Search

We estimated modern contraceptive prevalence rate (mCPR) and examined predictors of modern contraceptives utilization amongst 1,445 sampled reproductive age women in Lagos (Nigeria’s epicenter) during the devastating COVID-19 pandemic. Estimated mCPR was 30.8%. Women aged 20–29 years were 50% (95%CI:0.37–0.71) less likely to use modern contraceptives during the pandemic than those 30–39 years. Married and divorced women were about three (95%CI:1.37–5.25) and over three (95%CI:1.32–7.79) times more likely to use modern contraceptives compared to single women. Though mCPR has not reduced, sustained contraceptive needs assessment of sometimes obscure sub-populations is required, especially if outbreaks like COVID-19 become our ‘new normal’.

Faculty from groups that are underrepresented in medicine encounter unique challenges to advancement within academic medicine. The authors describe a fellowship created for junior underrepresented in medicine academic faculty in Family Medicine focused on promoting writing skills and scholarship. Supplemental digital content is available in the text., Objectives The diversity of the US physician workforce lags significantly behind the population, and the disparities in academic medicine are even greater, with underrepresented in medicine (URM) physicians accounting for only 6.8% of all US medical school faculty. We describe a “for URM by URM” pilot approach to faculty development for junior URM Family Medicine physicians that targets unique challenges faced by URM faculty. Methods A year-long fellowship was created for junior URM academic clinician faculty with funding through the Society of Teachers of Family Medicine Project Fund. Seven junior faculty applied and were accepted to participate in the fellowship, which included conference calls and an in-person workshop covering topics related to writing and career advancement. Results The workshop included a mix of prepared programming on how to move from idea to project to manuscript, as well as time for spontaneous mentorship and manuscript collaboration. Key themes that emerged included how to address the high cost of the minority tax, the need for individual passion as a pathway to success, and how to overcome imposter syndrome as a hindrance to writing. Conclusions The “for URM by URM” approach for faculty development to promote writing skills and scholarship for junior URM Family Medicine physicians can address challenges faced by URM faculty. By using a framework that includes the mentors’ lived experiences and creates a psychological safe space, we can address concerns often overlooked in traditional skills-based faculty development programs.

Objective: We conducted a cross-sectional study in the five administrative regions of Northern Ghana to determine the diversity of Mycobacterium tuberculosis complex (MTBC) sub/lineages and their susceptibility to isoniazid (INH) and rifampicin (RIF). Methods: Sputum specimens were collected and cultured from 566 pulmonary tuberculosis patients reporting to 17 health facilities from 2015 to 2019. Mycobacterial isolates obtained from solid cultures were confirmed as members of the MTBC by PCR amplification of IS6110 and rpoß and assigned lineages and sub-lineages using spoligotyping. Results: Of 294 mycobacterial isolates recovered, MTBC species identified were: M. tuberculosis sensu stricto (Mtbss) 241 (82.0%), M. africanum 41 (13.9%) and M. bovis four (1.4%) with eight (2.7%) unidentified. The human-adapted lineages (L) identified (N=279) were L1 (8/279, 2.9%), L2 (15/279, 5.4%), L3 (7/279, 2.5%), L4 (208/279, 74.5%), L5 (13/279, 4.7%) and L6 (28/279, 10.0%) with three unidentified lineages. Among the 208 L4, the dominant sub-lineages in the region were the Cameroon 120/208 (57.7%) and Ghana 50/208 (24.0%). We found 4.4% (13/294) and 0.7% (2/294) of the patients infected with MTBC isolates resistant to INH only and RIF only, respectively, with 2.4% (7/294) being infected with MDR strains. Whereas L6 was associated with the elderly, we identified that the Ghana sub-lineage of L4 was associated with both INH and MDR (p

Differential rewarding of work and experience has been a longtime feature of academic medicine, resulting in a series of academic disparities. These disparities have been collectively called a cultural or minority “tax,” and, when considered beyond academic medicine, exist across all departments, colleges, and schools of institutions of higher learning–from health sciences to disciplines located on university campuses outside of medicine and health. A shared language can provide opportunities for those who champion this work to pool resources for larger impacts across the institution. This article aims to catalog the terms used across academic medicine disciplines to establish a common language describing the inequities experienced by Black, Latinx, American Indian/Alaska Native and Native Hawaiian/Other Pacific Islander, Women, and other underrepresented people as well as queer, disabled, and other historically marginalized or excluded groups. These ideas are specific to academic medicine in the United States, although many can be used in academic medicine in other countries. The terms were selected by a team of experts in equity, diversity, and inclusion, (EDI) who are considered national thought leaders in EDI and collectively have over 100 years of scholarship and experience in this area.

The global high prevalence of diabetes mellitus has resulted into the development of several oral hypoglycemic agents. However, these drugs have limited efficacy and harmful side effects, which call for the search for alternatives from natural sources. The inhibition of dipeptidyl peptidase‐4 (DPP‐4) activity increases the level of glucagon‐like peptide‐1 and glucose‐dependent insulinotropic polypeptide, which in turn reduces hyperglycemia by activating insulin secretion and inhibiting glucagon secretion. Some studies have reported the in vitro DPP‐4 inhibitory potential of functional foods, but there is no repository of information on these reports. This article is an attempt to present in concise form, reports of functional foods with DPP‐4 inhibitory potentials in vitro. This will guide the use of these foods as well as in antidiabetic drug development.

Highlights • Unresolved previous infection as major cause of recurring tuberculosis (TB) in Ghana. • Genomic epidemiology identifies high relapse among recurrent TB cases in Ghana. • 15-locus MIRU-VNTR typing is sufficient to predict the cause of TB recurrence. • Evidence of recent household-related TB transmission in Ghana. • Need for increased education by national TB control program., Objective To retrospectively investigate the cause of recurring tuberculosis (rcTB) among participants with pulmonary TB recruited from a prospective population-based study conducted between July 2012 and December 2015. Methods Mycobacterium tuberculosis complex isolates obtained from rcTB cases were characterized by standard mycobacterial genotyping tools, whole-genome sequencing, and phylogenetic analysis carried out to assess strain relatedness. Results The majority (58.3%, 21/36) of study participants with rcTB episodes had TB recurrence within 12 months post treatment. TB strains with isoniazid (INH) resistance were found in 19.4% (7/36) of participants at the primary episode, of which 29% (2/7) were also rifampicin-resistant. On TB recurrence, an INH-resistant strain was found in a larger proportion of participants, 27.8% (10/36), of which 40% (4/10) were MDR-TB strains. rcTB was attributed to relapse (same strain) in 75.0% (27/36) of participants and 25.0% (9/36) to re-infection. Conclusion Our findings indicate that previous unresolved infectiondue to inadequate treatment, may be the major cause of rcTB.

Women of advanced reproductive age (ARA) constitute a growing proportion globally, as more women delay entry into motherhood, in a bid to accommodate their educational and career goals. Social, economic and technological realities propel women to postpone childbearing to a later and more convenient age. What are the maternal outcomes of such delays? This paper reviewed studies that have examined the association between advanced reproductive age and maternal health outcomes. It also attempts to develop a conceptual framework regarding relationship between ARA and maternal outcomes. The Google Scholar search engine was used to search for published studies on the subject in the last ten years. A total of 40 studies were sampled, of which the majority were retrospective studies, using secondary data, in particular health institutes reports. Only 17% of the studies was conducted in Nigeria, and none by social scientists. Ninety percent (90%) of the studies reviewed, established that advanced reproductive age predisposes women to adverse reproductive events. Some of the maternal, and per-natal outcomes include; spontaneous abortion, pre-eclampsia, eclampsia, gestational diabetes, antepartum hemorrhage, postpartum hemorrhage, intrauterine growth restriction, obstructed labour, caesarean delivery, placenta abruption and, congenital abnormalities. Others are, – low birth weight, fetal distress, mal-presentation, perinatal lacerations, preterm births, stillbirth, early neonatal death, perinatal and maternal mortality. The study recommends the needs for sociological studies to compliment the discourse on ARA and the maternal health outcomes from the social angle.

Vegetation variation offers significant information for environmental planning, management, sustainability and prompts caution of ecosystem degradation, particularly for the semiarid regions. Normalized difference vegetation index (NDVI) discloses the coverage growth situation, biomass and photosynthesis strength of vegetation and land-cover alterations. Wavelet was used to decompose NDVI time series into subseries at various timescales. This study used a multi-resolution analysis in association with Mann–Kendall and Sen’s Slope at 95% confidence interval to determine the trends in vegetation dynamics at the Upper East Region (UER) of Ghana. GIMMS NDVI3g time series was used to evaluate the performance of the vegetation at seasonal, interannual and intraannual timescale from 1982 to 2015. The results showed that the variability in NDVI in the region is annually significant. At the seasonal level, the whole surface area showed negative vegetation trend. In terms of the intraannual changes, 11.76% of the surface area showed critical patterns. At the interannual scale, results revealed that 4.40% of the surface area demonstrated significant patterns, while 95.60% indicated nonsignificant pattern. Overall, there was negative performance in the vegetation growth from 1982 to 2015. The 16.6% decrease in vegetation dynamics can be attributed to anthropogenic activities. The results from this study would benefit and provide helpful assistance to water resources managers, agricultural and ecological development officers for sustainable planning of UER.

BACKGROUND: Buruli ulcer is a neglected tropical disease caused by Mycobacterium ulcerans infection that damages the skin and subcutis. It is most prevalent in western and central Africa and Australia. Standard antimicrobial treatment with oral rifampicin 10 mg/kg plus intramuscular streptomycin 15 mg/kg once daily for 8 weeks (RS8) is highly effective, but streptomycin injections are painful and potentially harmful. We aimed to compare the efficacy and tolerability of fully oral rifampicin 10 mg/kg plus clarithromycin 15 mg/kg extended release once daily for 8 weeks (RC8) with that of RS8 for treatment of early Buruli ulcer lesions.METHODS: We did an open-label, non-inferiority, randomised (1:1 with blocks of six), multicentre, phase 3 clinical trial comparing fully oral RC8 with RS8 in patients with early, limited Buruli ulcer lesions. There were four trial sites in hospitals in Ghana (Agogo, Tepa, Nkawie, Dunkwa) and one in Benin (Pobè). Participants were included if they were aged 5 years or older and had typical Buruli ulcer with no more than one lesion (caterories I and II) no larger than 10 cm in diameter. The trial was open label, and neither the investigators who took measurements of the lesions nor the attending doctors were masked to treatment assignment. The primary clinical endpoint was lesion healing (ie, full epithelialisation or stable scar) without recurrence at 52 weeks after start of antimicrobial therapy. The primary endpoint and safety were assessed in the intention-to-treat population. A sample size of 332 participants was calculated to detect inferiority of RC8 by a margin of 12%. This study was registered with ClinicalTrials.gov, NCT01659437.FINDINGS: Between Jan 1, 2013, and Dec 31, 2017, participants were recruited to the trial. We stopped recruitment after 310 participants. Median age of participants was 14 years (IQR 10-29) and 153 (52%) were female. 297 patients had PCR-confirmed Buruli ulcer; 151 (51%) were assigned to RS8 treatment, and 146 (49%) received oral RC8 treatment. In the RS8 group, lesions healed in 144 (95%, 95% CI 91 to 98) of 151 patients, whereas lesions healed in 140 (96%, 91 to 99) of 146 patients in the RC8 group. The difference in proportion, -0·5% (-5·2 to 4·2), was not significantly greater than zero (p=0·59), showing that RC8 treatment is non-inferior to RS8 treatment for lesion healing at 52 weeks. Treatment-related adverse events were recorded in 20 (13%) patients receiving RS8 and in nine (7%) patients receiving RC8. Most adverse events were grade 1-2, but one (1%) patient receiving RS8 developed serious ototoxicity and ended treatment after 6 weeks. No patients needed surgical resection. Four patients (two in each study group) had skin grafts.INTERPRETATION: Fully oral RC8 regimen was non-inferior to RS8 for treatment of early, limited Buruli ulcer and was associated with fewer adverse events. Therefore, we propose that fully oral RC8 should be the preferred therapy for early, limited lesions of Buruli ulcer.FUNDING: WHO with additional support from MAP International, American Leprosy Missions, Fondation Raoul Follereau France, Buruli ulcer Groningen Foundation, Sanofi-Pasteur, and BuruliVac.

Background: In high-income countries, mortality related to hospitalized patients with the Coronavirus disease 2019 (COVID-19) is approximately 4-5% However, data on COVID-19 admissions from sub-Saharan Africa are scanty Objective: To describe the clinical profile and determinants of outcomes of patients with confirmed COVID-19 admitted at a hospital in Ghana Methods: A prospective study involving 25 patients with real time polymerase chain reaction confirmed COVID-19 admitted to the treatment centre of the University Hospital, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana from 1st June to 27th July, 2020 They were managed and followed up for outcomes Data were analysed descriptively, and predictors of mortality assessed using a multivariate logistic regression modelling Results: The mean age of the patients was 59 3 ± 20 6 years, and 14 (56%) were males The main symptoms at presentation were breathlessness (68%) followed by fever (56%) The cases were categorized as mild (6), moderate (6), severe (10) and critical (3) Hypertension was the commonest comorbidity present in 72% of patients Medications used in patient management included dexamethasone (68%), azithromycin (96%), and hydroxychloroquine (4%) Five of 25 cases died (Case fatality ratio 20%) Increasing age and high systolic blood pressure were associated with mortality Conclusion: Case fatality in this sample of hospitalized COVID-19 patients was high Thorough clinical assessment, severity stratification, aggressive management of underlying co-morbidities and standardized protocols in-country might improve outcomes © 2021 Bioexcel Publishing LTD All rights reserved

Microalgae have been widely used for treatment of swine wastewater. However, the research on combined treatment of refractory pollutants ammonia nitrogen, Cu (II) and antibiotics from swine...

Tuberculosis (TB), an airborne infectious disease caused by Mycobacterium tuberculosis complex (MTBC), remains a global health problem. West Africa has a unique epidemiology of TB that is characterized by medium- to high-prevalence. Moreover, the geographical restriction of M. africanum to the sub-region makes West Africa have an extra burden to deal with a two-in-one pathogen. The region is also burdened with low case detection, late reporting, poor treatment adherence leading to development of drug resistance and relapse. Sporadic studies conducted within the subregion report higher burden of drug resistant TB (DRTB) than previously thought. The need for more sensitive and robust tools for routine surveillance as well as to understand the mechanisms of DRTB and transmission dynamics for the design of effective control tools, cannot be overemphasized. The advancement in molecular biology tools including traditional fingerprinting and next generation sequencing (NGS) technologies offer reliable tools for genomic epidemiology. Genomic epidemiology provides in-depth insight of the nature of pathogens, circulating strains and their spread as well as prompt detection of the emergence of new strains. It also offers the opportunity to monitor treatment and evaluate interventions. Furthermore, genomic epidemiology can be used to understand potential emergence and spread of drug resistant strains and resistance mechanisms allowing the design of simple but rapid tools. In this review, we will describe the local epidemiology of MTBC, highlight past and current investigations toward understanding their biology and spread as well as discuss the relevance of genomic epidemiology studies to TB control in West Africa.

Germ cells are physically coupled to somatic support cells of the gonad during differentiation, but this coupling must be disrupted when they are mature, freeing them to participate in fertilization. In mammalian females, coupling occurs via specialized filopodia that project from the ovarian follicular granulosa cells to the oocyte. Here, we show that signaling through the epidermal growth factor receptor (EGFR) in the granulosa, which becomes activated at ovulation, uncouples the germ and somatic cells by triggering a massive and temporally synchronized retraction of the filopodia. Although EGFR signaling triggers meiotic maturation of the oocyte, filopodial retraction is independent of the germ cell state, being regulated solely within the somatic compartment, where it requires ERK-dependent calpain-mediated loss of filopodia-oocyte adhesion followed by Arp2/3-mediated filopodial shortening. By uncovering the mechanism regulating germ-soma uncoupling at ovulation, our results open a path to improving oocyte quality in human and animal reproduction., Uncoupling of mature oocytes from somatic granulosa cells is required for their fertilization. Here the authors show that activation of EGFR signalling in granulosa cells during ovulation triggers ERK-dependent loss of filopodia oocyte adhesion, and Arp2/3 mediated retraction of granulosa cell filopodia.

Objectives. This study aimed to describe the prevalence of ergonomic factors associated with computer vision syndrome (CVS), and knowledge and practices of computer usage among bank workers in the Cape Coast Metropolis, Ghana. Methods. A comprehensive eye examination was performed for 139 bankers in the Cape Coast Metropolis. Measurements of ergonomic practices at workstations were carried out and self-administered questionnaires were used to collect socio-demographic data, symptoms of CVS and associated factors as well as knowledge, attitudes and practices of the bankers on CVS. Descriptive statistics and logistic regression were carried out to compute the different proportions and relevant associations. Results. Headaches (73.4%), eyestrain (65.5%) and itching (63.3%) were the most common reported symptoms. The prevalence of CVS in the study population was 71.2% with a high level of poor ergonomic practices (78.4%) at computer workstations. With regard to knowledge, attitudes and practices of the participants on CVS, 68.3% of the participants had low levels of knowledge on CVS, while 90.6% had negative attitudes towards CVS and 46.0% of the participants had poor practices. Conclusion. Bankers had a high prevalence of CVS. Ergonomic practices, females and computer usage were all associated significantly with the presence of CVS.

Findings from previous comparative genomics studies of the Mycobacterium tuberculosis complex (MTBC) suggest genomic variation among the genotypes may have phenotypic implications. We investigated the diversity in the phenotypic profiles of the main prevalent MTBC genotypes in West Africa. Thirty-six whole genome sequenced drug susceptible MTBC isolates belonging to lineages 4, 5 and 6 were included in this study. The isolates were phenotypically characterized for urease activity, tween hydrolysis, Thiophen-2-Carboxylic Acid Hydrazide (TCH) susceptibility, nitric oxide production, and growth rate in both liquid (7H9) and solid media (7H11 and Löwenstein–Jensen (L-J)). Lineage 4 isolates showed the highest growth rate in both liquid (p = 0.0003) and on solid (L-J) media supplemented with glycerol (p

ContextAvailable molecular epidemiological data from recent studies suggest significant genetic variation between the different phylogenetic lineages of Mycobacterium tuberculosis complex (MTBC) and the MTBC lineages might have adapted to different human populationsAimThis study sought to determine the phylogenetic population structure of clinical MTBC isolates from the Volta Region of Ghana.MethodsThe MTBC isolates obtained from collected sputum samples were characterized by standard methods. Non-tuberculous mycobacterial isolates were characterized by amplification of the heat shock protein 65 (hsp65) gene and sequencing. The drug susceptibility profiles of the MTBCs determined using GenoType MTBDRplusResultsOne hundred and seventeen (117, 93.6%) out of 125 mycobacterial positive isolates were characterized as members of the MTBC of which M. tuberculosis sensu stricto (MTBss) and M. africanum (Maf) were respectively 94 (80.3%) and 23 (19.7%). In all, 39 distinct spoligotype patterns were obtained; 26 for MTBss and 13 for Maf lineages. Spoligotyping identified 89 (76.04 %) Lineage 4, 16 (13.7 %) Lineage 5, 7 (6.0%) Lineage 6, 3 (2.6%) Lineage 2, 1(0.9%) Lineage 3 and 1 (0.9%) Lineage 1. Among the Lineage 4 isolates, 62/89 (69.7%) belonged to Cameroon sub-lineage, 13 (14.6%) Ghana, 8 (9.0%) Haarlem, 2 (2.2%) LAM, 1 (1.1%) Uganda I, 1 (1.1%) X and the remaining two were orphan. Significant localization of Maf was found within the Ho municipality (n=13, 29.5%) compared to the more cosmopolitan Ketu-South/Aflao (n=3, 8.3%) (p-value= 0.017). Eight (8) non-tuberculous mycobacteria were characterized as M. abscessus (7) and M. fortuitum (1)ConclusionWe confirmed the importance of M. africanum lineages as a cause of TB in the Volta region of Ghana.Key MessageThe phylogenetic population structure obtained agrees with previously described prevalence of M. tuberculosis complex phylogenetic lineages from other regions of Ghana. It also confirms the stable prevalence of M. africanum as an important human TB causing pathogen in Ghana.

Background: There is limited evidence that syndesmotic implant removal (SIR) is beneficial. However, many surgeons advocate removal based on studies suggesting improved motion. Methodologic difficulties make the validity and applicability of previous works questionable. The purpose of this study was to examine the effect of ankle dorsiflexion after SIR using radiographically measured motion before and after screw removal utilizing a standardized load. Methods: All patients undergoing isolated SIR were candidates for inclusion. Dorsiflexion was measured radiographically: (1) immediately before implant removal intraoperatively, (2) immediately after removal intraoperatively, and (3) 3 months after removal. A standardized torque force was applied to the ankle and a perfect lateral radiograph of the ankle was obtained. Four reviewers independently measured dorsiflexion on randomized, deidentified images. A total of 29 patients met inclusion criteria. All syndesmotic injuries were associated with rotational ankle fractures. There were 11 men (38%) and 18 women (62%). The mean, and standard deviation, age was 50.3 ± 16.9 years (range 19-80). Results: The mean ankle dorsiflexion pre-operatively, post-operatively, and at a 3-month follow-up was 13.7 ± 6.6 degrees, 13.3 ± 7.3 degrees and 11.8 ± 11.3 degrees, respectively ( P = .466). For subsequent analysis, 5 patients were excluded because of the potential confounding effect of retained suture button devices. Analysis of the remaining 24 patients (and final analysis of 21 patients who had complete 3-month follow-up) demonstrated similar results with no statistically significant difference in ankle dorsiflexion at all 3 time points. Conclusion: Removal of syndesmotic screws may not improve ankle dorsiflexion motion and should not be used as the sole indication for screw removal. Level of Evidence: Level II, prospective cohort study.

Background and Objectives: Increasing the number of underrepresented minority (URM) physicians improves access and quality of care. URMs are more likely to practice primary care and work in underserved communities. The racial and ethnic diversity of family physicians lags behind the general population. To create a more diverse residency, the Boston Medical Center Family Medicine Residency Program (BMCFMRP) developed, implemented, and evaluated a strategic plan for diversity recruitment. Methods: In academic year (AY) 2014-2015, we set goals to increase the number of URM applicants and the percentage of matched URMs. From 2014-2017, we implemented an intervention focused on: (1) increasing outreach to URM candidates, (2) revising interviews to minimize bias, and (3) analyzing recruitment data. Results: From 2014-2017, the total number of URM applicants increased by 80% (61 to 110). Evaluating recruitment trends from 2010-2017, there was a statistically significant increase (P

This study focused on a comparative analysis of exposure to pollution in Ota and Ewekoro Township where we have concentration of industries that emits pollutant to the air. This was with a view to proffer solution to the negative effects of industrial activities on residents within industrial location. The study involved empirical observation and interview of residents. About 652 questionnaires were administered randomly on the residents. Analysis involved descriptive statistical tools including chi-square techniques. The results suggest that air pollution was most frequently reported in Ewekoro and Ota and this can help in the prediction of stringent factor in which industrial activities could pose to society. Keyword: Industrial zone, Pollution, Emission, Eco-system

Advancements in nanotechnology have provided insight into the unique opportunities for the application of nanomaterials such as gold nanoparticles (AuNPs) in medicine due to their remarkable properties, which includes low toxicity, large surface area, and the ease of synthesis and conjugation to other molecules. Therefore, AuNPs are often preferred for bio-applications. Citrate-capped AuNPs (cAuNPs) have been reported to be non-cytotoxic and are used in numerous studies as drug delivery vehicles to treat various diseases. However, the limitations of bioassays often used to assess the toxicity of AuNPs have been well documented. Herein, we investigate the cytotoxicity of 14 nm cAuNPs in the human colorectal adenocarcinoma (Caco-2) cell line. Treatment conditions (i.e. dose and exposure time) that were established to be non-toxic to Caco-2 cells were used to investigate the effect of cAuNPs on the expression of a Qiagen panel of 86 genes involved in cytotoxicity. Out of 86 studied, 23 genes were differentially expressed. Genes involved in oxidative stress and antioxidant response, endoplasmic reticulum (ER) stress and unfolded protein response, heat shock response, and lipid metabolism were more affected than others. While low concentrations of 14 nm cAuNPs was not cytotoxic and did not cause cell death, cells treated with these nanoparticles experienced ER and oxidative stress, resulting in the activation of cytoprotective cellular processes. Additionally, several genes involved in lipid metabolism were also affected. Therefore, 14 nm cAuNPs can safely be used as drug delivery vehicles at low doses.

The influence of variability in the biology of living organisms is poorly appreciated in toxicology. However, multiple lines of evidence indicate that sex-differences modulate toxicokinetics and toxicodynamics from cellular/molecular to whole animal levels resulting in different toxic responses of living organisms to xenobiotics exposure. In order to investigate the influence of sex in inorganic mercury (Hg) exposure, male and female Wistar rats were exposed to 0.5, 1.0 and 1.5 mg Hg/kg body weight orally as HgCl2 twice a week for 12 weeks. Higher Hg levels in the females (except heart) as compared to males were observed in the animals. At the highest dose of inorganic Hg, female renal Hg content was 3.3 times higher than that of the males. Mixed sexual dimorphism characterised circulating-lipid- and organ-lipid lipotoxic and non-lipotoxic dyslipidemia. The highest dose of inorganic Hg, induced hypercholesterolemia in the males as opposed to hypocholesterolemia in the female. Plasma and erythrocyte free fatty acids increased in both sexes, although the increase was more pronounced in the male. Reverse cholesterol transport was inhibited in the male at the highest dose of Hg, whereas female HDL became enriched with cholesterol. Female erythrocytes had all their lipids increased, whereas only male erythrocyte triglyceride increased. Brain cholesterol and phospholipids, and splenic phospholipids were depleted in both sexes. Our findings indicate that inorganic Hg exposure appears to affect Hg and lipid kinetics differently in both sexes, thus underscoring the need to develop sex-tailored approaches in the treatment of metal toxicosis and its metabolic outcomes., Highlights • The influence of sex in inorganic Hg exposure was investigated in the rat. • Higher Hg levels in females compared to males were observed. • Sexual dimorphism characterised inorganic Hg-induced dyslipidemia. • Inorganic Hg exposure affects Hg and lipid kinetics differently in both sexes.

This article sought to empirically find out factors behind the rising and falling nature of poverty among rural cashew farmers in the Jaman south district of the Brong Ahafo Region. A sample size of 160 cashew farmers were selected for the study. It was established that nine (9) major factors contribute to the rising level of poverty among the respondents at some point in the year. It is recommended that cashew farmers should be encouraged by the district assembly and other stakeholders to save during the harvesting season as well as borrow from the banks if the need be.

Background: Sputum culture is limited to centralized facilities. Thus, samples require transportation from peripheral laboratories to these facilities, compromising specimen quality since it is difficult to maintain cold chain. We evaluated OMNIgene SPUTUM Reagent (OMS) for transporting sputum samples for tuberculosis (TB) testing. The study was carried out at Noguchi Memorial Institute for Medical Research using sputa from Korle Bu Teaching Hospital and La General Hospital in Ghana. Methods: In a laboratory-based controlled experiment (CE), sputum contaminants were determined on blood agar before treatment with OMS and N-acetyl-L-cysteine-sodium hydroxide (NALC-NaOH). TB testing included smear microscopy, culture, and Xpert MTB/RIF. Afterward, two peripheral laboratories were trained to transport sputum samples with OMS without cold chain. Positivity, negativity, and contamination rates were compared between both methods using Chi-square and Fisher's exact tests. Cohen's Kappa was also used to determine agreements. Results: Among 104 sputum samples analyzed in the CE, 93 (89.4%) had bacterial growth on blood agar before decontamination, while 6 (5.8%) and 5 (4.8%) contaminated after NALC-NaOH and OMS treatment, respectively. Contamination was high with NALC-NaOH (12.8%) than OMS (4.3%) on Lowenstein–Jensen media (P < 0.001), but mycobacterial positivity was comparable: NALC-NaOH of 74.5% and OMS of 78.7%. Smear positivity after NALC-NaOH treatment was 89.4% and OMS was 75.9% (P = 0.491). All except one of the samples tested positive by Xpert MTB/RIF after both treatment. Sixteen samples were evaluated in the field experiment and 81.3% yielded positive culture, and no contamination on LJ was observed. Conclusion: Our findings indicate that OMS works well as a transport and decontaminating reagent of samples for TB testing.

This study investigated gender differences in the use of traditional and complementary medicine (TCM) in Ghana. Using an interviewer-administered questionnaire, we collected data from March to June 2013 from 324 randomly sampled adults in the Ashanti region. The prevalence of TCM use in the prior 12 months was 86 percent. Females constituted the majority (61 percent) of TCM users. Female TCM users were more likely than male users to have had only a basic education, been traders (p ˂ .0001), and have health insurance (p ˂ .05). Using multiple logistic regression, TCM use was associated with urban residence for females (odds ratio [OR] = 7.82; 95 percent confidence interval [CI]: 1.28-47.83) but negatively related for males (OR = 0.032; 95 percent CI: 0.002-0.63). Being self-employed was associated with TCM use among males (OR = 7.62; 95 percent CI: 1.22-47.60), while females' TCM use was associated with higher income (OR = 3.72; 95 percent CI: 1.21-11.48) and perceived efficacy of TCM (OR = 5.60; 95 percent CI: 1.78-17.64). The African sociocultural structure vests household decision-making power in men but apparently not regarding TCM use, and the factors associated with TCM use largely differed by gender. These findings provide ingredients for effective health policy planning and evaluation. Adoption and modernization of TCM should apply a gendered lens.

Whole genome sequencing (WGS) is progressively being used to investigate the transmission dynamics of; Mycobacterium tuberculosis; complex (MTBC). We used WGS analysis to resolve traditional genotype clusters and explored the spatial distribution of confirmed recent transmission clusters. Bacterial genomes from a total of 452 MTBC isolates belonging to large traditional clusters from a population-based study spanning July 2012 and December 2015 were obtained through short read next-generation sequencing using the illumina HiSeq2500 platform. We performed clustering and spatial analysis using specified R packages and ArcGIS. Of the 452 traditional genotype clustered genomes, 314 (69.5%) were confirmed clusters with a median cluster size of 7.5 genomes and an interquartile range of 4-12. Recent tuberculosis (TB) transmission was estimated as 24.7%. We confirmed the wide spread of a Cameroon sub-lineage clone with a cluster size of 78 genomes predominantly from the Ablekuma sub-district of Accra metropolis. More importantly, we identified a recent transmission cluster associated with isoniazid resistance belonging to the Ghana sub-lineage of lineage 4. WGS was useful in detecting unsuspected outbreaks; hence, we recommend its use not only as a research tool but as a surveillance tool to aid in providing the necessary guided steps to track, monitor, and control TB.

The interconnection between men’s sexual behaviour as a contributor to burden of reproductive and sexual health diseases in sub-Saharan Africa are often presented with complex and sophisticated statistical analyses with little or no comprehension among the affected population that are mostly with little or no statistical literacy and education. The study adopted simplicity-parsimony idea as amalgam of simplicity and parsimony theories in analysing the trends and patterns of men’s sexual behaviour in Ethiopia, Nigeria and Zambia, the three countries selected from Eastern, Western and Southern parts of sub-Saharan Africa. Demographic Health Survey male-recode datasets (2000–2014) were used. Simple descriptive statistical techniques at univariate and bivariate levels were conducted. The results highlighted that men’s sexual behaviour are not the same in these regions. The men median sexual debut is 18 (Nigeria and Ethiopia) but 16 in Zambia. The median age at first cohabitation differs: 22 in Zambia and Ethiopia but higher in Nigeria. From 2000/2004 to 2010/2014, cohabitation practice reduced in Ethiopia across all ages but increased among men aged 25–29 (Zambia: 14.7–15.0%, Nigeria: 13.3–13.9%). There were declined in union-turnover in Ethiopia (−8.8%), Nigeria (−11.4%) and Zambia (−9.3%) including condom use; but non-spousal sex increased. The study concludes that the increase in non-spousal sex, non-condom use could have implications for STIs/HIV spread and zero-AIDS deaths agenda in the region. The authors suggest that policy decision-takers focus on non-spousal sex, non-use of condom, and union-turnover as crucial factors in the fight against STIs/HIV in sub-Saharan Africa.

Aim. The aim of this study was to assess the prevalence of computer vision syndrome (CVS) and its associated ergonomic factors among university administrative staff in Ghana. Methods. A cross-sectional survey was conducted among 200 administrative staff of the University of Cape Coast. The procedure included a self-administered questionnaire, comprehensive ocular health examination, and assessment of computer workstation and lighting conditions. The prevalence of CVS among the subjects and the association between CVS and ergonomic practices were determined. Results. The mean age of the study sample was 31.0 ± 4.7 years, and the majority were males (56.0%). The prevalence of CVS was among 103 (51.5%)participants. Over a third of the respondents used computers for 6 or more hours daily. Significant association was found between CVS and poor ergonomic practices (χ = 15.175, p=0.001). Conclusion. In addition to poor ergonomic office setup, university administrative staff spend several hours behind computer screens leading to the development of CVS. Increased awareness of CVS and adherence to recommended ergonomic practices are necessary to reduce the prevalence of CVS and ultimately enhance work satisfaction and productivity.

Cholera remains a major global public health threat and continuous emergence of new Vibrio cholerae strains is of major concern. We conducted a molecular epidemiological study to detect virulence markers and antimicrobial resistance patterns of V. cholerae isolates obtained from the 2012-2015 cholera outbreaks in Ghana. Archived clinical isolates obtained from the 2012, 2014 and 2015 cholera outbreaks in Ghana were revived by culture and subjected to microscopy, biochemical identification, serotyping, antibiotic susceptibility testing, molecular detection of distinct virulence factors and Multi-Locus Variable-Number of Tandem-Repeat Analysis (MLVA). Of 277 isolates analysed, 168 (60.6%) were confirmed to be V. cholerae and 109 (39.4%) isolates constituted other bacteria (Escherichia coli, Aeromonas sobria, Pseudomonas aeruginosa, Enterobacter cloacae and Enterococci faecalis). Serotyping the V. cholerae isolates identified 151 (89.9%) as Ogawa, 3 (1.8%) as Inaba and 14 (8.3%) as non-O1/O139 serogroup. The O1 serogroup isolates (154/168, 91.7%) carried the cholera toxin ctxB gene as detected by PCR. Additional virulence genes detected include zot, tcpA, ace, rtxC, toxR, rtxA, tcpP, hlyA and tagA. The most common and rare virulence factors detected among the isolates were rtxC (165 isolates) and tcpP (50 isolates) respectively. All isolates from 2014 and 2015 were multidrug resistant against the selected antibiotics. MLVA differentiated the isolates into 2 large unique clones A and B, with each predominating in a particular year. Spatial analysis showed clustering of most isolates at Ablekuma sub-district. Identification of several virulence genes among the two different genotypes of V. cholerae isolates and resistance to first- and second-line antibiotics, calls for scaleup of preventive strategies to reduce transmission, and strengthening of public health laboratories for rapid antimicrobial susceptibility testing to guide accurate treatment. Our findings support the current WHO licensed cholera vaccines which include both O1 Inaba and Ogawa serotypes.

Category: Ankle Introduction/Purpose: There is limited evidence that removal of syndesmotic implants is beneficial. Despite this, many surgeons advocate removal based on previous studies suggesting improved ankle dorsiflexion. Methodologic difficulties make the validity and applicability of previous works questionable. The purpose of this study was to examine the effect of ankle dorsiflexion after syndesmotic implant removal using radiographic measurements of ankle dorsiflexion before and after screw removal utilizing a standardized, applied load. Methods: All patients undergoing isolated syndesmotic implant removal were consented for participation. Ankle dorsiflexion was measured radiographically at three different time points: (I) immediately before implant removal intraoperatively, (II) immediately after implant removal intraoperatively and (III) approximately three months after implant removal. A standardized dorsiflexion torque force of 33.4 newton-meter (Nm) was applied to the ankle by a research assistant using a tensiometer at these time points and a perfect lateral radiograph of the ankle was obtained. Four reviewers independently measured ankle dorsiflexion on randomized, deidentified and blinded images using a digital measurement tool. Chi-square tests were used for categorical variables. Paired T-test or analysis of variance (ANOVA) with repeated measures was used for continuous variables. Intra-class correlation coefficients (ICC) were calculated using a 2-way random effects model and the absolute agreement definition. Results: 29 patients met inclusion criteria and were enrolled in the study. There were 11 men (38%) and 18 women (62%). The mean, and standard deviation, age was 50.3 ± 16.9 years (range 19-80). The mean ankle dorsiflexion pre-operatively, post-op and at 3 month follow up was 13.7°± 6.6°, 13.3°±7.3° and 11.8°±11.3°, respectively (p=0.466). For subsequent analysis, 5 patients were excluded due to potential cofounding effect of retained suture button devices. Analysis of the remaining 24 patients demonstrated similar results with no statistically significant difference in ankle dorsiflexion at all three time points. Conclusion: Removal of syndesmotic screws does not improve ankle dorsiflexion motion and should not be used as an indication for screw removal.

Cypermethrin (CYP), a synthetic pyrethroid is a common environmental toxicant owing to its wide usage as a broad-spectrum insecticide. Its exposure to non-target organisms, including man, elicits numerous adverse effects making it a major public health issue. Epicatechin (EC) has proven anti-oxidative and anti-inflammatory properties. The present study was undertaken to evaluate the protective efficacy of epicatechin with regards to altered oxidative and inflammatory parameters subsequent to CYP treatment in rats. Animals were divided into four groups. The first group served as the control, while groups 2, 3, and 4 were orally treated with EC (30 mg kg−1 body weight), CYP (25 mg kg−1 body weight), and CYP plus EC, respectively. Oral administration of CYP for 14 days increased the levels of oxidative stress markers such as malondialdehyde, lipid hydroperoxides, and advanced oxidized protein products in the liver and kidney. These were accompanied by a decrease in glutathione and total antioxidant capacity levels. The activity of the enzyme superoxide dismutase was increased while catalase and glutathione peroxidase activities were decreased in these organs. Moreover, CYP increased plasma levels of the pro-inflammatory cytokines, interleukin-6 and tumor necrosis factor alpha. The plasma content of the nitrative nucleic acid marker, 8-nitroguanine was also markedly elevated by CYP. Administration of EC to CYP-exposed rats mitigated the induced oxidative and inflammatory effects. These data suggest that EC can attenuate the toxic effects induced by CYP exposure.

Background: We aimed to evaluate the whether AFP levels alone is an adequate screening indicator, or a combination of Generally, alpha-fetoprotein (AFP), CA19-9 and CEA could provide a better diagnostic tool in detecting and screening asymptomatic patients with primary hepatic cancer (PHC), and also evaluate the correlation of degree of differentiation with serum biomarker levels. Methods: We retrospectively reviewed the medical records of 1362 patients form 2014-2018 who visited the first Affiliated Hospital of Zhejiang University, Hangzhou, China for health check-ups or were diagnosed with cancer or cirrhosis. We then analyzed preoperative tumor markers level of AFP, CA19-9, and CEA. The standard reference values (AFP ≤20 ng/L CEA ≤ 5 ng/L, and CA19-9 ≤ 37 U/mL) were as positive or negative cut off values. Further, the histological sections of patients were categorized and correlated them with the three serum biomarkers. Results: Serum AFP, CEA, and CA19-9 levels in the PHC group were significantly higher compared to those with liver cirrhosis and healthy control groups (P < 0.03). With AFP as a single tumor marker for PHC diagnosis, it had a sensitivity of 63.3% with a specificity of 80.8%. AFP combined with CA19-9 and CEA showed specificity of 100%, a sensitivity 2.5% with the positive and negative predictive values of 100% and 22% respectively. Furthermore, histological evaluation revealed the highest AFP level of 9366.14±23902.61 ng/L associated with poorly differentiated HCC, while well-differentiated HCC, had the lowest mean AFP level of 45.19±181.27 ng/L. Conclusion: Combined serum levels of AFP, CA19-9 and CEA does not provide a superior advantage over AFP alone as a screening and diagnostic tool for HCC detection.

Context Available molecular epidemiological data from recent studies suggest significant genetic variation between the different lineages of Mycobacterium tuberculosis complex (MTBC) and the MTBC lineages might have adapted to different human populations. Aim This study sought to determine the population structure of clinical MTBC isolates from the Volta Region of Ghana. Methods The MTBC isolates obtained from collected sputum samples were identified by PCR detecting of IS6110 and genotyped using spoligotyping. Non-tuberculous mycobacterial isolates were characterized by amplification of the heat shock protein 65 (hsp65) gene and sequencing. The drug susceptibility profiles of the MTBCs determined using GenoType MTBDRplus. Results One hundred and seventeen (117, 93.6%) out of 125 mycobacterial positive isolates were characterized as members of the MTBC of which M. tuberculosis sensu stricto (MTBss) and M. africanum (MAF) were respectively 94 (80.3%) and 23 (19.7%). In all, 39 distinct spoligotype patterns were obtained; 26 for MTBss and 13 for MAF lineages. Spoligotyping identified 89 (76%) Lineage 4, 16 (13.6%) Lineage 5, 7 (6.0%) Lineage 6, 3 (2.6%) Lineage 2, 1(0.9%) Lineage 3 and 1 (0.9%) Lineage 1. Among the Lineage 4 isolates, 62/89 (69.7%) belonged to Cameroon sub-lineage, 13 (14.7%) Ghana, 8 (9.0%) Haarlem, 2 (2.2%) LAM, 1 (1.1%) Uganda I, 1 (1.1%) X and the remaining two (2.2%) were orphan. Significant localization of MAF was found within the Ho municipality (n = 13, 29.5%) compared to the more cosmopolitan Ketu-South/Aflao (n = 3, 8.3%) (p-value = 0.017). Eight (8) non-tuberculous mycobacteria were characterized as M. abscessus (7) and M. fortuitum (1). Conclusion We confirmed the importance of M. africanum lineages as a cause of TB in the Volta region of Ghana.

Cataracts are the leading cause of blindness worldwide. Current methods for discriminating cataractous lenses from healthy lenses of Sprague-Dawley rats during preclinical studies are based on either histopathological or clinical assessments which are weakened by subjectivity. In this work, both cataractous and healthy lens tissues of Sprague-Dawley rats were studied using multispectral imaging technique in combination with multivariate analysis. Multispectral images were captured in transmission, reflection and scattering modes. In all, five spectral bands were found to be markers for discriminating cataractous lenses from healthy lenses; 470 nm and 625 nm discriminated in reflection mode whereas 435 nm, 590 nm and 700 nm discriminated in transmission mode. With Fisher’s Linear discriminant analysis, the midpoints for classifying cataractous from healthy lenses were found to be 14.718 × 10−14 and 3.2374 × 10−14 for the two spectra bands in the reflection mode and the three spectral bands in the transmission mode respectively. Images in scattering mode did not show significant discrimination. These spectral bands in reflection and transmission modes may offer potential diagnostic markers for discriminating cataractous lenses from healthy lenses thereby promising multispectral imaging applications for characterizing cataractous and healthy lenses.

Summary We spoligotyped and screened 1490 clinical Mycobacterium tuberculosis complex strains from Northern and Greater Accra regions of Ghana against INH and RIF using the microplate alamar blue phenotypic assay. Specific drug resistance associated genetic elements of drug resistant strains were analyzed for mutations. A total of 111 (7.5%), 10 (0.7%) and 40 (2.6%) were mono-resistant to INH, RIF, and MDR, respectively. We found the Ghana spoligotype to be associated with drug resistance (INH: 22.1%; p = 0.0000, RIF: 6.2%; p = 0.0103, MDR: 4.6%; p = 0.0240) as compared to the Cameroon spoligotype (INH: 6.7%, RIF: 2.4%, MDR: 1.6%). The propensity for an isolate to harbour katG S315T mutation was higher in M. tuberculosis (75.8%) than Mycobacterium africanum (51.7%) (p = 0.0000) whereas the opposite was true for inhApro mutations; MAF (48.3%) compared to MTBSS (26.7%) (p = 0.0419). We identified possible novel compensatory INH resistance mutations in inhA (G204D) and ahpCpro (-88G/A and -142G/A) and a novel ndh mutation K32R. We detected two possible rpoC mutations (G332R and V483G), which occurred independently with rpoB S450L, respectively. The study provides the first evidence that associate the Ghana spoligotype with DR-TB and calls for further genome analyses for proper classification of this spoligotype and to explore for fitness implications and mechanisms underlying this observation.

Laser-induced autofluorescence (LIAF), combined with multivariate techniques, has been used to discriminate a cataractous lens from healthy lens tissues. In this study, 405 nm and 445 nm were used as excitation sources to induce the autofluorescence. Results show higher autofluorescence intensity in cataractous lens tissues than in healthy ones. Cataractous lens tissues show a red shift of 0.9 nm and 1.2 nm at 405 nm and 445 nm excitations, respectively. Using principal component analysis (PCA), three principal components (PCs) gave more than 99% variability for both 405 nm and 445 nm excitation sources. Based on the three PCs, Fisher’s linear discriminant model was developed. An accuracy of 100% was obtained in classifying the lens tissues using Fisher’s linear discriminant analysis (FLDA). The LIAF technique assisted by PCA and FLDA may be used for objective discrimination of cataractous lens from healthy lens tissues of Sprague–Dawley rats.

[Background]: Bovine tuberculosis (bTB) caused by Mycobacterium bovis is a re-emerging problem in both livestock and humans. The association of some M. bovis strains with hyper-virulence, MDR-TB and disseminated disease makes it imperative to understand the biology of the pathogen., [Methods]: Mycobacterium bovis (15) among 1755 M. tuberculosis complex (MTBC) isolated between 2012 and 2014 were characterized and analyzed for associated patient demography and other risk factors. Five of the M. bovis isolates were whole-genome sequenced and comparatively analyzed against a global collection of published M. bovis genomes., [Results]: Mycobacterium bovis was isolated from 3/560(0.5%) females and 12/1195(1.0%) males with pulmonary TB. The average age of M. bovis infected cases was 46.8 years (7-72years). TB patients from the Northern region of Ghana (1.9%;4/212) had a higher rate of infection with M. bovis (OR = 2.7,p = 0.0968) compared to those from the Greater Accra region (0.7%;11/1543). Among TB patients with available HIV status, the odds of isolating M. bovis from HIV patients (2/119) was 3.3 higher relative to non-HIV patients (4/774). Direct contact with livestock or their unpasteurized products was significantly associated with bTB (p, [Conclusion]: Our data indicate potential zoonotic transmission of bTB in Ghana and hence calls for intensified public education on bTB, especially among risk groups., This work was supported by the Wellcome Trust Intermediate Fellowship awarded to DYM (Grant Number 097134/Z/11/Z).

BackgroundDiabetes Mellitus (DM) is a known risk factor for tuberculosis (TB) but little is known on TB-Diabetes Mellitus (TBDM) co-morbidity in Sub-Saharan Africa.MethodsConsecutive TB cases registered at a tertiary facility in Ghana were recruited from September 2012 to April 2016 and screened for DM using random blood glucose and glycated hemoglobin (HbA1c) level. TB patients were tested for other clinical parameters including HIV co-infection and TB lesion location. Mycobacterial isolates obtained from collected sputum samples were characterized by standard methods. Associations between TBDM patients' epidemiological as well as microbiological variables were assessed.ResultsThe prevalence of DM at time of diagnosis among 2990 enrolled TB cases was 9.4% (282/2990). TBDM cases were significantly associated with weight loss, poor appetite, night sweat and fatigue (pConclusionOur findings confirms the importance of screening for diabetes during TB diagnosis and highlights the association between genetic diversity and diabetes. in Ghana.

The main aim of the study was to explore the attitudes and health perceptions of faith healing users in Kumasi Metropolis, Ghana. This has become necessary because faith healing practice is an important area but remains neglected in the health care literature. In an age when biowestern medicine is touted as the cure for most diseases, understanding how and why individuals seek alternative treatment, specifically faith healing modalities may help to develop more effective health care interventions.We employed exploratory study design of purely qualitative research approach involving 40 conveniently selected participants from four different purposively selected faith healing centres to get a maximum variation of experiences and opinions on the time of consultation, perceived effectiveness and challenges of faith healing practices in Ghana. In-depth interviews were conducted from 10th June to 30th July, 2017. Data were thematically analysed and presented based on the a posteriori inductive reduction approach.The main findings were that faith healers served as the first port of call for disease curing and prevention for most users. Consumers of faith healing perceived their health status to be good due to the perceived effectiveness of faith healing for curing of health problems. However, users faced challenges such as stigmatisation and victimisation in seeking health care.This study has provided the first baseline evidence in this important area of inquiry that has been neglected in the scholarly discourse in Ghana. By implication, users' positive attitudes and perceptions toward faith healing call for integration policies that allow formal medical services to have open idea to faith healing practices in Ghana.

Background The main aim of the study was to explore the attitudes and health perceptions of faith healing users in Kumasi Metropolis, Ghana. This has become necessary because faith healing practice is an important area but remains neglected in the health care literature. In an age when biowestern medicine is touted as the cure for most diseases, understanding how and why individuals seek alternative treatment, specifically faith healing modalities may help to develop more effective health care interventions. Methods We employed exploratory study design of purely qualitative research approach involving 40 conveniently selected participants from four different purposively selected faith healing centres to get a maximum variation of experiences and opinions on the time of consultation, perceived effectiveness and challenges of faith healing practices in Ghana. In-depth interviews were conducted from 10th June to 30th July, 2017. Data were thematically analysed and presented based on the a posteriori inductive reduction approach. Results The main findings were that faith healers served as the first port of call for disease curing and prevention for most users. Consumers of faith healing perceived their health status to be good due to the perceived effectiveness of faith healing for curing of health problems. However, users faced challenges such as stigmatisation and victimisation in seeking health care. Conclusion This study has provided the first baseline evidence in this important area of inquiry that has been neglected in the scholarly discourse in Ghana. By implication, users’ positive attitudes and perceptions toward faith healing call for integration policies that allow formal medical services to have open idea to faith healing practices in Ghana.

The shoulder is a common area for traumatic injury in the adolescent football player. The most common areas of injury include the acromioclavicular (AC) joint, sternoclavicular joint (SC), and glenohumeral joint. The AC joint is susceptible to sprains, fractures, and dislocations, often termed as “separated shoulder,” most commonly following a direct blow injury such as a fall onto the shoulder. The SC joint is rarely injured, but posterior SC joint dislocations do occur and can be life threatening and thus require accurate and prompt diagnosis and treatment. The glenohumeral joint can dislocate following traction injuries to the outstretched arm which may require sideline reduction and eventual surgical repair. Proper diagnosis and treatment of these injuries requires an understanding of the anatomy and physiology of the adolescent athlete as well as the anticipated outcomes following treatment.

The present study was designed to investigate aluminium phosphide (ALP)-induced testicular toxicity, including its effects on sperm parameters and histological alterations in Wistar rats, and the possible protective role of hesperidin (HSD). Oral administration of ALP at 1.15 mg/kg body weight (1/10 LD50) for 30 days resulted in a significant increase in testicular malondialdehyde, lipid hydroperoxides, and oxidized protein levels. These indicators of oxidative stress were accompanied by decreased activity of the antioxidant enzymes superoxide dismutase, catalase and glutathione peroxidase, followed by a drastic reduction in the non-enzymatic antioxidant indices of glutathione and total antioxidant capacity when compared to control. Furthermore, ALP treatment produced a marked reduction in sperm count, motility and viability while increasing abnormal sperm morphology and adverse histopathological changes in testis. Co-administration with HSD significantly ameliorated ALP-induced testicular damage by suppressing oxidative stress indices and enhancing antioxidant status while also improving the sperm parameters and histological alterations in ALP-treated rats. The results of the present study indicated that testicular toxic effects of ALP are due to oxidative imbalance and that HSD could be a potential therapeutic agent against ALP-induced testicular damage.

C1q/tumor necrosis factor-related protein 6 (CTRP6) is a newly identified adiponectin paralog with modulating effects on metabolism and inflammation. CTRP6 transcript is detected in human ovarian tissue. However, the expression pattern and function of CTRP6 on ovary have been rarely studied. In the present study, we preliminarily examined the structure feature and function of CTRP6 in porcine granulosa cells. The results indicated that the signaling peptide of CTRP6 was located at among positions 21 and 22, and the phosphorylation sites were at 15 (Ser), 4 (Thr) and 4 (Tyr), respectively. Meanwhile, CTRP6 was extremely homologous in livestock and chiropteran. The qPCR results showed that CTRP6 was moderately expressed in porcine follicle. Immunohistochemistry manifested that CTRP6 was presented in various types of ovarian cells. Immunofluorescence revealed that CTRP6 was located in cytoplasm in primary porcine granulosa cells. ELISA results showed that the concentration of CTRP6 in the follicular fluid was gradually decreased with the growth of antral follicle. In addition FSH increased CTRP6 expression levels in a time- and dose-dependent manner in primary porcine granulosa cells, while LH had no effect on CTRP6 basal gene expression, which suggesting CTRP6 is an FSH-responsive gene in porcine granulosa cells. Our findings imply that the CTRP6 may be a candidate gene to regulate folliculogenesis and reproductive performance.

Stephen Osei-Wusu,1,2 Michael Amo Omari,3 Adwoa Asante-Poku,1 Isaac Darko Otchere,1 Prince Asare,1 Audrey Forson,3 Jacob Otu,4 Martin Antonio,4 Dorothy Yeboah-Manu1 1Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Ghana; 2West Africa Centre for Cell Biology of Infectious Pathogens, University of Ghana, Legon, Ghana; 3Department of Chest Diseases, Korle-Bu Teaching Hospital, Accra, Ghana; 4Medical Research Council Unit, Fajara, The Gambia Background: Drug resistance surveillance is crucial for tuberculosis (TB) control. Therefore, our goal was to determine the prevalence of second-line anti-TB drug resistance among diverse primary drug-resistant Mycobacterium tuberculosis complex (MTBC) isolates in Ghana. Materials and methods: One hundred and seventeen MTBC isolates with varying first-line drug resistance were analyzed. Additional resistance to second-line anti-TB drugs (streptomycin [STR], amikacin [AMK] and moxifloxacin [MOX]) was profiled using the Etest and GenoType MTBDRsl version 2.0. Genes associated with resistance to AMK and MOX (gyrA, gyrB, eis, rrs, tap, whiB7 and tlyA) were then analyzed for mutation. Results: Thirty-seven (31.9%) isolates had minimum inhibitory concentration (MIC) values ≥2µg/mL against STR while 12 (10.3%) isolates had MIC values ≥1 µg/mL for AMK. Only one multidrug-resistant (MDR) isolate (Isolate ID: TB/Nm 919) had an MIC value of ≥0.125 µg/mL for MOX (MIC = 3 µg/mL). This isolate also had the highest MIC value for AMK (MIC = 16µg/mL) and was confirmed as resistant to AMK and MOX by the line probe assay GenoType MTBDRsl version 2.0. Mutations associated with the resistance were: gyrA (G88C) and rrs (A514C and A1401G). Conclusion: Our findings suggest the need to include routine second-line anti-TB drug susceptibility testing of MDR/rifampicin-resistant isolates in our diagnostic algorithm. Keywords: tuberculosis, drug resistance, diagnosis, Ghana, XDR

There is consensus over the possibility of improved wealth situation leading to fertility decline. However, the likelihood of fertility decline leading to a significant improvement in wealth situation remains a subject of intense debate. This study examines the current pattern of linkages between fertility behaviour and wealth situation in Nigeria in an attempt to contribute to the debate. The study used the 2013 Nigeria Demographic and Health Survey data. Analysis involved use of descriptive statistical tools at univariate and bivariate levels while at multivariate level we used ordinary least square and hierarchical regression techniques. Results suggest that the contribution of the fertility behaviour indicators to the variance in wealth status, demonstrated through the R-square change in women and men hierarchical regression models that controlled for selected confounding variables, was almost zero percent (1 %). Although the individual fertility behaviour indicators exhibited some significant association with wealth status, the beta coefficients were visibly small in magnitude compared to the magnitude observed in the unadjusted OLS regression models. Thus, the current data suggest that the role of fertility behaviour in wealth status in Nigeria among women and men is not as important as other social, spatial and economic forces prevailing in the country. The study concludes that we have to seek explanation for the poor wealth situation in Nigeria in other factors other than fertility behaviour.

The general objective of this study was to evaluate community pharmacists’ participation in primary health care as well as to assess community pharmacists’ knowledge of primary health care and determine their level of participation in health promotion, disease prevention and curative primary health care activities in Lagos, Nigera. A total of 120 community pharmacists were used for this study. Data was collected through the use of a self completion questionnaire given to community pharmacists in their premises and collected on the spot or after some time. Analysis was done through the use of Microsoft SPSS Version 10. This study revealed that most of the community pharmacists are aware of primary health care (95.8%), even though they do not know much of its history (26.6%). Participation in the different components of primary health care i.e. in health promotion, disease prevention and in curative primary health care services was very high. However, participation in immunization services was very low (14.1%) and many of them agreed that their participation in PHC could further be improved through continuous education and training in primary health care programmes (91.6%). Community pharmacists participate actively in primary health care activities in Lagos State, Nigeria. A large number of community pharmacists are aware of primary health care and have undergone training in primary health care activities mostly at the undergraduate level, though only a few have undergone refresher course in primary health care. The community pharmacists participate actively in health promotion mostly in the provision of drug information services, tobacco/alcohol cessation services as well as other health promotion services as well as in disease prevention activities. The community pharmacists also participate actively in disease treatment as a first contact health care provider. Key words: Community pharmacy, primary health care, community pharmacists, participation.

Aim: Fruit extracts of Apple (Malus domestica), coconut (Cocos nucifera) and cucumber (Cucumis sativus) were tested for their antidiabetic potential in rats with fructose-induced insulin resistance for 28 days. Study Design: In-vivo antidiabetic study using fructose-induced insulin resistant rats. Place and Duration of Study: Department of Biochemistry, Lagos State University, Ojo, Lagos, Nigeria, between March and May 2014. Methodology: Wistar rats were randomized into 5 groups comprising 5 animals each. Group A (control) was fed on standard rat chow and distilled water ad libitum while Groups B-E were fed standard rat chow and 10% w/v fructose. Groups C-E were also administered 500 mg/kg body weight of apple, coconut and cucumber extracts for 28 days. At the end of the experiment, all animals were sacrificed and the serum glucose, lipid profile and electrolytes were determined. Results: The fructose-fed rats had significantly decreased weight and increased blood glucose concentration (P < 0.05), when compared to the control rats. The fructose-fed rats also witnessed significant increase (P < 0.05) in total cholesterol and low density lipoprotein cholesterol (LDLC) concentration as well as significant decrease (P < 0.05) in the high density lipoprotein (HDLC) and serum electrolytes concentration compared to control. Administration of the aqueous extracts of apple, coconut and cucumber to the fructose-fed rats significantly increase (P < 0.05) their body weights, HDLC and serum electrolytes’ concentration in the rats while significantly reducing (P < 0.05) blood glucose, total cholesterol and LDLC. Conclusions: Aqueous extracts of apple, coconut and cucumber displayed antidiabetic effect, but apple exhibited the most potent effect as it ameliorates most of the derangements observed in insulin-resistant rats.