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Background: Due to its affordability in disease-affected communities and suitability for field application, microscopy has historically been considered the gold standard for field diagnosis of trypanosomosis in rural settings., Aim: This works aims to compare the performance of microscopists on bovine trypanosome microscopy by organizing the first comparative assessment on a correct reading of slides by laboratory professionals using the read slide results and a structured interviewer-administered questionnaire in North-central Nigeria., Methods: Ten participants were addressed, as they were sent a panel of two slides (Slide 1: No Trypanosome present; Slide 2: Trypanosome present) and a questionnaire., Results: All participants greater than 41 years old reported correctly the presence and absence of parasites on slides. Only 3/8 of microscopists from routine diagnostic laboratories reported correctly the presence of the parasite., Conclusion: Our study confirmed errors in reading slides. Therefore, training of microscopists besides a nationwide quality assessment is recommended., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper.

Background: Cervical cerclage is the procedure of choice for preventing preterm delivery due to cervical insufficiency. The indication for its application may be based on the woman's reproductive history, findings at ultrasound, or clinical findings on vaginal examination. Pregnancy outcomes from these indications are variable according to the available literature., Objective: To compare the effectiveness and reproductive outcomes (miscarriage, preterm birth rates, and birth weights) of McDonald's cervical cerclage after history-indicated and ultrasound-indicated cervical cerclage in pregnant women., Methods: The retrospective cohort study was conducted at Life International Hospital Awka, Nigeria and Life Specialist Hospital Nnewi, Nigeria. Pregnant women, who had a McDonald's cervical cerclage performed due to either history or ultrasound indication between January 1, 2011, and December 31, 2020, were included in the study. Women with multiple pregnancies and those with physical examination-indicated or emergency cerclages were excluded. The main outcome measures included the prevalence of cervical cerclage, miscarriage, and preterm delivery rates. Outcomes were compared between groups with the chi-square test, Fisher's exact test, or Student's t test. p value of < 0.5 was set as significant value., Results: Overall, during the study period, 5392 deliveries occurred in the study sites, of which 103 women had a history-indicated or ultrasound-indicated cervical cerclage. This resulted in a 1.91% prevalence rate for history-indicated and ultrasound-indicated cervical cerclage. Of these, 68 (66%) had history indicated, while 35 (34%) had ultrasound-indicated cerclage. There was no difference in the sociodemographic characteristics of both groups. Both groups had similar miscarriage rates: 1.18 in 1000 and 1.04 in 1000 deliveries, respectively (RR 1.160, 95% CI: 0.3824 to 3.5186, p = 0.793). There was more preterm delivery in history-indicated cerclage than ultrasound-indicated cervical cerclage (26.50% vs. 17.10%; p = 0.292), though the difference was not statistically significant. The ultrasound group had a higher average birthweight than the history group (2.67 ± 0.99 vs. 2.53 ± 0.74). However, this difference was not statistically significant., Conclusion: The effectiveness and reproductive outcomes (miscarriage, preterm birth rates, and birth weights) of pregnant women with cervical cerclage due to history-indicated and ultrasound-indicated cervical cerclage appear similar. When needed, cervical cerclage should be freely applied for cervical insufficiency, irrespective of the type of indication., Competing Interests: None of the authors has a conflict of interest., (Copyright © 2023 Joseph Ifeanyichukwu Ikechebelu et al.)

This study aimed to evaluate the pregnancy rates, adverse reactions, and medication costs of two luteal phase support regimens: oral dydrogesterone and micronized vaginal progesterone (MVP) pessary in in vitro fertilization cycles. A randomized open-label trial with participants randomly assigned to either 400 mg MVP twice daily or 10 mg dydrogesterone three times daily. The primary endpoints were pregnancy rates, and the secondary endpoints included tolerance, miscarriage rates, and medication cost. Per-protocol principle analysis was performed. The baseline characteristics of the 162 participants were similar. Dydrogesterone had statistically similar (p>0.05) positive pregnancy test rates fifteen days post embryo transfer (35.8% vs . 32.7%), clinical pregnancy rates at the gestational age of 6 weeks (32.1% vs . 28.8%), ongoing pregnancy rates (26.4% vs . 23.1%) and miscarriage rates at 14 weeks of gestation (9.2% vs . 9.4%) and safety profile to MVP. Dydrogesterone was better tolerated as vaginal itching was significantly more prevalent in the MVP arm (p=0.008). Dydrogesterone is significantly less expensive than MVP pessary. Oral dydrogesterone and MVP pessary had similar pregnancy rates and adverse effects. Dydrogesterone appears more user-friendly and less expensive in cases of luteal-phase support in in vitro fertilization cycles., Competing Interests: The authors declare no conflict of interest., (©2022 JOURNAL of MEDICINE and LIFE.)

Purpose: This study evaluated the biochemical effects of ethanol leaves extract on Wistar rats and also shed light on its constituents and phytonutrients., Methods: The ethanolic extract of J. secunda leaves was prepared using conventional methods. Then, proximate and phytochemical analyses of the extracts were carried out using several methods previously reported in the literatures. The biochemical studies were also carried out as reported in previous literatures., Results: The ethanolic leaves extract contains appreciable quantities of phytonutrients and micronutrients as well as phytochemical constituents. The LD 50 of the extract was determined to be 3800mg/kg body weight. There was a dose-dependent elevation of the blood sugar in comparison with the control. There was no significant increase on the bilirubin and liver enzymes levels or on the haematological parameters of the lab animals. The extract significantly elevated the lipid profile (P value < 0.0001), the glomerular filtration rate (increased creatinine and blood urea levels - P value < 0.0001), the serum electrolytes and the animals' weight. There was a significant decrease in the anion gap (P value < 0.01)., Conclusion: The ethanol leaf extract of Justicia secunda has negative cardiac and renal effects on Wistar rats, causing increased lipid profile values, creatinine and blood urea levels in the experimental animals compared with control. The LD 50 is below the safety level. Caution should be exercised as the biochemical profiles of cardiac and renal effects do not seem to be promising and the LD 50 is below the safety level., Competing Interests: The authors declare that they have no competing interests., (© 2020 Onochie et al.)

Background and Aim: Newcastle disease (ND) virus of free-range turkeys may be linked to outbreaks of ND in backyard chickens seen during Harmattan in Enugu State in Southeast Nigeria. This study aimed to determine the prevalence of ND virus and (NDV) detect NDV in the feces of free-range, domestic turkeys in Enugu, Nigeria., Materials and Methods: A total of 569 serum and 569 cloacal swab samples were collected from adult turkeys in selected households that keep turkeys and chickens together in the study area. The serum samples were assayed for antibodies against NDV using the hemagglutination inhibition (HI) test, whereas the cloacal samples were subjected to virus detection using a hemagglutination (HA) test., Results: A total of 186 serum samples (32.7%) were positive for NDV and 383 (67.3%) were negative. Of the 186 NDV-positive serum samples, 138 (74.2%) had HI titers ≥ 8. The remaining 48 (25.8%) serum samples had HI titers <8. NDV was detected from the cloacal swabs of turkeys with NDV -positive serum samples., Conclusion: The turkeys in this study were not previously vaccinated with the NDV vaccine; thus, those with NDV -positive serum samples and virus shedding in their feces may be potential risks to chickens reared in the same households as well as on commercial farms in the area. Those turkeys with sera negative for NDV are regarded to be at risk if they encounter a virulent strain of NDV. Regular vaccination of turkeys against the NDV is advised, especially in backyard farms, where turkeys are reared together with chickens and other species of poultry., (Copyright: © Okoroafor, et al.)

The emergence and spread of Carbapenem-resistant Enterobacteriaceae (CRE) is seriously posing threats in effective healthcare delivery. The aim of this study was to ascertain the emergence of CRE at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital (COOUTH) Awka. Biological samples were collected from 153 consenting patient from 5 clinics in the hospital. The isolates were identified using standard microbiological protocols. Susceptibility to meropenem was done using Kirby-Bauer disc diffusion method on Mueller Hinton Agar. A total of 153 patients were recruited in this study. About one half of those from rural, 63.64% from Sub-urban and 42.27% from urban areas had significant E. coli and Klebsiella spp infections. The male: female ratio of the Enterobacteriaceae infection was 1:1. Almost as much inpatient as outpatient study participants had the infections. The infections were observed mostly on participants with lower educational status. The unmarried individuals were most infected compared to their married counterparts. Enterobacteriaceae infection rate was 50.98%. Of this, 28.21% had CRE infection while the overall prevalence of the CRE in the studied population was 14.38% (22/153). This study shows that CRE is quickly emerging in both community and hospital environments. Klebsiella spp was the most common CRE in this hospital especially Klebsiella oxytoca . Hospitalization was a strong risk factor in the CRE infections. Rapid and accurate detection is critical for their effective management and control.

This study examined whether the association between age and the three burnout dimensions (emotional exhaustion, depersonalisation and reduced personal accomplishment) depend on the extent of nursing professionals' use of emotion-focused coping strategy. Participants were 283 nurses (Mage = 35 years, SD = 8.17, Range = 23-66 years) from a tertiary healthcare institution in south-eastern Nigeria. They completed self-report measures of relevant variables in paper and pencil form. Increased age was associated with reduced personal accomplishment for nurses with high emotion-focused coping, but not for those who were low or moderate in use of emotion-focused coping. Such moderation effects were not found for emotional exhaustion and depersonalisation. Findings clarify the conditions under which age may be associated with reduced sense of achievement at work among nursing professionals. The study adds to knowledge in combating burnout in nursing and could guide health managers in developing strategies that might prevent or ameliorate nurses' burnout.

Purpose: To determine mother-to-child transmission (MTCT) rate and associated risk factors of human immune-deficiency virus (HIV) among HIV-infected pregnant women with term premature rupture of membranes (PROM) in comparison with those without PROM at term., Materials and Methods: All optimally managed HIV-positive pregnant women of Nnamdi Azikiwe University Teaching Hospital, on highly active anti-retroviral therapy (HAART) who had PROM at term were enrolled. Maternal HIV-1 viral load was not assessed. Follow up was for a minimum of 18 months for evidence of HIV infection., Results: Of the 121 women with PROM at term, 46 (38.0%) were HIV sero-positive, 22/46 (47.8%) of which had their babies followed up till 18 months. The mean latency period was 10.5 ± 5.3 h in PROM group. Apart from duration of PROM (OR = 0.01; 95%CI = 0.00-0.13; p < 0.001), there were no differences in risk factors seen between cases and controls (p > 0.05). Of the 22 (47.8%) babies followed-up in the PROM group and 13 in non-PROM group, none tested positive to HIV, given an MTCT rate of 0%., Conclusions: MTCT rate was 0% following term PROM and in women without PROM. Since maternal HIV-1 viral load was not assessed, we need to be critical while interpreting the findings.

Complex partial seizure complicated by psychiatric comorbidities like depression and conduct disorder presents management challenges for both the physician and parents. The etiology of such psychiatric comorbidities may be related to the seizure or to several other unrelated risk factors. The psychiatric comorbidities and the seizure affects the child's activities of daily living and are often a source of worry to parents and school authorities A high index of suspicion and a multidisciplinary approach are essential in the management of the affected adolescents.

Background: The National Health Insurance Scheme (NHIS), operated majorly in Nigeria by health maintenance organisations (HMOs), took off formally in June 2005. In view of the inherent risks in the operation of any social health insurance, it is necessary to efficiently manage these risks for sustainability of the scheme. Consequently the risk-management strategies deployed by HMOs need regular assessment. This study assessed the risk management in the Nigeria social health insurance scheme among HMOs., Materials and Methods: Cross-sectional survey of 33 HMOs participating in the NHIS., Results: Utilisation of standard risk-management strategies by the HMOs was 11 (52.6%). The other risk-management strategies not utilised in the NHIS 10 (47.4%) were risk equalisation and reinsurance. As high as 11 (52.4%) of participating HMOs had a weak enrollee base (less than 30,000 and poor monthly premium and these impacted negatively on the HMOs such that a large percentage 12 (54.1%) were unable to meet up with their financial obligations. Most of the HMOs 15 (71.4%) participated in the Millennium development goal (MDG) maternal and child health insurance programme., Conclusions: Weak enrollee base and poor monthly premium predisposed the HMOs to financial risk which impacted negatively on the overall performance in service delivery in the NHIS, further worsened by the non-utilisation of risk equalisation and reinsurance as risk-management strategies in the NHIS. There is need to make the scheme compulsory and introduce risk equalisation and reinsurance.