Conceptual Barricades to Coronavirus Disease 2019 Biomedical Waste Management

Biomedical waste management (BMWM) is a major environmental health concern. Corona Virus Disease 2019 (COVID-19) pandemic came as bolt from the blue for governance with negligible preparedness. Pandemic COVID-19 has led to generation of solid waste in large volumes. Such BMW is an additional challenge in COVID-19 situation for healthcare facilities supplementary to COVID-19 pandemic management, control and prevention strategies. Centre for Pollution Control Board (CPCB) issued guidelines for COVID-19 related BMW waste in 3rd week of March 2020 and subsequently revised the same on 25th March 2020 and then on 18th April 2020. Scenario becomes compounded with less literate workers handling BMW required to develop newer competencies with deficient training and timeframe. Lots has been done to prepare COVID-19 related BMW waste management and lots still needs to be done to cover all the guidelines including practicality of implementation and ensuring less compromise on quality healthcare. This article focuses to review the COVID-19 related revised BMW requirements and their critical appraisal.

Cellular Inflammatory Indices in Hospitalized Nigerian COVID-19 Patients

The pandemicity of coronavirus disease 2019 (COVID-19) necessitated its novel biomarkers in prognosis and monitoring in low resource settings. Changes in total white blood cell counts have been associated with the progression of diseases. This study determined the prognostic value of some cellular inflammatory cells and their indices in relation to duration of hospital admission, gender, and age of COVID-19 patients. This longitudinal and case–control study determined blood cell components (total white blood cells (TWBC), neutrophil, lymphocyte, monocyte, and platelet) and inflammatory indices (neutrophil lymphocyte ratio [NLR], lymphocyte monocyte ratio [LMR], platelet lymphocyte ratio [PLR], derived NLR [DNLR], and systemic immune inflammatory index [SII]) in 95 symptomatic hospitalized COVID-19 patients and 45 COVID-19 free controls. These parameters were related to age, sex, and days of admission of the patients. Blood samples obtained were analyzed using hematological autoanalyzer (Sysmex XN-450) and indices calculated. Data were analyzed using the Statistical Package for the Social Sciences (SPSS Inc., USA) version 20.0. The mean platelet count (P = 0.016) and PLR (P = 0.000) were significantly lower while TWBC counts (P = 0.013) were significantly increased in COVID-19 patients compared with control. The mean TWBC count (P = 0.030) and SII (P = 0.029) were significantly increased while lymphocyte count (P = 0.015) and LMR (P = 0.026) were significantly decreased in COVID-19 patients at discharge compared with COVID-19 patients at admission. The mean neutrophil count (P = 0.048), PLR (P = 0.015), and SII (P = 0.022) were significantly lower while mean lymphocyte count (P = 0.026) was significantly higher in COVID-19 patients aged <40 years compared with patients aged ?40 years. This study concluded that inflammatory response is a phenomenon in COVID-19 patients especially in patients ?40 years of age and that this inflammation persist till discharge, though gender has no influence on cellular inflammatory indices of COVID-19 patients.

Vascular Endothelial Growth Factor, Pigment Epithelium-derived Factor, and Renal Function Determinants in Type 2 Diabetics in Kaduna, Northern Nigeria: A Case–Control Study

Context: the role of vascular endothelial growth factor (VEGF) and pigment epithelium-derived factor (PEDF) on renal function of diabetics is unclear. Objective: This study investigated the relationship between VEGF, PEDF and urea, creatinine and estimated glomerular filtration rate (eGFR) in type 2 diabetics. Materials and Methods: 100 type 2 diabetics and 50 controls were recruited into this case-control study. Analytes were determined by standard methods. Statistical significance was set at p<0.05 and 95% Confidence interval. Results: VEGF, PEDF (p=0.0001), urea (p=0.024) and creatinine (p=0.026) were significantly higher in diabetics than controls but eGFR was comparable (p>0.05) in both groups. VEGF and PEDF were comparable (p>0.05) in the diabetics with eGFR<60 ml/min and >60 ml/min. Renal function parameters did not correlate with either VEGF or PEDF. Conclusion: plasma VEGF and PEDF are higher in diabetics but there seem to be no association between renal function determinants and either VEGF and PEDF.

Practice of Breast Self-Examination among Female Students of Chukwuemeka Odumegwu Ojukwu University, Awka

ABSTRACT: Background: Breast self examination (BSE) is a fairly reliable procedure for early detection of breast cancer especially in limited resource countries where access to and availability of mammography is inadequate. BSE helps women to be familiar with their breasts and increases awareness of breast cancer and breast cancer screening modalities like Clinical breast examination (CBE) and Mammography. This study aims at testing the knowledge base of our female tertiary students on breast cancer in addition to knowledge, attitude and practice of BSE. Methods: A cross-sectional descriptive study based on self-administered pre-tested questionnaire on the knowledge, attitude and practice (KAP) of Breast self examination (BSE) among females of a tertiary institution. Data were analyzed using the IBM Statistical Package for Social Sciences (SPSS) version 21. Results: A 284 female student with mean age of 20.8±3.3 years participated in the study. 98.6% have heard of breast cancer, with media and books being the commonest source of information. Only 60.0% of the participants had been taught BSE, with commonest source of teaching being teachers and parents. Above half of the participants (55.6%) practiced BSE with only 8.1% ever discovered abnormality. There was significant association between practice of BSE and being taught BSE or hearing about BSE (p < 0.001). Conclusion: The knowledge of breast self examination among the study participants acquired largely through books and media though very high but the level of practice is still very low. There is significant association between knowledge and teaching of BSE with the practice of BSE.

Self-Induced Stomal Obstruction Post-LAGB – A Case Report

Laparoscopic adjustable gastric banding (LAGB) is an effective surgical tool for the management of morbid obesity. Many complications are associated with this operation. This case report presents a rarely encountered complication following LAGB wherein a patient self-induced stomal obstruction. The patient was managed on outpatient basis by band deflation. This case stresses on the importance of proper information sharing with the patients who undergo surgical operations.

Facial Medial Dermoid Cyst – A Case Report.

A facial medial dermoid cyst in a 7-year-old male child is presented along with its Computed tomography (CT) imaging scans. The CT scan images depict clear nasal bone indentation with no erosion. Dermoid cysts are a subset of benign heterotopic neoplasms termed choristomas and periorbital dermoid cysts account for up to 9-10% of paediatric of head and neck dermoid cysts. The periorbital dermoid may occur in two variants as per the plane of location: anterior (superficial) or deep. The presented case in this report is of anterior variety at frontonasal suture.

Diabetes Mellitus and Epilepsy: A Comparative Quality of Life Study

Background: Diabetes mellitus and epilepsy are two of the most frequent, chronic diseases affecting many millions of people around the world. Both diseases can cause long-term and acute complications that adversely affect the sufferers’ lives. Objective: The purpose was to compare the quality of life (QoL) of patients suffering from diabetes or epilepsy in relation to the general population in Greece. Methodology: A matched-control prospective design was used with a sample consisting of three sub-groups (i.e., 30 patients with diabetes, 30 with epilepsy, and 30 healthy volunteers) matched for age, gender, and socioeconomic status. Data were collected through SF-36. Statistical analysis was performed using the SPSS v.21 and both descriptive and inferential statistics were employed. The x2, the Mann–Whitney, and the Kruskal–Wallis test were employed for group comparisons at a significance level of <0.05. Results: The sample’s mean age was 52 years, range 48–65, and the majority was women (i.e., 60). There were no statistically significant differences among the three subcategories for an educational level or income level for the three sub-groups (P < 0.05). The mean SF-36 scores per domain for each group are as follows: Diabetes: Mean: 48.46, SD =15.83, Median: 50.2, Mode: 70.6. For Epilepsy Mean: 52.92, SD =17.37, Median: 52.7, Mode: 81.6 and Healthy volunteers Mean: 70.47, SD =14.97, Median: 69, Mode: 86.6. Thus, the general population has a higher mean, that is, 70.47 compared to diabetics 48.46 and epileptics 52.92. All comparisons were statistically significant (P < 0.05) except for the Pain, Health Vitality, and Mental Health domains (P > 0.05). Discussion: The findings highlight the impact of both diabetes and epilepsy on the QoL in Greece. Patients with DM may feel challenged by their disease and the tiring daily management of their medication and lifestyle changes. Similarly, patients with epilepsy are facing daily anxiety and practical difficulties related to their diagnosis. Both patent groups carry the constant stress of not knowing of when their condition will manifest itself with either a seizure or a hypo/hyperglycemic reaction. Conclusions: Results have shown that the general population has a better QoL than diabetic and epileptic patients. Of course, we should bear in mind that the difference in results between the three categories of the sample is minimal; thus, there is no difference in the QoL of diabetics and epileptics in the general population.

Anti-Toxoplasma gondii Antibodies: Prevalence and Risk Factors among Pregnant Women Accessing Antenatal Care in Some Primary Health Centers in Jos Metropolis, Nigeria

Toxoplasma gondii infection causes high rate of gestational and congenital infection across the globe and is considered a both a public health problem and a neglected disease. The study was carried out to determine the prevalence of anti-Toxoplasma gondii antibodies and the associated risk factors among pregnant women attending antenatal care in some Primary Health Centres in Jos, Plateau State, Nigeria. In this cross-sectional study carried out within 5 months between Jan – May 2019, a total of 182 blood samples were collected from consenting pregnant women. Structured questionnaire was used to obtain data on socio-demography and risk factors. Three millilitres (3 ml) of blood samples were collected from the study participants. Sera were separated from the blood and evaluated for anti-Toxoplasma gondii antibodies (IgG and IgM) using enzyme-linked immunosorbent assay (ELISA). The data collected from the experiment were analysed using Statistical Package for the Social Sciences. Out of the 182 samples examined, 84 (46.2%) had anti-Toxoplasma gondii IgG antibody, 2 (1.1%) had IgM antibody while 98 (53.4%) were neither seropositive for IgG nor IgM. Trimester of pregnancy was significantly associated with prevalence of anti-Toxoplasma IgM antibody. In conclusion, Toxoplasmosis is prevalent in Jos. Eleven out of every 1000 women (i.e. 1.1%) had recent toxoplasmosis and 53.4% were not protected against primary infection thereby underscoring the need for prevention and control during pregnancy through enlightenment.

Transabdominal Preperitoneal Patch Plasty versus Open Lichtenstein Hernia Repair – A Study

A study to compare the outcomes of laparoscopic transabdominal preperitoneal patch plasty (TAPP) and open Lichtenstein repair in the management of inguinal hernia was carried out at the Department of Surgery, SKIMS Medical College, Bemina, Srinagar, Kashmir, India, from June 2017 to December 2018. Sixty patients with inguinal hernia were enrolled in the study. It was a type of non-randomized prospective cohort study, wherein 30 patients were treated with TAPP and 30 with open Lichtenstein repair. Patients were studied since admission till discharge and followed for 2 years in the outpatient department. Mean operation time in TAPP was higher than the Open Lichtenstein Repair, but the overall complications were higher in the latter. Patients with inguinal hernias who underwent repair by TAPP approach had significantly better post-operative courses than those who undergo open Lichtenstein repair.

Internet of Diagnostic Things: Emerging Horizon towards Precision and Digital Health Care

Digital revolution and advancement of information technologies, smart phone industry, multi-omic technologies, availability with 5G networks and emergence of big data era has greatly impacted on diagnostic, biomedical and e-healthcare sectors. Intelligent sensors, wearable, digital imaging, smart phone based diagnostic and connected networking provides smart approach and platform towards precision diagnostics. Recently, Internet of Things (IoT) have shown remarkable impact on diverge sectors such as digital imaging, smart sensing, digital diagnostic, digital biotech, telemedicine, precision farming, lab-on phone, smart home, smart city planning, smart retails and Research and Development (R&D) automation etc. Application of IoT technology in diagnostic and healthcare opens a way for personalization in the medical care depending on individual needs, additionally giving option for well-organized way for remote healthcare and management. This review focuses on theoretical, technological, advanced aspects of digital diagnostic utilizing IoT technology. Furthermore, we have also highlighted the opportunities and challenges for IoT in exploring the futuristic scope and innovation in diagnostic application. IoT based diagnostic, sensing and imaging devices provides unprecedented precision, automation in the diagnostic and thereby could significantly improve the biomedical and e-healthcare area.