International Medical Journal

Abstract :

More evidence confirmed the dopaminergic system involvement in ulcerative colitis (UC) pathogenesis. Genes, coding for D3 dopamine receptor were found in neuromuscular and mucosal layers in colon, as well as on immune cells mostly of primary immune response which indicates D3 receptor as the potential therapeutic target for UC. In present study we checked the hypothesize on the protective role of D3 receptor agonist in experimental models of UC. We used two models of UC: 6% iodoacetamide (IA)-induced UC in Wistar rats (0.1 ml, i.c.); and spontaneously developed colitis in IL-10 KO mice. Rats with IA-induced UC were treated with D3R agonist 7-OH-DPAT (in doses of 0.2 mg/kg and 1 mg/kg, s.c. on the 2nd and 5th days). Autopsy on the 7th day. Clinical, macroscopic and microscopic evaluation of UC were performed. It was indicated that during the normal condition D3R were localized on epithelial, endothelial and enteric neurons of rat’s colon mucosa. During the development of IA-induced UC in rats and UC in IL-10 KO mice, expression of D3R protein markedly decreased and its expression was observed mainly on the surface colonocytes. Treatment with 7-OH-DPAT in dose of 0.2 mg/kg had positive effect on clinical and morphological signs of IA-induced UC in rats. The administration of 7-OH-DPAT altered the mucus composition, also enhanced mast cell and macrophage functional reserve. Activation of D3 dopamine receptor might be the potential molecular target for UC treatment.

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Abstract : COVID-19 is a major Public Health challenge that has affected the world’s economy. Assessment of the knowledge, attitude and practices of Healthcare workers (HCWs) towards COVID-19 can improve or sustain successes being recorded by relevant agencies in the fight against COVID-19. This study sought to determine the levels of knowledge, attitude of HCWs towards COVID-19 among Healthcare workers at the Alex Ekwueme Federal University Teaching Hospital, Abakaliki. A cross-sectional survey was done using semi- structured questionnaires which were pre-tested for clarity and a simple sampling technique. Data collected were analyzed using SPSS version 22. Categorical variables were presented as frequencies and percentages while continuous variables were presented as mean and standard deviation. Out of the 368 respondents, 205 (55.7%) were doctors while 150 (40.8%) were nurses. Others were clerical workers, administrative officers and maintenance workers. The sex distribution showed 181 (49.2%) were males while 187 (50.8%) were females. The 25-34 years’ age group was the modal age group. Knowledge of COVID-19 was generally high amongst respondents recording a correct response to questions about knowledge of COVID- 19 in more than 90% of the case. However, the attitude and practice of COVID-19 infection, prevention and control protocols were generally poor especially for this group of the population who are Health care professionals. Out of the respondents, 41.8% would not stay at home if they had minor COVID-19 like symptoms, only 39.4% would take responsibility to ensure people around them follow good respiratory hygiene. Respondents who would keep social distancing while talking with co-workers, ensure safe disposal of personal protective equipment (PPEs) and safe waste management of PPEs were 56%, 39.9% and 53.8% respectively. This study showed that knowledge of COVID-19 disease prevention protocols is high but attitude/practice of these laid out protocols still desires a lot of effort from HCWs. There is need for training/retraining of HCWs on COVID-19 infection, prevention control strategies to ensure the success being recorded against the disease is sustained while preventing the possibility of a second wave of infection and to be armed with relevant skills to reduce infection amongst co-workers and the public if it does occur.
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Abstract : Better follow-up can provide an unrealized opportunity to identify diabetic patients potentially at risk of complications. We evaluated the associations between serum kynurenin/tryptophan ratio and type 2 diabetes. Data were collected from a cohort of 111 patients with type 2 diabetes aged 40 years and older, recruited from January 15, 2018 to May 15, 2018. The K/T ratio was used as a marker of indoleamine 2,3-dioxygenase 1 enzyme activity. The determination of serum tryptophan and kynurenin levels was performed according to an analytical protocol based on liquid chromatography coupled with tandem mass spectrometry (LC-MS/MS). 11 non-insulin-treated men and 28 women, mean ages 47.82 ± 9.38 and 49.25 ± 9.77 years, respectively, and 21 insulin-treated men and 51 insulin-treated women, mean ages 66.52 ± 7.30 and 64.63 ± 8.96 years, respectively, were recruited. The K/T ratio was significantly associated with age (r = 0.453, p = 0.004) and duration of diabetes (r = 0.415, p = 0.009) in the non-insulintreated group. It was also significantly associated with age (p < 0.001), blood glucose (r = -0.291, p = 0.013), and HbA1c (r = -0.315, p = 0.007) in insulin-treated patients. The K/T ratio could serve as a novel biomarker for the progression of type 2 diabetes and as a threshold for earlier clinical intervention.
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Abstract :

Women with advanced breast cancer (ABC) who are hormone receptor (HR) positive and human epidermal growth factor receptor 2 (HER 2) negative are candidates for first line hormonal therapy including aromatase inhibitors (AI). In the past few years new combination therapies became available as  palbociclib with letrozole; increasing the progression free survival (PFS) [1]. Several studies were conducted to assess the chemo-endocrine combination in ABC among which some assessed the combination of capecitabine with aromatase inhibitors [2].Our study is a prospective phase II trial; we randomly assigned patients with HR positive, Her 2 negative ABC, who didn’t receive previous systemic endocrinal treatment for ABC to receive aromatase inhibitor (AI) or capecitabine (625 mg/m2 bid PO for 14 days; repeated every 21 days)  plus AI administered daily  (CapAI).We carried out an interim analysis to determine the toxicity of the CapAI combination. Toxicity was assessed in both arms. There was no significant difference in the rates of toxicity in both arms regarding haematological toxicity (anaemia, thrombocytopenia and neutropenia), fatigue, nausea, vomiting, diarrhoea, mucositis. But there was significant difference in the hand foot syndrome with the 14.8% in the CapAI arm versus 0 % in the AI only arm, peripheral neuropathy with 25.9 % vs 2.3% and hepatic toxicity 14.8% vs 0 %. Grade 3 toxicity was reported in only 3 patients in our study all in the CapAI arm (fatigue, thrombocytopenia and neutropenia). No permanent discontinuation occurred but 25% dose reduction was done in one patient due to decrease in creatinine clearance.

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Abstract : To assess the prevalence of academic stress and perceived self-esteem and to identify their associated risk factors among nursing students. A cross-sectional study in which 130 nursing students were selected by convenient sampling. Academic stress and perceived self-esteem were measured by using Academic Stress Scale and Rosenberg’s Self-Esteem Scale. Multiple logistic regression was used to assess the combined effect of various factors associated with academic stress and perceived self-esteem. Overall, 78.46% of nursing students experienced high academic stress and 23.50% had low perceived self-esteem. The highest level of academic stress was more common among second and third year students (AOR 0.35, P 0.04). Academic stress was less common among students who received family support (AOR 5.34, P 0.01) and those having family salary ≥8000 SAR (AOR 0.38, P 0.01). In contrast, perceived self-esteem was low among second and third year students (OR 0.43, P 0.02) and among students who did not received family support (AOR 2.46, P 0.03). It is recommended that academic advising and guidance unit in nursing college to provide psycho-educational interventions concerning academic stress management. These interventions would help make the students to be aware of their level of self-esteem.
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