Histopathological study and audit of the spleen in Nigerians

Studies on the spleen in Nigerians are rare. This study reviewed retrospectively the gross and histopathological findings in spleens received at the histopathology laboratory of the Obafemi Awolowo University Hospital (OAUTHC), Ile-Ife, Nigeria. 119 consecutive splenectomy specimens received within a period of 18 years were analysed with respect to age, sex, pathological diagnoses and indication for splenectomy. There were 76 males and 43 females with a mean age of 34.8 years (STD 19.6 years). Spleen weight, size, the presence of malarial parasite as well as fibrosis was not documented in many cases. The most frequent finding both grossly and microscopically was haemorrhagic necrosis from laceration of the spleen arising from trauma (62.7% of all cases). Road traffic accident (RTA) accounted for 86% of all trauma cases and was the predominant finding in both sexes up to the age of 50 years. Thereafter, haematological malignancy was the predominant finding in the spleen. Chronic lymphocytic leukaemia (CLL) was the most common haematological malignancy in the spleen. The indications for splenectomy correlated well with the histological findings (kappa=0.81). Pathological description of spleen specimens is inadequate. Trauma is the major reason for splenectomy. In elderly Nigerians, splenectomy specimen would likely show CLL

Efficient extraction of antioxidants from Vernonia cinerea leaves: Comparing response surface methodology and artificial neural network

Despite response surface methodology (RSM) has been the most preferred statistical tool for optimizing extraction processes, artificial neural network (ANN) has been one of the most effective tools used for optimization and empirical modelling since the last two decades, most especially for non-linear equations. Thus, this study was carried out to compare the performance of RSM and ANN in optimizing the extraction yield and antioxidant capability of extract from Vernonia cinerea leaves using microwave-assisted extraction (MAE) techniques. The responses (extraction yield and antioxidant capabilities) were modelled and optimized as functions of four independent MAE parameters (irradiation time, microwave power level, ethanol concentration, and feed-to-solvent ratio) using RSM and ANN. The coefficient of determination (R2), root mean square error (RMSE) and absolute average deviation (AAD) were employed to compare the performance of both modelling tools. ANN model has a higher predictive potential compared to RSM model with higher correlation coefficients of 0.9912, 0.9928 and 0.9944 for extraction yield, DPPH and ABTS scavenging activities, respectively. Thus, ANN model could be a better alternative in data fitting for the MAE of antioxidants from Vernonia cinerea leave

Gender Differences in Students-Staff Violence in Urban and Rural Secondary Schools of Osun State, South Western Nigeria

Background: School violence is of public health importance. One important but often overlooked dimension is student-staff violence. The aim of the study was to assess the gender differences in the pattern of students-staff violence in urban and rural areas of Osun state with the hypothesis that male students and staff perpetrate violence more than female students and staff respectively. Methodology: A cross sectional study conducted among 800 secondary school students from JSS 2 to SSS 3 (400 in urban and 400 in rural areas) selected by multi-stage sampling technique. Results: The mean age for all the respondents was 14.3 years ±2.0, with the mean age for males as 14.2±2.0 and females as 14.3±2.0. Male respondents were 51.5% in urban schools and 51% in rural schools. Males were the main perpetrators in both urban and rural areas but more females in the rural areas perpetrated violence than their urban counterparts. Out of those who verbally abused school staff in urban areas, males constituted 61.5% compared to 38.5% of females. Respondents also experienced violence in the hands of academic staff (male and female). Conclusion: All forms of violence were perpetrated against school staff with prevalence higher in rural than urban areas. Males perpetrated most forms of violence than females in both urban and rural schools, though this was marked in urban schools. Female respondents in rural areas experienced significantly higher perpetration of most forms of school-related violence than urban females.Journal of Community Medicine & Primary Health vol 23 (1-2) 2011

Vitamins C and E attenuate lipid dystrophy in tissues of rats administered aluminium

To investigate the effects of aluminum chloride (AlCl3) in the deviation of tissue lipid profiles and ways to reduce its effect using antioxidant vitamins C and E, thirty-six male albino rats (120-150g) were divided into six groups with six rats each. Group (1) received normal saline and served as control, Group (2) was administered with AlCl3 (20mg/kg body weight b.wt)), Group (3) was administered with vitamin C (200mg/kg b.wt), Group (4) was administered with vitamin E (200mg/kg b.wt), Groups (5) and (6) were administered aluminium (20mg/kg b.wt) along with vitamins C and E (200mg/kg b.wt) respectively. At the end of the experiment, blood samples and organs (liver, testis, heart, kidney and brain) were harvested and used for lipid profile determination. The results showed that oral administration of aluminum significantly (p<0.05) increased cholesterol level in plasma and VLDL+LDL and significantly decreased in erythrocyte, HDL and testis. Cholesterogenesis was induced in the brain, liver, kidney and heart. Plasma and VLDL+LDL triglyceride were significantly (p<0.05) increased while erythrocyte and brain triglyceride were significantly decreased. Plasma, VLDL+LDL and brain phospholipid levels were significantly (p<0.05) decreased and that of erythrocyte significantly increased. There was no significant difference (p>0.05) in rats supplemented with vitamin C and vitamin E compared with control. The vitamins significantly attenuated the affected lipid levels in the tissues affected. It was concluded that administration of vitamin C and vitamin E supplements may be used as therapies against the effects of Aluminium exposure on lipids.Keywords: Aluminium exposure, lipid dystrophy, vitamin C, vitamin E, tissue

PREDITORS AND ACCEPTABILITY OF HUMAN PAPILLOMA VIRUS VACCINE UPTAKE AMONG SENIOR SECONDARY SCHOOL STUDENTS IN ILE-IFE

Introduction: Cervical cancer is the second most common cancer in women worldwide and in Nigeria. Human papilloma virus (HPV), has been implicated as the causative agent of cervical cancer. The fact that HPV vaccination can prevent the occurrence of this deadly cancer is well established. Though the vaccine has been licensed in Nigeria since 2008 with widespread availability, it is yet to be included in National immunization program in Nigeria. This study aimed to assess the predictors and acceptability of the HPV vaccine among senior secondary girls in Ile-Ife. Methods: This descriptive cross-sectional study recruited 400 students randomly selected from various secondary schools in Ife central-local government. The data was collected with the use of a pre-tested interviewer-administered questionnaire on knowledge, attitude, and acceptability of cervical cancer, HPV and HPV vaccine. Data were analyzed using descriptive and inferential statistics. Results: Most respondents (93.2%) had poor knowledge of cervical cancer, HPV and HPV vaccine. Attitude towards cervical cancer and HPV vaccine was good and the majority (74.5% ) had high acceptability for the HPV vaccine. Only 2.8% of the respondents have been vaccinated. Predictors of acceptability of HPV vaccine were younger age group ((AOR) 4.05 ,CI= 2.30-5.45), good knowledge ((AOR =2.50,CI=2.31-6.83) , mother’ higher level of education (AOR= 1.55, CI=2.62- 4.58 ), perceived fatality of cervical cancer ( AOR=4.13,CI=1.49 – 4.19) and perceived efficacy of the HPV vaccine( AOR=1.57, CI= 0.49 – 3.18). Conclusions: The knowledge of secondary school girls in the study area on cervical cancer, HPV and HPV vaccine is poor though the HPV vaccine acceptability is high. The high acceptability of the vaccine in this study is a reflection of the willingness of this vulnerable group to learn more about the subject matter. There is the need to create school health programs that will focus on health educating the students on this preventable cancer and the available vaccine. Including HPV vaccine into National immunization program in Nigeria may also improve awareness of cervical cancer and the vaccine uptake

Geochemistry and mineral chemistry of quartz mica schists within Iseyin-Oyan Schist Belt, Southwestern Nigeria

© 2020 The Authors. Published by Indian Society for Education and Environment. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: https://indjst.org/articles/geochemistry-and-mineral-chemistry-of-quartz-mica-schists-within-iseyin-oyan-schist-belt-southwestern-nigeriaBackground/Objectives: The Iseyin-Oyan schist belt is made up metasedimentary rocks, gneisses, granites and pegmatite intrusions. The study was aimed at identifying the schist within this belt and assess their metamorphism, geochemical characteristics and tectonic origin. Methods: Detailed geologic field mapping was undertaken where rocks were located, studied in-situ and identified. Samples of the schist were prepared for petrographic studies. Mineralogical contents were determined using X-Ray Diffraction technique. Polished sections were studied for mineral chemistry using Scanning Electron Microscope-Energy Dispersive Spectroscopy. Rock samples were analysed using X-Ray Fluorescence Spectroscopy and Inductively Coupled Plasma Emission Spectrometry. Geochemical data were elucidated using diverse geochemical discrimination diagrams. Findings: The schists are quartz mica schists and occur in close association with amphibolites, intrusive granitoids and pegmatites. The Mineral assemblage indicates upper (at the western part) to lower (at the central part) amphibolite facies grade metamorphism in the area. Pyrope-almandine garnets occur in quartz mica schist at the western parts reinforcing higher pressure-temperature metamorphic conditions. The concentration (in %) of SiO2 ranged from 56.4-71.6; Al2O3, 13.7-21.1; Fe2O3, 2-8; MgO, 0.7-2.4; and K2O, 2.1-5.5 supporting the evidence for differential degrees of metamorphism. Large iron lithophile and high field strength elements are similar to the average upper continental crust. Pronounced negative Europium anomaly pointed to the major roles played by feldspars during the geological processes. Plagioclase ranged from albite-oligoclase and oligoclase- andesine. The precursors of the quartz mica schist are possibly arkosic and greywacke sands deposited within the active continental margins. Evidence of uplift and overturning suggested for the differential metamorphism may be due to these events usually associated with active continental margins. Applications: This study has identified the once named undifferentiated schist in the study area to be quartz mica schist with details in their grades of metamorphism elucidated.Published versio

Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000–2018

Background: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15–59 years across SSA. Methods: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. Results: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. Conclusions: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA

Mapping age- and sex-specific HIV prevalence in adults in sub-Saharan Africa, 2000-2018

BACKGROUND: Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustainable Development Goals (SDGs). Precise HIV burden information is critical for effective geographic and epidemiological targeting of prevention and treatment interventions. Age- and sex-specific HIV prevalence estimates are widely available at the national level, and region-wide local estimates were recently published for adults overall. We add further dimensionality to previous analyses by estimating HIV prevalence at local scales, stratified into sex-specific 5-year age groups for adults ages 15-59 years across SSA. METHODS: We analyzed data from 91 seroprevalence surveys and sentinel surveillance among antenatal care clinic (ANC) attendees using model-based geostatistical methods to produce estimates of HIV prevalence across 43 countries in SSA, from years 2000 to 2018, at a 5 × 5-km resolution and presented among second administrative level (typically districts or counties) units. RESULTS: We found substantial variation in HIV prevalence across localities, ages, and sexes that have been masked in earlier analyses. Within-country variation in prevalence in 2018 was a median 3.5 times greater across ages and sexes, compared to for all adults combined. We note large within-district prevalence differences between age groups: for men, 50% of districts displayed at least a 14-fold difference between age groups with the highest and lowest prevalence, and at least a 9-fold difference for women. Prevalence trends also varied over time; between 2000 and 2018, 70% of all districts saw a reduction in prevalence greater than five percentage points in at least one sex and age group. Meanwhile, over 30% of all districts saw at least a five percentage point prevalence increase in one or more sex and age group. CONCLUSIONS: As the HIV epidemic persists and evolves in SSA, geographic and demographic shifts in prevention and treatment efforts are necessary. These estimates offer epidemiologically informative detail to better guide more targeted interventions, vital for combating HIV in SSA

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Wyjaśnienie zależności pomiędzy przymierzem terapeutycznym a efektami terapii:rola pośredniczącego wpływu wieku i płci w leczeniu uzależnień u osób nieletnich

Związek pomiędzy przymierzem (relacją, sojuszem) terapeutyczną a rezultatami terapii został już dawno przedstawiony w wielu opracowaniach i metaanalizach. Jeśli jednak chodzi o leczenie osób uzależnionych nieletnich, to nadal jest to obszar mało zbadany. Niniejsze opracowanie obejmuje badanie czynników wpływających na związek pomiędzy relacją terapeutyczną a efektami leczenia uzależnionych nieletnich. Zbadano pośredniczący wpływ zmiennych demograficznych, tzn. wieku i płci, na próbie uzależnionych nieletnich w centrum rehabilitacji szpitala uniwersyteckiego (UCH) w Ibadan, stan Oyo, Nigeria. W badaniu wzięło udział pięćdziesięciu trzech nieletnich, którzy przed leczeniem wypełnili ankiety oceny własnej gotowości i oczekiwań (teoria zmiany pacjenta) względem terapii, a w czasie leczenia ankiety dotyczące relacji terapeutycznej. Wyniki prezentowanych badań wskazują, że wiek nie wpływa na związek pomiędzy relacją terapeutyczną a efektami leczenia uzależnień osób nieletnich. Ponadto, wyniki wykazały istotną zależność od płci, jeśli chodzi o zmienne motywacyjne przed terapią oraz opinie pacjentów na temat relacji terapeutycznej i wyników leczenia. Ostatecznie zaproponowano, że wczesna identyfikacja zmiennych demograficznych wpływających na leczenie uzależnień wśród nieletnich, jako atrybucja ich odporności, ma związek z wiekiem i płcią