Problems Associated With Glocalization of Locally Manufactured Products of Nigeria:: The Role of the Media Technology

 The concept of Glocalization is the act of designing products or services to benefit a local market while at the same time, developed to suit a global patronage (www.investopedia.com, 2020). But in Nigeria where the political, socio- economic climate, business terrain, the level of insecurity is high and technological development is still at its low ebb when compared to advanced nations, local manufacturers of products find it difficult to strive well. Developing market for local products on a global scale has been downplayed by these factors that are beyond the local producer. The specific objectives of this research paper were to; Find out the factors that prevent the glocalization of locally manufactured products of Nigeria, Identify the role of the media technology towards enhancing the glocalization of Nigerian manufactured products. The theoretical framework for this paper are the Framing and Uses and Gratification theories. The methodology for this paper was based on survey with the questionnaire as instrument for gathering data. The scope of the study was on the manufacturers and business merchants/ owners within Onitsha, Anambra State, Nigeria. The reason being that, it is a business hub. The population of study for Anambra State for this paper is 4,177,828 (NPC, 2016) with its sample size of approximately 400 derived from using Taro Yamene Formula. The paper concludes thus, the Nigerian government and Nigerians as a people have not created an enabling environment for the glocalization of its locally manufactured products especially outside the shores of Nigeria. As a result therefore, the study recommended that, the Nigerian mass media should create programmes that can help to sensitize and mobilize the average Nigerian towards embracing the idea of glocalization for its locally manufactured products in order for it to have markets locally and globally.

Sleep Quality and Lower Urinary Tract Symptoms Among Patients with Prostatic Diseases

Background: Incidence of symptomatic prostatic diseases increases with age. Nocturia disturbs sleep. We set out to determine the quality of sleep and severity of lower urinary tract symptoms (LUTS) and bother score in patients with benign prostatic hyperplasia (BPH) and carcinoma of the prostate (CAP). Methods: A cross-sectional study of new patients seen in the urology outpatient clinic with bladder outlet obstruction (BOO) from either BPH or CAP over a period of 18 months. Patients were interviewed using Pittsburgh Sleep Quality Index (PSQI) and International prostate symptoms score (IPSS) questionnaires. Data obtained were analyzed using SPSS version 23. Results:168 patients were interviewed. CAP patients were older than their BPH counterparts. About 45% of the patients had poor sleep quality. CAP patients (52.9%) were more of poor sleepers compared with BPH patients (40.0%). CAP patients (46.3%) had more severe IPSS than BPH patients (33.3%). Both CAP (70.6%) and BPH (76.0%) patients reported high bother score. Conclusion: CAP and BPH patients have high bother score, affirming need for early treatment. CAP patients had more severe lower urinary tract symptoms and poorer sleep quality than BPH patients. Keywords: IPSS, Sleep quality, LUTS, Bother scor

Large penile plexiform neurofibroma in an 11-year old boy

BackgroundNeurofibromatosis is a genetically inherited disorder of the nervous system (brain and spinal cord) which mainly affects the development of nerve (neural) cell tissues, causing tumors (neurofibromas) to develop on nerves. It is the most common single gene disorder of the nervous system and inheritance is through autosomal dominance. They are usually classified into types 1 and 2, the type 1 is the commoner type and also known as superficial neurofibroma. Plexiform neurofibromas are the next most common type of tumor in individuals with type 1 neurofibroma.   Plexiform neurofibromas are histologically benign tumors that are made up of a variety of cell types including neuronal axons, Schwann cells, fibroblasts, mast cells, macrophages, perineural cells and extracellular matrix materials such as collagen.  They can occur in any part of the body and can grow throughout the person’s lifetime, often becoming disfiguring, disabling or deadly via compression of vital structures or conversion to a malignant sarcoma or malignant peripheral nerve sheath turmor. The aim of this report is to present a large penile plexiform neurofibroma which required extensive dissection for complete excision and reconstruction of the phallus and glans penis.ObjectivesTo present a huge penile plexiform neurofibroma and the mode of surgical treatment.MethodsThe huge penile plexiform neurofibroma was completely excised and the penile defect resulting from the excision was repaired.ConclusionPlexiform neurofibromas are congenital tumors of peripheral nerve sheaths which may also develop near nerve roots deep within the body. They are usually benign but carry a malignant potential in 5-10% of patients. Plexiform neurofibromas are commoner in the face, chest and limbs but the index case occurred on the penile shaft.

Thoracoabdominal injury with evisceration from a chainsaw assault: a case report

The usual cause of penetrating thoracoabdominal injuries with evisceration are stab wounds with knives and other sharp weapons used during fights and conflicts. Evisceration of the abdominal viscera as a result of trauma, with its attendant morbidity and mortality, requires early intervention. Gunshot wounds can also cause penetrating thoracoabdominal injuries. We report the case of a 52-year-old male patient, a worker at a timber-processing factory, who was assaulted with a chainsaw by his colleague following a disagreement. He was seen at the accident and emergency department of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria with a thoracoabdominal injury about 1.5 hours after the attack. He had a left thoracoabdominal laceration with abdominal evisceration and an open left pneumothorax. He was managed operatively, made a full recovery, and was discharged 16 days after admission. He was readmitted 4 months after the initial surgery with acute intestinal obstruction secondary to adhesions. He underwent exploratory laparotomy and adhesiolysis. He made an uneventful recovery and was discharged on the 9th postoperative day for subsequent follow-up

Congenital hydronephrosis in a 2-year-old boy

Hydronephrosis is enlargement of renal collecting system including renal calyces with or without ureters. It is the most common prenatal anomaly and accounts for about 30–50% prenatal ultrasonography anomalies. Urinary tract dilation occurs in 1/100 pregnancies (1%) and causes significant uropathy in 1/500 (0.2%) cases. Antenatal hydronephrosis means dilation of the fetal renal collecting system that could be detected on prenatal ultrasonography and the prevalence is between 0.5% and 4%. Outcome depends on the underlying etiology. The index case was prenatally discovered at a gestational age of 6 months and postnatal assessment revealed a Grade V hydronephrosis with the absence of excretion or function on the right side

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Early impact of COVID-19 pandemic on paediatric surgical practice in Nigeria: a national survey of paediatric surgeons

Introduction The novel coronavirus disease has had significant impact on healthcare globally. Knowledge of this virus is evolving, definitive care is not yet known and mortality is increasing. We assessed its initial impact on paediatric surgical practice in Nigeria, creating a benchmark for recommendations and future reference.Methods Survey of 120 paediatric surgeons from 50 centres to assess sociodemographics and specific domains of impact of COVID-19 on their services and training in Nigeria. Valid responses were represented as categorical data and presented in percentages. Duplicate submissions for centres were excluded by combining and taking the mean of responses from centres with multiple respondents.Results Response rate was 74 (61%). Forty-six (92%) centres had suspended elective surgeries. All centres continued emergency surgeries but volume reduced in March by 31%. Eleven (22%) centres reported 13 suspended elective cases presenting as emergencies in March, accounting for 3% of total emergency surgeries. Twelve (24%) centres adopted new modalities for managing selected surgical conditions: non-operative reduction of intussusception in 1 (2%), antibiotic management of uncomplicated acute appendicitis in 5 (10%) and more conservative management of trauma and replacement of laparoscopic appendectomy with open surgery in 3 (6%), respectively. Low perception of adequacy of personal protective equipment (PPE) was reported in 35 (70%) centres. Forty (80%) centres did not offer telemedicine for patients’ follow-up. Twenty-nine (58%) centres had suspended academic training. Perception of safety to operate was low in 37 (50%) respondents, indifferent in 24% and high in 26%.Conclusion Majority of paediatric surgical centres reported cessation of elective surgeries while continuing emergencies. There was, however, an acute decline in the volume of emergency surgeries. Adequate PPE needs to be provided and preparations towards handling backlog of elective surgeries once the pandemic recedes. Further study is planned to more conclusively understand the full impact of this pandemic on children’s surgery

Infantile hypertrophic pyloric stenosis with unusual presentations in Sagamu, Nigeria: a case report and review of the literature

A 24-day old female Nigerian neonate presented with protracted vomiting, fever and dehydration but without palpable abdominal tumour or visible gastric peristalsis. There was no derangement of serum electrolytes. The initial working diagnosis was Late-Onset Sepsis but abdominal ultrasonography showed features consistent with the diagnosis of IHPS. This case report highlights the atypical presentation of this surgical condition and the need to investigate cases of protracted vomiting in the newborn with at least, ultrasonography to minimize complications and reduce the risk of mortality in a resource-poor setting.Pan African Medical Journal 2016; 2

Preschool wheeze, genes and treatment.

Preschool wheeze is a common but poorly understood cause of respiratory morbidity that is both distinct from and overlaps with infantile bronchiolitis and school age asthma. Attempts at classification by epidemiology, pathophysiology, therapeutic response and clinical phenotype are imperfect and yet fundamental to both treatment choice and research design. The four main therapeutic classes for preschool wheeze, namely beta2 agonists, anticholinergics, corticosteroids and leukotriene modifiers are employed with variable and often scanty evidence base, with evidence for a genetic influence on response variations. The article will discuss the pharmacogenetics of the various options, summarise current treatment recommendations, and explore future research directions

Biomarkers to predict asthma in wheezing preschool children

Wheezing in preschool children is a very common symptom. An adequate prediction of asthma in these children is difficult and cannot be reliably assessed with conventional clinical tools. The study of potential predictive biomarkers in various media, ranging from invasive sampling (e.g. bronchoscopy) to non-invasive sampling (lung function testing and exhaled breath analysis) was comprehensively reviewed. The evolution in biomarker discovery has resulted in an 'omics' approach, in which hundreds of biomarkers in the field of genomics, proteomics, metabolomics and 'breath-omics' can be simultaneously studied. First results on gene expression and exhaled breath profiles in predicting an early asthma diagnosis are promising. However, many hurdles need to be overcome before clinical implementation is possible. In order to reliably predict asthma in a wheezing child, probably a holistic approach is needed, combining clinical information with blood sampling, lung function tests, and potentially exhaled breath analysis. The further development of predictive, non-invasive biomarkers may eventually improve an early asthma diagnosis in wheezing preschool children, and assist clinicians in early treatment decision-making. This article is protected by copyright. All rights reserved