Open Access Short Communication

Occurrence of Carbapenem Resistant Klebsiella pneumoniae in Clinical Samples from Some Selected Hospitals in Zaria, Kaduna State

I. M. Hussaini, O. S. Olonitola, A. B. Suleiman

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-11
DOI: 10.9734/JAMPS/2017/30388

Aims: The aim of the study was to determine the occurrence of carbapenem resistant Klebsiella pneumoniae in clinical samples from some selected hospitals in Zaria, Kaduna state.

Study Design: Hospital based cross sectional study. The study was carried out over a period of 6 months from June to November 2015. 

Methodology: A total of 150 clinical samples were collected from which 19 Klebsiella pneumoniae were isolated. Antibiotic susceptibility testing was carried out for all the isolates. The isolate that was resistant to Imipenem was screened for K. pneumoniae carbapenase production using the Modified Hodge Test.

Results: Out of the 19 isolates screened, only one was intermediately resistant to Imipenem. This isolate was screened for Klebsiella pneumoniae carbapenemase (KPC) production using the Modified Hodge Test (Cloverleaf test). The isolate was a non KPC producer, suggesting the resistance to Imipenem is likely due to other mechanism such as decreased outer membrane permeability, over expression of β-lactamases, production of cephalosporinase and porin loss but not due to carbapenemase production. Carbapenem resistant Klebsiella pneumoniae in Zaria as seen in this study occurs at the rate of 0% and that of KPC producing Klebsiella pneumoniae occurs also at 0%. 

Conclusion: Even though the level of carbapenem resistance was low and none of the isolates was a KPC producer, most of the isolates were multidrug resistant isolates and this is alarming.

Open Access Original Research Article

The Spectrum of Breast Diseases in Nigeria North Central: A Histopathological Survey

B. A. Eke, B. A. Ojo, P. D. Akaa, C. N. Ahachi, C. Soo, A. Adekwu

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-6
DOI: 10.9734/JAMPS/2017/32384

Breast diseases to most patients are sources of uncertainty and apprehension. The diseases of the breast are a heterogeneous group of lesions consisting of both benign and malignant. This study from North Central Nigeria is aimed at examining these diverse lesions. 249 breast biopsies with histopathological diagnosis seen at Benue State University Teaching Hospital, Makurdi, Nigeria between October, 2012 and January 2017 were examined. The cases were retrieved from the data base of the histopathology department with the patients request forms. The patient’s bio data was extracted from the request form including age, sex and histopathological diagnosis. The 249 breast biopsies with diagnosis accounted for 8.1% of all tissue specimens diagnosed within the study period. 244 cases were females and 5 cases were males. The breast lesions are seen from second decades of life. Benign Breast Diseases (BBDs) accounted for 54% of cases while malignant breast diseases (MBDs) accounted for the remaining 46%. The commonest BBD is fibroadenoma accounting for 54.1% of all BBDs. The commonest histological type of breast cancer is invasive ductal carcinoma (88.6%). The incidence of breast diseases especially malignancy is on the increase in our environment with most patients presenting at advanced stages of the disease. There is a need to increase advocacy with screening of patients at increased risk in order to get the patient at an early stage that will help improve prognosis.

Open Access Original Research Article

Assessment of National Health Insurance Scheme’s (NHIS) Effectiveness in a Tertiary Teaching Hospital in Southeast Nigeria

N. Ele Grace, O. Ogbonna Brian, M. Ochei Uche, U. Odili Valentine

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-9
DOI: 10.9734/JAMPS/2017/32767

Background: The fundamental concept of health insurance is risk sharing and burden bearing. The scheme is undermined by limitations ranging from very frequent use of the services more than necessary by enrollees, to cost escalation, poor management, and skimming. Assessment of services is a quality control measure in patients’ care and service delivery. It helps to identify gaps for improvement of care and services.

Objective: This study assessed the effectiveness of NHIS from the perspective of healthcare providers and managers involved in its implementation to understand the nature of services, and gaps with the view to exploring ways of improving its service delivery.

Methods: The study was a descriptive cross-sectional survey using focused group discussion guide to extract information from managers and healthcare providers. Structured interview guides were used to conduct key informant interview (KII). Data were summarized using descriptive statistics.

Results: The greatest challenge was limited availability of essential drugs (60.0%), followed by inadequate space (40.0%), inadequate number of staff (40.0%) to meet up with the demand of NHIS patients and delay on reimbursement (40.0%). Most of the key informants 6.0 (60%) attested to poor availability of essential drugs.

Conclusion: There is the need for an improvement in accessibility and availability of essential drugs in the scheme. Improvement on the quality of services can promote increased enrolment. Findings suggests the need for improved funding, staff training and development, and more investigative studies into the activities and operations of the scheme to positively impact health insurance operations and improve enrolment by clients. Improved funding, provision of adequate space, infrastructure, good monitoring and evaluation system will boost service delivery and promote sustainability.

Open Access Original Research Article

Development and Validation of Stability Indicating UFLC Method for the Estimation of Anti-spasmodic Drug - Valethamate Bromide

R. Sairam Aditya, Anandkumar Tengli, Ramesha ., R. S. Chandan, K. Anupama, B. M. Gurupadayya

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-12
DOI: 10.9734/JAMPS/2017/26825

A stability indicating Ultra-Fast Liquid Chromatography (UFLC) method has been developed to estimate valethamate bromide (V&B) in tablet dosage forms and to separate analyte from other degradants and to carryout forced degradation studies. The chromatographic separation was achieved by using phenomenex kinetex 5 μ C18 100A (250x 4.6 mm) column with a flow rate of 1 mL/min in an isocratic mode with the mobile phase consisting of 0.05 M potassium dihydrogen phosphate buffer pH 7.5 (adjusted with potassium hydroxide) and acetonitrile in the ratio of 50:50. The eluents were monitored with PDA detector at 227 nm. In this developed method valethamate bromide was eluted at a retention time of 4.4 ± 0.1 min. The proposed method is having linearity in the concentration range of 2-12 μg/mL. The present method was successfully validated with respect to system suitability, linearity, precision, accuracy, limit of detection (LOD), limit of quantification (LOQ) and robustness as per international council for harmonization (ICH) guidelines. The drug was subjected to different degradation conditions like acid and alkali hydrolysis, oxidation, thermal and UV radiation etc. Peak purity of the drug was passed in all degradation conditions which demonstrated the specificity of assay method for it in presence of degradation products. The proposed method can be applied for determination of valethamate bromide in pure drug and in pharmaceutical formulation.

Open Access Original Research Article

Enzyme link Immunosorbent Assay-based Detection of Hepatitis B Virus Infection in Correctional Facilities in Sokoto Metropolis, Sokoto State Nigeria

B. R. Alkali, B. I. Aisha, M. F. Useh, A. B. Shuaibu, M. Bello, A. Firdausi, A. J. Okwori

Journal of Advances in Medical and Pharmaceutical Sciences, Page 1-9
DOI: 10.9734/JAMPS/2017/32199

ELISA-Based detection of HBV infection in correctional facilities in Sokoto metropolis, Sokoto state Nigeria was carried out using a questionnaire survey to determine the associated risk factors of the disease and serological method using [Enzyme link immunosorbent Assay (ELISA)] to determine hepatitis B surface antigen (HBSAg) among inmates. Of the 180 participants from the two correctional facilities in Sokoto state (Sokoto central prison and Remand home) overall prevalence rate of (42.2%) was obtained. The distribution of HBV infection according to age was statistically significant, and the age groups of 21-25 and 36-40 years had the highest prevalence rates (61.3%). However higher prevalence was recorded among males (42.6%) than females (36.4%). Analysis of spatial distribution of prevalence of HBV infection showed that Remand home (juvenile detention centre) had the highest prevalence rate of (75%). It was concluded that hepatitis B virus infection was found to be prevalent in correctional facilities in Sokoto state in which duration of stay and multiple sexual partners were the main risk factors. Furthermore there is need for Nigerian government to establish a policy that would make general screening of all the inmates in correctional facilities for HBV infection and vaccinate them against the disease.