Journal de recherche clinique

Aim: To measure the change in depth of periodontal pockets after performing local drug delivery with GREEN TEA GEL and comparing it with chlorhexidine gel (Hexidine Gel).

Materials Method: A total of 20 chronic periodontitis patients participated based on the inclusion and exclusion criteria. Complete Scaling and Root Planing (SRP) was performed for all subjects and LDD was done using green tea gel on one site and with hexidine gel on contralateral site. Following parameters including Gingival Index (GI), Clinical Attachment Loss (CAL), and Probing Pocket Depth (PPD) were recorded at baseline and on the 28th day.

Results: During follow up being done on 28th , tooth sites which received green gel showed significantly lower mean scores (GI=1.72, p=0.006,CAL=1.60,p=0.003 and PPD=3.83 mm,) as compared to baseline (GI=2.00, CAL=1.90, and PPD=4.79).

Conclusion: Green tea gel was found be successful in reducing pocket depths and inflammation, after 4 weeks, in chronic periodontitis patients, when been used as an LDD agent as an adjuvant to SRP

Population of cancer stem cells in solid tumors represents a major factor of resistance to conventional therapy that influences patient survival. We recently identify RASSF1A as a novel regulator of cancer stemness that plays a key role in regulation of mechanical properties provided by ECM in lung cancer. We showed that epigenetic loss of RASSF1A promotes YAP1 nuclear accumulation which, via P4HA2 expression, drives ECM remodeling associated with Cancer Stem Cell (CSC) plasticity during malignant carcinogenesis.

Retinitis Pigmentosa (RP) is an incurable disease for which effective treatments are lacking. Mer tyrosine kinase (MERTK) is a causative gene of RP. Royal College of Surgeons rats with a Mertk mutation showed impaired phagocytosis of the photoreceptor outer segment by the Retinal pigment Epithelium (RPE). Using RPE differentiated from induced Pluripotent Stem Cells (iPSC-RPE) of RP patients carrying MERTK mutations, recent studies have shown deterioration of phagocytosis in the iPSC-RPE. This review focused on the function of phagocytosis of iPSC-RPE cells derived from RP patients carrying MERTK mutations and discussed the possibility of developing treatments for this disease using this in vitro disease model.

Background: Most studies related to maternal mortality have focused mainly on women and direct clinical causes. However, it is important to look at the background predisposing factors in order to reduce maternal deaths. Men’s involvement in reproductive health is recommended. Their involvement in antenatal care service is identified as important in maternal health. Awareness of obstetric danger signs facilitates men in making a joint decision with their partners regarding accessing antenatal and delivery care. The aim of this study was to assess the level of awareness and perception of factors associated with maternal mortality among men/ husbands of women attending antenatal at Ndola Teaching Hospital in Copper belt province, Zambia. Methodology: A descriptive cross-sectional study was carried out in 2021 using a structured questionnaire to collect information on sociodemographic characteristics, awareness levels, perception, knowledge of factors associated with maternal mortality and the role of men in antenatal care. A total of 316 respondents (men/husbands of women attending antenatal care) were sampled using a simple random sampling technique. Data were analysed based on descriptive statistics, chi- square and Fisher's exact test using SPSS version 21. The level of statistical significance was set at p<0.05. The results were presented using tables and charts. Results: Awareness scores show that approximately 56% of the respondents had high awareness level, while 34.4% had low awareness level and 9.6% had average level. Delay/problems of going to the hospital in case of an emergency was the most commonly identified (97.2%) maternal mortality risk factor and Lack of preparation for a pregnancy was the least identified (31.9%). Perception of maternal mortality risk factors was negative in just above half (51.9%) of the respondents. There was a statistically significant relationship between educational level; occupation with both awareness and perception scores.

Introduction: First Aid is immediate care given for the purpose of preserving life and minimizing the consequences of injury and illness until help, from trained medical workers is obtained. The likelihood of an injury or accident victim living or dying depends on the timeliness of the aid given. On a global scale, someone dies every 5 seconds as a result of an injury, over 15000 people’s lives are cut short every day and about 5.8 million people die in a year. Survival is greatly increased if bystanders quickly begin applying first aid. Therefore, this study aims to assess the levels of first aid knowledge in secondary pupils at three selected schools in Ndola, Zambia. Methods: An analytical cross sectional study was carried out among pupils at three selected schools in Ndola, Zambia. The data collection tool that was used is a self-administered questionnaire. A two stage sampling method was used. Firstly, a non-probability sampling method was used to select schools. Thereafter, classes and their respective pupils were sampled randomly. A sample size of 376 was used. The study was carried out at Chiluba Secondary School, Lubuto Secondary School and Ndola Skill School. Data was entered and analysed using SPSS version 20, and categorical variables were analysed using chi Square. Results: In this study, majority of the participants had poor knowledge (87.8%), followed by those with average knowledge (6.4%), then those with no knowledge (5.3%) and finally those with good knowledge (0.5%). The mean score was 3.70, the median was 4.00, the mode was 3, the standard deviation was 2.008 and the sum was 1393. It was found that there is an association between levels of first aid knowledge and exposure to first aid information from the media, receiving first aid knowledge from guardians and religion. However, there was no association between levels of first aid knowledge and age, economic status, opinion, being taught first aid at school and being a member of a first aid club. It was found that the factors that influence levels of first aid knowledge include exposure to first aid information from the media and receiving first aid information from guardians.

Background: Unattended home delivery is when the pregnant woman is unassisted or only attended by a lay person, perhaps their spouse, family, friend, or a non-professional birth attendant, sometimes also called free-births. The prevalence of home deliveries shows regional variations with South East Asia showing values reaching as high as 65%; Europe less than 2% and Africa with estimates reaching as high as 62% in some areas. In sub-Saharan Africa, statistics on deliveries that occurred at home showed prevalence rates of 19% in Namibia, 43%in Malawi, 52% in Zambia and 53% in Tanzania. At the provincial level, 68.4%of the deliveries in Northern Province occurred at home followed by Central Province and Luapula Province at 66.1 percent and 64.3 percent respectively. Home deliveries in developing countries that are largely unplanned, accidental and unhygienic have contributed to ninety-nine percent of maternal deaths occurring worldwide. Births occurring outside the health facility in Zambia are more likely to have pregnancy complications that may result in maternal and fetal deaths due to lack of skilled attendance. Socioeconomic variables and physical distance from a health facility influence the place of delivery. Sunkutu village is one of the rural areas in Kasama District with high maternal morbidity and mortality. No particular study has been done in the area on prevalence and risk factors of home deliveries hence this study. Objectives: To determine the prevalence and risk factors of unattended home births in Sunkutu village of Kasama District. Methods: An analytical cross sectional study was employed aimed at determining the prevalence and risk factors of unattended home births in Sunkutu Village of Kasama District. The target population will comprise women of child bearing age (15-49 years).

Familial Hypercholesterolaemia (FH) is the most common primitive cause of hypercholesterolaemia, affecting 1: 200-250 individuals and characterized by lifelong elevation of lowdensity lipoprotein cholesterol (LDL-C) levels which significantly accelerate atherosclerosis. Early detection and treatment of hypercholesterolaemia in childhood can reduce the impact on the cumulative life-burden of LDL cholesterol. In the last ten years, many screening strategies involving the whole family have been carried out: selective screening, cascade screening, inverse screening, and universal screening. Blood lipid profile evaluation (total cholesterol, LDL-C, HDL-C and triglycerides) is the first step. It has to be ideally performed between 2 and 10 years of age. Hypercholesterolaemia has to be confirmed with a second sample and followed by the detection of family history for premature (before 55 y in men and 60 y in women) or subsequent cardio-vascular events and/or hypercholesterolaemia in 1st and 2nd degree relatives. The management of hypercholesterolaemia in childhood primarily involves healthy lifestyle and a prudent low-fat diet, emphasizing the benefits of the Mediterranean diet. Statins are the cornerstone of the drug therapy approved in USA and in Europe for use in children. Ezetimibe or bile acid sequestrants may be required to attain LDL-C goal in some patients. Early identification of children with severe hypercholesterolaemia or with FH is important to prevent atherosclerosis at the earliest stage of development, when maximum benefit can still be obtained via lifestyle adaptations and therapy.

Non-steroidal anti-inflammatory drugs are a drugs that are used to treat inflammatory processes and also used to relieve pain in inflammatory areas of the body by inhibiting two enzymes that are involve in inflammation. This group of drugs includes aspirin, Indometacin, Brustan, Diclofenac, Ibuprofen, Sulindac, Naproxen, Piroxcam, and Paracetamol. Though Paracetamol is included in here, it does not basically work in the same way as other NSAIDS and does not prevent inflammation but it relieve pain and is also commonly abused. These drugs are used to treat wide variety of pain such as headache, backache, dysmenorrhea, muscular pains etc. people overuse them and this cause many effects in the body of humans. The study focused on the prevalence, the most affected group of people that abuse the NSAIDs and Paracetamol the signs and symptoms associated with the abuse of NSAIDs. The study was a cross sectional study which focused on residents Ndola district of Copperbelt province of Zambia. Objectives: The objectives of this research were to determine the causes, associated risk factors and prevalence of NSAIDs abuse cases among the residents of Ndola city. Methodology: The study was a cross-sectional study that targeted Ndola city residents both males and females aged 18 years and above. The sample size was 385 but only 371 questionnaires were filled give a response rate of 96%the study was conducted from June 2020 to January 2021. The data was analyzed using SPSS software considering the frequencies and the chi-square method. Results: Out of 371 respondents 198 were females which make 53.4% and 173 were male which make up to 46.6%. The mean age was young adults making up to 63.3%, above 45 years old was 14.6%, 18.6% were middle age. 52.8% were tertiary education. 32.6% were of secondary education the remaining percentage was primary education and illiterate which. 89.1% used pain killers. Brufen, diclofenac and paracetamol were the most commonly used drugs. 9.23% of the population was found to abuse drugs No associated risk factor pain killer use was found however female sex showed to use pain killers more than males. Those above the age of 45years used pain killers than younger age. Conclusion: We have shown that on average about 9.23% of the population abuse pain killers however no factor was identified to contribute the abuse of these drugs further studies on this topic will help to establish the factors responsible for abuse of these pain killer drugs. Recommendations: Based on my finding from this research I recommend that the Zambia medicines regulatory committee should step up there inspections of shops and drug stores possibly to limit the sale of pain killers to pharmacies that have a qualified pharmacists who can guide the people who buy pain killers on the dosage and duration of taking pain killers, the ZAMRA also should start conducting health education to educate the people about the side effects of using and abusing pain killers.

Rosmarinus officinalis and Psidium guajava plant leaves are having phytochemical compounds those inhibit the growth of microorganism. Wound healing property was developed on organic cotton fabric using an equal ratio of Rosmarinus officinalis and Psidium guajava extract by following pad-dry-cure method. The antibacterial activity of the herbal extract and treated cotton fabric was evaluated using the agar well diffusion and parallel streak method. High zone of inhibition attained against Escherichia coli and Staphylococcus aureus indicates antibacterial potency of the extract. The thickness, stiffness, air permeability, vertical wicking length and water vapour permeability properties were marginally affected after treatment. The wound healing analysis of the treated fabrics was carried out using in vitro wound healing scratch assay.

Introduction: Zambia currently has an estimated number of 1.2 million people living with the HIV virus and approximately 800, 000 of these are on life saving Antiretroviral therapy. According to UNAIDS, the prevalence of HIV/AIDS in Zambia is much higher in women as compared to men standing at 11.2% for women and 7.3% for men aged 20-24. This implies that as more women become infected, mother to child transmission continues to be a challenge. The general objectives where to access knowledge, attitude and practice about mother to child transmission of HIV among mothers of Ndola district, Zambia. Method: This was an institutional-based cross sectional study conducted in Ndola from the 15th of December 2020 to 10th of February 2021.The study enrolled women attending antenatal clinic at new masala clinic. Data was collected through structured questionnaire, data was entered into SPSS version 26 and was then analyzed. Frequencies, percentages, chi square -association as well as linear regression were manipulated Results: A total of 384 women were enrolled in the study, 44.3% were in the age group of 16-24. 24% had attained tertiary level of education. All of the participants (100%) had received information about HIV/AIDS but there was a substantial amount of knowledge about MTCT of HIV/AIDS. Only 60.2% knew that once positive a pregnant woman could transmit the HIV infection to unborn baby, very few (24.2%) knew that it can be transmitted via labor as well as delivery. In this study 58.6% showed good knowledge, 78.1% showed good attitude and only 58.6% had good practice towards mother to child transmission of HIV. The pearson value was, P= 0.000 meaning that there was an association between the amount of knowledge a mother had and level of practice towards mother to child transmission of HIV/AIDS. Conclusion: Overall, all the respondents knew what mother to child transmission of HIV was but there was a considerable lack of knowledge, attitude and practice towards mother to child transmission as evidenced by the results. Hence, this warrants scaling up ANC services, PMTCT measures as well as health education towards mother to child transmission of HIV and most importantly improving all sectors of life in women lives.

Introduction: First Aid is immediate care given for the purpose of preserving life and minimizing the consequences of injury and illness until help, from trained medical workers is obtained. The likelihood of an injury or accident victim living or dying depends on the timeliness of the aid given. On a global scale, someone dies every 5 seconds as a result of an injury, over 15000 people’s lives are cut short every day and about 5.8 million people die in a year. Survival is greatly increased if bystanders quickly begin applying first aid. Therefore, this study aims to assess the levels of first aid knowledge in secondary pupils at three selected schools in Ndola, Zambia. Methods: An analytical cross sectional study was carried out among pupils at three selected schools in Ndola, Zambia. The data collection tool that was used is a self-administered questionnaire. A two stage sampling method was used. Firstly, a non-probability sampling method was used to select schools. Thereafter, classes and their respective pupils were sampled randomly. A sample size of 376 was used. The study was carried out at Chiluba Secondary School, Lubuto Secondary School and Ndola Skill School. Data was entered and analysed using SPSS version 20, and categorical variables were analysed using chi Square. Results: In this study, majority of the participants had poor knowledge (87.8%), followed by those with average knowledge (6.4%), then those with no knowledge (5.3%) and finally those with good knowledge (0.5%). The mean score was 3.70, the median was 4.00, the mode was 3, the standard deviation was 2.008 and the sum was 1393. It was found that there is an association between levels of first aid knowledge and exposure to first aid information from the media, receiving first aid knowledge from guardians and religion. However, there was no association between levels of first aid knowledge and age, sex, economic status, opinion, being taught first aid at school and being a member of a first aid club. It was found that the factors that influence levels of first aid knowledge include exposure to first aid information from the media and receiving first aid information from guardians. Conclusion: Overall, first aid knowledge amongst secondary school pupils at the three selected school in Ndola Zambia was poor. The mean score was 3.70 which is poor knowledge. It is recommended that first aid training be added to the school curriculum as this will allow a good number of students to be reached over a period of time Furthermore, awareness of first aid should be raised through the media, campaigns and brochures. Finally, it is recommended that like studies be conducted in the future.

Triple-Negative Breast Cancer (TNBC) encompasses heterogeneous subtypes. Apocrine-type TNBC, defined as TNBC immunoreactive for both androgen receptor and forkhead-box protein A1, should be distinguished from basal-like TNBC. In apocrine-type TNBC, neoadjuvant chemotherapy (NAC) tends to be ineffective, but with a favorable prognosis despite chemoresistance. We analyzed 51 cases of TNBC in stages I and II. Thirty-four TNBCs treated with NAC were divided into “good responders” (n=22) showing therapeutic effect G2b or G3 in surgical specimens and “poor responders” (n=12) with therapeutic effect G0, G1a, G1b and G2a. NAC was spared in 17 cases (categorized as the non-NAC group). TNBC other than apocrine-type (n=16) and special types (myoepithelial, medullary, adenoid cystic and spindle cell carcinomas, n=6) was categorized as basal-like subtype (n=29). The prognosis was evaluated in each category. NAC showed significant effects against basal-like TNBC with high Ki-67 labeling (≥ 50%), and tumor-infiltrating lymphocytes predicted high chemosensitivity. NAC was ineffective and avoidable in TNBC of apocrine- and special types showing low (<50%) Ki-67 labeling. Ten (59%) lesions in the non-NAC group belonged to the apocrine-type. When clinical complete remission shown by contrast-enhanced magnetic resonance imaging was reached in the course of NAC against basal-like TNBC, the NAC period was shortened (de-escalated) in 14 (64%) of 22 good responders. Disease-free and overall survival was excellent in all groups. The following two hypothetical proposals should be proven by large-scale clinical trials. Immunohistochemical recognition of apocrine-type TNBC with low Ki-67 labeling is important for avoiding ineffective/unnecessary NAC. By employing appropriate clinical imaging, de-escalation of NAC is achievable in basal-like TNBC with high Ki-67 labeling.

Background: Cancer of the Prostate is one of the leading cause of cancer death in men and its incidence rates are expected to continue escalating. Globally it is the second most common cancer affecting older men and it presents with a need to urinate frequently, weak and dribbling of urine, painful urination, and blood is seen in urine or semen. Aim: was to determine the pattern and distribution of Urology neoplasms, particularly cancer of the prostate gland seen at Ndola Teaching Hospital. Methodology: In this study a retrospective cross section study design was used, data was collected and sampled by complete enumeration of all urology patient’s files that visited Ndola Teaching Hospital from June 2018 to August 2020. Out of a total of 404 urology patients files enrolled, 212 were diagnosed urological neoplasms. Data entry involved tabulations and use of SPSS software for analysis. All information collected was confidentially handled in accordance with the ethics. Ethical approval was obtained from Tropical Disease Research Centre (TDRC) and permission to conduct the study at the health institution was granted by both the Provincial Health Office and Hospital administration. Results: The prevalence of prostate cancer among urological neoplasms seeing at NTH was found to be 44.3%. It is densely distributed and more common between the ages of 70 to 79 years old. Other urological neoplasm such as Benign Prostatic Hyperplasia, Penile Cancer, Bladder Cancer, Kidney Cancer and Testicular cancer recorded the prevalence of 42.9%, 6.1%, 6.1%, 0%, 0.5% respectively. No single case was recorded above the age 90 this could be due to patients dying before reaching the age of 90. Conclusion and recommendations: At this prevalence of 44.3%, there is need to implement screening strategies, sensitize and encourage people to always visit hospital care for regular checkups, more especially when the male gender starts to advance in age and experiencing symptoms of the impending prostate cancer. Although there is no strong evidence yet on how to fully prevent prostate cancer, it is very possible to lower the risks of developing it by stopping to take alcohol, to cease smoking, limit high fat foods, increasing the intake of vegetables and fruits and performing more exercise.