Vol 4 Issue 1 April 2016-September 2016

Abstract: The performance of the public health sector in Kenya has been a major concern to the Kenyan people. Good health is a prerequisite for enhanced economic growth and poverty reduction and a precursor to the realization of Kenya Vision 2030’s social pillar goal. The country is confronting numerous gaps in health outcomes like high infant mortality rate caused by neonatal problems. Therefore, the purpose of this study was to determine the influence of supply planning practice on the performance of the unit of vaccines and immunizations in the Ministry of Health, Kenya. The study adopted mixed research design using both quantitative and qualitative approaches. The target population of the study was 244 from the Unit of Vaccine and Immunizations (UVIS) headquarter, KEMSA depot and warehouse staff, Nairobi, Mombasa, Kisumu, and Busia counties. The study used random sampling to pick a sample size of 74 respondents. Data was collected using questionnaire. Descriptive statistics was used aided by Statistical Packages for Social Sciences version 24 to compute percentages of respondents’ answers. Inferential statistics multiple regression and correlation analysis was applied to examine the relationship between the research variables. The study established that there is strong positive correlation between supply planning and the performance of the unit of vaccines and immunizations. Therefore, supply planning practices such as optimum inventory procurement, determination of health requirements of health facilities at every node, aggregate determination requirements and joint coordination with suppliers if adopted by the unit of vaccines and immunizations will increase the performance positively. Keywords: Unit of Vaccines, Immunizations (UVIS) headquarter, KEMSA depot. Title: Influence of Supply Planning Practice on the Performance of the Unit of Vaccines and Immunizations in the Ministry Health, Kenya Author: Samuel Okanda, G. S. Namusonge, Esther Waiganjo International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Patients with nerve injury particularly extreme damage, regularly confront poor nerve recovery and not entirely utilitarian recuperation, even after surgical nerve repair. Recent studies about the new methodologies for the treatment of nerve injuries. Different than other tissues in the body, nerve recovery nerve regeneration is slow and usually inadequate. Not as much as half of patients who experience nerve repair after damage recapture great to amazing engine or tactile capacity. Our expanding information about nerve physiology and recovery far exceeds our surgical capacities to repair injured nerves and effectively recover engine and tangible capacity. Thus this review aims to summarizes treatments of nerve injures, and also describe why surgical management is still inadequate in using the new biological research that has documented the changes that occur after the nerve injury, which could cause suboptimal clinical outcomes. Keywords: their repair, methodologies, engine and tangible capacity. Title: Nerves injuries and their repair Author: ALSHARIF, RAKAN ALHUSSAIN A, BARRADA, ABDULLH KHALID A, BARABIE, AHMED SALEM M, ALJEHANI, ABDULILAH HAMDAN A, Mahmood Asadullah Shahabuddin Yasawy International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Background: Obesity is a chronic low grade inflammatory state associated with the development of insulin resistance, type 2 diabetes mellitus and atherosclerosis. TNF and Interleukin 6 are proinflammatory cytokines which relate starting of immune response. The aim of the study: Relationship between TNF and Interleukin 6 in people with and without metabolic syndrome. Materials and methods: The study involved 131 healthy individuals aged 25-55 years old randomly chosen in Tirana. Data concerning generalities, sex, residence, age, weight, height, abdominal circumference, systolic blood pressure, diastolic blood pressure , pulse, BMI, cholesterol, triglycerides, LDL, HDL, glycemia, TNF , interleukin 6 , insulinemia and HOMA-IR were collected. Insulin resistance and insulin sensitivity were calculated and compared within people with and without MS. MS prevalence was determined according IDF criteria. Results: We found in people with and without MS significant difference between Interleukin 6 levels (P 0,01) and between TNF alpha levels (P<001). In subjects with MS we observed an important correlation between interleukin 6 and insulinemia (p=0.029, r=0.292 )and between TNF and total cholesterol (p=0.001, r=0.315 ). Also a significative correlation was noticed between Homa-IR and TG in the MS population (p=0.001, r=0.489). Conclusions: According our results metabolic syndrome subjects have a higher inflammatory state compared to the healthy population. The results show a strong correlation of pro inflammatory cytokines levels with insulinemia, triglycerides and cholesterolemia suggesting an important role of pro inflammatory cytokines in the metabolic syndrome pathogenesis. Keywords: MS – metabolic syndrome IDF – International Diabetes Federation. Title: The connection between TNF and IL-6 in persons with and without metabolic syndrome Author: Violeta Hoxha , Dorina Ylli , Gerond Husi , Thanas Furreraj , Zamira Ylli , Pranvera Doci , Eni Celo , Elizana Petrela , Marjeta Kermaj , Agron Ylli International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research publish Journals

Abstract: Objective: Chronic kidney disease (CKD) is a general term for heterogeneous disorders affecting kidney structure and function. Many studies have been done on correlating sonographic renal changes with renal function by using serum creatinine as a functional mark of renal failure but less is reported on correlation of eGFR with sonographic findings. The aim of this study was to determine the role of renal biometry in predicting renal function among patients with chronic kidney disease (CKD). Method: This was a hospital based cross-sectional study which evaluated 145 patients with CKD at Muhimbili National Hospital. All patients underwent both kidney sonography and renal function test based on estimated glomerular filtration rate (eGFR). Renal volume was compared to eGFR by using correlation and Likelihood Ratio. Results: Almost half of the patients with CKD had renal cortical volume below the normal health adult average. About twelve percent (12.4%) of patients had above normal cortical volume average however this was among patients with HIV nephropathy. Pearson correlation coefficient revealed positive relationship as right and left renal cortical volume and eGFR of (r ≈ +0.49 (p < 0.001); and r ≈ +0.43 (p < 0.001). Despite significant p-values, Pearson coefficient ranged between +0.7 and +0.3 defining a weak linear association between eGFR and renal cortical volume. Conclusions: Renal cortical volume is a weak biomarker in predicting renal function in patients with CKD. Keywords: CKD, Ultrasonography, renal biometry, cortical volume, eGFR. Title: RENAL CORTICAL VOLUME IN PATIENTS WITH CHRONIC KIDNEY DISEASE AT MUHIMBILI NATIONAL HOSPITAL, TANZANIA Author: Mboka Jacob, Joel J. Bwemelo, Ramadhan Kazema International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Femoral artery pseudoaneurysm is a devastating complication after arterial access. It may thrombose spontaneously with conservative management. Failure to thrombose is multifactorial. We present a case of iatrogenic femoral artery pseudoaneurysm, developed recurrence after consumption of anticoagulant, which was surgically treated using traditional open repair. Keywords: Femoral artery pseudoaneurysm, recurrent, iatrogenic, anticoagulant, open pseudoaneurysm repair. Title: Recurrent Femoral Artery Pseudoaneurysm: Anticoagulant No More A Life Savior Author: Firdaus Hayati, Nornazirah Azizan, Aishath Azna Ali, Azim Idris International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Background: according to the literature the prevalence of anxiety and depression remains high among family members which need to be approaches by the family doctors, thus Clinicians should be aware of the high rates of anxiety as well as depressive symptoms in family Objective: the aim of this study was to determine the prevalence, risk factors, and risk behaviors associated with depressive and anxiety symptoms and mostly approaches of anxiety and depression in family. Methodology: We performed a systemic review study thorough US National Library of Medicine National Institutes of Health (Pubmed database) and we included all studies that contributed in discussion the factors and approaches of anxiety and depression in family. Conclusion: The literature indicates that a broad array of parent and family factors are associated with risk for depression and anxiety mostly among youths Keywords: Family medicine, anxiety, depression, family approached. Title: Problem-oriented approaches of anxiety and depression in family practice Author: Jubran abdullah shnaimer, Fahad jaber alfaifi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Background: Congestive heart failure (CHF) have been negatively effecting the budget of health care systems, Thus interventions designed to prevent readmissions among populations transitioning from one care setting to another are often called “transitional care interventions Purpose: this review aimed to assess the efficacy, comparative effectiveness and the impact of transitional care interventions (TCIs) on acute health service use to prevent harms to patients with congestive heart failure in primary care. Methodology: We conducted a systematic review and meta-analysis by searching the Medline, PsycInfo, EMBASE, and Cochrane Library databases. We have selected most of studies that concerning the topic of this study including randomized, controlled trials published in English reporting hospital readmissions and emergency department (ED) visits. Conclusion: this research is a review on studies that evaluated the effectiveness of a transitional care model for patients with congestive heart failure (CHF). The evaluation focused on improving the transition from hospital to home care by upgrading traditional discharge practices and implementing an evidence-based educational program. Keywords: Congestive Heart Failure, Transitional Care Interventions, PCPs. Title: Transitional Care for Patients with Congestive Heart Failure Author: Talal Duhaim M Alanazi, Fahad Saad Z Alanazi, Mohana Jabban A Alenezi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: TTIs can be rooted by microorganisms which may be present in the blood or blood component. The major worldwide prevalent TTIs are caused by HIV, HBV, HCV, Treponema pallidum and malaria. The popular of the problems are due to the prevalence of asymptomatic carriers in the public and under window episode of infections. The WHO and National Blood Policy of India recommend that National Blood Services should be based on voluntary, non-remunerated blood donation. Laws related to blood transfusion in India are a part of the Drugs and Cosmetics Act 1945 (D&C Act). Every collected unit mandatorily tested for five major TTIs. With every unit of blood transfusion there is 1% chance of transfusion associated problems including transfusion-transmitted diseases. Design: This retrospective study was carried out over a period of 5 year i.e. 2011 to 2015. The testing protocol was followed in the blood bank, after complete physical examination of blood donor by blood bank medical officer. Results: Over a five year period total blood donation was 33507, in which 30184 (90%) were voluntary and remaining 3323 (10%) were replacement. This was due organized the blood donation camp time to time. The prevalence of HIV, HBsAg, HCV, Syphilis and Malaria was 52 (0.15%), 404 (1.20%), 396 (1.18%) and 04 (0.01%) respectively. The seropositivity of HBV was decreased every year continuously, whereas HIV, HCV and syphilis remain similar. The overall prevalence of the five year retrospective study (2011-2015) was 2.55%. Conclusion: Nucleic acid amplification testing (NAT) must be applied that identify blood donation made during the immunological window period before seroconversion. Information to TTIs reactive donor be a best method for prevent the chance of repeat reactive donation. Donor self-exclusion and encourage about the autologus blood transfusion will be effective in decreasing the TTI’s as well as practices of autologus blood transfusion should be encouraged. Keywords: HIV, HBsAg, HCV, VDRL, North India, TTI. Title: Prevalence of Transfusion Transmitted Infections among Blood Donors at Regional Blood Bank in north India Author: Yogesh Kumar, Dr. Rajeev Panwar, Aarti Sharma International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: The aim of the study was to investigate the effectiveness of the air-gap technique as a substitute for the grid in the pelvic examination for patient radiation dose reduction while maintaining the image quality. An anthropomorphic phantom (PBU-50) was used in this study to simulate an actual human pelvic structure. The phantom was exposed for pelvic examination using the grid and the air-gap technique to compare the exposure factors, the patient dose and the image quality produced from both methods. The patient dose was measured using a Dose Area Product (DAP) meter which was then used to estimate the gonadal dose. The images were scored by three experienced radiographers based on the Commission of European Communities (CEC) image quality criteria to determine the image quality. The result of the study indicated that the air-gap of 25 cm was the optimum air-gap distance. The gonadal dose and the effective dose were reduced from 0.130 mGy to 0.062 mGy and from 0.357 mGy to 0.172 mGy respectively when using the air-gap technique and when using the grid. The study indicated that the image quality produced by the air-gap technique was more superior to the grid. In conclusion, besides the magnification issue, the air-gap technique is suitable to be used in the pelvic radiographic examination as it reduces the patient radiation dose while improving the image quality. Keywords: Air gap technique, pelvic radiography, anti-scatter grid, gonadal dose, effective dose. Title: OPTIMISATION OF IMAGE QUALITY AND RADIATION DOSE USING AIR-GAP TECHNIQUE IN PELVIC RADIOGRAPHY Author: Soo-Foon Moey, Mariyya Mohd Rosli, Inayatullah Shah Sayed International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Background: Caffeine can cause a short, but dramatic increase in your blood pressure healthy individual people including postmenopausal women, but it’s unclear whether the caffeine can be a hypertension risk factor among postmenopausal women or not. Objective: The study aims to examine the relationship between coffee consumption and blood pressure and incident hypertension in postmenopausal women Methodology: Literature was obtained by searching MEDLINE (last 35 years), and the Cochrane Database of Systematic Reviews. Search terms included caffeine, blood pressure, postmenopausal women. Literature was also obtained from citations in relevant articles. Conclusion: Over many years of follow-up, coffee drinking is associated with small increases in blood pressure among postmenopausal women, but appears to play a small role in the development of hypertension. Keywords: blood pressure, caffeinated coffee, caffeine, hypertension, postmenopausal women. Title: Coffee and Caffeine Consumption and the Risk of Hypertension in Postmenopausal Women Author: Abeer Mohmmad Aodh, Noura Qadhab Alruwaili, Entsar Owaid Alanazi, Hanan Saleh Alruwaili, Amal Dhabyan Aldhilan, Ebtisaam Mataan Alenezi, Zainab Farhan Alanazi, Maram Awied Alenezi International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Background: Street foods have been associated with health problems to their consumers with increased risk of mortality and reduced quality of life due to poor food handling and sanitary practices. Objectives: To determine the occurrence of microbial agents in street foods through laboratory analysis and testing the response/resistance of pathogenic agents to anti-microbial drugs. Materials and Methods: This was a microbial analysis of 150 samples of cooked street food chosen from rice and stew, beans, cakes, peppersoup, moi moi and fried meat selected through systematic random sampling technique. Results: The highest occurrence of bacterial isolate was Vibrio sp with 60%, followed by Escherichia coli 53%, Streptococcus pneumoniae 49%, Aerococcus sp 48% ,while Actinomyces and Shigella dysenteriae occurred at 36% frequency each. The most occurring mycological species were Saccharomyces sp 44%, Verticillum sp 37% and Aspergillus niger 35%. On microbial sensitivity testing, Vibrio sp showed resistance to all antibiotics, E. coli showed moderate response to Erythromycin (30mm) and Shigella dysenteriae also showed moderate response to Chloramphenicol (31mm). Conclusions: Hawked Street foods in Uyo Metropolis have shown to be of poor microbial quality. Keywords: hawked foods, microbial, food contamination. Title: CULTURE-DEPENDENT MICROBIAL ANALYSIS OF HAWKED STREET FOODS IN UYO METROPOLIS, SOUTHERN NIGERIA Author: Emaediong Ibong Akpanekpo, Edidiong Ime Frank International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Performance parameters, e.g., spatial linearity and uniformity of single photon emission computed tomography (SPECT) imaging systems are affected by scattered gamma events. Hence, the quality of the reconstructed image is degraded. In this study, material filter method was employed for reducing the adverse effects of scatter events from the Tc-99m spatial linearity images. Material filters work by absorbing the scattered gamma photons before they can reach the surface of the detector of the gamma camera. The filters used were copper (Cu) 0.125mm and aluminum (Al) 0.2mm thick flat sheets. SPECT data were collected by scanning Carlson’s phantom with the linearity insert. The radionuclide, Tc-99m was injected into the phantom. Symmetrical energy window (+/-10% centered at 140keV) was selected. Filters were separately mounted on the outer surface of the gamma camera (GCA-901A/HG) with either low energy general purpose or low energy high resolution collimator. Results of material filtered data images show improvement in the image linearity. It is concluded that material filters have the potential to improve overall image quality in Tc-99m SPECT. Keywords: Gamma Camera, Performance Parameters, Spatial Linearity, Material Filter, Scattered Gamma Photons. Title: Investigations into the Effects of Material Filters (Cu 0.125mm and Al 0.2mm) on Image Linearity in Tc-99m SPECT Author: Inayatullah Shah Sayed, Fong Shu Yee International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: With the technological advancements in the medical imaging field, the past decade has witnessed a dramatic evolution of multimodality imaging systems. Scientists, technologists and researchers have been able to bring systems in clinical practice, in which two or more standalone diagnostic imaging modalities have been combined. Some of those multimodality imaging systems are: PET/CT, SPECT/CT, PET/MRI and PET/SPECT/CT. With this technique a patient is scanned in a single session and the desired structural and functional information of the organ of interest is achieved. Recent clinical imaging studies in the areas of cardiology, endocrinology, infection, musculoskeletal and neurology has shown, that with multimodality diagnostic imaging, a significant increase in diagnostic accuracy is achieved, as compared to single diagnostic imaging modality. In this review, emphasis is given to the technical aspects and clinical applications of the SPECT/CT hybrid imaging modality. Keywords: Hybrid Imaging, SPECT/CT, PET/CT, SPECT, Diagnostic Accuracy. Title: Hybrid Imaging – SPECT/CT: Making a Difference Author: Inayatullah Shah Sayed, Soo-Foon, Moey International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: With nuclear medicine imaging technique, abnormalities in the human body can be detected at early stages and therefore an effective treatment planning is possible to make. Consequently, human lives can be saved and the health condition of patients can also be improved. However, this depends upon the reliable diagnostic information that is obtained by an imaging system. Presence of scattered gamma photons leads to the inaccurate representation of counts in the image projection, thus the loss of image contrast and overall image degradation. This study uses the unconventional (material) filters i.e., Aluminum (Al) 0.1 & 0.2mm and Copper (Cu) 0.125 & 0.127mm thick flat sheets for the reduction of scattered gamma photons before they reach to the gamma camera detector. Quality of images reconstructed from the data acquired by three gamma camera systems (Toshiba GCA109A/HG, Philip ADAC Forte dual head and GE Infina dual head) installed at two different nuclear medicine departments was assessed. Data were acquired by imaging R. A. Carlson’s phantom with hot region and cardiac inserts and Tc-99m radionuclide was used. LEHR collimator was used and unconventional (material) filter(s) were mounted on the outer surface of collimator, separately. Symmetrical energy window (20% for Tc-99m) was selected. Images were investigated in terms of contour analysis and lesion detectability. Improvement was achieved in the parameters that were investigated for images obtained from the data with unconventional (material) filters, as compared to without material filtered data images. Thus, the technique may be tested further by using more complicated phantoms, such as; Heart/Thorax phantom. Moreover, results are suggestive, that the technique may be proved to be useful when applied in clinical studies. Keywords: Scatter correction, SPECT, Image quality, Noise, Contrast, Unconventional filters, Gamma camera. Title: Effects of Unconventional (Material) Filters on the Quality of Images Produced By Three Gamma Camera Systems in Tc-99m SPECT Author: Inayatullah Shah Sayed, Fong Shu Yee, Farhana Mansoor, Nurul Farizan Binti Mohd Zulkele International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals

Abstract: Vein of Galen aneurysmal malformation (VGAM) is a rare congenital vascular malformations found in children. Chronic cerebral ischemia in VGAM is manifestation of long-term pial venous congestion secondary to venous outflow stenosis. Spontaneous hemorrhagic complication in a patient with VGAM is rare. We reporting a case of VGAM associated with intracranial hemorrhage (ICH), hydrodynamic disorder and cerebral ischemia, which was treated with multistage transarterial embolization. Keywords: Vein of Galen, hydrodynamic disorder, vascular malformation in pediatric, galenic aneurysmal malformation. Title: Spontaneous Hemorrhagic Complication of Vein of Galen Aneurysmal Malformation Case Report Author: Aishath A. Ali, Mohammed M. Hajhamad, Yasir S. Khaleel, Redzuan M. Ismail, Ramesh Kumar International Journal of Healthcare Sciences ISSN 2348-5728 (Online) Research Publish Journals