Notes

The consequences from the Affordable Proper care Act upon Utilization of Weight loss surgery.
Medicinal plants are regarded as a large source of phytochemicals that may have anticancer properties. This could lead to the development of innovative drugs or alternative therapy against cancer.

This study was designed to determine the antioxidant and cytotoxicity effect of 5 selected indigenous South African medicinal plants namely;
, and
.

Phytochemical extracts namely; methanol, 50%, 100% ethanol, and water extracts were prepared from the root and shoot of the plants. The antioxidant effect of methanol extracts of the plant materials was performed using a DPPH assay. A preliminary cytotoxicity screening of the phytochemical extracts in the human colon (Caco-2), cervical (HeLa), and hepatocellular (HepG2) cell lines were determined followed by the half-maximal inhibitory concentration (IC50) using MTT assay.

The methanol root extract of
and
(33.20% and 26.33% respectively) and shoot extract of
(17.10%) showed the highest antioxidant. Out of the 5 plants, only 100% ethanol extract of
, and
caused more than 80% cytotoxicity in HepG2 and Caco-2 cell lines. The shoot of
(10.43 µg/ml),
(23.0 µg/ml), and root of
(23.77 µg/ml) were the most active with the highest cytotoxicity.

, and
possess significant cytotoxicity that is promising in developing alternative drugs against colon and liver cancers. Our results provided new pieces of evidence for antioxidant and cytotoxic activities of these plants which could be useful for developing new anticancer therapies.
C. comosum, K. uvaria, and T. violacea possess significant cytotoxicity that is promising in developing alternative drugs against colon and liver cancers. Our results provided new pieces of evidence for antioxidant and cytotoxic activities of these plants which could be useful for developing new anticancer therapies.
Strictly adherence to antiretroviral therapy (ART) is needed to achieve viral suppression. Studies have focused on HIV positive pregnant women's adherence. Factors affecting non-pregnant HIV positive women's adherence has been understudied in Enugu.

The study objective was to identify factors affecting adherence to ART among HIV positive women attending retroviral clinic of a tertiary hospital in Enugu.

Using a descriptive cross-sectional design, a pre-tested structured questionnaire was used for data collection among 286 HIV positive women aged 18 years and above. Data were analyzed using descriptive statistics of proportions, percentages, and means. Responses with a mean score of ≥2.5 were taken as important factor affecting adherence.

Overall adherence was 56.2%. Participants were considered adherent if they took ≥95% of their prescribed ART. Lack of transport fare (2.69 ±1.36), long-distance to clinic (2.82±1.26), health workers' poor attitude (2.74±1.28), and lack of partners' and parents' support (2.57±1.05) affected adherence negatively while ease in renewing prescription and minimal side effects of drugs enhanced adherence. Enfuvirtide (21.1%) and Lamivudine (17.4%) were drugs that were mostly skipped.

Adherence to ART was low among the women attending the HIV clinic in Enugu. Adherence counseling and education should be provided before ART initiation. Strategies to reduce stigma, increase family support, and improve healthcare providers' attitudes should be employed.
Adherence to ART was low among the women attending the HIV clinic in Enugu. Adherence counseling and education should be provided before ART initiation. Strategies to reduce stigma, increase family support, and improve healthcare providers' attitudes should be employed.This paper presents voices from Africa on digital health in Africa. These voices were gleaned during interviews and an online, focus group session in May 2020, during which 30 experts across Africa, among others from the South, were asked about their experiences and observations on the conceptualisation of, and practices in, digital health in their respective communities and countries. Extensive input was provided, both orally and textually. The quotes gathered and presented in this paper indicate that there is a distinct need for the respectful co-development of digital health interventions in Africa. In addition, the quotes show how a one-size-fits-all solution approach does not exist, it is not a solution to Africa. Further, the community-focus, fit, and fragmentation of existing activities digital health interventions is questioned. The narratives provide a rich resource indicating capable and local agency and the need to address power-differences in international health development.
The expression of p53 has been associated with the severity of other types of cancer. There is scanty information when it comes to oesophageal cancer.

This study aimed to explore the use of p53 protein expression as an indicator of oesophageal cancer severity from a high-risk incidence in the African rural population.

Fifty-one patients newly diagnosed with oesophageal cancer were recruited from the endoscopic unit at Nelson Mandela Academic Hospital in Mthatha, South Africa. The serological expression of p53 was measured using the ELISA method and the severity of oesophageal cancer expressed in grade was obtained from the histopathology report from patient's oesophageal biopsies.

We found that the expression of p53 was equally distributed among the histological grades of cancer with the value of 2495 pg/mL ± 1736 pg/ mL for lower grades and 2520 ± 1539 pg/mL for higher grades. Furthermore, we found that the level of p53 expression was equally distributed in patients from grade 1, 2, 3, and 4.

The expression of p53 protein does not vary according to the histological grade of oesophageal cancer in the given population, therefore may not be helpful as a prognostic factor.
The expression of p53 protein does not vary according to the histological grade of oesophageal cancer in the given population, therefore may not be helpful as a prognostic factor.
Health-risk behaviours such as tobacco smoking and alcohol are now identified among adolescents in most of the secondary schools of South Africa.

The study investigated the prevalence of smoking and alcohol use as health risk behaviours among secondary school learners in Thembisile Hani municipality of Mpumalanga province in South Africa.

A quantitative descriptive research design was used for the study. A simple random sampling was employed in the selection of schools and proportional stratified sampling was used to select learners from each school according to grades. Closed-ended questionnaires were used to collect data from learners in their schools. Data were analysed using SPSS version 26.0.

Out of 385 learners, 64.4% have drank alcohol whilst 64.7% have smoked cigarette in the school premises. The socio-economic status of many learners such as the employment and income of the family was found to be one of the factors exposing them to alcohol and tobacco use.

There was high prevalence of alcohol use and smoking among learners in secondary schools. Excessive use of alcohol and smoking could affect the health of learners in their late life and therefore community collaboration to curb the problem is crucial.
There was high prevalence of alcohol use and smoking among learners in secondary schools. Excessive use of alcohol and smoking could affect the health of learners in their late life and therefore community collaboration to curb the problem is crucial.
Diarrhoeagenic
(DEC) is a leading cause of childhood diarrhoea. This study estimated the prevalence of DEC and DEC pathotypes among children with acute diarrhoea in Southern Uganda.

A cross-sectional study was conducted on 267 children less than 5 years with acute diarrhoea, admitted to Rakai General Hospital in Southern Uganda. Faecal samples were collected from the children and processed for isolation of
. The presence of DEC and the distribution of DEC pathotypes were determined by polymerase chain reaction.

A total of 102 (38.2%, 102/267) children had DEC of various pathotypes - enteroaggregative
(EAEC) (14.2%); enteropathogenic E. coli (EPEC) (6.7%); enterotoxigenic
(ETEC) (6%); enteroinvasive
(EIEC) (7.5%); enterohemorrhagic
(EHEC) (3%); and cell-detaching E. coli (CDEC) (0.75%). The difference in the overall prevalence of DEC was not significant regarding HIV but individually, EAEC and CDEC were associated with HIV-positive status while ETEC was associated with HIV-negative status.

DEC is prevalent in children with acute diarrhoea in Southern Uganda and its identification in children should be considered among strategies for combatting childhood diarrhoea in Africa.
DEC is prevalent in children with acute diarrhoea in Southern Uganda and its identification in children should be considered among strategies for combatting childhood diarrhoea in Africa.
Blood is an essential body fluid for the transport of substances to all parts of the body. Knowledge of blood group distribution within any population is important in determining the direction of blood bank inventory for emergency blood services.

We report for the first time the blood group distribution pattern for the Volta region of Ghana.

Data were extracted and analyzed from 14,360 medical records of blood donors and recipients at seven major hospitals within the Volta region for a period of seven years (2012 to 2018).

ABO distribution within the region was 46.3%, 18.9%, 24.4%, 3.1%, 4.4%, 1.7%, 1.3% and 0.1% for O+, A+, B+, AB+, O-, A-, B- and AB- blood groups respectively. Rh (D)+ to Rh (D)- ratio was 92.5/7.5% respectively. Blood group O+ (>35 %) was highest in all ethnic groups in the region.

Healthcare facilities in the region should adopt a strategy to stock-pile sufficient O+ blood which is the prevalent blood group in the region. All types of blood groups were reported hence our findings should provide information to guide clinical practice and/or blood transfusion services in the region.
Healthcare facilities in the region should adopt a strategy to stock-pile sufficient O+ blood which is the prevalent blood group in the region. All types of blood groups were reported hence our findings should provide information to guide clinical practice and/or blood transfusion services in the region.
The Coronavirus disease (COVID-19) pandemic as a large scale stressor could have negative effects on the mental health of medical students. Since gender differences in mental health may exist, it is important to see if a large scale stressor like the pandemic may be associated with variances in the psychological distress between both genders.

To assess and compare the psychological distress of male and female medical students during the COVID-19 pandemic.

A cross-sectional survey was carried out among 1010 medical students from three universities in southwestern Nigeria within the first six months of the first reported case of the COVID-19 pandemic. The respondents were purposively selected. Data was obtained online on participants' demographic and psychological distress using the General Health Questionnaire 12 (GHQ-12). Data was analyzed using the SPSS version 21, student t and chi-square tests were used to assess gender differences, and multivariate regression to assess the predictors of psychological distress among both genders.
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