Background: Due to the differences in reference intervals (RIs) for clinical parameters between geographical regions, each laboratory needs to establish its own RIs to aid in effective clinical diagnosis and management. This study developed age- and sex-specific RIs for prothrombin time (PT) and activated partial thromboplastin time (aPTT) among apparently healthy adults in Tamale, Ghana. Methods: This cross-sectional study recruited 206 apparently healthy individuals, aged 18-46 and residing in Tamale, Northern Region of Ghana. The PT and aPTT were determined using the HumaClot Duo Plus semi-automated coagulation analyzer. The data were analyzed using SPSS version 26. The RIs for PT and aPTT were established at 2.5th-97.5th percentiles. Results: The RIs for PT and aPTT were 10.2-13.37 seconds and 20.41–35.28 seconds, respectively. Females had relatively wider PT RI values than their male counterparts [(9.91–13.39) vs. (10.10–13.37) seconds]. Conversely, males showed relatively wider RIs for aPTT as compared to the female population [(19.86–35.47) vs. (21.40–35.20) seconds]. Adults between the ages of 31-46 years had the widest PT RIs (10.10–13.55) seconds, while the 18-20 years age group had the lowest range (10.10–12.85) seconds. For aPTT, individuals aged 18 -20 years had relatively wider RIs of 19.50–35.25 seconds than the rest of the age groups. A weak positive correlation was observed between PT and age (r =0.166, p=0.017), while aPTT showed a weak inverse correlation with age (r= -0.203, p=0.003). Conclusion: Relatively wider RIs for PT (10.02–13.37 seconds) and aPTT (20.41–35.28 seconds) were found among the population in Northern Ghana. PT correlated positively with age, while aPTT inversely correlated with age. Females had relatively wider PT-RI values than their male counterparts. Conversely, males showed relatively wider RIs for aPTT than the female group. Doi: 10.28991/SciMedJ-2023-05-03-01 Full Text: PDF

Introduction: Methicillin-resistant S. aureus is known to have a significant negative impact on both immunocompetent and immunocompromised individuals (HIV patients). Aim: This study evaluated the antibiotic susceptibility profile of MRSA staphylococcus aureus isolated from HIV patients attending Barau Dikko Teaching Hospital, Kaduna. Methods: Using sterile wet swabs, within the period of 3 months (January– March 2020), a total of 180 samples were collected from the skin, ear, and nasal cavities of 60 HIV patients who gave their consent to be part of the survey, and S. aureus was isolated. Isolation, bacterial characterization, and antimicrobial susceptibility tests were carried out using the methods described by Chesbrough and Kirby-Bauer, respectively. Results: The bacterial isolation rate was 76.7% (138/180) in the samples collected, with 56.5% (78) been Gram positive. The incidences of S. aureus and MRSA were 12.8% and 8.6%, respectively. From the sample sources, the distribution of S. aureus was more in the nostrils, followed by the skin and ear swabs. Resistance was observed against imipenem (86.9%), vancomycin (65.3%), tetracycline (65.3%), and erythromycin (60.9%), while susceptible to ciprofloxacin (60.9%), streptomycin (43.5%), and gentamycin (52.2%). A high percentage (91.3%) of S. aureus were multidrug-resistant and had MARI > 0.2. Conclusion: This study established that high-resistant S. aureus with a possible MRSA gene could be responsible for frequent staphylococcus-associated infections and resistance to treatment among HIV patients in Kaduna, Nigeria. Doi: 10.28991/SciMedJ-2023-05-03-03 Full Text: PDF

The COVID-19 pandemic has given rise to new clinical challenges in healthcare settings. One of these challenges includes a heightened risk of secondary invasive bacterial and fungal infections, which have been associated with a notable mortality rate. We report a fatal case of a COVID-19 patient with two bacterial and one fungal infection successfully cured. A woman went to the hospital with fatigue, cough, chest and abdominal pain, nausea, and vomiting symptoms. She tested positive for COVID-19 and had underlying health conditions. She had a bacterial infection called Klebsiella Pneumoniae. The bacteria were resistant to many antibiotics, but colistin was effective. After 20 days in the ICU, she developed a fungal and Enterococcus faecalis(which was a Vancomycin-Resistant Enterococcus (VRE)) infection. The second bacteria were treated with linezolid. After 35 days in the hospital, she was discharged with no signs of infection. It is crucial to include proper bacterial screening and treatment when addressing COVID-19. Doi: 10.28991/SciMedJ-2023-05-03-02 Full Text: PDF

Recent studies have suggested that diet may affect the gut microbiome, subsequently influencing mental health. While several systematic reviews have been done on the effects of diet on mental health via the gut microbiome, there are focused on either specific diets or mental disorders. This systematic review examines the effect of diet and broad-based mental health via the gut microbiome. 21 out of 99 studies published prior to 2023 and listed in PubMed are included. Our analysis suggests that a vegan diet, a Mediterranean-style diet, fiber, probiotics, dietary vitamin D, unpasteurized milk, foods with a low omega-3 to omega-6 ratio, and Xiao Yan Sanmay have positive effects on gut microbiome, leading to a positive influence on mental health, while a meat-rich diet, a high-fat diet, high fructose intake, and zinc deficiency may have negative effects on gut microbiome, leading to a negative influence on mental health. Collectively, the effects of diet on mental health via gut microbiome may be explained by the composition of gut microbiome and the metabolites produced by gut microbiome on gut permeability. Doi: 10.28991/SciMedJ-2023-05-02-05 Full Text: PDF

In a pressing global health concern with substantial morbidity and mortality rates, accurate survival prediction is paramount for informed decision-making and enhanced patient well-being. This study presented a comparative investigation aimed at predicting the survival events of heart failure (HF) patients through the utilization of both machine learning and statistical algorithms. A comprehensive dataset drawn from Allied Hospital and the Faisalabad Institute of Cardiology, Faisalabad, Pakistan, was used. The Synthetic Minority Over-Sampling Technique (SMOTE) was employed on the data to rectify the imbalance, and a notable improvement was observed. To ascertain significant variables, statistical methods (Mann-Whitney and Chi-Square) were compared with machine learning-based feature selection to identify pivotal features for survival prediction, namely ejection fraction and serum creatinine. Remarkably, on final training with these features, the Random Forest Classifier emerges as the top-performing model, boasting an accuracy exceeding 90%. These findings hold the potential to substantially enhance patient prognosis, management, and outcomes, consequently alleviating the strain on healthcare systems. Doi: 10.28991/SciMedJ-2023-05-02-01 Full Text: PDF

Background: The Universal Test and Treat (UTT) strategy ensures that people test and initiate early treatment in health facilities. Communities have benefited from this strategy to help manage HIV and prevent the spread of the disease, but the way people perceive the strategy and their experiences of testing and initiating antiretroviral therapy (ART) on the same day have an impact on their remaining on treatment and on their adherence. The aim of the study: The aim of this study was to describe the perceptions and explore the experiences of newly enrolled patients regarding the UTT strategy employed in health facilities in Kgetleng sub-district. Method: This is a qualitative study that used in-depth interviews to describe the perceptions and explore the experiences of newly enrolled patients regarding the UTT strategy employed in health facilities in Kgetleng sub-district. The twenty-seven participants were purposefully selected from three health facilities in the sub-district. The data were collected and transcribed verbatim. The transcripts were analyzed using thematic content analysis. Results: The participants reported that they were not knowledgeable about or aware of the strategy until they tested positive in their clinics. HIV testing services (HTS) are still underused, as the participants presented to the facilities only when they were seriously ill, had various symptoms, or were pregnant. They described accepting their status and treatment because they were already sick, and there was nothing that they could do but take treatment. Despite the different emotions they experienced, the participants were able to accept their treatment and their status. Surprisingly, those who were still in denial also accepted treatment. Some were able to disclose and received support from their family, partners, and friends, but others had not disclosed. The data also showed their fear of stigmatization if they were seen coming to the clinic frequently. Conclusion: Being diagnosed with the human immunodeficiency virus (HIV) is still a source of embarrassment. There is still a need to educate communities about the virus, encourage them to use HTS, and empower them with information to minimize stigma and promote social support. Doi: 10.28991/SciMedJ-2023-05-02-02 Full Text: PDF

Background: Different seasons present varied environmental factors that influence the occurrence of transfusion-driven diseases. Therefore, this study determined the patterns of blood transfusion among hospitalized patients and the effect of season on ABO/Rh phenotypes. Methods: A single-center retrospective cross-sectional study was conducted on 5089 hospitalized patients that were transfused with blood at Sunyani Municipal Hospital. Archived blood transfusion records were retrieved and analyzed using GraphPad Prism, and SPSS. The association, effect size, and yearly trends of transfusion patterns were determined. Results: The majority of the participants were females (63.0% [3208]), 36-49 years old (20.4% [1039]), O phenotype (48.1% [2447]), Rh-positive (93.1% [4737]), and transfused in the rainy season (61.0% [3103]). Patients’ ABO was weakly associated with age (r = 0.07, p≤0.001) and season (r = 0.05, p = 0.008). Eighty percent (4053/5089) of the transfusions were ABO group-specific, and 28.3% (1146/4053) of this occurred at the emergency ward. The source of transfusion request was weakly associated with season (r = 0.1, p≤0.001) and type of transfusion (r = 0.1, p = 0.002). The rainy season (slope: 142.9, p≤0.001) and ABO-specific transfusions (slope: 219.5, p≤0.001) showed consistent increasing trends over the years. Conclusion: Blood transfusion was frequent among females, adults, Rh-positive and O phenotypes, and in the rainy season. Age and season were significantly associated with ABO, but not Rh. A transfusion request was associated with the season and type of transfusion, with the majority of transfusions occurring in the rainy season and emergency ward. There was an increasing yearly trend in blood transfusions. Doi: 10.28991/SciMedJ-2023-05-02-03 Full Text: PDF

Phyllodes Tumors are rare fibroepithelial neoplasms of the breast, accounting for less than 1% of all breast neoplasms. Preoperative diagnosis of Phyllodes Tumors is not easy, and a definitive diagnosis depends on a complete excision of the tumor. We present a case of a Giant Fungating Borderline Phyllodes Tumor of the breast. The main objective is to share our experience with the Phyllodes tumor of the breast from Mankweng Academic Hospital, Limpopo, South Africa. Case Report: A 50-year-old postmenopausal patient presented to our Breast Oncology clinic with a history of a slow-growing left breast mass for a duration of more than 1 year. It started as a small mass and progressively increased in size. She previously had two core needle biopsies, of which both histological analyses were inconclusive. In the last four months, there were multiple ruptured round masses associated with pain, bleeding, and an offensive discharge. The patient does not have any family history of breast cancer. On examination, the left breast has a fungating mass of 15×15 cm, with areas of necrosis and hemorrhage. There were no associated axillary lymph nodes and no abnormal findings in the right breast. Chest X-ray: normal. A mammogram was not done owing to the fear and risk of bleeding. A mastectomy was performed, and it was a highly vascularized mass. The excised specimen weighed 2.7 kg and was sent for histological assessment, which showed features of fibroepithelial proliferation consistent with Borderline Phyllodes Tumor with areas of stromal atypia, focal increase in cellularity, mitosis 5 per 10 High Power Field (HPF), and clear surgical margins of 0.9 millimeters (mm). The patient was reviewed six weeks after the operation. Conclusion: Owing to the rare nature and misdiagnosis of Phyllodes tumors, it is important to obtain a tissue biopsy for histological assessment of all suspicious breast lesions, regardless of age. Doi: 10.28991/SciMedJ-2023-05-02-04 Full Text: PDF

The study ascertained the production practices of small-scale broiler farmers in Aguata Local Government Area of Anambra State, Nigeria. A multistage sampling procedure was adopted for the random selection of 80 farmers using a structured interview schedule. The data were analysed using descriptive statistics. The result reveals that 87.5% of the farmers adopted a deep litter housing system, and 98.75% ensured their poultry houses were sited in well-drained soil and properly ventilated pens. About 93% and 98% of the farmers had brooding and finishing houses separately on their farms and ensured adequate lighting and heat in their brooding houses, respectively. The result shows that 100% and 93.75% of the respondents administered antibiotics and multivitamins at the early stage of day-old chicks and adhered to the Gumboro and Lasota vaccine schedules, respectively, while only 1.25% of the farmers provided a footbath at the entry of their poultry house. All the farmers used broiler starters and finishers in feeding their birds, and the mean weekly duration of broiler starter and finisher feeding was 4.09 and 4.28 weeks, respectively, while 98.75% ensured to always provide water for their birds. The study concluded that the use of recommended production practices was high to some extent among farmers. Hence, the level of information on broiler production practices should be increased by the government extension service unit to enable farmers to keep abreast of current and necessary information on broiler production. Doi: 10.28991/SciMedJ-2023-05-01-03 Full Text: PDF

Background: Ivabradine is a selective inhibitor of (If) channels in the sinoatrial node and a pure bradycardic agent with no deleterious effect on other aspects of cardiac function nor on blood pressure. This study was conducted to evaluate the effect of Ivabradine on controlling tachycardia in sepsis patients as compared to placebo. Methods: A total of 100 patients admitted to the Medical Intensive Care Unit (MICU) were recruited in this randomized controlled trial. A total of 50 patients were randomly allocated to either Group A (the Ivabradine group) or Group B (the control group). Heart rate (HR) was recorded for all patients at baseline, 12, 24, 48, 72, 96, and 120 hours. Mean arterial pressure (MAP), ejection fraction (EF), and change in Norepinephrine (NE) dosage were recorded at baseline and post-intervention (120 hours). A mortality rate was recorded for both groups. Results: The patients had a mean age of 32.49 + 16.22 years. There were 56 males and 44 females in the study. Epilepsy (n = 12, 12%) and tetanus (n = 11, 11%) were the most common primary diagnosis. Ventilator Associated Pneumonia (n = 60) was found to be the most common infection. Patients in Group A (23.2 + 11.02 beats per minute) had a significantly greater heart rate reduction at 120 hours in mean heart rate as compared to Group B patients (8.92 + 30.46 beats per minute, p = 0.002). The increase in mean MAP for Group A (1.68 + 2.44 mm Hg) was also significantly greater than that for Group B (0.54 + 2.46 mm Hg, p = 0.022). There was no difference in the mean change in NE dosage between Groups A (0.63 + 0.25 units/minute) and B (-0.34 + 0.36 units/minute, p = 0.106). A significantly greater increase in EF was found for Group A (1.16 + 1.5%), in comparison to Group B (0.30 + 1.69 %, p = 0.009). There were 22 (44%) deaths reported in Group A as compared to 24 (48%, p = 0.688) in Group B. Conclusion:Ivabradine has a significantly greater effect on controlling heart rate as compared to placebo in sepsis patients. The use of Ivabradine should be included in clinical guidelines for managing sepsis patients in ICU settings. Doi: 10.28991/SciMedJ-2023-05-01-04 Full Text: PDF