Market Vendor’s Poor Adherence to Sops for COVID-19: A Potential Source for Transmission of the Virus to the Local Communities. A Case Study of Sironko District

Introduction: COVID-19 is one of the huge health burdens on the earth in the recent times. Massive campaigns on the adherence to standard operation procedures (SOPs) have been emphasized by the Government of Uganda and even the county has been put in two lockdowns to curtail the spread of this disease. Despite all these efforts, market vendors in Sironko district have seemingly not complied with these SOPs and this makes them potential hotspot for disease transmission, but no qualitative study has so far been documented. Therefore, the current study investigated the adherence of SOPs for COVID-19 amongst market vendors in this area. Methodology: A qualitative survey research design was adopted and a total of 53 participants, selected by both purposeful and simple random were involved. Interview, focus group discussion and observations techniques were used in data collection. The date was analyzed by the statistical software called MedCalc, version 20.0008 Results: The result showed that 65 % were females, most were aged between 29 females aged between 31-40 year took part in the study contributing 55% to the total subjects and married and of which 37 (70 %) were married. The market experienced challenges of inadequate & inappropriate facilities for SOPs but water was abundant (45, 85 %). All the SOPs for COVID-19 were flouted in these markets. Conclusions: Market vendor rarely adhered to SOPs for COVID-19 and this makes them a potential source for transmission of COVID-19 to the local communities in the entire sub-regions. Therefore, there is need for department of production in Sironko district to re-enforce observance to SOPs guidelines for COVID-19 in this area.

Intervention is Urgently Needed to Address Poor Awareness of South Asian Family Caregivers for Dementia Care: A Qualitative Study

Introduction: “The National Dementia Strategies” in Canada emphasizes improving the knowledge of formal and informal caregivers for better care for the person living with dementia. Aim: This study aimed at exploring awareness and the attitudes of South Asian Bangladeshi family caregivers towards dementia care. Methods: It was purposive sampling and a qualitative study. The study included 45 family caregivers (>55 years) for the face-to-face interviews in Toronto, Ontario. The study used semi-structured questions. The duration of the data collection was between February and March 2020. Results: The study included the three areas related to dementia, such as a) the awareness of dementia, b: awareness of prevention and treatment as well as the awareness of caregivers about what is needed for better dementia care, and c) attitudes of caregivers towards dementia care. Many caregivers described dementia as memory loss and forgetfulness. According to the caregivers, anxiety, depression, and aging were the risk factors of dementia. The caregivers commonly perceived dementia as an unpreventable and incurable disease. Moreover, many caregivers did not know about the appropriate health providers who diagnosed and treated dementia, and they were not aware of non-pharmacological care of dementia. The caregivers perceived dementia as a shameful disease. They would not go for diagnosis if they had risks for dementia and would hide their dementia after diagnosis. Many caregivers confessed that training was essential to improve knowledge about dementia, but they did not want to be a caregiver for the person living with dementia. Conclusion: The South Asian Bangladeshi family caregivers had not enough awareness about dementia, prevention, and treatment. Dementia was associated with shame, and they had less interest in dementia care. Urgent educational training is needed in their language to improve knowledge, reduce stigma, engage them in dementia care, and achieve the goals of the National Dementia Strategies.

The Magnitude and Risk Factors of Acute Respiratory Distress Syndrome among Newborn Admitted To Neonatal Intensive Care Unit at Benghazi Medical Center

Background: Hyaline Membrane Disease (HMD)/Respiratory Distress Syndrome (RDS) is the most common lung condition affecting premature babies. The inadequate amount of surfactant causes alveoli to collapse when the baby breathes out. It is hard for your baby to re-inflate the collapsed alveoli when he breathes. The lack of surfactant and resulting inflammation is called. Hyaline Membrane Disease (HMD)/Respiratory Distress Syndrome (RDS). Aim of the Study: To determine the magnitude of Hyaline membrane disease or respiratory distress syndrome and identify the risk factors and complication among newborn babies in neonatal intensive care unit at Benghazi medical center (BMC). Materials and Methods: Case series study. The study was conducted during the period between March 2017 to March 2018 of HMD cases at Benghazi medical center. A convenient sample of 120 cases diagnosed as HMD. Studied variables include the following; gestational age, birth weight, gender, type of pregnancy and type of delivery also the data for mothers such as (diabetes mellitus, preeclampsia hypothyroidism, receiving of Dexamethasone injection and premature rupture of membrane). Also investigation and treatment and finally the outcomes of babies. Statistical Methods: Data were analyzed with SPSS version 17, analysis of associations was made with application Chi - square test for categorical variables comparison, was applied for test of association P <0.25. P was considered statistically significant if ≤ 0.05. Results: Female gender was predominant (52%). Most of cases of HMD were between 1000 -2000 kg. Among the 120 cases we have (15%) sever HMD and the majority of cases have moderate –to sever Hyaline membrane disease 39 (32.5%) whereas very sever HMD were observed in nearly 27% of cases. The risk factors were history of maternal preeclampsia, maternal diabetes mellitus, prematurity and low birth weight babies and neonatal sepsis, all these were found to be very common risk factors of HMD. Pearson chi-square test p value highly significant of female gender with complications of HMD. Our results observed more than half of babies were died. Conclusion: The risk factors were history of maternal preeclampsia, maternal diabetes mellitus, prematurity and low birth weight babies and neonatal sepsis all these were found to be very common risk factors of HMD. Also we concluded that the cases had premature rupture of membrane, which identified as risk factors of hyaline membrane disease. Furthermore, we concluded that highly significant of female gender with complications of HMD, such as Pneumothorax, bronco pulmonary, dysplasia, intra ventricular hemorrhage and congenital heart diseases were common co- morbidities with respiratory distress syndrome, all these could be have an association with the development of hyaline membrane disease, finally we observed more than half of babies were died this is a warning sign for health services.

Assessment of the Associated Risk Factors of Chronic Low Back Pain among Bankers in Port Harcourt Metropolis: A Cross-Sectional Study

Background: Working condition is a factor that does not only affect productivity but also the health of the workers. Aim: This study aimed to evaluate some of the associated risk factors of chronic low back pain among bank workers in Port Harcourt Metropolis of Rivers State in Nigeria. Methods: The study employed a cross-sectional design. A questionnaire was used to obtain information on chronic back pain among the bank 313 workers. Results: 165(52.7%) of the respondents have previously been treated for low back pain. They resorted to using different means of treatment for the pain; 24.8% (massage), 15% (exercise), 47.3% (drugs) 4.2% (surgery) and 8.5% (bed rest). 119 (38.1%) had a history of high blood pressure whereas 193 (61.9%) have not, 66 (21.2%) had a history of diabetes mellitus whereas 246 (78.8%) had not, 26 (8.3%) had sickle cell anemia whereas 286 (91.7%) do not, 55 (17.6%) had a history of convulsion whereas 257 (82.4%) do not, 93(29.8%) have had blood transfusion whereas 219 (70.2%) have not. The frequencies of chronic back pain bank workers and the associated risk factors were; road traffic accident 42 (22.7%), work-related stress (70.7%), use of computer 155 (84.7%), heavy lifting of equipment 83 (45.8%), and lack of exercise 55 (30.1%). Conclusion: These findings show that some individuals having chronic back pain had some underlying conditions which could predispose them to have the pain.

Distal 3rd Diaphysial Fracture of Humerus Fixed with Dynamic Compression Plate Using Posterior Approach- The Assessment of the Outcome

Objectives: The effectiveness of open reduction and Dynamic Compression Plate (DCP) fixation with or without autogenous bone grafting using the posterior midline approach in the treatment of distal third diaphyseal humeral fractures was assessed. Methods: For humeral nonunion, comminuted fractures, or early failure of conservative therapies, 33 patients (24 men, 9 women; mean age 37 years; range 20 to 60 years) were operated on. The study was carried out at Dhaka Medical College Hospital (DMCH), Dhaka from July 2005 to December 2006. Results: After an average of 17 weeks, all of the patients had union (range 14 to 26 weeks).There was no deep infection, nonunion, malunion, implant failure, or nerve injury in any of the patients. In two cases, transient radial nerve palsy occurred. Minor infections were seen in four of the individuals. All of the patients were pain-free after surgery.The functional outcome was outstanding in all instances and good in 16 patients, yielding 87 % satisfying results. Functional outcomes increased considerably postoperatively compared to preoperatively (p<0.001). In 20 individuals, the range of motion of the shoulders was great. The range of motion at the elbow was considerable in 21 patients and moderate in seven others. More than three-quarters of the patients (75.8%) experienced no problems. Four patients (12.1%) were infected, and two patients (6.1%) developed iatrogenic radial nerve palsy as a result of the surgery. One patient (3%) had a loose screw, while another (3%) needed blood transfusions owing to extensive bleeding at the donor graft site. Conclusion: In distal third humeral fractures, open reduction and posterior DCP fixing, with or without autogenous bone grafting, is a safe and effective treatment option, especially when there is no infection or bony or neurovascular damage. Very few study conducted on distal 3rd diaphysial fracture of humerus fixed with DCP using posterior approach, therefore this study conducted to know the assessment of the outcome.

Pharmacopeial Testing of Poly-Herbal Formulation for the Management of Diabetes Mellitus

Diabetes mellitus is a global cause of morbidity and mortality. There is a continuous rise in the patients of diabetes in Pakistan. Many conventional and natural origin medicines are available for maintaining optimum blood sugar level. There is a need to carry out standardization of the natural origin medicine to authenticate their efficacy and safety. The objective of this research work was to carry out preliminary pharmacognostic, phytochemical, biological, pharmacological studies on poly-herbal formulation. The poly-herbal preparation was prepared and evaluated for the standard pharmacopeial tests. The results of the tests performed were found to be adequate to evaluate the poly-herbal formulation and may be used as reference standards in future for further studies.

Impact of COVID -19 on Gallstones Patients

Background: It is well known that most of the healthcare centers have redistributed their material and human resources to face the health issues associated with COVID-19 pandemic. Aims: In the current study, we aimed to investigate the impact of COVID-19 pandemic on gall stone patients. Methods: Comparison was conducted in our own center regarding gallstones related activities before, during and after the pandemic. We reviewed also the number of elective laparoscopic cholecystectomies during these periods. Data were obtained from the hospital recording system. Results: We found a significant increase in the number of gall stones related complications during the COVID-19 pandemic when compared with non-pandemic periods. Conclusion: It is recommended that laparoscopic cholecystectomies should be considered whenever possible, taking all relevant measures to avoid contagion of patients and the health team.

Perception and Determinants of Gender Preference among Men in Isoko South Local Government Council, Oleh, Delta State

Introduction: Some couples do not have the gender of children they prefer which could result in physical, psychological, sexual, obstetric and several other consequences. The present study was conducted among men to determine their perception of gender preference and factors responsible for their gender preference. Objective: To assess the perception of gender preference and factors responsible for gender preference among men. Methods: A descriptive survey research design was adopted for the study. Proportionate stratified random sampling technique was used to select 143 out of 221 male Civil Servants from nine (9) different departments. The instrument used for data collection was a self-developed Questionnaire on Perception and Determinants of Gender Preference (QPDGP). The reliability of the instrument was established through the test-retest method using Cronbach’s alpha which yielded co-efficient of 0.82. Data collected were summarized using frequencies and percentages. Results: The results showed that 90 (62.9%) men preferred male gender. For 79 (55.2%) men, the choice of gender was aimed at psychological satisfaction in marriage. Also, 77 (53.8%) preferred male children because they had better initiative, were easier to train 101 (70.6%), to allow for security of family inheritance 142 (99.3%) and continuity of family name 141 (98.6%). Some reasons given for female child preference were better ability to take care of younger ones 99 (69.2%), more supportive to aged parents 115 (80.4%) and being a reliable emotional support 88 (61.5%). Conclusion: Male gender preference is strongly perceived among the men. It was recommended that reproductive health services be modified to allow male involvement.

Effects of Anti-Sickling Polyherbal Mixture on Haematological Indices in Normal and Anaemia-Induced Rabbits

Some plants used in the management of sickle cell disease (SCD) have been shown to increase gelling time of sickle cell blood and inhibits sickling in vitro, reversal of sickling, inhibiting osmotically induced haemolysis of erythrocytes, membrane stabilization. Plants such as Sorghum bicolar, Phyllanthus amarus, U. afzelii, Securidaca longipedunculata, Momordica charantia, Dalium guineense have been found to exhibit anti-sickling properties. The polyherbal combination of these drugs was used in this study for the investigation of the effects of anti-sickling polyherbal mixture on haematological indices in rabbits. Sixty (60) New Zealand rabbits weighing 1200g ±200g, conducted in duplicate and designated experiment X (normal rabbits) and Y (anaemia induced using Cadmium 2mg/kg +10 mg/Kg body weight phenylhydrazine for 15 days). Both groups were further subdivided into four groups (A-D) with 5 animals each, administered saline substitute, different grades of polyherbal mixtures for 8 weeks. Blood sample (2mls) was collected into Ethylene Diamine Tetra Acetic Acid (EDTA) bottles for full blood count. The results in the experiment (X) showed significant increase in WBC (103/μl) count across the groups (B=8.15±0.33; C=9.3±0.74; D=9.8±0.59) compared to the control group (A=7.25±0.44) (p<0.05). RBC (106/μl) count showed insignificant increase in group B (5.1±0.20) and C (5.6±0.450), decrease level in D (4.4±0.26) compared to control A (4.8±0.29) (p<0.05). Hb(g/dl) and HCT (%) showed similar pattern with insignificant increased levels across all treatment groups (B=14.8±0.59, 43.4±1.74; C=15.5±0.78, 45.8±3.; D=14.2±0.85, 43.7±2.62) compared to control A (13.6±0.68; 41.5±2.49) respectively. Platelets showed significant increase in group B and C (286±17.16 and 286±17.16) compared to control A (244±9.76) with significant decrease in group D (226±18.08) (p<0.05). In experiment (Y), WBC count showed significant increase across all treatment groups (B= 6.4±0.26 C= 6.8±0.54 D =10.6±0.64) compared to control (A= 4±0.24) (p<0.05). RBC (106/μl) count in control A gave (2.5±0.15), insignificant increase in B (3.1±0.12) with significant increase in group C (3.5±0.28) and insignificant decrease in D (2.2±0.13) (p<0.05). Higher level of Hb (g/dL) was seen in group B and C (B= 8.4±0.34; C= 9.1±0.46), while D (7.7±0.46) had a slightly elevated value compared to the control A (7.1±0.36) (p<0.05). HCT (%) showed significant increase across the groups (B=26±1.04; C=28±2.24; D=24±1.44) (p<0.05) compared to control A (18±1.08). Red cell indices showed some degree of derangement across the study groups. Findings in this study suggest that polyherbal mixture have a positive effect on the haemoglobin, red blood cells, packed cell volume and white blood cell count of the rabbits in a dose dependent manner.

The Usefulness of Glycated Hemoglobin (HbA1c) in the Detection of Diabetes Mellitus

Background: Health conditions like Diabetes mellitus sometimes affects serious to health due to unavailability of accurate check. But with advancements of diagnostics test like glycated hemoglobin (HbA1c) can save many lives to detect Diabetes Mellitus. Objective: In this study our main goal is to evaluate the accuracy of glycated hemoglobin (HbA1c.) in the diagnosis of Diabetes Mellitus. Methods: The Tertiary Medical College, Bangladesh, outpatient department (OPD) conducted this cross-sectional study. Where information was gathered between January 2019 and January 2020. During the research, a total of 100 individuals were enrolled with contemporaneous FPG, OGTT and A1c findings and diabetes mellitus suspicion. Purposive sampling was used to acquire the samples according to the inclusion criteria. Results: Most of the patients in the research were aged 47 to 57. 30.8% of the population and the majority (60%) were male. 71% of diabetes patients were identified alone by A1c, followed by 66% by 2h OGTT, and 43% of diabetic patients were diagnosed solely by fasting plasma glucose (FPG). IFG was found in 58% of the patients, whereas OGTT found IGT in 20% of the patients, and A1c found IGT in 24% of the patients. The difference between A1c and OGTT in diagnosing glucose intolerance was statistically significant (P 0.0001). Conclusion: This study's findings support the use of HbA1c as a screening tool for type 2 diabetes. Increasing access to diabetes care in Bangladesh may be made easier by using the HbA1c test, which is less onerous for patients than either FPG or oral glucose tolerance testing.