Faculty of Clinical Sciences
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- ItemOpen AccessPharmaceutical care and syndromic management of sexually transmitted infections (STIs) by Community Pharmacists in Lagos State(School of Postgraduate Studies of the University of Lagos, Akoka, 2011-09) Joda, A.E.Sexually Transmitted Infections (STIs) are infections passed from one person to another during sexual contact though some are also passed from mother to child during pregnancy, birth or while breast feeding. STIs constitute an important public health problem. The early detection and treatment of STIs are important aspects of a comprehensive approach to reducing the spread of HIV. Although public-sector services are available even in the most resource-poor countries, they are not acceptable to many clients because they do not have appropriate health personnel or the necessary medicines. Private providers are often preferred because they are perceived to offer better access and confidentiality, and often have the reputation of being less stigmatizing than public sector facilities. However, many of these patients are not managed rationally as their management does not conform to stated guidelines. The main aim of this work was to determine the knowledge and practice of the community pharmacists on pharmaceutical care and syndromic management of STIs and assess the impact of training. The work also investigated the patronage of STI patients in health facilities, knowledge and practice of the general public as well as the quality of ciprofloxacin tablets in pharmacies in the State.
- ItemOpen AccessThe contribution of adrenoceptors and calcium to the control of ventilation during carotid body stimulation in Cats(School of Postgraduate Studies of the University of Lagos, Akoka, 1991) Jaja, S.IThe contribution of alpha-adrenoceptors, beta-adrenoceptors and calcium to ventilation during carotis body simulation remains controversial. In the present study, this has been investigated. The experiments were performed in cats anesthetized with a mixture of urethane and chlralose.
- ItemOpen AccessEarly Tuberculosis Immunodetection using Genomic Antigens and Inducement of T-Cells in HIV+TB Subjects in Lagos, Nigeria(School of Postgraduate Studies University of Lagos, 2015-03) Adeiga, A.A.The probability of developing tuberculosis (TB) disease is higher in immune compromised subjects such as HIV/AIDS patients. Conventional methods of diagnosing TB which include sputum smear microscopy, culture and chest X-ray have drawbacks and established limitations. The limitations are pronounced in immuno-compromised subjects. The consequence of poor diagnosis of TB especially in resources limited environment like Nigeria contributes to the rising incidence of TB. Introducing immuno detection method using genomic antigens is priming for early detection of TB. This study was designed to evaluate the available genomic TB antigens for T-cell stimulation and to explore possibility of improving diagnostic performance in immuno-compromised patient by inducing T-cells. The study population includes subjects with active TB only, HIV+TB, HIV only, subjects with TB contacts and apparently healthy controls. Smear microscopy and culture were performed on sputum samples obtained. Whole blood cells from suspected TB infected subjects and TB contacts were incubated with RPMI 1640 and glutamine to provide enriched medium of protein and vitamins for the T-cells in the blood and fetal calf serum (FCS) to induce T-cells during incubation so as to make the T-cells respond better when stimulated during incubation. Low dosage of 2.5 µg/ml of TB antigens (ESAT-6,CFP-10 and ELLI the new TB antigen) obtained from LIONEX Inc. Germany was used to stimulate the T-cells in the whole blood during the 72 hour incubation. Sera obtained after stimulation were used for Interferon Gamma Release Assay (IGRA) to assess the IFN-γ released during T-cell stimulation. The result of smear microscopy and culture revealed that even though a high percentage of positivity was obtained from the result of smear microscopy and culture, some of the positives (20.83%) smear microscopy were negative for culture. These were part of the drawbacks of high sensitivity and low specificity observed. Result of using TB antigens for T-cell stimulation showed that ELLI the new antigen was the most immunogenic of the antigens used when compared with existing ESAT-6 and CFP-10. T-cells performed optimally when induced with 1% FCS and stimulated with low dose antigen of ELLI and the combined ESAT-6+CFP-10. The inducement of T-cells improved the diagnosis of TB in HIV subjects that were asymptomatic of TB and individuals at risk especially the previous TB contacts. Sensitivity and specificity of IGRA increased above 80% with the inducement of T-cells. In conclusion, the study attempts to improve TB diagnosis using genomic antigens relative to the conventional non genomic antigens methods. This approach has the potential to improve detection of TB subjects using immunodetection technique.
- ItemOpen AccessCardiopulmonary and Quality of Life Responses of Individuals with Type 2 Diabetes to Therapeutic Excercises(2011-04) Osho, O.ABACKGROUND: Cardiopulmonary complications of diabetes mellitus contribute greatly to the morbidity, mortality, and reduced quality of life in people with type 2 diabetes (T2DM). These complications require multifactorial treatment which includes targeting hyperglycaemia, obesity, hypertension and reduced lung functions among other factors which had been shown to pose challenge to people with T2DM. The inclusion of an appropriate exercise program is thus critical for optimal health in individuals with diabetes. OBJECTIVE: This study was designed to investigate the cardiopulmonary, biochemical, anthropometric and QoL of individuals with T2DM in response to therapeutic exercises. It was also aimed at determining the time frame when therapeutic effects of exercise interventions occur. METHODOLOGY: Sixty individuals with T2DM, both male and female within the age range of 20-75years participated in this study. They were consecutively recruited and randomly allocated into two exercise groups and a control group. Therapeutic exercise interventions for groups I and II were existing exercise protocols which were aerobic exercises on treadmill and bicycle ergometer respectively at progressive moderate intensity of 60%, 70% and 80% of heart rate reserve combined with resistance exercises at moderate intensity of 50%, 60% and 70% of one repetition maximum. The outcome measures were obtained at baseline, 4th week, 8th week and 12th week of the intervention period. These included cardiovascular parameters [resting arterial systolic (RASBP) and diastolic blood pressure (RADBP) and resting rate pressure product (RRPP)], pulmonary parameters [oxygen uptake (VO2max), forced vital capacity (FVC) and forced expiratory volume in 1 second (FEV1)], anthropometric parameters (body mass index (BMI), waist hip ratio (WHR), and waist circumference (WC)) and QoL variables. The QoL was assessed using Diabetes Quality of Life Clinical Trial Questionnaire-Revised. The biochemical parameter [glycosylated haemoglobin (HbA1C)] of the subjects was assessed at baseline and at the end of the 12th week. Descriptive and inferential statistics were utilized for data analysis. Level of significance was set at p<0.05. RESULTS: Groups I and II recorded significant reduction in cardiovascular, biochemical and some anthropometric variables while pulmonary and QoL variables were significantly increased post intervention (<0.05). RASBP, RADBP, RRPP, HbA1c were significantly reduced while VO2max, FEV1, and QoL were significantly improved in the two exercise groups when compared with the control group (P<0.05). However, FVC and WC were only significant in group I (p=0.00 and 0.03). Furthermore, Group I recorded better improvement in pulmonary function (FEV1 and FVC) when compared to group II. Therapeutic effect of moderate intensity combined aerobic and resistance exercise on some cardiopulmonary variables occurred as early as four week post exercise intervention (RRPP, VO2max and FEV1), the trend of this effect continue to the eighth and twelfth week post intervention. CONCLUSION: Weight bearing and non-weight bearing aerobic exercises when combined with resistance exercise both gave significant therapeutic benefits on the cardiopulmonary and QoL of people with T2DM. However, the choice of either should ultimately depend on the superior judgment of the clinicians; it should also depend on the outcome measures which the clinicians are aiming at improving on. In the absence of significant reduction of pulmonary variables, non-weight bearing exercises combined with resistance exercises will be suggested especially if there are contradicting foot pathologies which may be aggravated by weight bearing aerobic exercises combined with resistance exercises (WBARE). Otherwise, WBARE will be more beneficial in the absence of foot pathologies. In addition, assessment of RRPP, VO2max and FEV1 in people with T2DM should commence after four weeks post intervention.
- ItemOpen AccessTherapeutic Exercises for Female Breast Cancer Survivors: Assessment of Cardiopulmonary, Anthropometric and Quality of life outcomes.(2014) Aweto, H.ABreast cancer (BC) is a prevalent disease whose incidence continues to rise especially in economically developing countries. Reduction in cardiopulmonary capacity of BC Survivors, which is positively associated with reduction in quality of life (QoL) and premature death, is a major problem associated with the disease. Therapeutic approaches that will improve cardiopulmonary capacity, QoL and survival rate of BC survivors are pressing concern. This study therefore investigated the effects of therapeutic exercises on selected cardiopulmonary, anthropometric and QoL parameters in premenopausal and postmenopausal BC survivors. Ninety-six (96) female BC survivors with stage I, II and III BC, recruited through referrals by physicians from the Radiotherapy and Oncology Department of Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos State completed the study. They were randomly assigned to 4 groups (A, B, C and D) and each group was further subdivided into 2 subgroups (1 and 2) based on their menopausal status. Group A underwent moderate intensity aerobic exercise using treadmill with educational and counseling sessions, Group B, stretching exercises with educational and counseling sessions and Group C, combined moderate intensity aerobic exercise using treadmill and stretching exercise with educational and counseling sessions. Group D was the control group which had no therapeutic exercise intervention but had only group educational and counseling sessions. Topics discussed during the group educational and counseling sessions included problems BC survivors are faced with as a result of the disease and its treatments as well as the means to deal with them. The duration of therapeutic exercises started at 15 minutes for weeks 1 – 3 and systematically increased by 5 minutes after every 3 weeks. Therapeutic exercise frequency was 3 times a week for 12 weeks. The moderate intensity for aerobic exercise was calculated as the equivalence of the subjects’ target heart rates. Statistical Package for Social Sciences (SPSS) version 20.0 was used to analyse the data. Data was analysed using descriptive statistics of mean and standard deviation. Analysis of variance (ANOVA) was used to compare the physical characteristic variables of subjects across groups. Repetitive ANOVA was used to compare the cardiovascular, pulmonary and anthropometric variables across the baseline, end of 3rd, 6th, 9th and 12th weeks within the groups. Paired t test was used to compare the pre and post treatment mean values of the same outcome variables within groups. Paired t test was used to compare the changes in the selected variables of premenopausal BC survivors with those of postmenopausal BC survivors at the end of 12th week. Paired t test was also used to compare the changes in the various exercise groups with those of the control group. Friedman test was used to analyse QoL values within groups and Kruskal-Wallis H test across groups. Level of significance was set at p<0.05. Subjects in the three therapeutic exercise groups had significant improvements in the cardiopulmonary and QoL variables although in various degrees. Those in Group C recorded the highest improvements followed by those in Group A and then those in Group B. Improvements in the cardiovascular variables of Groups B and C were more in the postmenopausal BC survivors than those of the premenopausal BC survivors while the reverse was the case for Group A. No significant improvement was observed in the anthropometric variables of any of the groups. Combined aerobic exercise using treadmill and stretching exercise brought about the most significant therapeutic effects on selected cardiovascular and pulmonary parameters in BC survivors. This was followed by aerobic exercise using treadmill alone and then stretching exercise alone. All the therapeutic exercises brought about significant improvements in the QoL of the BC survivors. The combined exercise therapy and stretching exercise alone brought about more prominent therapeutic improvements in the cardiovascular parameters of postmenopausal BC survivors than those of premenopausal BC survivors. None of the therapeutic exercises brought about significant improvements in the anthropometric variables of the BC survivors. Therefore, an ideal dosage of therapeutic exercise intervention that improves cardiopulmonary functions and QoL of BC survivors is combined moderate intensity aerobic exercise using treadmill and stretching exercise performed for 30 minutes, 3 times a week for at least 12 weeks.
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