A media framing analysis of urban flooding in Nigeria: current narratives and implications for policy

© 2017, The Author(s). A critical element of current flood management is the importance of engaging key policy actors when policy decisions are to be made. However, there is still only limited understanding of how narratives of flood management actors may influence flood management policies, even though there is a suggestion that actors can strategically use their narratives to influence policy directions. In a developing country like Nigeria, there are still questions around lessons that can be learnt from understanding the narratives of policy actors, to unravel the complex nature of strategies and policy directions in managing urban floods. To help fill these gaps, this paper uses quantitative content analysis to explore the frame of five policy actor groups (government, local communities, business, multilateral organisations and non-governmental organisations (NGOs)) as expressed in local and national newspapers between 2012 and 2016 to understand their narratives of causes and strategies to solve the problem of urban flooding in Nigeria. The narratives of government, local communities and businesses align with the premise that flooding can and should be prevented whilst that of multilateral and business actors champion adaptation strategies on the basis that flooding is inevitable and hence more energy should be directed at ‘living with water’—emergency response, damage reduction and the aftermath. The study also identified areas of potential consensus and conflict between direct actors such as government and local communities on the one hand and funders on the other. Better discussion among actors aiding understanding of contemporary thinking and local realities will aid policy-making and policy implementation in the Nigerian context. An important step will be in the collaborative design of an urgently needed ‘Nigerian policy on flooding’ which currently does not exist

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Biodegradation of hydrocarbon compounds in Agbabu natural bitumen

The recovery of an environment polluted by petroleum and allied hydrocarbons through bioremediation is being embraced globally as the best technology of removing hydrocarbon pollutants from environment. Infrared spectral changes and gravimetric analysis from the preliminary biodegradability study carried out on Agbabu Natural Bitumen showed the vulnerability of the bitumen to some bacteria: Pseudomonas putrefaciens, Pseudomonas nigrificans, Bacillus licheniformis, Pseudomonas fragi and Achromobacter aerogenes. This study investigates the ability of P. putrefaciens, P. nigrificans, B. licheniformis, P. fragi and A. aerogenes to degrade the aliphatic and polycyclic aromatic hydrocarbon fractions of Agbabu natural bitumen. Samples of the bitumen were separately inoculated with each of the bacteria for 14 days and the hydrocarbon profiles before and after inoculation were quantified using gas chromatography technique. The total aliphatic hydrocarbon compounds (C11 - C29) in the bitumen degraded by P. putrefaciens and P. nigrificans was slightly higher than that in the undegraded bitumen, while the concentration of compounds (C11 - C29) found in samples of the bitumen degraded by B. licheniformis, P. fragi and A. aerogenes was less than what was contained in the undegraded bitumen. Also the even-odd carbon-ratios of the degraded bitumen were higher than unity while these were less than unity in the undegraded bitumen. The polycyclic aromatic hydrocarbons (PAHs) profile in the bitumen degraded samples also differed from that of undegraded bitumen. A substantial reduction in the concentration of some PAHs was found in the bitumen samples following their degradation by the bacteria strains, typically from 55.98 to 30.79%, thus suggesting the possibility of using the bacteria strains for bioremediation process.Keywords: Agbabu, bitumen, bacteria, biodegradability, hydrocarbonsAfrican Journal of Biotechnology, Vol 13(11), 1257-126

The Incidence of Low Plasma Cholinesterase Level and Prolonged Suxamethonium Apnoea in Sub-Saharan Africa

Background: Plasma cholinesterase is involved in the metabolism of numerous drugs including the short acting muscle relaxants suxamethonium and mivacurium. Patients deficient in BChE will exhibit a prolonged reaction to suxamethonium, and apnoea can persist for a period varying from minutes to hours. Prolonged suxamethonium apnoea may arise from inherited or acquired abnormalities of BChE, this study aimed to determine the incidence of low plasma cholinesterase and prolonged apnoea following suxamethonium. Methods: One hundred healthy patients with the American Society of Anesthesiologists (ASA) physical status I and II scheduled for elective surgery under general anaesthesia requiring endotracheal intubation were studied. Blood samples were obtained before induction of anaesthesia for estimation of baseline cholinesterase using an automated spectrophotometric method employing benzoylthiocholine. Suxamethonium 2mg/kg was administered after induction of anaesthesia and its onset was determined as the time from the administration of suxamethonium to the time of cessation of spontaneous respiration. The duration of apnoea is time from cessation of respiration to the first evidence of return of spontaneous respiration, or using peripheral nerve stimulator the time from the cessation of respiration until the response to TOF stimulation of the ulnar nerve reappears as evidenced by adduction of the thumb. Results: The mean cholinesterase level was 6573.29 ±2128.29 (ranged from 1227-14536) IU/L, the cholinesterase activity was similar in both children and adults (p = 0.97). The mean duration of apnoea was 5.88 ±2.00 minutes. Normal cholinesterase level constituted 81%, high cholinesterase level 3%, and low cholinesterase level 16% of the patient population (11% in adults and 5% in children). Prolonged apnoea with a mean duration of 10.69 ± 0.52 minutes occurred in 7% of patients with cholinesterase levels between 1227-4206 IU/L. Conclusion - Low cholinesterase level is not uncommon among healthy Nigerians. The incidence of prolonged apnoea however is small. Key words: Plasma cholinesterase, suxamethonium, prolonged apnoe

A Retrospective study of Pressure ulcers in critically ill patients in a Sub-Saharan Tertiary Centre

Background: Critically ill patients are at increased risk of developing pressure ulcers because of the presence of confounding factors such as reduced mobility, poor nutrition, reduced tissue perfusion, neurologic deficits, faecal or urinary incontinence. This study determined the prevalence and risk factors for the development of pressure ulcer in the ICU. Methods: A retrospective study of 499 critically ill patients from January 2010 to December 2012. Patients were excluded if they were admitted into the ICU for less than 48 hours or had a pressure ulcer at the time of admission. Result: A total of 499 patients with mean age for of 34.95±18.48 years, (3months to 89years) were studied. Adults were 419(83.97%). The mean duration of ICU admission was 7.30±(SEM)0.43 days. The prevalence of pressure ulcer was 86(17.23%). The mean onset and duration of pressure ulcer was 3.55±2.11 and 6.44±(SEM)1.11 days respectively. The majority of the ulcers 57(66.28%) were located in the sacrococcygeal region, followed by head and neck region, 19(22.09%). The risk of development of pressure ulcers was higher in neurological pathology, odd ratio 1.985, (95% CI 1.242 3.173), p = 0.004, duration of ICU admission >3days, odd ratio 9.143, (95% CI 3.898 21.445), p<0.001, and mechanical ventilation, odd ratio 0.80 (95% CI 0.45-0.141), p <0. 001. The occurrence of pressure ulcers was significantly associated with poor ICU outcome, odd ratio 2.408, (95% CI 1.474-3.933), p<0.001. Conclusion: Pressure ulcer is not uncommon in our ICU, therefore, there is a need to put in place guidelines and protocols to minimize the occurrence.  Keywords: Pressure ulcer, prevalence, risk factors, intensive care unit

Point of Care Testing/Central Laboratory Analysis of Glucose and Electrolytes in Diabetic Emergencies. Are They Comparable?

Prompt diagnosis of electrolytes and acid-base abnormalities in diabetic emergencies, and quick intervention is the key to a good outcome. In the Third world, there is a delay in reporting of central laboratory results due to a mirage of problems. POCT testing has been shown to be valuable in the management of diabetic emergencies as it provides quick results and expedite treatment. To find out in this study if there was an agreement between the analytes evaluated with central laboratory and Abbot I-STAT point of care. A prospective comparison of paired venous blood samples with Abbot I-STAT POCT testing and central laboratory (ion-selective electrode, SFRI analyzer ISE 6000) measurements were obtained from 30 diabetic patients. There was good agreement with electrolytes and glucose values between Abbot I-STAT POCT analyser and SFRI ISE 6000 analyser in diabetic emergencies. The Lin's concordance correlation (agreement) for glucose (pc) =0.999, mean difference of 0.04 mmol/L and 95% limit of agreement (LOA) from -4.702 to +4.622 mmol/L, p = 0.986. Sodium (pc) =0.996, mean difference of 0.027 mmol/L and 95% LOA from -0.191 to +0.245 mmol/L, p = 0.991. Potassium (pc) = 0.990, mean difference of 0.03 mmol/L, and 95% LOA from -0.032 to +0.078 mmol/L, p =0.919. Chloride (pc) =0.996, mean difference of -0.04 mmol/L and 95% LOA from -0.197 to +0.284 mmol/L, p = 0.983. Bicarbonate (pc) =0.949, mean difference of 0.37 mmol/L and 95% LOA from -0.49 to +1.23mmol/L, p = 0.832. Blood urea nitrogen (pc) =0.999, mean difference of 0.12 and 95% limit of agreement from -0.501 to +0.254mmol/L, p = 0.202. PCV (pc) =0.483, mean difference of -3.7% and 95% LOA -7.78 to +0.40, p= 0.991. The agreement  between central laboratory testing and I-STAT Abbot point of care testing was good for electrolytes and glucose.Keywords: POCT, Central laboratory, Bland Althmans, Diabetic emergencies

Routine hemoglobin electrophoresis for pediatric surgery day case in at‑risk populations: Suggested algorithm for screening using clinical risk factors

Background: Hemoglobin electrophoresis (HBE) is a part of the preoperative routine requested by anesthetists. However, the prevalence of hemoglobinopathy in the population is low. This study aims to determine the clinical risk factors for hemoglobinopathies and propose clinical guidelines for preoperative screening of patients for pediatric day care surgery.Patients and Methods: A prospective study carried out over 12 months. Consecutive patients aged 6 months and older who had day case surgery were recruited to the study. Biodata and relevant clinical data were collated and documented in a proforma and analyzed using a statistical package for social sciences version 17.Results: There were 124 patients106 boys and 18 girls. The median age was 3 years. Scrotal lesions were the most common conditions managed (71.7%). Seventy‑eight percent of patients had HbAA, 15.3% had HbAS, and 4.8% had HbAC while 0.8% each had both HbSC and HbSS. At least one parent of 78.2% knew their Hb phenotype, of which, 79% were HbAA. A history of jaundice (P = 0.0001), hand and foot syndrome (P = 0.0001), frontal bossing (P = 0.0001), and low packed cell volume at surgery (P = 0.001) were found significant in predicting hemoglobinopathies. There was no mortality.Conclusion: Risk factors for hemoglobinopathies from this study included a positive history of jaundice, hand and foot syndrome, frontal bossing, and anemia. Proposed guidelines for HBE screening include the presence of hemoglobinopathy in one parent if one parent has sickle cell trait, and the other parent’s genotype is unknown or if any of the risk factors is present.Keywords: Algorithm, day case surgery, hemoglobin electrophoresis screenin

Effects of NPK Fertilizer Application on the Growth and Seed Yield of Cowpea in Ilorin, Southern Guinea Savanna Zone Of Nigeria

To forestall wastage and determine the optimum level of complete fertilizer needed for better production of cowpea, the application of NPK 16:16:16 fertilizer on the growth and yield of the crop was investigated. The field experiment was conducted on the Teaching and Research Farm of the Faculty of Agriculture, University of Ilorin. A medium-maturing cowpea variety IAR- 48 was tested with five NPK fertilizer rates viz: 200kgNPK/ha, 400kgNPK/ha, 600kgNPK/ha, 800kgNPK/ha and 0kgNPK/ha as the control. The experiment was laid out in a randomized complete block design, replicated twice. Data were collected on plant height, number of leaves, leaf area, number of branches, number of pods per plant, number of seeds per pod, weight of 100seeds and grain yield per treatment. All data were subjected to Analysis of Variance (ANOVA) using GENSTAT package while separation of significant means was done using Least Significance Difference (LSD) at 5% probability level. Results showed that NPK fertilizer at the rate of 200kg/ha improved pod production, weight of 100seeds, pod weight and final grain yield per hectare. It could, therefore, be inferred that, subject to further research, if NPK 16:16:16 is applied at rate of 200kgNPK/ha or less, better yield and reduction in the cost of production will be achieved with cowpea variety IAR- 48 in Ilorin, a location in the Northern Guinea Savanna Zone of Nigeria. Keywords: Complete fertilizer, cowpea, vegetative growth, yield potential and yield improvemen

Nitrogen utilisation and nitrient digestibility of west African dwarf goats fed combinations of dry leaves of Cynodon nlemfuensis, Spondias mombin or Gmelina arborea and pap processing waste meal

An experiment to evaluate and compare the nitrogen utilization and nutrient digestibility of goat fed a pasture species (Cynodon nlemfuensis) or browse plant leaves (Spondias mombin or Gmelina arborea) based diets was conducted with fifteen (15) growing male West African Dwarf goats aged 7 – 7.5 months and weighing between 6.67 – 7.02 Kg. The animals were randomly divided into three groups of approximately equal mean live weight in a completely randomized design and each group was assigned to one of the experimental diets (A, B and C). The cynodon nlemfuensis based diet served as the control (diet A) while Spondias mombin and Gmelina arborea based diets served as dietary treatments B and C respectively. Each animal was later kept in a metabolism cage equipped with feed and water troughs. Feed (0.40 kg/head/day) was offered at 08.00hrs and water provided ad libitum. Faeces and urine were collected during the sixth week of the experiment and analysed chemically. The dry matter intake (40.25 g/day/W0.75 kg) of goats fed diet C was significantly higher (P < 0.05) than those on diets A and B. Diet B was the least consumed (34.74 g/day/W0.75 kg). Animals on diet C recorded the highest Nitrogen intake (4.15 g / head/day) and nitrogen retention (0.44 g /day/W0.75 kg). Goats on diet C also recorded highest values for the digestibility of DM, CP and OM. Although goats on diet B recorded a higher nitrogen intake (2.90 g/head/day) as against that of diet A (2.27 g/head/day), the least nitrogen retention value (0.12 g/day/W0.75 kg) was obtained from them. The nitrogen retention value for goats on diet A was 0.17 g/day/W0.75 kg. The low DM intake and nitrogen retention recorded for goats on diet B was attributed to low palatability / availability of nitrogen due to the presence of high tannin content. Keywords: Cynodon, Spondias, Gmelina, nitrogen utilization, WAD goats, tanninJournal of Agriculture, Forestry and the Social Sciences Vol 3(1) 2005: 89-9

The incidence of electrolyte and acid-base abnormalities in critically ill patients using point of care testing (i–Stat portable analyser)

Background: Electrolytes and acid-base disorders are common challenges seen in the intensive care unit (ICU) resulting in difficulty in weaning patients off the ventilator, prolonged admission periods, preventable cardiac arrhythmias and cardiac arrest. These require prompt lab results most of which are done serially, ideally a point of care test (POCT), as most central hospital lab result's turnaround time (TAT) sometimes might not meet up with the urgency of clinical decision making in the ICU.Objective: To determine the incidence of electrolytes and acid-base abnormalities using i-Stat portable analysers in the ICU of the Lagos University Teaching Hospital (LUTH).Method: The i-STAT Portable Clinical Analyzer, a POCT system consisting of a hand-held analyzer and single-use cartridges that measure different panels of analytes in 65–100 μl of blood using an EC8+ cartridge type analyzer for sodium, potassium, chloride, urea, glucose, pH, blood gases [TCO2, pO2, pCO2]) and heamatocrit was used. Results: Over 66.78% of the patients had multiple electrolytes and acid-base abnormalities. Azotemia in 20%, hypoglycaemia in 13.33%, and hyperglycaemia in 53.33% of patients.Conclusion: it is concluded from this study that electrolyte and acid base abnormalities is not uncommon in the intensive care unit of LUTH and the i-STAT Portable Clinical Analyzer was helpful in facilitating early diagnosis and treatment.Key words: Electrolytes, acidosis, alkalosis, Critically-illpatient