Influence of agronomic practices on yield and profitability in kenaf (Hibiscus cannabinus L.) fibre cultivation

Field trials were conducted in 2003 and 2004 at the Institute of Agricultural Research and Training, Ibadan (7o 38’ N 3o 84’ E), Nigeria to determine the influence of some agronomic practices on yield andprofitability in kenaf bast fibre production. Three kenaf varieties, Cuba 108, Ifeken 400 and Ibadan local, were subjected to three agronomic practices in a split-plot experiment. The agronomic practicesinclude the farmers’ practice where no input was used and two levels of improved management practices (IMP) where the influence of pests and soil nutrition were ameliorated. The results showed that total dry matter, fibre and core yields increased by 150 – 170%, incidence of nematode reduced by 50% and severity scores of insects attack on foliage reduced by 83% in the improved management practice (IMP). The three kenaf varieties differ significantly in their leaf biomass, reaction to nematode and foliage pests attack. In the control treatment, Ibadan local had more leaf biomass and was tolerantto pests attack while other varieties were susceptible. Economic analysis showed that net return was higher in the local cultivar than in the improved varieties under the farmers’ practice. However,economic returns and marginal rate of returns were higher under IMP’s than the control in Cuba 108 and Ifeken 100 varieties than the local cultivar

Plasmid profile of Escherichia coli 0157:H7 from apparently healthy animals

One hundred samples from healthy animals were screened for the presence of enterohaemorrhagic Escherichia coli 0157: H7 and 17 were positive for EHEC 0157:H7 after confirmation using serology kits. Antibiotic susceptibility patterns showed the isolates to be highly susceptible to the various antibiotics screened with a few showing multiple antibiotic resistance. The plasmid profiles revealed that 8/17 (47%) of the animal isolates harboured detectable plasmids ranging in size from 0.564 kb to >23 kb. Key words: Escherichia coli, EHEC, animals, plasmid profile. African Journal of Biotechnology Vol.2(9) 2003: 322-32

Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality. Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children <18 years who were newly diagnosed with or undergoing active treatment for acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, retinoblastoma, Wilms tumour, glioma, osteosarcoma, Ewing sarcoma, rhabdomyosarcoma, medulloblastoma and neuroblastoma. Of 2327 cases, 2118 patients were included in the study. The primary outcome measure was all-cause mortality at 30 days, 90 days and 12 months. Results All-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3-11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); p<0.001), lower middle income (OR 3.32 (95% CI 1.96 to 5.61); p<0.001) and upper middle income (OR 3.49 (95% CI 2.02 to 6.03); p<0.001) country status and chemotherapy (OR 0.55 (95% CI 0.36 to 0.86); p=0.008) and immunotherapy (OR 0.27 (95% CI 0.08 to 0.91); p=0.035) within 30 days from MDT plan. Multivariable analysis revealed laboratory-confirmed SARS-CoV-2 infection (OR 5.33 (95% CI 1.19 to 23.84); p=0.029) was associated with 30-day mortality. Conclusions Children with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Sarcoidosis in Lagos Revisited. A Retrospective Analysis of 15 cases, Seen at the Pulmonology Unit of an Urban Tertiary Centre in Lagos, South West, Nigeria.

Sarcoidosis amongst Nigerians remains a condition with limited information in literature despite the high prevalence of Sarcoidosis amongst Afro- Americans. This study was conceived to describe the presentation of the cases seen in an urban tertiary centre in Nigeria. A three year retrospective study of Sarcoidosis was carried out at a tertiary hospital in Lagos Nigeria. Fifteen cases were identified with confirmed Sarcoidosis with F: M ratio of 4:1. The mean age of the patientswas55±12.89years. Weight loss was the most predominant symptom which occurred in 12(80%) of the patients while only 2(13.3%) were assymptomatic. All the patients had pulmonary involvement, and the most frequent site for extrapulmonary sarcoidosis was the skin which occurred in 04(26.7%) of the patients. Splenomegaly was present in 2(13.3) while 03 (20%) had hepatomegaly. One(6.7%) patient had ocular manifestations including dry eye and dry mouth due to salivary gland involvement. Tissue biopsy was done in 09(60%) of the patients which showed non caseating granuloma. CXR was abnormal in all cases. HRCT was done in 14 cases. The mean serum ACE was elevated in 12(80%) of the patients. Most of the patients were treated with oral steroid and in some cases topical hydroxyl chloroquine. There is female preponderance of sarcoidosis amongst Nigerians. Pulmonary involvement is common while the skin is the most common site for extrathoracic involvement. Erythema nodosum was not seen in any of the patients. There is need to increase the surveillance for sarcoidosis and carry out more studies to describe its possible peculiarities amongst Nigerian.Key words: Sarcoidosis, pulmonary, extrapulmonary

Willingness of Nigerians to Donate a Kidney

Background: Kidney transplantation is a popular modality of RRT in the developed world.Objective: To assess the willingness of the general population of Nigerians across the country to donate a kidneyMethods: This is a multiregional, cross sectional, questionnaire based study. One thousand Three hundred respondents participated in the study. This study was carried out in four major Towns and cities across Nigeria between January 2009 and December 2010.The locations are Birnin Kebbi in the north, Ilorin in the middle belt, Iddo Ekiti in the south and Lagos, the economic capital of Nigeria. The respondents were randomly selected within the four localities. Those below the age of 16 or above the age of 65 years were excluded from the studyResults: There were 727 (55.9%) males. The mean age (S.D) of respondents was 39.5 (10.7) years. The largest population of participants, 494 (38.3%) were non health workers and 692 (53.2%) of them were Muslims. Eight hundred and fifty eight (66%) of the participants were willing to donate a kidney. Twenty five percent (25%) were not willing and 115 (8.9%) were not sure. Majority of those who were unwilling to donate a kidney, 325 (99.4%) will not change their minds even if they were to be given incentivesConclusion: Nigerians are willing to donate a kidney irrespective of geographical location, religion or gender and many are willing to do so altruistically.Keywords: Kidney, donation, Nigeri

Video‑assisted thoracic surgery in a Nigerian teaching hospital: Experience and challenges

Background: Video‑assisted thoracic surgery (VATS) is well established. Its application in Nigeria has however been limited and not been reported. The aim of this study was to describe our institutional experience and challenges with VATS.Materials and Methods: This was a retrospective cross‑sectional study of all patients that underwent VATS in our institution between March 2008 and June 2013. Data were extracted from a prospectively maintained database.Results: Two hundred and sixty‑one patients were assessed as potential VATS cases. VATS was initiated in 26 patients, but completed in 25 patients (9.6%) as there was one case of conversion of a planned VATS bullectomy due to the failure of one lung ventilation. There were 12 males and 13 females. Mean age was 40.7 ± 13.9 years. The indication was interstitial lung disease in 9 patients (36%), malignant pleural effusion in 6 patients (24%), spontaneous pneumothorax in 5 patients (20%), indeterminate pulmonary nodule in 2 patients (8%), pleural endometriosis in 2 patients (8%) and bronchogenic cyst in one patient (4%). Procedures performed were lung biopsy in 13 patients (52%), pleural biopsy and pleurodesis in 6 patients (24%), bullectomy and pleurodesis in 5 patients (20%) and excision of bronchogenic cyst in one patient (4%). Mean hospital stay was 4 ± 0.7 days. There were no complications and no mortalities.Conclusion: VATS is being performed in our institution with successful outcomes. The use of VATS in Nigeria is encouraged. The relatively high cost of VATS is, however, a major limitation to more widespread use.Key words: Nigeria, video‑assisted thoracic surgery, experienc