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Nigerian Postgraduate Medical Journal

Antibiotic prophylaxis for transrectal prostate biopsy: a comparison of one-day and five-day regimen.

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Agbugui JO, Obarisiagbon EO, Osaigbovo EO, Osime CO, Akumabor PN.

Department of Surgery, University of Benin Teaching Hospital, Benin, Edo state.

Correspondence to: Agbugui JO 08050526052 This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Summary

Aims and Objectives: To determine the difference in outcome between a 1- day and 5- day antibiotic regimen in the prevention of infective complications following transrectal prostate biopsy.

Patients and Methods: This prospective comparative study was done in the urology unit of University of Benin Teaching Hospital over a period of 14 months. Eighty seven patients were randomly assigned to 2 groups prior to the procedure. The patients in group I (N=42) received oral ciprofloxacin (500mg, 12 hourly) and oral metronidazole (400mg, 8 hourly) for 1 day while those in group II (N=45) received same antibiotic combination for 5 days. Urine samples for culture were taken an hour before the procedure and then 5 days after in all patients. Temperature monitoring with an easy-to-use thermometer was done thrice daily by the patients. Post biopsy fever and positive urine cultures were indicative of infection.

 

Results: The mean age of the patients was 68.5± 8.1 years. Infective complications occurred in 8(19%) in group I and 7(15.6%) in group II. Fever was noted in 5 patients in group I and 4 patients in group II (p=0.73) while positive urine culture was noted in 4 patients in each group (p=1.00). Complications were minor and transient except in a case of septicaemia in group II that required hospitalisation. Escherischia coli was the most common organism isolated from positive urine cultures.

Conclusion: A 1-day antibiotic regimen of oral ciprofloxacin and metronidazole is as effective as a 5-day regimenin the prevention of infective complications following transrectalprostate biopsy.

Key words: antibiotic prophylaxis, transrectal prostate biopsy

 

Compliance with driver’s license laws and illegal licensing among commercial bus drivers in Lagos, Nigeria: Policy implications and evidence for action

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1Ifeoma P Okafor 1,2 Kofoworola A Odeyem 3Duro C Dolapo 2Adebukola A Adegbola

1Department of Community Health & Primary Care, College of Medicine, Idi-Araba, P.M.B. 12003, Lagos, Nigeria

2Department of Community Health, Lagos University Teaching Hospital, Idi-Araba, P.M.B. 12003, Lagos, Nigeria

3Leverage Consulting Ltd, Road 425, Zone 6, Abuja, Nigeria.

Correspondence to: Ifeoma P Okafor Phone numbers: 234-8033272199, 234-7043294609

E-mail address: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Summary

Aims and Objectives: To determine the level of compliance with drivers license laws among commercial bus drivers in Lagos, Nigeria.

 

Subjects, Materials and Methods: Two intercity motor parks were selected by simple random sampling and all consenting minibus drivers participated in the study. Key Informant Interviews (KIIs) were also conducted with selected officials in the driver training and licensing authorities.

Results: Compliance with the minimum age for driving was high (93.6%), so also was having driving test prior to drivers license procurement (83.3%). Formal driver training and VA testing were very low, (26.1% and 32.9% respectively) Overall, only 9.3% of them were found to have fulfilled all the pre-license obligations before obtaining their first drivers license. The odds of a driver with a secondary education having formal driver training is 3.33 times higher than those with no education (OR 3.33, 95% CI 1.01-11.35). Drivers who were 60 years or older were 3.62 times more likely to be compliant than those who were between 20-29 years (OR 3.62, 95% CI 0.56-29.19). For the 98.3% of them who possessed valid licenses, 52.3% of them obtained them illegally. All the key officials saw RTIs as a serious public health problem but faced several challenges in the course of their work.

Conclusion: Overall compliance with pre-license regulations was very poor. There is need for a review and strict enforcement of drivers license laws to improve compliance. Also vital are fostering inter-sectoral collaboration and improvement in the operations of all establishments involved in driver training and license procurement in Nigeria.

Key words: road safety; policy; enforcement; Drivers License; Nigeria

 

Relevance of fibrinolytic protein (D-dimer) and fibrinopeptide A as markers of sickle cell anaemia vaso-occlusive crisis

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Ekwere TA 1Ogunro PS, 2Ebele U, Ekanem M

Department of Haematology, College of Health Sciences, University of Uyo, Akwa-Ibom State, Nigeria.

1Department of Clinical Pathology, College of Health Sciences, Ladoke Akintola University of Technology

Osogbo, Osun State Nigeria.

2Department of Haematology, College of Medicine, Lagos State University, Lagos, Nigeria.

Correspondence to: PS Ogunro E-mail: This e-mail address is being protected from spambots. You need JavaScript enabled to view it Mobile Phone: 08033061119

Summary

Aims and Objectives To determine the plasma concentration of fibrinolytic protein (D-dimer) and Fibrinopeptide A(FPA) in sickle cell anaemia (SCA) patients in steady state and vaso-occlusive crisis(VOC) for the purpose of determining their clinical value in assessing/or predicting the onset of VOC Subjects and Methods: A total of 25 (14 Males: 11Females) HbSS subjects in VOC , 24 (13M:11F) HbSS subjects in steady state between the ages of 10-40 years old and 30 (17M:13F) healthy HbAA volunteers, of the same age and sex wit th subject wer recruite fo th study Haematological parameters{Haemoglobi(Hb)Haematocrit(HCT)Whitbloocell count(WBC) and Platelets(Plt)} prothrombin time(PT), activated partial thromboplastin time(APTT), plasma concentrations of D-dimer and FPA were determined.

Results: Haemoglobin concentration of 6.22±1.75 g/dl and HCT of 18.45±6.43% for SCA subjects in VOC; Hb of 7.42±1.36 g/dl and HCT of 22.83±4.68% in steady state were significantly decreased(p<0.01) compared with Hb(13.0±1.04 g/dl and HCT( 41.09±3.50%) for HbAA controls. However, plasma FPA of 680.99 ± 411.37 ng/ml, WBC of 19.44±14.88 x109/L, Plt of 292.72±148.57 x109/L, APTT of 52.24±5.34sec. for SCA subjects in VOC and Plasma FPA of 449.67 ± 310.01 ng/ml, WBC of 11.84±7.67 x109/L, Plt of 292.72±148.57 x109/L, APTT of 47.76±4.80secs in steady state were significantly increased when compared with FPA(163.52 ± 86.26ng/ml), WBC(5.15±1.24 x109/L), Plt(173.44±59.90 x109/ L), APTT( 37.75±1.41secs) for HbAA controls.

Conclusion: Fibrinolysis is not significantly increased in SCA either in the steady state or during VOC. Fibrinopeptide A assay appears to be of value in the assessment of VOC in sickle cell anaemia.

Key words: SCA, HbAA, HbSS, D-dimer, Fibrinopeptide A

   

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