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Abstract

Objective: We aimed to determine the prevalence of depression and to find factors associated with depression in admitted medical patients. The differences in the pattern of depression between a university hospital (UH) and a regional hospital (RH) were determined as well.

Methods: This is a cross-sectional study. The Patient Health Questionnaire-9 (PHQ-9) was administered among hospitalized patients in medical wards. PHQ-9 could not differentiate between the type of depressive disorder that could be from medical conditions, adjustment disorder with depressed mood, major depressive disorder, or dysthymia.

Results: A total of 343 patients (191 in UH, 152 in RH group) with age of 52.1 ± 16.9 years were included. Timing of interview was 4.3 ± 1.4 days after admission. The prevalence of depression (PHQ-9 score ≥ 9) was 12% (7.3% in UH vs 17.8% in RH, p < 0.005). According to PHQ-9 scoring, the prevalence of moderate-to-severe depression was 3.8%. Mean PHQ-9 score in RH was significantly higher than in UH (p < 0.001). Multiple baseline characteristics were analyzed by logistic regression and found no factors associated with depression. There was no difference in baseline characteristics of UH patients with depression compared to RH, except for universal health coverage plan.

Conclusions: The prevalence of depression was 1 in 10 patients and was found to be more frequent and severe in RH than UH. All patients were at equal risk to develop depression during admission.

Abstract

The connection between venous thrombotic events in patients with implanted pacemakers and changes in coagulation factors has been the basis of numerous scientific studies for years. Results show that the effect on the coagulation system is a long-term and dynamic process, as well as presence of a significant dependence with many concomitant cardiovascular diseases.

Advances in medicine in recent decades and increase in life expectancy of patients with implanted cardiac devices (ICD) increase the risk of a variety of complications. These adverse events may be associated with development of thrombosis, change in the stimulation threshold, need for ablation due to concomitant rhythm pathology and others. Analysis of data from literature shows unequivocally that placement of endocardial electrodes leads to activation of the coagulation system in the body. On the one hand, this is a result of the direct traumatic moment and endothelial damage in the early post-procedure period, and subsequently, the presence of electrodes of the foreign body type in some individuals can provoke a procoagulation state.

More in-depth research is needed in this area to clarify the answers to these questions, namely: in which phase of the coagulation cascade are the changes most significant; is there a way to anticipate these changes and prevent them accordingly; is disturbed homeostasis of coagulation temporary or persistent.

These questions will be answered after sufficient data have been accumulated on these changes and how to modulate them.

Abstract

The novel coronavirus SARS-CoV-2 has caused a global health threat. This review summarizes comprehensive research findings about the SARS-CoV-2 persistence in inanimate surfaces and opportunities for applying biocides to limit spread of COVID-19. SARS-CoV2 is highly stable at 4°C but sensitive to heat and extremely stable in a wide range of pH values at room temperature. Coronaviruses also well survive in suspension. Desiccation has a more severe effect. SARS-CoV-2 can survive in the air for hours and on surfaces for days. Hospitals are significant epicenters for the human-to-human transmission of the SARS-CoV-2 for healthcare workers. The most contaminated SARS-CoV-2 zones and objects in isolation wards, in intensive care unit specialized for novel coronavirus pneumonia, are under discussion. SARS-CoV2 is sensitive to standard disinfection methods. Studies revealed that 62-71% ethanol, 0.5% hydrogen peroxide or 0.1% sodium hypochlorite inactivated SARS-CoV2 in 1 minute exposition; while 0.05-0.2% benzalkonium chloride or 0.02% chlorhexidine digluconate were less effective. Both ethanol and isopropanol were able to reduce viral titers after 30-seconds exposure. It was found for reusing personal protective equipment vaporized hydrogen peroxide treatment exhibits the best combination of rapid inactivation of SARS-CoV-2 and preservation of N95 respirator integrity under the experimental conditions. Overall, SARS-CoV-2 can be highly stable in a favourable environment, but it is also susceptible to standard disinfection methods. Environmental infection control of the air and especially for surfaces is considered as a mandatory step in addition to limiting person-to-person contact.

Abstract

Background. Conflicts across professional workgroup and hierarchies inundate the clinical workplace. Early Career Doctors (ECDs) are also affected either as victims or as a provocateur/perpetrator. The effects of conflict at their workplaces have both significant positive and negative dimensions and impacts on ECDs. Little has been reported about conflict among ECDs in Nigeria.

Thus, this study explored the issue of conflict and conflict resolution among ECDs in Nigeria, in a bid to elicit information on the causes, consequences, perpetrators and victims.

Method. This was a qualitative study, using Focus Group Discussions (FGD) to explore information on conflict and conflict management among purposively selected key respondents (n = 14) from seven tertiary hospitals in Nigeria. The respondents are ECDs who were leaders and representatives of other ECDs in their various hospitals. Two FGDs were conducted.

Results. The result showed that conflict is inescapable in clinical settings and occurred at different levels. The perpetrators are varieties of health workers, and most are task-related conflicts, although there are relational ones. The conflicts with the government on labour-related issues are also frequent. The lack of job description and specification and power struggle among others were highlighted as the drivers of conflicts between ECDs and other health-workers. Conclusion. The findings of the study were discussed, and suggestions were made to reduce its effect, which would require structural solutions to mitigate at different levels and the diverse players in the health sectors.

Abstract

Pathological aggregation and accumulation of α-synuclein in neurons play a core role in Parkinson’s disease (PD) while its overexpression is a common PD model. Autophagy-lysosomal pathways are general intraneural mechanisms of protein clearance. Earlier a suppressed autophagy in the brain of young transgenic mice overexpressing the А53Т-mutant human α-synuclein (mut(PD)) was revealed. Previous studies have recognized that Cystatin C displays protective activity against neurodegeneration. This cysteine protease inhibitor attracts particular attention as a potential target for PD treatment related to autophagy modulation. Here we evaluated the mRNA levels of Cst3 encoding Cystatin C in different brain structures of 5 m.o. mut(PD) mice at standard conditions and after the chronic treatment with a neuroprotective agent, ceftriaxone (100 mg/kg, 36 days). The inflammatory markers, namely, microglial activation by IBA1 expression and mRNA levels of two chitinases genes (Chit1, Chia1), were also assessed but no significant difference was found between control and transgenic mice. Cst3 mRNA levels were significantly reduced in the striatum and amygdala in the transgenic PD model. Furthermore, this was associated with autophagy decline and might be added to early signs of synucleinopathy development. We first demonstrated the modulation of mRNA levels of Cst3 and autophagy marker Becn1 in the brain by ceftriaxone treatment. Taken together, the results support the potential of autophagy modulation through Cystatin C at early stages of PD-like pathology.

Abstract

A clinical case of successful repair of a combination of total anomalous pulmonary venous connection (TAPVC) with collector stenosis in one-day-old newborn. Only one case of successful correction of such a pathology is reported previously. The operation was performed with cardiopulmonary bypass and temporary antegrade brain perfusion. The narrowed aortic area was resected, the integrity of the aortic arch was restored using an extended anastomosis, and TAPVC correction was performed using a “sutureless technique”. The postoperative period was uneventful. The newborn was discharged from hospital on the 12th day.

Abstract

Practical domestic monitoring of the menstrual cycle requires measurements of urinary metabolites of reproductive hormones: oestrone glucuronide (E1G) and pregnanediol glucuronide (PdG). Data reported in the literature are expressed as (i) concentration, without or with either creatinine- or specific gravity correction, or (ii) excretion rates. This variation in such a fundamental issue prompts consideration of the relationships between the four measures. Because the menstrual cycle kinetics of E1G and PdG are complex, we consider measurements of urinary creatinine, urea, galactose, xylose and inulin which tend to be more stable. We show that uncorrected concentration measurements of these urinary analytes can be positively correlated, negatively correlated or uncorrelated with the serum concentration. Based on measurements of urinary creatinine concentrations, urinary specific gravity and creatinine excretion rates, we conclude that urinary analyte concentration are likely to be more reliable when creatinine-corrected rather than corrected using specific gravity, but that both are less reliable than measurements of the excretion rate. This has implications for the quantitation of any urinary analyte, but especially for the monitoring of the menstrual cycle in which changes in E1G and PdG from one day to the next can be physiologically significant for a woman monitoring her fertility.

Abstract

Background: Historically, the Rod of Asclepius is considered as the correct symbol of Medicine. Unfortunately, many medical/health institutions in the world have erroneously interchanged the Rod of Asclepius symbol with erroneous symbols (e.g. Caduceus) to depict Medicine. This study aims to assess the official logos (i.e. institutional symbols) of university teaching hospitals in Nigeria and determine if these logos actually depict the true symbol of Medicine.

Methods: This study was a cross-sectional online survey of teaching hospitals in Nigeria on their official logos. A total of 40,556 operating hospitals and clinics in Nigeria were identified. After systematic screening, a total of 35 hospitals were identified as university teaching hospitals and used for the survey. Official information about the geopolitical zone, ownership and official logo of the selected hospitals was obtained (via online and offline search). Data collected was analysed using SPSS version 22 software.

Results: Out of the 35 surveyed university teaching hospitals, only 7 did not have snake(s) as part of their official logo. However, out of the remaining 28 hospitals that have snake(s) as part of their official logos, only 57.1% (16/28) of them have only one snake in their logo. Exactly half of the surveyed hospitals having logos with two entwined snakes (i.e. Caduceus) were owned by the federal government. Bivariate analysis showed that there exists statistically significant relationship between the geopolitical zone where a hospital is situated and the number of entwined snakes indicated in their official logo (p-value=0.034).

Conclusion: This study shows that the correct symbol of Medicine is not universally indicated in the official logos of the university teaching hospitals in Nigeria.

Abstract

The problem of physiological gait stereotype restoration in patients with post-stroke central hemiparesis remains relevant to this day. This is primarily associated with high risk of falls in this category of patients. At this point, there is a wide variety of methods related to exercise treatment and robotised correction or restoration of impaired gait against the background of post-stroke hemiparesis. At the same time, the problem of management of talipes equinovarus associated with this syndrome remains quite complex and not completely solved. We have analysed existing methods of talipes equinovarus correction with different levels of evidentiality.