these areas is recommended., Competing Interests: We declare that no competing interest of any kind from an individual or corporate body manifested during this study., (© 2024 Published by Elsevier Ltd.)

Background: The effectiveness of reducing healthcare-associated infections (HCAIs) depends on increasing healthcare providers' awareness, skills, and adherence to standard practices. Mhealth applications provide an innovative approach to enhancing access to information and resources while reducing time and expenses., Objective: The study aimed to develop and evaluate a mhealth application for healthcare providers that offers quick access to updated recommendations, evidence-based guidelines, and protocols for managing patients with HCAIs., Method: The study included the development of the app, followed by a pilot test of its usability among physicians and nursing staff by using the Mobile Application Usability Questionnaire (MAUQ)., Results: The mhealth application, named HCAI Shield, was developed with four main menus. The menu includes HCAI's care bundle: hand hygiene, personal protective equipment, and standard precautions. The information has been gathered following standards established by both national and international organizations. Twenty-one participants took part in the evaluation, and the mean score for the application's usability was 5.28 ± 0.38. The areas of "ease of use," "interface and satisfaction" received high mean scores., Conculsion: The HCAI Shield app provides convenient access to evidence-based guidelines and standards for HCAI management. Further evaluation is recommended., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Pharmacy and Bioallied Sciences.)

Background: There is paucity of data describing the rate and quality indices of antibiotics used among hospitalized patients at continental level in Africa. This systematic review evaluated the pooled prevalence, indications, and types of antibiotics used in hospitals across Africa., Methods: Three electronic databases, PubMed, Scopus, and African Journals Online (AJOL), were searched using search terms. Point prevalence studies of antibiotic use in inpatient settings published in English language from January 2010 to November 2022 were considered for selection. Additional articles were identified by checking the reference list of selected articles., Results: Of the 7254 articles identified from the databases, 28 eligible articles involving 28 studies were selected. Most of the studies were from Nigeria (n = 9), Ghana (n = 6), and Kenya (n = 4). Overall, the prevalence of antibiotic use among hospitalized patients ranged from 27.6 to 83.5% with higher prevalence in West Africa (51.4-83.5%) and North Africa (79.1%) compared to East Africa (27.6-73.7%) and South Africa (33.6-49.7%). The ICU (64.4-100%; n = 9 studies) and the pediatric medical ward (10.6-94.6%; n = 13 studies) had the highest prevalence of antibiotic use. Community-acquired infections (27.7-61.0%; n = 19 studies) and surgical antibiotic prophylaxis (SAP) (14.6-45.3%; n = 17 studies) were the most common indications for antibiotic use. The duration of SAP was more than 1 day in 66.7 to 100% of the cases. The most commonly prescribed antibiotics included ceftriaxone (7.4-51.7%; n = 14 studies), metronidazole (14.6-44.8%; n = 12 studies), gentamicin (n = 8 studies; range: 6.6-22.3%), and ampicillin (n = 6 studies; range: 6.0-29.2%). The access, watch, and reserved group of antibiotics accounted for 46.3-97.9%, 1.8-53.5%, and 0.0-5.0% of antibiotic prescriptions, respectively. The documentation of the reason for antibiotic prescription and date for stop/review ranged from 37.3 to 100% and 19.6 to 100%, respectively., Conclusion: The point prevalence of antibiotic use among hospitalized patients in Africa is relatively high and varied between the regions in the continent. The prevalence was higher in the ICU and pediatric medical ward compared to the other wards. Antibiotics were most commonly prescribed for community-acquired infections and for SAP with ceftriaxone, metronidazole, and gentamicin being the most common antibiotics prescribed. Antibiotic stewardship is recommended to address excessive use of SAP and to reduce high rate of antibiotic prescribing in the ICU and pediatric ward., (© 2023. The Author(s).)

The coronavirus disease (COVID-19) pandemic affects the healthcare system worldwide and challenges many governments and institutions. Antimicrobial stewardship program advocating the wise use of antimicrobial agents. Its metrics include antimicrobial use measures, process, and outcome performance indications. We will conduct a retrospective observational study with the main hypothesis that the COVID-19 pandemic does not affect the antimicrobial stewardship program and its metrics. We will compare antimicrobial stewardship metrics (process, outcome, utilization) and antibiotic resistance two years before (2018-2019) (Group A) & two years with the COVID-19 pandemic (2020-2021) (Group B). The study will be conducted in Saqr Hospital, a secondary care hospital in the emirate of Ras Al Khaimah in the United Arab Emirates. Data will be analyzed using SPSS version 22. Numerical data will be presented as mean (SD) or median (IQR). Chi-square or Fisher's exact test will be used to analyze categorical data. The t -test or Mann-Whitney U test will be used to compare the difference of numerical variables. p < 0.05 will be considered statistically significant. Multivariate logistic regression will be used to investigate the relation between different variables with (1) cost and (2) antibiotic resistance., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Sickle cell disease is the most common inherited blood disorder in humans and constitutes a major public health burden. It is a multisystemic condition with long-term renal complications. Early detection of sickle cell nephropathy and initiation of appropriate interventions are associated with improved survival and quality of life. This study aimed to compare the cystatin C-derived estimated glomerular filtration rate (GFR) of the study groups and also, to correlate the clinical features of chronic kidney disease (CKD) with decreased GFR in children with sickle cell anaemia (SCA)., Methods: This hospital-based cross-sectional analytic study recruited 86 SCA subjects in steady-state and 86 age and sex-matched healthy HbAA controls aged 1-14 years who attended the Paediatric Haematology and Outpatient clinics of Federal Medical Centre Bida over six months. Data were collected using a semi-structured questionnaire, and participants' length/height, weight, and blood pressure were measured using standard procedures. Blood samples were drawn for serum cystatin C assay via the sandwich enzyme-linked immunosorbent assay (ELISA) technique. Filler's equation was used to calculate the glomerular filtration rate., Results: There was a significant difference in the mean cystatin C-derived GFR between the two groups, i.e. 116 ± 30mL/min/1.73m 2 vs. 106 ± 24mL/min/1.73m 2 for the SCA and control groups, respectively (p = 0.017). The prevalence of supernormal GFR (i.e. GFR > 140mL/min/1.73m 2 ) and decreased GFR (i.e. GFR < 90mL/min/1.73m 2 ) was 19.8% and 22.1%, respectively, in children with SCA. There was no significant association between the age at diagnosis of SCA, blood transfusions, blood pressure, packed cell volume and presence of peripheral oedema with decreased GFR in the study subjects., Conclusions: Supernormal GFR is common in children with SCA and there is no significant association between clinical features of CKD with decreased GFR. Regular evaluation of renal function is, however, recommended in children with SCA for early detection and treatment of renal complications in order to halt the progression to end-stage kidney disease (ESKD)., (© 2023. The Author(s).)

Background: Infection prevention measures are the gold standard for preventing the spread of hospital-acquired infections (HAIs). COVID-19 pandemic caused major disruptions in infection prevention measures, and this has implications on the rate of HAIs. This study assessed the impact of COVID-19 pandemic on the rate and the types of HAIs at Sultan Ahmed Shah Hospital., Method: This is a retrospective cohort study that compared the rate of HAIs from April to October 2019 (pre COVID period) and April to October 2020 (during COVID period). Data was collected through the review of patients' electronic medical records., Results: There were a total of 578 patients included in the selected wards during the pre- and during the pandemic. Thirty-nine episodes (12.1%) of HAIs were report in the pre COVID period and 29 (11.3%) during COVID-19. In both periods, hospital-acquired pneumonia (HAP) was the most frequent HAI among the patients. There was a rise in catheter-associated bloodstream infections (CLABSI) (0.8%) and ventilator associated pneumonia (VAP) (1.1%) during the COVID-19 period. The most common bacteria were methicillin-resistant Staphylococcus aureus (MRSA) (28.2%) and Enterococcus faecalis (17.9%) in the Pre COVID-19 period, and Pseudomonas aeruginosa (27.6%) and Stenotrophomonas maltophilia (6.9%) during COVID-19., Conclusion: Our research concluded that the rates of HAIs during the COVID-19 pandemic were not significantly impacted by the improved in-hospital infection prevention efforts to control the pandemic. There is need for further efforts to promote adherence to preventive practices., (© 2023. The Author(s).)

This study investigated how the Coronavirus Disease 2019 (COVID-19) pandemic has affected the rate of healthcare-associated infections (HAIs). PubMed, Scopus and Google Scholar were searched to identify potentially eligible studies published from December 2019 to September 2022. A random effect model was used to determine the changes in the rate of HAIs during the pandemic. Thirty-seven studies, mostly from the United States ( n = 13), were included. Fifteen studies described how the pandemic affected the rate of CLABSIs and CAUTIs, and eight of them showed a significant increase in CLABSIs. The risk of CLABSIs and CDIs was 27% (pooled odds ratio [OR]: 0.73; confidence interval [CI]: 0.61-0.89; p < 0.001) and 20% (pooled OR: 1.20; CI: 1.10-1.31; p < 0.001) higher during the pandemic compared to before the COVID-19 pandemic period, respectively. However, the overall risk of HAIs was unaffected by the pandemic (pooled OR: 1.00; 95 CI: 0.80-1.24; p = 0.990). Furthermore, there were no significant changes in the risk of CAUTIs (pooled OR: 1.01; 95 CI: 0.88-1.16; p = 0.890), and SSIs (pooled OR: 1.27; CI: 0.91-1.76; p = 0.16) between the two periods. The COVID-19 pandemic had no effect on the overall risk of HAIs among hospitalized patients, but an increased risk of CLABSIs and CDI were observed during the pandemic. Therefore, more stringent infection control and prevention measures and prudent interventions to promote the rational use of antibiotics are warranted across all healthcare facilities to reduce the burden of HAIs.

Introduction: The issues of incorrectness and incompleteness for written prescriptions may result to dispensing errors and unintended outcomes of care. The objective of the study was to assess the legibility of handwritten prescriptions and adherence to W.H.O. prescription writing guidelines in Ahmadu Bello University Teaching Hospital Zaria. Method: A cross-sectional prospective study design was used, and existing prescriptions were sampled from selected in-patient and outpatient pharmacy units of Ahmadu Bello University Teaching Hospital Zaria. This was approved by the ethics and research committee of the institution. The prescriptions were then evaluated for quality based on the layout, legibility, and clarity of the details in the prescriptions and screened for medication errors. Result: The extent of prescribing drugs by generic name was (68.37%), the legibility percentage was moderate and the percentage of prescriptions in which details of the drug, route of administration, and duration of treatment were complete was 85.23%, 80.80%, and 82.40%, respectively. The doctor's signature (84.87%) was present in the prescriptions. Many of the prescribers did not use to indicate patients' weight, age, and clinic on prescriptions, these are deviations from good prescribing practices while total medication error was 38.01%. Conclusion: Prescribers have a duty of care to their patient and a professional duty to their colleagues (pharmacists) to ensure drug prescriptions are readily identifiable. Interventional techniques such as the use of printed or electronic prescriptions can improve the ease of interpreting information and reduce medication errors., (© Individual authors.)

Clinicians frequently study arterial Doppler velocimetric waveforms depicted by Doppler sonography of the kidneys, the heart, the brain, and the feto-maternal circulation to assess the well-being of the aforementioned vital organs. The waveform interpretation of the Doppler indices can be studied using a mathematical model. The developed models serve as teaching tools and for easy comprehension of the regulatory mechanism of the organs. It will also obtain accurate wall shear stress (WSS) and likely atherosclerotic sites can be predicted early. The aim of this review is to reveal the imperatives of mathematical models in the study of the physical interpretation of Doppler velocimetry. The models will explore sonographic Doppler velocimetry and computational fluid dynamics (CFD) in determining the segments of the arteries that are prone to the development of atheromatous plaque. It will be achieved by comparing and computing the measurement differences of the WSS. A thorough literature review was carried out between 1971 and 2021 on the mathematical modeling of blood dynamics and Doppler velocimetry of different blood vessels, across various electronic databases including NC AHEC Digital Library, PUBMED, ERIC, MEDLINE, Free Medical Journals, and EMBASE. The results of the literature search were presented using the PRISMA flow chat. The narrative review of the mathematical models of arterial blood dynamics is based on incompressible Navier-Stokes equations, the Windkessel model, and CFD. It was deduced that the blood flow velocity decreased with time across the varying frequency from 0.2Hz to 0.50Hz in the interlobar arterial channels. The review also revealed that adult humans' Doppler indices of the renal-interlobar artery agree with developed models of renal interlobar arterial blood dynamics. The mathematical model measurements of the great vessels matched the sonographic Doppler velocimetry with <15% variation. In our fast-paced world of epidemiological transition, the imperatives of mathematical modeling of arterial flow dynamics based on the Navier-Stokes equations to represent various physiologic and pathologic situations cannot be overstated. The practical consequences include the possibility of mathematical models to acquire precise WSS distribution and early detection of potential atherosclerotic sites during cardiovascular Doppler sonography., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Medical Ultrasound.)

An influenza pandemic happens when a novel influenza A virus is able to infect and transmit efficiently to a new, distinct host species. Although the exact timing of pandemics is uncertain, it is known that both viral and host factors play a role in their emergence. Species-specific interactions between the virus and the host cell determine the virus tropism, including binding and entering cells, replicating the viral RNA genome within the host cell nucleus, assembling, maturing and releasing the virus to neighboring cells, tissues or organs before transmitting it between individuals. The influenza A virus has a vast and antigenically varied reservoir. In wild aquatic birds, the infection is typically asymptomatic. Avian influenza virus (AIV) can cross into new species, and occasionally it can acquire the ability to transmit from human to human. A pandemic might occur if a new influenza virus acquires enough adaptive mutations to maintain transmission between people. This review highlights the key determinants AIV must achieve to initiate a human pandemic and describes how AIV mutates to establish tropism and stable human adaptation. Understanding the tropism of AIV may be crucial in preventing virus transmission in humans and may help the design of vaccines, antivirals and therapeutic agents against the virus.

Background: Community pharmacists play a vital role in promoting appropriate use of antibiotics in the community. This study evaluated the practices and perceptions of community pharmacists towards antibiotic use, antibiotic resistance, and antimicrobial stewardship in Libya., Methods: A cross-sectional study was conducted among community pharmacists in Libya using a 47-item validated, pre-tested online questionnaire. Data was collected from December 2021 to February 2022 and was analysed using descriptive and inferential analyses., Results: Of the 114 questionnaires included in the analysis, 54.4% were females, 78.1% had < 10 year working experience (78.1%), and 81.6% had a Bachelor of Pharmacy. Most (78.1%) strongly agreed/agreed that community pharmacists have an important role to play to reduce antibiotic resistance. Overall, the participants had a moderate perception towards antimicrobial resistance (median score: 21.5; IQR [16-28] out of 35.0). More than 40% supply antibiotics when patients requested them specifically, because if they do not supply them, patients will just go to another pharmacy. About 47% strongly agreed/agreed that if a patient cannot afford a full course of antibiotics all in one go, they will give them a smaller amount that they are able to afford at that time, even when a longer duration of treatment is required. Most (66.7%) had no previous involvement in antibiotics awareness campaign due to 'I have never heard about the campaign' (48.7%) and 'I do not have enough time to participate' (22.4%). Overall, the perception towards antimicrobial stewardship was good (20 [13-25] out of 25.0). Raising awareness of rational antibiotic use, including antimicrobial resistance, among pharmacy students (83.4%) and patient education by pharmacists in community pharmacies at the time medicines are supplied to patients (81.6%) were the most common strategies to improve rational use of antibiotics in community pharmacy., Conclusions: Community pharmacists in Libya recognise their role in reducing antimicrobial resistance. They had a moderate perception towards antimicrobial resistance and a good perception towards antimicrobial stewardship. However, inappropriate antibiotic practices were common. The most common strategies to improve rational use of antibiotics in community pharmacy were raising awareness about the rational antibiotic use among pharmacy students and patient education by community pharmacists at the time antibiotics are dispensed to patients. Regulations are needed to restrict dispensing antibiotics without prescription among community pharmacists., (© 2023. The Author(s).)