University Of Benin Teaching Hospital Research Articles

Association of abruptio placentae with hypertension in pregnancy: Analysis of risk factors in Nigerian women

AbstractObjectiveThe incidence of abruptio placentae complicating hypertensive diseases of pregnancy is high in Nigerian referral hospitals. We conducted a retrospective case‐control study to identify the socio‐demographic, behavioural, and clinical risk factors associated with abruptio placentae in women with hypertensive diseases of pregnancy.MethodsThe 41 cases of hypertensive diseases complicated by abruptio placentae identified in the records of the University of Benin Teaching Hospital over 2 years (January 2021–December 2022) were compared with 208 women (controls) who had hypertensive diseases without developing abruptio placentae. Multiple regression analysis was used to develop maximum likelihood estimates of the adjusted odds ratios and 95% confidence intervals to predict the likelihood of the association between the exposure factors and the risk of abruptio placentae.ResultsHigh blood pressure levels at presentation, when managed, can decrease the odds for abruptio placentae by 9% OR 0.91, CI:0.83–0.9, but smoking and alcohol intake were not significantly associated with abruptio placentae. A higher haemoglobin concentration decreased the likelihood of abruptio placentae by 60% OR 0.40, (CI 0.24– 0.68), while higher birth weight babies minimally decreased the odds for abruptio placentae, OR 1.01 (CI 0.08–12.49).ConclusionWe conclude that abruptio placentae is most likely to complicate hypertensive diseases of pregnancy in Nigerian women when there are concurrent pregnancy anaemia and low birth weight babies, while higher blood pressure levels at presentation, when promptly managed, can reduce the risk of abruptio placentae. Efforts to address the concurrent management of anaemia associated with hypertensive diseases in pregnancy will most likely reduce the incidence of abruptio placentae in this population.

To Determine the Histomorphological Variants of Kaposi’s Sarcoma in HIV-infected Patients in the University of Benin Teaching Hospital

Abstract Introduction: There are different histopathological variants of Kaposi’s sarcoma (KS) aside the typical patch, plaque, and nodular variants. The baseline data of the unfamiliar variants of this lesion have not been determined in our environment. Their determination will bring to the foreclose differential diagnoses that may lead to diagnostic pitfalls. Aim and Objectives: To determine the histomorphological variants of KS in the University of Benin Teaching Hospital over a 3-year 2-month period from May 1, 2014, to July 31, 2017. Materials and Methods: This was a prospective study. The patients were all adult human immunodeficiency virus-positive highly active antiretroviral therapy users who had symptomatic cutaneous lesions that were histopathologically identified as KS. The histopathological variants of KS were noted. The Statistical Package for Social Sciences, version 16, was used to analyse the data. Results: Fifty patients had KS. The histomorphological variants (stages) of KS, as seen in this study, ranged from the typical progressive lesions of patch (13.2%), plaque (43.4%), and nodules (18.4%) to rarely diagnosed variants that are lymphangioma-like KS (6.6%), lymphangiectatic KS (5.2%), hyperkeratotic KS (1.3%), keloidal KS (9.2%), ecchymotic KS (1.3%), and pyogenic granuloma-like KS (1.3%). The mixed pattern (spindle cells and vascular channels) was the predominant (63%) histologic cellular group in this study. Conclusion: In addition to the common histopathological subtypes of KS, this study also found less common histopathological variants.

Premalignant and Malignant Ocular Surface Squamous Cell Neoplasia: A Retrospective Hospital-Based Study Spanning 18 Years

Abstract Ocular surface squamous cell neoplasia can arise from a premalignant lesion (conjunctival intraepithelial neoplasia or ocular surface squamous cell intraepithelial neoplasia). Their respective magnitudes will provide an indication of early treatment or progression of the disease. This study, therefore, aims to determine the frequency of premalignant and malignant ocular surface squamous neoplasia. This is a retrospective study of all cases of premalignant and malignant ocular surface squamous neoplastic lesions histologically diagnosed over an 18-year period at the Department of Anatomic Pathology, University of Benin Teaching Hospital. The results showed that there were more malignant ocular surface squamous neoplastic lesions relative to ocular surface squamous cell intraepithelial neoplastic lesions. Also, the latter occurs at a relatively lower median age in comparison to the former. In conclusion, our findings suggest that late presentation of symptoms may account for higher frequency of malignant ocular surface squamous neoplastic lesions.

Employee Retention and Performance of University of Benin Teaching Hospital (UBTH) in Edo State, Nigeria

This study examined employee retention and performance of University of Benin Teaching Hospital (UBTH) in Edo State, Nigeria. To accomplish the study objective, cross sectional survey was performed on a sample of three hundred and one (301) clinical UBTH staff in Nigeria, using a well structure questionnaire on five-point Likert scale. Data were collected and analysed by using descriptive statistics, ANOVA and ordinary least square regression. The result indicated that technology integration, welfare policies and job satisfaction were found to be significant and positively related with performance while self-actualization had positive but insignificant relationship with performance of University of Benin Teaching Hospital in Nigeria. The study came to conclusion that a determined workforce needs to be develop in order to uphold organizational success and emphasizes the need for comprehensive strategy to retention, integrating technology, improving welfare, developing self-actualization and then guarantee job happiness.

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.

Socio-Demographic Profiling of Patients with Hypertension and Diabetes in Public Hospitals In Nigeria: A Study of University of Benin Teaching Hospital (UBTH) Edo State Nigeria (2018 – 2023)

Socio-Demographic Profiling of Patients with Hypertension and Diabetes in Public Hospitals In Nigeria: A Study of University of Benin Teaching Hospital (UBTH) Edo State Nigeria (2018 – 2023)

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.

Influence of health education and physiotherapy on functional independence among Nigerian stroke survivors

This study was carried out to compare the effectiveness of physiotherapy and combined health education and physiotherapy intervention on functional independence among Nigerian stroke survivors. A total of 50 stroke survivors in University of Benin Teaching Hospital (UBTH) and Irrua Specialist Teaching Hospital (ISTH) were divided into the control (ISTH) and experimental group (UBTH) which were made up of 25 participants each. The experimental group were administered a combination of health education and structured physiotherapy programme while the control group were administered only structured physiotherapy programme. Analysis of co-variance (ANCOVA) was used to test the hypothesis. Bonferroni post-hoc test was used to identify the source of the difference between the groups. Statistical significance was accepted for p value of <0.05. Findings showed that there was improvement in the Functional Independence Measure (FIM) following combined health education and physiotherapy from 32.08 ± 1.10 to 112 ± 1.75. Also, there was improvement in FIM following only physiotherapy from 33.20 ± 1.15 to 55.64 ± 1.81. However, there was an adjusted mean difference of 57.031 ± 2.53 in FIM between the experimental and control group. A variance of 91.5% in FIM was accounted for health education. It is therefore concluded that a combination of physiotherapy with health education is the best approach to substantially optimize the functional independence of Nigerian stroke survivors.

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.

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 (HRQoL) examines the impact of the symptoms of dyspepsia on the daily life of sufferers. There are a few published studies related to HRQoL of persons with dyspepsia in Africa. this was a hospital-based cross-sectional study involving 324 dyspeptic patients referred for upper gastrointestinal endoscopy to the University of Benin Teaching Hospitals (UBTH) The ROME IV criteria were used to recruit patients with dyspepsia. The short form Nepean Dyspepsia Index (SF NDI) was used to assess HRQoL in all participants. Upper gastrointestinal endoscopy was performed on all 324 dyspeptic patients. the mean age of patients was 47.6 ± 15.6 years. Three hundred (92.6%) patients had significantly impaired HRQoL with an SF NDI mean score of 31.3 ± 9.1. Interference with daily activities and eating and drinking subdomains were more impaired than other subdomains of HRQoL (p < 0.001). There was no statistical difference between the impaired HRQoL in patients with functional dyspepsia and organic dyspepsia (p = 0.694). Among patients with organic dyspepsia, those with upper gastrointestinal cancers had significantly worse HRQoL SF NDI mean (sd) scores (39.7 ± 5.9) compared with patients with gastritis, peptic ulcer disease and GERD with (30.3 ± 9.2, 31.5 ± 9.7 and 32.9 ± 7.1 respectively) (p = 0.01). health-related quality of life is significantly impaired in patients with dyspepsia and those with upper gastrointestinal cancers having overall worse scores. The physical, social and psychological well-being of a majority of patients with dyspepsia in South-South Nigeria is negatively affected by dyspepsia.

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.

Ergonomic Standard Compliance of Nurses in Tertiary Hospitals in Edo State, Nigeria

Healthcare professionals are responsible for many people’s lives. In their daily routines, they care for a number of people and have a lasting impact on patients. Nursing can take a toll on the body and one way to mitigate long-term bodily damage is through an ergonomic friendly work environment. There are many work-related dangers that nurses face on a daily basis. Thus the study assessed the compliance of nurses towards the ergonomics standard in University of Benin Teaching Hospital UBTH, Nigeria. A descriptive survey research design was used in the study. The study population was all nurses in University of Benin Teaching Hospital and the sample size for the study was One hundred and fifty five (155) respondents selected across ten departments in the tertiary health center. The purposive sampling technique was used to select the participants in the study. After obtaining the informed consent from the subjects, compliance level was assessed by using ergonomic task analysis scale by observation method. The result of the study showed that the subjects had low compliance on the ergonomic standards of healthcare workers (nurses). Also various ergonomic-based risk factors are associated with their work process including awkward postures, high repetition and excessive work durations which are of great concern in this case. Several engineering and administrative-based controls were offered which would help to eliminate/reduce the presence of the ergonomic-based risk factors, improve their compliance to ergonomic standards and thus lower the potential of developing WMSDs among nurses. Keywords: Ergonomics, Nurses, Safety and task analysis

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.