Stool specimens from 113 adult outpatients with diarrhea in southwestern Nigeria and 63 controls were examined for bacterial and parasitic enteric pathogens. Enterohemorrhagic Escherichia coli (EHEC) (P < 0.02), enteroaggregative E. coli (EAEC) (P < 0.02), and Entamoeba histolytica (P < 0.0002) were significantly associated with diarrhea. Salmonella, Shigella, nontoxigenic Vibrio cholerae, other categories of diarrheagenic E. coli, as well as a variety of helminths were recovered more frequently from the stools of patients than from the stools of controls but did not show a significant association with disease. Multiple pathogens were recovered from 36.3% of specimens, and bloody diarrhea was commonly associated with E. histolytica and diarrheagenic E. coli infections. The majority of EHEC isolates were non-O157 strains that carried the stx 2 gene. Of the 23 EHEC-infected patients, 12 (52.2%) presented during the 10th week of the study. EHEC strains isolated within this cluster were more likely to hybridize with the enterohemolysin gene probe, to be nonmotile and sorbitol positive, and to fail to agglutinate O157 antisera. Pulsed-field gel electrophoresis demonstrated that the only strains with XbaI profiles that occurred more than once were isolated during the 10th and 11th weeks of the study, suggesting an outbreak. The study has demonstrated that E. histolytica, EHEC, and EAEC are important diarrheal pathogens within the study area and that sporadic and epidemic EHEC infections occur in developing as well as developed countries. Routine surveillance for diarrheagenic E. coli, even only at the tertiary-care level, would be useful in identifying outbreaks and assist in identifying environmental reservoirs and transmission routes.Diarrhea is an important cause of disease and death among children in developing countries (20). Adult visitors to tropical developing countries frequently experience traveler's diarrhea, caused by agents that are endemic in those countries but to which visitors have not had the opportunity to develop protective immunity (36). Adult residents of developing countries are less likely to have sporadic diarrhea, and when it occurs, it is unlikely to be life threatening. Therefore, diarrheal pathogens in adults residing in developing countries have been the subject of few investigations, and very little is known about the etiologic epidemiology of pathogens other than epidemic Vibrio cholerae and Shigella. Sporadic endemic diarrhea in adults, however, contributes to the loss of productivity in developing countries and increases the risk that pathogens will be passed to susceptible children or visitors. When such infections do occur, they are often treated empirically, even though very little is known about the etiologic agents in this population; and in many cases, they prompt self-medication with antibiotics, which are often available without prescription (33). We conducted a case-control study over an 11-week period to determine the causes of diarrhea among adults visiting the outpatient c...

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Critical in the pharmaceutical business firms is the performance driven by the market share which has remained a constant demand and a determining factor in the global economy owing to public health contribution to the economic social life development in any nation. However, pharmaceutical companies were inundated with problem of achieving targeted market share due to poor customer orientation, competitors’ orientation, market intelligence, and inter-functional co-ordination characterized with pharmaceutical companies in Nigeria. This study evaluated the effect of market orientation dimensions on market share of quoted pharmaceutical companies in Nigeria. The study adopted survey research design. Population of the study was 388 staff of the selected pharmaceuticals firms in Nigeria. Total enumeration technique was adopted for the sample size. There were 388 study subjects-24 executive managers, 67 directors, 297 marketing and product managers. Primary method of data collection was employed via validated and reliable research instrument. Collected data were further analyzed with descriptive and inferential statistics adopting multiple linear regression. Findings revealed that market orientation dimensions have significant effect on market share (Adj.R2= 0.734, F-statistics = 202.060, p = 0.000. The study concluded that market orientation dimensions affect overall market share of selected pharmaceutical companies in Nigeria. The study recommended that pharmaceutical companies should key on to the enormous benefits of adopting market orientation practices as it is suggested that full employment of strategic market orientation in organizational management processes creates improved overall firm performance.