SEROEPIDEMIOLOGY OF HBV ANTIGEN AND ANTI-HCV AMONG GENERAL POPULATION IN A RURAL LOCAL IN BAUCHI STATE, NIGERIA

Background

HBV and HCV infections are a significant public health issue in developing countries with weak healthcare systems, high poverty rates, illiteracy, low HBV immunization coverage, and low public health education. A study assessed the sero epidemiology of HBV antigen, anti- HCV markers, biochemical and heamatological indices of 559 participants in Dambam local government during hepatitis day. A structured questionnaire was administered to assess demographic information and risk factors. Rapid latex immunochromtographic kits were used for HBV, HCV, and HBV Combo serological markers, with positive and negative control included in each batch analysis. Descriptive statistics analysis was conducted on the data.

Results

The 559 study participants, had a mean age of 35.5+10.9years, majority within the age- group, 18-39years 279(49.04%), female accounted for 291(52.1%) compared to male 268(47.9), educational background, tertiary 244(43.6%), married, 356(68.7%) and student were 254(45.4%). Seroprevalence of HBsAg was 10.7%, serological markers as follows, HbsAb 1.7%, HbeAg 13.3%, HbeAb 60.0% HbcAb 95.0% and Anti-HCV of 3.4%. Gender breakdown(M vs F) of HBV(13.4% vs 8.2%) and HCV(3.0% vs 3.8%). Significant association was observed in the seroprevalence of HBV and HCV with age-group, gender, marital status and occupation(<0.05). No significant difference was observed with the risk factors of HBV and HCV. Biochemical and heamatological indices showed a significant difference between seropositive and negative study participants(<0.05).

Conclusion

The study's findings affirmed the endemicity of HBV infection and the increasing trend of HCV infection in Bauchi state, posing serious public health concerns. HBV serological markers suggest a low HBV immunization coverage rate and exposure of participants to the viral etiology in the community. Strengthening immunization coverage and population-based surveillance is strategic in the prevention and control of viral hepatitis in Bauchi state.

UPPER GASTROINTESTINAL TRACT ENDOSCOPY: A RETROSPECTIVE ANALYSIS OF INDICATIONS AND FINDINGS AT ATBUTH BAUCHI

Introduction

Upper gastrointestinal (UGI) endoscopy is considered a safe procedure performed for diagnosis, monitoring the course of disease, early detection of complications, treatment, and responses to therapeutic intervention. The indications have increased over the years. This study aimed to analyse the indications, findings, and safety of UGI endoscopy in our environment.

Methodology

A retrospective study of consecutive patients who had UGI endoscopy at ATBUTH over the period of two years (2014 -2016). Data extracted from the records of the patients including biodata, clinical presentation, indications, findings, and complications of the procedure was analyzed using SSPS version 26. The procedure was explained to each patient. After a spray of 10% xylocaine spray to the patient's pharynx, the procedure was carried out with an Olympus CV-170 machine using standard protocols and monitoring of vital signs throughout.

Results

Two hundred and fifty-two patients were included, 148 (58.7%) males, 104 (41.3%) females, age range of 17-85 years (mean age ± SD = 44.1 ± 15.2). The commonest indications were dyspepsia 160 (63.5%). Hematemesis 32 (12.7%), suspicion for gastric 9(3.6%), and oesophageal tumours 6(2.4%) were also indications. The most common finding was gastritis 67 (26.6%). There was increased detection of gastric 11(4.4%) and oesophageal tumours 8(3.2%) more than clinical acumen and in elderly patients with troublesome symptoms. None of the patients developed complications from the procedure.

Conclusions

UGI endoscopy is a safe procedure, and detects gastric and oesophageal tumours more accurately than clinical acumen and is recommended in all patients with troublesome upper GI symptoms.

Diagnostic usefulness of serum procalcitonin in patients with bacterial sepsis

Background

The Sequential Organ Failure Assessment (SOFA) score is used for the diagnosis of sepsis and involves clinical and laboratory parameters that may not be readily and/or timely available in most resource-poor settings. Procalcitonin (PCT) has its level changed in response to bacterial sepsis and its measurement costs only a fraction of the total cost of investigations required to calculate SOFA score. This study aims to determine the diagnostic usefulness of PCT in bacterial sepsis.

Materials and Methods

Ninety-nine participants were studied, divided into three groups: apparently healthy volunteers, those with bacterial infection without sepsis (SOFA score <2), and patients with bacterial sepsis (positive culture and SOFA ≥2). PCT level of each participant was measured and median group levels compared. Pearson's correlation was used to determine the correlation between serum PCT levels and SOFA scores in the sepsis group using a significance level of 5 percent (P < 0.05). Diagnostic usefulness of PCT was assessed using receiver operating characteristic (ROC).

Result

Positive correlation was found between serum PCT levels and SOFA scores among patients with sepsis r = 0.42, P = 0.016. At a concentration of ≥4.25 ng/ml, serum PCT as a surrogate for SOFA score had a sensitivity and specificity of 57.60% and 84.80%, respectively, for indicating sepsis. The area under the ROC curve (AUC) was 0.74 (95% CI {0.62 to 0.86}, P = 0.001).

Conclusion

Serum PCT concentration was significantly higher in bacterial sepsis compared to bacterial infection without sepsis and healthy state. PCT concentration demonstrated positive correlation with SOFA score in bacterial sepsis and can be used as surrogate for sepsis screening/monitoring in resource-poor settings.

Burden, Severity and Characteristic Pattern of Coronary Artery Disease using 160-Slice Computed Tomographic Angiography: Earliest Report from Northern Nigeria

BACKGROUND

Coronary computed tomography angiography (CCTA) allows for non-invasive visualization of the coronary arteries which is promising in diagnosing coronary artery disease.

OBJECTIVES

To determine the prevalence, morphology, anatomic distribution pattern and correlates of CAD in our environment.

METHODS

This cross-sectional study was conducted on the first cohort of patients referred for CCTA in our hospital. The patients were examined with 160-slice Toshiba® CT scanner. Their demographic data, relevant clinical information as well as the findings on CCTA were extracted and documented. The data were analysed using the R programming software version 4.0.4.

RESULTS

Out of a total of 153 patients who presented for CCTA within the study period, 133 (84.7%) were eligible for analysis. Their age ranged from 22-78 years with a mean ± SD of 55.8 ± 11.7 years. A total of 33 (24.8%) had normal CCTA, while 100 (75.2%) had either stenosis or total occlusion. There was a significantly higher (p-value of 0.00001) calcium score among those with stenosis compared to those with normal CCTA. The severity of the stenotic lesion was associated with the calcium score. The logistic regression analyses showed a statistically significant (P = 0.0415, OR = 1.0569, 97.5% CI =1.078152-1.123240) association between age and the presence of coronary stenosis. In addition, most of the stenotic lesions were in the left anterior descending artery (LAD).

CONCLUSION

Majority of the patients had coronary artery disease of variable severity and the LAD was the most involved artery. There was no significant association between sex and severity of the disease; however, old age and higher number of lesions were associated with severe disease.

Clinical indication-based diagnostic reference levels for paediatric head computed tomography examinations in Kano Metropolis, northwestern Nigeria

INTRODUCTION

Paediatric patients are recognised to be at higher risk of developing radiation-induced cancer than adults because of rapidly growing organs and tissues which are vulnerable to cellular damage. The aim of the study was to determine indication based Diagnostic Reference Levels (DRL_CI) for paediatric head computed tomography (CT) examinations within Kano metropolis, Nigeria.

METHODS

CT dose index (CTDI_vol), dose length product (DLP) and other scan parameters were recorded for 113 paediatric undergoing CT head examinations. Different clinical indications were recorded and categorised in addition to patient age. Third quartile values (75th percentile) of the median dose were considered as DRL_CI. Analysis of Variance (ANOVA) was used to test for differences between DRL_CI, for different age groups, and variations among institutions. The Statistical Package for Social Sciences version 23.0 was used for analysis. Statistical significance was set at p < 0.05.

RESULTS

DRL_CI for Hydrocephalus for <5 years and 5-10 years was 28.10 mGy and 28.11 mGy with DLP of 1623.20 mGy cm and 1623.21 mGy cm, respectively. The 11-15 year group recorded 29.10 mGy and 1625.20 mGy cm. Indications of haemorrhage/trauma and post-seizure imaging all had same values for <5 years and 5-10 years (28.10 mGy and 1623.20 mGy cm) while the 11 to 15-year group recorded 39.60 mGy and 1626 mGy cm. Intracranial Space Occupying lesion had the same DRL_CI value for < 5years and 5-10 years (29.0 mGy and 1600 mGy cm, respectively) the 11 to 15-year group recorded values of 46.20 mGy and 1663.4 mGy cm. There was no statistically significant difference between DRL_CI for <5 years and 5 to 10-year age groups (p = 0.199), while different centres showed some statistically significant relationships (p = 0.02).

CONCLUSION

The study noted dose differences between age groups less than 10 years and above ten years, there were some statistically significant relationship with DRL_CI. Dose optimisation techniques for paediatric examinations together with selection of the right protocol for paediatric head CT are necessary.

IMPLICATIONS FOR PRACTICE

The study has provided DRL_CI for paediatric head CT examinations. These values can be used for future comparisons and as a potential dose optimisation tool. Such data can also guide radiographers when selecting appropriate parameters for indication-based CT examination to help achieve a low dose with acceptable image quality.

Perceived sources of stress in dental students

A 36-item questionnaire was used to investigate the stress perceived by students at Manchester Dental School to potential stressors, grouped under the headings of living accommodation, personal factors, educational environment, academic work and clinical factors. The stressors producing the highest ratings for perceived stress varied throughout the course but high values were allocated to examinations, fear of failing the course or year, shorter and fewer holidays than other university students and--for clinical students--approachability of staff and completing the required quantity and variety of work within a limited time. Female students experienced greater stress than their male counterparts. Since high levels of perceived stress can reduce student performance, dental schools should consider courses in stress management.