University Of Benin Teaching Hospital Research Articles

Physicians’ awareness and use of drug-drug interactions software: A preliminary study

Background: Drug-drug interactions software is used as a tool to investigate clinically harmful interactions. Prescribers need to be aware of these tools to improve the quality of drug prescriptions, thus ensuring better patient care. Drug-drug interactions are a common avoidable type of adverse drug reactions, which can have detrimental effects on patients in the form of drug toxicity Objective: To determine the awareness of prescribers and the use of drug-drug interaction software. Method: The awareness of physicians of drug interaction software was assessed. A self-administered questionnaire was administered to all resident physicians in the Department of Internal Medicine, University of Benin Teaching Hospital to assess their awareness and use of the drug-drug interaction software. The information sought includes sociodemographic characteristics, Physician’s awareness, and use of drug interaction software. The results are presented descriptively. Results: Thirty-four medical residents filled out the self-administered questionnaire. The number of physicians aware of drug-drug interactions software was 30 (82.2%) for Medscape, Drugs.com 21 (61.8%), Lexi-interact 4(11.8%), and 3 (8.8%) for Epocrates. Medscape interaction checker was most used by 26 (76.5%) while Micromedex was least used by one (2.9%) medical resident. Conclusion: Physicians were largely aware of and used Medscape.

Surgical demands of patients attending an Oral and Maxillofacial Surgery clinic in a Nigerian Hospital

Objectives: Reports on most performed oral and maxillofacial surgical procedures (OMSPs) are scarce globally. This study aimed to determine the pattern of surgical demands of patients attending oral and maxillofacial surgery services at the University of Benin Teaching Hospital, Edo State, Nigeria. Materials and Methods: A retrospective study was conducted on patients managed in the Department of Oral and Maxillofacial Surgery from March 2011 to April 2021. Data were collected from theatre logbooks and case notes of patients who had surgery. The data collected were the age of patients, gender, employment status, educational status, residential distance to the hospital, and type of surgery performed. Descriptive statistics were done using the IBM Statistical Package for the Social Sciences statistics for Windows version 20 (Armonk, NY: IBM Corp) software. Results: A total number of 550 patients were seen in the ten-year study period. The age of the patients ranges between 2 and 97 years. The mean age was 23.5 ± 2.08 years. More than half (55.6%) of the patients were male. The highest (47.1%) number of patients that had OMSP had only primary education, followed by tertiary education (25.1%), secondary (17.8%), and no formal education (10.0%). Cleft lip and palate repairs were the most common surgical demands (34.5%), followed by mandibulectomy, open reduction, and fixation. The least surgical demands were neck dissections (0.36%), and none (0.0%) of the patients had cosmetic surgery. Conclusion: The most common surgical demand by patients was cleft lip and palate repairs, while neck dissection was the least common demand, respectively.

Predictors of potential clinically harmful drug-drug interactions at the medical wards in the University of Benin Teaching Hospital, Benin City.

Drug-drug interactions are preventable causes of adverse events. Different factors have been recognized as important predictors of drug-drug interactions but few studies have addressed these predictors in patients admitted into medical wards of a tertiary hospital in Nigeria hence this study. This was a retrospective study conducted using case records of patients admitted into the medical wards between January 1 and December 31, 2020. Patients were selected using a systematic random sampling method. Socio-demographic details including age, gender, number of comorbidities, and number of medications prescribed and diagnosis were collected on days 1, 3, and at discharge. Potential drug-drug interactions were checked using Lexi-interact® software. Analysis was set at p < 0.05. A total of 430 case records were included in this study based on the inclusion criteria. Lexi-interact recorded a prevalence of (217) 50.5% on day 1, (146) 34.0% on day 3, and (290) 67.4% at discharge. A significant association (p < 0.05) was found between the potential drug-drug interactions (DDI) and an increased number of medicines prescribed on all the days of admission. Also, patients without certain infectious or parasitic diseases have reduced odds of developing DDI. There is a need for continuous monitoring of medications from admission to discharge especially in the elderly, those on multiple medications, certain infectious or parasitic diseases, and comorbidities as these impact on DDIs.

Plasma Fibrinogen Levels and Protein C Activity in Patients with Chronic Kidney Disease in a Nigerian Tertiary Hospital

Introduction: Haemostatic abnormalities have been observed in patients with chronic kidney disease (CKD). Hypercoagulability and thrombotic complications may contribute to the increased morbidity and mortality associated with CKD. Thrombotic tendency has not been fully evaluated in CKD subjects in our environment. This research was to assess the plasma fibrinogen and protein C activity levels in patients with CKD in a Nigerian tertiary hospital, with the view of deducing their associations with thromboembolic manifestations and providing possible therapeutic interventions.&#x0D; Material and Methods: A hospital based, cross-sectional survey conducted amongst CKD patients on renal replacement therapy (RRT), who were managed in the renal unit of the University of Benin Teaching Hospital (UBTH). Participants were appropriately matched with apparently healthy control subjects and these were interviewed with a structured questionnaire to obtain data on their clinical details as well as hospital records. Citrated plasma was obtained and analysed to determine the functional protein C activity as well as the fibrinogen levels of both subjects on RRT and apparently healthy control. Haematologic and biochemical parameters were also determined including complete blood count, urea and creatinine and liver function tests. Descriptive and Inferential statistics were performed using Statistical Package for Social Sciences (SPSS) version 20. Results were presented in tables and charts&#x0D; Results: A total of 222 subjects participated in this study, comprising 74 patients with CKD on conservative management, 74 subjects with CKD on RRT, and 74 apparently healthy control subjects. The mean age across the groups including subjects on conservative management, RRT, and controls were 54.70±14.42, 49.5±15.73, and 49.3±12.5 years respectively; with the median age of 56-, 52-, and 48.5- years f across the groups respectively. The mean plasma fibrinogen levels across the groups were 240.4±57.76, 241.8±54.87, 360.9±69.5mg/dl respectively. This was statistically significant. The mean protein C activity for the respective groups was 59.6 ± 24.20, 63.6 ± 28.89, 86.7.±2.6%. Protein C activity was significantly depleted in the CKD subjects (p = 0.002).&#x0D; Conclusion: The study showed a low protein C activity amongst patients with CKD and those with cardiovascular or thromboembolic events, suggestive of thromboembolic risk in these individuals. Contrary to existing literature, plasma fibrinogen levels were not significantly elevated in patients with CKD, and there was no association with thromboembolic events.

Effect of work stress on service delivery of health workers in University of Benin Teaching Hospital, Benin City Nigeria

The study examined work stress and service delivery among health workers in University of Benin Teaching Hospital Benin City. The study adopted descriptive research method. Data were collected through questionnaire, focus group discussion guide, in depth interview and secondary sources. The study revealed that work overload has nexus with service delivery of the health workers of University of Benin Teaching Hospital. The study recommended among other things that University of Benin Teaching Hospital (UBTH) should deploy more student doctors in their residency programmes who would be closely supervised by their superiors in order to reduce the workload on existing doctors in their provision of health services. The work schedule for medical and health workers at the University of Benin Teaching Hospital (UBTH), should be made more flexible to accommodate the peculiarities in female medical personnel, especially married women, nursing mothers and those that are pregnant. The government should do better in the disbursement and payment of hazard allowances to medical and health workers in order to encourage their selfless services to God and humanity through the provision of quality healthcare services.

Comparison of Pre-emptive Analgesic Effect of Paracetamol, Ibuprofen, and Placebo in Reducing Post-operative Pain in Intra-alveolar Tooth Extraction at The University of Benin Teaching Hospital, Benin City. A Randomised Trial.

Objective: Pain is one of the most common postoperative complications of extraction. Thus, this study is aimed at determining the pre-emptive effectiveness of paracetamol and ibuprofen in the management of post extraction pain.&#x0D; Methods: A randomized, placebo‐controlled, single‐blinded comparative study of patients who needed intra-alveolar extraction of posterior teeth. Sixty‐nine patients aged 18 years and above were randomly assigned to one of three groups: (A) paracetamol 1g; (B) ibuprofen 400mg; and (C) placebo (calcium lactate) 300mg. Each of the three tablets was given 30 minutes before administration of the local anesthetic agent. The pain level was assessed using the visual analogue scale®. Chi-square (X²) test, one-way analysis of variance (ANOVA) with an appropriate post-hoc test was used. Level of significance was set at 95% (p-value &lt; 0.05).&#x0D; Results: Ibuprofen and paracetamol groups showed lower pain scores compared to placebo.  Although, there was no significant difference between the VAS scores at the post-operative period (P= 0.080). There was a significant difference in time taken for use of rescue medication among the three groups (p = 0.022), with those in placebo group 8 times more likely to use rescue medication relative to the analgesics.&#x0D; Conclusion: The use of preemptive analgesics showed lower pain scores compared to placebo, and also significantly increased the time for use of rescue medication postoperatively.

Accuracy of Saliva as a Diagnostic Medium for Hepatitis B Virus Infection: A Quantitative ELISA Analysis

Abstract Context: Diagnosis of hepatitis B virus infection (HBV) has been traditionally serum-based with its attendant risks and invasive procedure. Massive research interests are being directed to the use of saliva for screening, diagnosis, and monitoring of several infectious diseases, including HBV. Various reports suggest that saliva contains biomarkers that are comparable with that of sera. It can also be obtained with minimal risk to the clinician and patient as well. Aim: To determine the diagnostic accuracy of saliva in quantitative detection of hepatitis B surface antigen (HBsAg) using enzyme-linked immunosorbent assay (ELISA). Settings and Design: This cross-sectional analytical study was performed on HBV seropositive patients at the Gastroenterology clinic of the University of Benin Teaching Hospital, Benin City, Edo State. Materials and Methods: Under standardized conditions, equal amounts of blood and saliva samples of 43 HBsAg seropositive patients were analyzed using ELISA to quantitatively detect the concentration of HBsAg. Statistical Analysis Used: The analysis relied on Spearman’s correlation coefficient, linear regression analysis, and Bland–Altman plots to describe the correlational, predictive, and agreements between measurements of HBsAg in sera and saliva. The statistical significance was set at P &lt; 0.05, while a 95% confidence level was used to construct intervals. Results: All participants had detectable levels of HBsAg in both saliva and serum with mean titers of 1.70 ± 0.35 ng/ml and 2.80 ± 0.77 ng/ml, respectively. Correlational and linear regression showed poor fit and predictive relationships of the HBsAg levels. Bland–Altman analysis showed good agreement and no significant bias in their diagnostic agreements. Conclusion: Saliva can be reliably used in screening and diagnosis of HBV infection. There was agreement in their levels independently and within their averages. It may be premature to rely on saliva for quantitative assay of HBsAg in treatment monitoring.

Haematological Perturbations in Human Immunodeficiency Virus (HIV) Positive Patients Receiving Antiretroviral Therapy in Edo State, Nigeria

Aim: This study sought to investigate the haematological perturbations in HIV-positive patients undergoing antiretroviral therapy (ART) in Edo State, Nigeria.&#x0D; Methodology: This cross-sectional case-controlled study was conducted at the HIV clinic of the University of Benin Teaching Hospital. The research enrolled 150 HIV-positive patients and an equal number of sex and age-matched HIV-negative control subjects. Inclusion criteria encompassed individuals aged 18 years and older, confirmed HIV-positive, and receiving ART for at least six months. Exclusion criteria excluded those with sickle cell disorder, recent transfusions, or ongoing sepsis/malaria. Data collection involved self-administered questionnaires, HIV diagnosis via WHO-approved Nigerian National testing algorithms, and comprehensive haematological assessments. The obtained data were analysed using SPSS software, employing descriptive statistics and t-tests with a significance level of 0.05.&#x0D; Results: Results revealed significant differences in demographic variables, duration of HIV infection, smoking history, and alcohol consumption between HIV-positive patients and control subjects. Furthermore, CD4+ T lymphocyte counts showed substantial variations, indicating immunological differences. Haematological parameters such as haemoglobin levels, packed cell volume, white blood cell, platelet counts, and erythrocyte sedimentation rate exhibited statistically significant differences between the two groups. Additionally, a sub-analysis of HIV-positive patients based on CD4+ T lymphocyte counts highlighted specific haematological changes associated with varying immunological statuses.&#x0D; Conclusion: The findings underscore the impact of HIV and ART on haematological parameters, emphasizing the need for comprehensive monitoring and management strategies. This research contributes valuable insights into the context of HIV management in Nigeria, aiding healthcare professionals in optimizing patient care.

Liquid-based Cytology Profile of Street Sex Workers in Benin City, Edo State, Nigeria

Aim: To investigate street sex workers in Benin City Edo state Nigeria using liquid-based cytology method.&#x0D; Study Design:  Analytical cross-sectional study.&#x0D; Place and Duration of Study: Department of Medical Laboratory Science, Histopathology Sub-Department, University of Benin, Benin City and the Histopathology Laboratory, University of Benin Teaching Hospital (UBTH)., between December 2016 and May 2017.&#x0D; Methodology: This study was conducted in the local government areas that make up the Benin metropolitan City in Edo State. A simple random sampling method was used to recruit the 113 participants, after which the questionnaire was used as the data gathering tool. The liquid-based cytology method was used for sampling following the cervix examination by a gynecological nurse. Data were analyzed using Frequency tables, and factor analysis using Minitab version 17.0 and the statistical significance was set at p &lt; 0.05.&#x0D; Results: From a total of 113 participants within the street sex workers ring in Benin City, acute cervicitis was predominant 7/113(6.2%) closely followed by the chronic 4/113(3.5%). The prevalence of SSWs living with cervicitis in Benin City 11/113(9.7%) revealed that Teenage SSWs were 5/113 (4.4%) and Migrant SSWs 11/113 (9.7%) and were affected by age and duration of sexual practices (p= 0.583; p= 0.204). The prevalence of HPV sera-positivity revealed that 3/113(2.7%) is infected and is largely distributed amongst the age group 21-30years. A hundred percent (100%) of the SSWs agreed to having heard about condoms and have been using it; while regular condom usage was revealed in the HPV sera-negative group amounting to 101/110 (92%) and 2/3(66.7%) amongst the HPV sera-positive group.&#x0D; Conclusion: In conclusion, cervicitis is the only cervical lesion observed in the street sex workers with HPV infection predominantly affecting the age group (21-30years). Also, teenage prostitution is on the increase and HPV infection amongst the street sex workers in Benin City, Nigeria.

Health-related quality of life in patients with dyspepsia presenting at the University of Benin Teaching Hospital, Benin City, South-South Nigeria: a cross-sectional study

Health-related quality of life in patients with dyspepsia presenting at the University of Benin Teaching Hospital, Benin City, South-South Nigeria: a cross-sectional study

MOLECULAR IDENTIFICATION AND ANTIBIOGRAM OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS FROM WOUNDS OF BOTH IN- AND OUT-PATIENTS AT UNIVERSITY OF BENIN TEACHING HOSPITAL (UBTH), BENIN CITY, NIGERIA

Methicillin-resistant Staphylococcus aureus (MRSA) stands as a prominent bacterial pathogen associated with various human infections, characterized by its remarkable ability to rapidly develop resistance to multiple antibiotics. The study aimed to characterize MRSA isolated from wounds among hospital patients. A total of eighty-seven unique S. aureus isolates were obtained from wound cultures collected from patients at the University of Benin Teaching Hospital (UBTH) in Benin City, Nigeria. These samples underwent assessment for methicillin resistance through conventional cultural methods, and detection of methicillin resistance (mecA) and S. aureus specific (nuc) genes using PCR amplification. The MRSA isolates underwent assessment for antimicrobial resistance through disc diffusion testing and for virulence factors using phenotypic testing procedures. An overall prevalence of 34/87 (39.1%) MRSA isolates was recorded. Based on the source of the isolate, the distribution of MRSA isolates from in-patients was 22/56 (39.3%) and out-patients was 12/31 (39.7%). Total Panton valentine leucocidin (PVL) screening revealed 11/34 (32.4%). All the isolates were resistant to penicillin 34/34 (100%) and cefepime 34/34 (100%). Lower level of resistance was demonstrated towards ciprofloxacin 3/34 (8.8%). Overall, every isolate displayed resistance to at least three antibiotics, resulting in a multiple antimicrobial resistance index of at least 0.33. The total virulence factors observed were beta-hemolytic activity 22/34 (64.7%), protease activity 14/34 (41.2%), and lipase activity 19/34 (55.9%). This study emphasized the significance of regularly monitoring MRSA prevalence within both the hospital and the local community. Therefore, the need for better intervention and continuous enlightenment on risks associated with the abuse...

Prevalence of Coagulase Negative Strains of Staphylococcus aureus in Clinical Specimens at the University of Benin Teaching Hospital, Benin City, Nigeria

The test for coagulase activity is a simple and non-expensive test for the identification of S. aureus strains from clinical samples in resource-poor settings. The results of these tests have been reported to vary with the source of plasma and with some atypical strains that test negative with the coagulase test. The study was carried out to determine if misidentification of strains of S. aureus exists on account of the reliance on the coagulase tests. Clinical isolates of Staphylococci that tested negative by the coagulase tests from wounds, pus, aspirates, blood cultures and urogenital samples were collected and re-tested by the slide and tube coagulase tests and confirmed to be negative. Each isolate was inoculated onto mannitol sat agar and DNAse agar plates and incubated at 37oC for 18 h. Isolates that fermented mannitol and showed a positive DNAse test were 25/366 (6.8%). The highest number of coagulase-negative Staphylococcus aureus (CNSA) occurred within blood culture samples 25.7% and in wound, pus and aspirates, 6.9% and the least proportion, 2.9% from urogenital samples. The generation of CNSA strains is strongly associated with severely-ill patients and the potential for the administration of cell-wall inhibiting antibacterial agents may have important roles to play in the emergence CNSA. The inclusion of DNAse test in the routine identification of staphylococci is advocated especially when an isolate has tested coagulase-negative.

Effects of probiotic saccharomyces bourlardii on cytokine levels and outcomes of childhood severe malaria: Study protocol for a randomized controlled trial

Background: Severe malaria is acute malaria with signs of organ dysfunction and/or hyperparasitaemia. About 90% of the world’s severe and fatal malaria is estimated to affect young children in sub-Sahara Africa. Systemic complications and neuropathology in severe malaria include ‘cytokine storm hypothesis’. Probiotic immunomodulation may show therapeutic benefits in severe malaria. Aim: This study aims to evaluate the effects of probiotic saccharomyces bourladii on serum cytokine levels (IL-6 and TNF), clinical course and outcome of children with severe malaria. Methods: Participants shall be recruited based on WHO diagnostic criteria for severe malaria and their clinical-demographic data shall be obtained with a pretested questionnaire. The study design is randomized controlled trial (RCT); participants shall be randomized into two study sub-groups (intervention vs. control). All participants shall receive standard anti-malarial therapies. In addition, probiotic saccharomyces bourladii 250mg twice a day shall be administered to those in the intervention sub-group for 3 days. There after, their serum cytokines (IL-6 and TNF) shall be measured quantitatively by a Sandwich enzyme-linked immunosorbent assay (ELISA) technique. Primary outcomes shall be cytokine levels and length of stay (LOS) while secondary measures shall be coma scores, seizure, neurological deficits and mortality. The data shall be analyzed using SPSS version 26.0 statistical software for Windows. Both ‘intention-to-treat analysis’ and ‘analysis as per protocol’ shall be done. P-value&lt; 0.05 shall be considered significant in all tests. Discussion: At the end of this clinical trial, it is expected that the potential benefits of probiotic saccharomyces bourladii in modulating pro-inflammatory cytokines, averting systemic complications and reducing mortality in childhood severe malaria would have been verified. Protocol No: ADM/E22/A/ VOL.VII/148312145; University of Benin Teaching Hospital’s Health Research Ethics Committee Approval; August 5th, 2022.

Prevalence, molecular characterization and risk factors of vancomycin-resistant enterococci: evidence from patients admitted in University of Benin Teaching Hospital, Benin City Nigeria

The aim of this study was to determine the prevalence, antimicrobial susceptibility patterns and associated risk factors of vancomycin-resistant enterococci among patients upon admission. One hundred and seventeen samples from newly admitted patients at University of Benin Teaching Hospital were screened. Ten (8.55%) samples were positive for vancomycin resistant enterococci (VRE) isolates based on chromogenic and molecular screenings. The speciation prevalence revealed that 8/10 (80%) was E. faecalis while 2/10 (20%) was E. faecium. The prevalence based on recent histories of antibiotics usage showed that 8/74 (10.8%) of the patients with histories of antibiotics usage in the last six months appeared positive while 2/43 (4.7%) appeared positive from patients with no histories of antibiotics usage in the last six months. The prevalence based on sample types was 4/31 (12.9%) in stool samples, 2/24(8.3%) in wound swabs and 4/49 (8.2%) in urine samples. Most of the isolates 6/10 (60%) showed the presence of van A gene. The VRE isolates showed total resistance towards vancomycin and ampicillin. The MAR index of the isolates tested in this study ranged from 0.33 – 0.78. The prevalence of virulence factor formation as observed was gelatinase activity 6/10(60%), biofilm formation 8/10 (80%), β-hemolytic activity 7/10 (70%), and DNase activity 3/10 (30%). This study demonstrated the presence of VRE in healthcare settings, which is a great threat to public health. Therefore, the development of proper surveillance policies and antimicrobial sensitization programmes to monitor the use of antibiotics is advised with a view to curtailing its spread.

Extrapulmonary tuberculosis among tuberculosis suspects at a tertiary hospital in Benin City, Nigeria: A retrospective study

There is paucity of data on extrapulmonary tuberculosis (EPTB) subsets in Nigeria despite contributing to the burden of tuberculosis. This study investigated extrapulmonary tuberculosis (EPTB) among tuberculosis (TB) suspects presenting at a tertiary health facility in Benin City, Nigeria. Patients' clinical and laboratory records domiciled at the DOTS clinic, University of Benin Teaching Hospital, Benin City, Nigeria, were extracted. Appropriate statistical tools were deployed to analyze data retrieved between January 2018 and December 2020. A total of 683 suspected TB cases were reported, among these, 360 (52.7%) had pulmonary TB while 28 (4.1%) had EPTB. Of this number, 21 (5.6%) males were EPTB positive, while 7 (2.3%) females were positive: an association was observed between the male gender and EPTB (OR = 2.567; 95%CI= 1.076, 6.122; p = 0.0451). A significant increase in yearly prevalence of EPTB was also observed across the years 2018, 2019 and 2020 (p = 0.0442). No statistical significance was observed between age and EPTB as well as HIV status and EPTB (p&gt; 0.05). Lymphadenitis was the most frequent clinical presentation of EPTB. The prevalence of EPTB was 4.1%. Our findings call for concerted efforts of all stakeholders in order to reduce the prevalence of EPTB to the barest minimum.

Comparative assessment of renal volume and doppler velocimetric indices among subjects with sickle cell disease and controls in Benin, Nigeria

Background: Sickle Cell Disease (SCD), a hereditary blood disorder caused by an abnormality in haemoglobin can be complicated by impairment of renal function. Renal Doppler ultrasound has been found to be an effective method of evaluating reno-vascular events prior to abnormal laboratory renal function tests.&#x0D; Aim and Objectives: This study aimed to evaluate and compare the renal volume (RV), intra-renal resistive and pulsatility indices (RI, PI) among sickle cell patients and controls in UBTH, Benin City using ultrasonography.&#x0D; Materials and Method: This was a cross-sectional comparative study of renal volume, intra-renal resistive and pulsatility indices among 50 sickle cell disease patients attending sickle cell clinic of the University of Benin Teaching Hospital and equal number of “Age and Sex” matched controls. The study was conducted using a 2-8MHz curvilinear transducer of a SONOACE X6 (Medison Inc., Korea 2010) Doppler ultrasound machine.&#x0D; Data analysis: Collated data was analysed using IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp, Armonk. N.Y., USA)&#x0D; Results: The mean age for the HbSS subjects was 22.4±3.7years while that of the control group was 23.3 ±4.5 years. The left RV was higher than the right RV in HbSS and HbAA: 169.3±40.2 cm3 versus 162.2±40.3 cm3 and 153.9±30.9cm3 versus 134.7±26.4 cm3 respectively. The mean RV, RI and PI was significantly higher in HbSS than controls (RV: 165.8±39.8cm versus 122.9±13.4 cm3 ; p = 0.0001, RI: 0.74±0.02 versus 0.61±0.04; p= 0.0001, PI: 1.43±0.06 cm3 versus 0.90±0.05; p = 0.0001).&#x0D; Conclusion: Renal volume, RI and PI were statistically significantly higher in HbSS patients than controls.

The Contribution of Curable Plasmid-Mediated Resistance in Isolates of Staphylococcus aureus at the University of Benin Teaching Hospital, Benin City, Nigeria

aureus, is an important human pathogen and commensal that is responsible for infections ranging from minor to deep-seated life-threatening conditions. Multi-drug resistant S. aureus or MRSA is a major cause of hospital acquired infection (HAIs) or nosocomial infections with consequential reduction in treatment options and overtly increased cost of healthcare, morbidity and mortality. The study was conceived to determine the contribution of curable transmissible plasmids to the ever-increasing proportion of multi-drug resistant S. aureus at the University of Benin Teaching Hospital, Benin City. A total of 448 consecutive multi-drug resistant clinical isolates of S. aureus were collected, confirmed by SCT and TCT and resistance to commonly used antimicrobial agents. Each isolate was inoculated into Mueller-Hinton Broth containing 100 µg/mL acridine orange and incubated at 37oC for 24 h. Each broth culture was subsequently sub-cultured onto blood agar plates and incubated at 37oC for 24 h. Sensitivity tests were thereafter done on each sub-culture by the Kirby-Bauer disc diffusion method. SCT and TCT were re-tested on each sub-culture. Isolates with curable transmissible plasmids were 31/448(6.9%) and there was complete reversion to sensitivity in all the cured strains to antimicrobial agents tested including ampicillin. The remaining isolates (93.1%) retained their resistance to all the antimicrobial agents. The isolates with curable plasmids (6.9%) also lost the coagulase activity of both types. Plasmid-mediated resistance in S. aureus remain an important route of multi-drug resistance, however this is dwarfed by chromosomally-mediated resistance as the major mechanism of resistance in multi-drug resistance S. aureus. Additionally, the cure of drug resistance was also concomitantly associated with lose of the pathogenicity factor-coagulase in these isolates. Keywords: S. aureus, multi-drug resistance, transmissible plasmids. 

Prevalence of musculoskeletal related morbidity and its perceived impact on health among pregnant women in a tertiary centre

Background: Pregnancy is a physiological condition associated with musculoskeletal symptoms of which the site, perception, severity, effect on the quality of life and treatment vary in individuals. &#x0D; Objective: To determine the prevalence of musculoskeletal morbidity, its relationship with socio-clinical characteristics, perception, and impact on the quality of life of pregnant women attending antenatal clinics at the University of Benin Teaching Hospital. &#x0D; Results: Four hundred antenatal women participated in this study; 146 (48.7%) experienced musculoskeletal problems during the index pregnancy. Most respondents (51.3%) were 31-40 years (mean 31.9±5.6). For those who experienced problems, the onset of symptoms was highest (49.3%) in 3rd trimester, and the majority (76%) had tertiary education. The most typical problem was pelvic pain (48.8%); the most common predisposing factor was previous trauma (100%). Most (72.6%) perceived symptoms as moderate pain that affected their quality of life. Treatment was majorly rest (47.5%), 59.4% had their symptoms relieved, and 76.3% were satisfied with their treatment.&#x0D; Conclusion: This study showed a prevalence of approximately 50%, with the commonest predisposing factor being previous trauma and pelvic pain being the most common problem. Therefore, Clinicians should be aware of the musculoskeletal problems in otherwise healthy pregnant women and manage them appropriately.

A Microbiological Assessment of Stethoscopes Used by Clinicians in a Tertiary Hospital in Benin City, Nigeria.

The hospital environment serves as a niche for pathogenic microorganisms, so efforts are constantly being made to identify the potential mode of microbial pathogen transmission causing clinical infections. The aim of this study was to microbiologically examine the stethoscopes used by clinicians at the University of Benin Teaching Hospital (UBTH) in Benin, Nigeria. A total of 106 clinicians' stethoscopes were cleaned using cotton-tipped swabs dampened with normal saline. This included both earpieces along with the diaphragm (three samples per stethoscope). The samples were then sent to the Medical Microbiology Laboratory of UBTH and processed immediately as per the standard guidelines. The emergent colonies were subsequently identified, and antimicrobial susceptibility tests were performed. A total of 114 (35.8%) bacterial isolates were recovered, including Staphylococcus aureus (S. aureus) (33.3%), coagulase-negative staphylococci (CoNS) (33.3%), Bacillus spp. (22.8%), Acinetobacter spp. (5.3%), Escherichia coli (E. coli) (1.8%) and Klebsiella spp. (3.5%). Diaphragms had the highest yield of methicillin-resistant S. aureus (MRSA) (46.2%) and CoNS (17.9%). Age (P = 0.0387) and cadre of clinician (P = 0.0043) were risk factors for contamination, whereas clinicians who never cleaned their stethoscopes (P = 0.0044) or cleaned only the earpieces (P = 0.0001) had more contaminated stethoscopes. The contamination rate of stethoscopes used by clinicians in Benin City was 56.6%. There is a need to establish proper stethoscope cleaning practices for all cadres of personnel in clinical practice to minimise health risks to patients and healthcare workers (HCW).

Pre-Operative Electrocardiographic Patterns of Children Who Had Adenotonsillectomy at University of Benin Teaching Hospital, Nigeria

Adenotonsillitis is a relatively common condition among children attending Paediatric Otorhinolaryngology clinics. It is sometimes associated with obstructive sleep apnea (OSA) which can predispose to certain cardiac changes detectable by electrocardiography (ECG). We studied the preoperative electrocardiographic patterns of children surgically managed for adenotonsillitis in our hospital. This was a one-year retrospective study of children who had adenotonsillectomy at University of Benin Teaching Hospital, Benin-City, Nigeria between January and December 2017. Data was extracted from patients’ case files including sociodemographic parameters, clinical features and electrocardiographic profiles. These were analyzed using SPSS version 22.0. A total of 63 children were studied comprising 40 males (63.5%) and 23 females (36.5%) with a maleto-female (M:F) ratio of 1.74:1. Their ages ranged from 11 months to 192 months with mean age of 53.5±35.9 months. The modal age group of 3 to 4 years comprised 26 children (41.3%). The main presenting complaints were snoring in 58 (92.1%), mouth-breathing in 56 (88.9%), noisy breathing in 52 (82.5%) and OSA in 45 (71.4%). The duration of symptoms ranged from 5 to 96 months. Abnormal ECG was detected in 32 children (50.8%) with the common patterns being T wave abnormalities (9.5%), sinus arrhythmias (7.9%), incomplete bundle branch block (7.9%) and right ventricular hypertrophy (4.8%). There was statistically significant association between presence of OSA and abnormal ECG (p=0.043) among the children. We conclude that ECG abnormalities are relatively common among children with obstructive sleep apnoea due to adenotonsillar hypertrophy in Benin-City, Nigeria.