OBJECTIVES: The purpose of this study is to present a scoping review of the measurements of tongue strength available, particularly in adult patients, following partial glossectomy. The subsequent impact on functionality and quality of life were also explored. MATERIALS AND METHODS: This study used a scoping review and the study selection comprised two stages of screening: the review of the title and abstract followed by a full-text review. During the first stage of screening, the title and abstracts of all retrieved references were reviewed against the predetermined inclusion criteria. In the second stage of screening, all studies were reviewed at full-text level, utilising the Full-Text Screening Relevance measure. A total of 20 articles were reviewed as they met the inclusion criteria. RESULTS: The study found that subjective and quality-of-life measures may still be useful in measuring tongue strength in developing contexts as they closely approximate objective measures and are reliable as an interim measure. However, there is still a need for the development of other objective measures, should funding be available.

BACKGROUND: Endometrial carcinoma (EC) is a common gynaecological malignancy in postmenopausal females. Diagnosis is made on endometrial biopsy, where histological subtype and tumour grade are used to predict disease progression and to plan surgical management OBJECTIVES: To determine the accuracy of preoperative biopsies compared with the final diagnosis on hysterectomy specimens Methods. This was a retrospective, cross-sectional study in which 126 biopsies and corresponding hysterectomy specimens, collected over a 3-year period, were reviewed. Patient demographics and histological features were recorded and statistically analysed. RESULTS: The most prevalent tumours were endometrioid endometrial carcinoma (EEC) (48.5%), serous carcinomas (25.4%) and carcinosarcomas (16.7%). The majority (66.7%) of tumours were high-grade tumours on biopsy and hysterectomy specimens (58.7% EECs had a poor sensitivity level (65.1%) compared with other subtypes but had a high specificity rate (90%). There was moderate agreement between biopsy and excision specimen diagnoses. High-grade tumours had a high sensitivity level (94.3%). CONCLUSIONS: Our study showed moderate agreement between histopathological diagnoses on biopsy and excision specimens. There was

BACKGROUND. Information on adverse events (AEs) in hospitalised patients in developing countries is scanty. OBJECTIVE. To compare the magnitude and characteristics of inpatient AEs in a tertiary, not-for-profit healthcare facility in Kenya, using medical records review and incident reporting. METHODS. Estimation of prevalence was done using incidents reported in 2010 from a random sample of medical records for hospital admissions. Nurse reviewers used 18 screening criteria, followed by physician reviewers to confirm occurrence. An AE was defined as an unexpected clinical event (UE) associated with death, disability or prolonged hospitalisation not explained by the disease condition. The kappa statistic was used to estimate inter-rater agreement, and analysis was done using logistic regression. RESULTS. The study identified 53 UEs from 2 000 randomly selected medical records and 33 reported UEs from 23 026 admissions in the index year. The prevalences of AEs from medical records review and incident reports were 1.4% (95% confidence interval (CI) 0.9 - 2.0) and 0.03% (95% CI 0.012 - 0.063), respectively. Compared with incident reporting, review of medical records identified more disability (13.2% v. 0%; p=0.03) and prolonged hospital stays (43.4% v. 18.2%; p=0.02). CONCLUSIONS. Review of medical records is preferable to incident reporting in determining the prevalence of AEs in health facilities with limited inpatient quality improvement experience. Further research is needed to determine whether staff education and a positive culture change through promotion of non-punitive UE reporting or a combination of approaches would improve the comprehensiveness of AE reporting.

Background: A high level of adherence is required to achieve the desired outcomes of antiretroviral therapy. There is paucity of information about adherence to combined antiretroviral therapy in Bayelsa State of southern Nigeria. Objectives: The objectives of the study were to determine the level of adherence to combined antiretroviral therapy among the patients, evaluate the improvement in their immune status and identify reasons for sub-optimal adherence to therapy. Methods: The cross-sectional study involved administration of an adapted and pretested questionnaire to 601 consented patients attending the two tertiary health institutions in Bayesla State, Nigeria: The Federal Medical Centre, Yenagoa and the Niger-Delta University Teaching Hospital Okolobiri. The tool was divided into various sections such as socio-demographic data, HIV knowledge and adherence to combined antiretroviral therapy. Information on the patient's CD4+ T cells count was retrieved from their medical records. Adherence was assessed by asking patients to recall their intake of prescribed doses in the last fourteen days and subjects who had 95-100% of the prescribed antiretroviral drugs were considered adherent. Results: Three hundred and forty eight (57.9%) of the subjects were females and 253 (42.1%) were males. The majority of them, 557 (92.7%) have good knowledge of HIV and combined anti-retroviral therapy with a score of 70.0% and above. A larger proportion of the respondents, 441 (73.4%), had > 95% adherence. Some of the most important reasons giving for missing doses include, “simply forgot” 147 (24.5%), and “wanted to avoid the side-effects of drugs” 33(5.5%). There were remarkable improvements in the immune status of the subjects with an increment in the proportion of the subjects with CD4+ T cells count of greater than 350 cells/mm3 from 33 (5.5%) at therapy initiation to 338 (56.3%) at study period (p<0.0001). Conclusion: The adherence level of 73.4% was low which calls for intervention and improvement. The combined antiretroviral therapy has significantly improved the immune status of the majority of patients which must be sustained. “Simply forgot” was the most important reason for missing doses.

INTRODUCTION: Global travel is an efficient route of transmission for highly infectious pathogens and increases the chances of such pathogens moving from high disease-endemic areas to new regions. We describe the rapid and safe identification of the first imported case of Ebola virus disease in a traveler to Lagos, Nigeria, using conventional reverse transcription polymerase chain reaction (RT-PCR) in a biosafety level (BSL)-2 facility. CASE PRESENTATION: On 20 July 2014, a traveler arrived from Liberia at Lagos International Airport and was admitted to a private hospital in Lagos, with clinical suspicion of Ebola virus disease. METHODOLOGY AND OUTCOME: Blood and urine specimens were collected, transported to the Virology Unit Laboratory at the College of Medicine, University of Lagos, and processed under stringent biosafety conditions for viral RNA extraction. RT-PCR was set-up to query the Ebola, Lassa and Dengue fever viruses. Amplicons for pan-filoviruses were detected as 300 bp bands on a 1.5% agarose gel image; there were no detectable bands for Lassa and Dengue viral RNA. Nucleotide BLAST and phylogenetic analysis of sequence data of the RNA-dependent RNA polymerase (L) gene confirmed the sequence to be Zaire ebolavirus (EBOV/Hsap/NGA/2014/LIB-NIG 01072014; Genbank: KM251803.1). CONCLUSION: Our BSL-2 facility in Lagos, Nigeria, was able to safely detect Ebola virus disease using molecular techniques, supporting the reliability of molecular detection of highly infectious viral pathogens under stringent safety guidelines in BSL-2 laboratories. This is a significant lesson for the many under-facilitated laboratories in resource-limited settings, as is predominantly found in sub-Saharan Africa.

An in-house loop-mediated isothermal amplification (LAMP) reaction was established and evaluated for sensitivity and specificity in detecting the presence of Salmonella Typhi (S. Typhi) isolates from Kelantan, Malaysia. Three sets of primers consisting of two outer and 4 inner were designed based on locus STBHUCCB_38510 of chaperone PapD of S. Typhi genes. The reaction was optimised using genomic DNA of S. Typhi ATCC7251 as the template. The products were visualised directly by colour changes of the reaction. Positive results were indicated by green fluorescence and negative by orange colour. The test was further evaluated for specificity, sensitivity and application on field samples. The results were compared with those obtained by gold standard culture method and Polymerase Chain Reaction (PCR). This method was highly specific and -10 times more sensitive in detecting S. Typhi compared to the optimised conventional polymerase chain reaction (PCR) method.

This paper investigates the natural frequencies of the profiled steel sheet dry board (PSSDB) system. Frequency response functions (FRFs), estimated experimentally, were used to determine the natural frequencies of three different PSSDB panels with different screw spacing. Finite element models (FEMs) were developed to predict the natural frequencies of the tested panels. The FEMs were verified by comparing their results with results of the experimental test, and these confirmed the natural frequencies of the system. The effect of screw spacing on the natural frequencies of the system was studied experimentally and numerically. The numerical results uncovered the effect of various parameters, such as the PSS and DB thicknesses and boundary conditions, on the fundamental natural frequency (FNF) of the system. Fifteen finite element models were developed to determine the FNF of the PSSDB system with practical dimensions. When applied as a flooring system these panels are categorised as low-frequency floor (LFF) or high-frequency floor (HFF), to determine occurrence of resonance, design criteria, and whether or not they would be comfortable for humans.

Background: Hypertension is a public health problem worldwide, but the prevalence in Amassoma, Southern Ijaw Local Government Area is not known. Objective: To investigate the prevalence of hypertension in the locality and the extent of control in diagnosed cases. Methods: It is a prospective study involving interviewing. Four hundred adults aged 20 years and above selected through stratified random sampling across the various compounds called "AMA"; a unit of settlement comprising extended families of common ancestors. A self-developed, validated and pretested interviewer-administered questionnaire on demographics, predisposing factors, and medication history was used. In addition, measurement of respondents´ blood pressure, weight and height was carried out. The Body Mass Index calculated and the data were appropriately analysed. Results: The response rate of questionnaire distribution was 100.0% being interviewer administered alongside weight, height and blood pressure measurement. Majority of respondents were female. Almost half of respondents (46.5%) had their BMI above normal, 15.3% (61) of which falls within the obese region (>30.0kg/m2). The mean (SD) systolic blood pressure among males was 133.3 (3.2) mmHg and that of females was 127.4 (3.0) while the mean (SD) diastolic blood pressures were 86.2 (1.7) and 83.9 (2.4) for males and females respectively. Crude prevalence rate of hypertension in the community was 15.0% (60) out of which 13.8 % (55) were previously diagnosed. The hypertension was that of Stage I in 11.5% (46) and Stage II in 3.5% (14). Hypertension prevalence was slightly higher in males (18.8%) than that of the females (12.5%) (p= 0.0889), Relative Risk (RR)=1.500 [95%CI 0.9422:2.388]. The prevalence rate among 40 years and above was 41.6% (42/101) who also constituted 70.0% (42/60) of participants with hypertension in the survey and 10.5% (42/400) of the total. Of the previously diagnosed cases of hypertension, only 31% (17/55) were taking their drugs during the survey and only 12.7% (07/55) had regular adherence to medication and adequate BP control was achieved in 7.3% (04/55). Majority of the patients on drugs (21.8%) (12/55) were either taking methydopa as monotherapy or in combination with amiloride and hydrochlorothiazide. Other drugs being taken by patients include lisinopril, propranolol, amlodipine, atenolol, nifedipine and low dose aspirin. Conclusion: The prevalence of hypertension in the semi urban community is 15.0% with a pre-hypertension in another 23.5%. There was poor control of blood pressure among previously hypertensive patients.

Antecedentes: La hipertensión es un problema de salud pública mundial, pero la prevalencia en Amassoma, Región del gobierno local de Southern Ijaw, es desconocida. Objetivo: Investigar la prevalencia de hipertensión en la localidad y el grado de control de los casos diagnosticados. Métodos: Estudio prospectivo que incluyó una entrevista. Se seleccionó a 400 adultos de 20 años o más mediante un muestreo aleatorio estratificado en los varios sectores llamados "AMA"; la unidad familiar comprendía las familias con los antepasados comunes. Se utilizó un cuestionario auto-desarrollado, validado y pre-testeado administrado por encuestador sobre demografía, factores predisponentes y medicación. Además, se realizó una medición de presión arterial, peso y altura de los respondedores. Se calculó el índice de masa corporal y se analizaron los datos pertinentemente. Resultados: La tasa de respuesta de la distribución del cuestionario fue del 100%, siendo el entrevistador quien midió peso, altura y presión arterial. La mayoría de los respondentes eran mujeres. Casi la mitad de los respondentes (46,5%) tenían un IMC por encima de lo normal, 15,3% (61) de ellos estaban en la zona de obesidad (>30,0 kg/m2). La media (DE) de la presión arterial sistólica entre hombres era de 133,3 (3,2) mmHg y en mujeres de 127,4 (3,0), mientras que la media (DE) de la presión arterial diastólica fue de 86,2 (1,7) y de 83,9 (2,4) para hombres y mujeres, respectivamente. La tasa de prevalencia cruda de hipertensión en la comunidad fue del 15,0% (60) de los que el 13,8% (55) habían sido previamente diagnosticados. La hipertensión era de estadio I en el 11,5% (46) y de estadio II en el 3,5% (14). La prevalencia de hipertensión fue ligeramente mayor en hombres (18,8%) que en mujeres (12,5%) (p=0,0889; riesgo relativo (RR)=1,500 [IC95%= 0,9422:2,388]. La tasa de prevalencia entre los de 40 años o más fue del 41,6% (42/101) que también constituían el 70,0% (42/60) de los participantes con hipertensión en el estudio y el 10,5% (42/100) del total. De los casos previamente diagnosticados de hipertensión, sólo el 31% (17/55) estaban tomando medicamentos regularmente durante la encuesta y sólo el 12,7% cumplían regularmente la medicación y se alcanzó el control adecuado de la presión arterial en el 7,3% (4/55). La mayoría de los pacientes medicados (21,8%) (12/55) estaban o con metildopa en monoterapia o en combinación de amiloride and hydrochlorothiazide. Otros medicamentos utilizados incluían lisinopriolo, propranolol, amlodipina, atenolol, nifedipina y bajas dosis de aspirina. Conclusión: La prevalencia de hipertensión en el área semi-urbana es del 15,0% con una pre-hipertensión en otro 23,5%. Había in pobre control de la presión arterial entre los pacientes previamente diagnosticados.

OBJECTIVE: To assess the efficacy of chloroquine and sulfadoxine/pyrimethamine in the treatment of uncomplicated Plasmodium falciparum infections in Somalia. METHODS: Patients with clinical malaria in Merca, an area of high transmission of the disease, were treated with the standard regimens of chloroquine (25 mg/kg) or sulfadoxine/pyrimethamine (25 mg sulfadoxine and 1.25 mg pyrimethamine per kg). Similar patients in Gabiley, an area of low transmission, received the standard regimen of chloroquine. The clinical and parasitological responses were monitored for 14 days. FINDINGS: Chloroquine treatment resulted in clinical failure in 33% (n = 60) and 51% (n = 49) of the patients in Merca and Gabiley respectively. There were corresponding parasitological failures of 77% RII/RIII and 35% RII/RIII. Patients who experienced clinical failure had significantly higher initial parasitaemia than those in whom there was an adequate clinical response, both in Merca (t = 2.2; P t = 2.8; P n = 50) of the patients achieved an adequate clinical response despite a parasitological failure rate of 76% RII/RIII. CONCLUSION: Chloroquine should no longer be considered adequate for treating clinical falciparum malaria in vulnerable groups in the areas studied. Doubts about the therapeutic life of sulfadoxine/pyrimethamine in relation to malaria are raised by the high levels of resistance in the Merca area and underline the need to identify suitable alternatives.

OBJETIVO: Evaluar la eficacia de la cloroquina y la sulfadoxina/ pirimetamina en el tratamiento de las infecciones por Plasmodium falciparum sin complicaciones en Somalia. MÉTODOS: Se trató a pacientes con paludismo clínico de Merca, un área de alta transmisión de la enfermedad, con las pautas estándar de cloroquina (25 mg/kg) o sulfadoxina/pirimetamina (25 mg/kg de sulfadoxina y 1,25 mg/kg de pirimetamina). Se administró también el régimen ordinario de cloroquina a pacientes comparables de Gabiley, una zona de transmisión baja. La respuesta clínica y parasitológica se controló por espacio de 14 días. RESULTADOS: El tratamiento con cloroquina no tuvo efecto clínico en el 33% (n = 60) y el 51% (n = 49) de los pacientes de Merca y Gabiley, respectivamente. Los casos correspondientes sin efecto parasitológico (fracasos RII/RIII) representaron el 77% y el 35%. Los pacientes que no respondieron clínicamente presentaron una parasitemia inicial significativamente mayor que la de quienes sí lo hicieron, tanto en Merca (t = 2,2; P t = 2,8; P n = 50) de los pacientes respondieron favorablemente a nivel clínico, pese al 76% de fracasos RII/RIII observado a nivel parasitológico. CONCLUSIÓN: La cloroquina ha dejado de constituir una opción adecuada para tratar el paludismo clínico por falciparum entre los grupos vulnerables de las áreas estudiadas. Los altos niveles de resistencia observados en el área de Merca plantean dudas respecto a la vida terapéutica de la sulfadoxina/pirimetamina como agente antipalúdico y subrayan la necesidad de identificar alternativas adecuadas.

OBJECTIF: Evaluer l'efficacité de la chloroquine et de la sulfadoxine/pyriméthamine dans le traitement des infections non compliquées à Plasmodium falciparum en Somalie. MÉTHODES: Les patients atteints de paludisme clinique dans la région de Merca, où la transmission de la maladie est intense, ont été traités selon le schéma standard par la chloroquine (25 mg/kg) ou la sulfadoxine/pyriméthamine (25 mg/kg de sulfadoxine et 1,25 mg/kg de pyriméthamine). Des patients de mêmes caractéristiques mais dans la région de Gabiley, où la transmission de la maladie est faible, ont reçu le traitement standard par la chloroquine. La réponse clinique et la réponse parasitologique ont été suivies pendant 14 jours. RÉSULTATS: Le traitement par la chloroquine s'est soldé par un échec clinique chez 33 % des patients (n = 60) dans la région de Merca et 51 % des patients (n = 49) dans la région de Gabiley. Les taux d'échec parasitologique correspondants (RII/RIII) étaient respectivement de 77 % et 35 %. Chez les patients ayant présenté un échec clinique, la parasitémie initiale était significativement plus élevée que chez ceux ayant montré une réponse clinique satifaisante, aussi bien dans la région de Merca (t = 2,2 ; p<0,04) que dans celle de Gabiley (t = 2,8 ; p<0,01). Avec la sulfadoxine/pyriméthamine, 98 % des patients (n = 50) ont présenté une réponse clinique satisfaisante malgré un taux d'échec parasitologique (RII/RIII) de 76 %. CONCLUSION: Dans les régions étudiées, la chloroquine ne doit plus être considérée comme traitement adéquat du paludisme clinique à falciparum dans les groupes vulnérables. Les hauts niveaux de résistance observés dans la région de Merca soulèvent des doutes quant à la durée de vie thérapeutique de la sulfadoxine/pyriméthamine pour le traitement du paludisme et soulignent la nécessité d'identifier des alternatives convenables.