Assessment of the Efficiency of Disinfection Methods for Improving Water Quality

The efficiencies of three disinfection methods namely boiling, water guard and pur purifier were assessed. The micro-organisms isolated from the groundwater samples were Escherichia coli and E. aerogenes. The major components of Water Guard and Pur Purifier were found to be NaNO2,SO4, Cl2; and NaNO2, Ca, CaCO3, SO4, Mg and ClO2 respectively. Pur purifier was most effective for removal of electrical conductivity, nitrate, total coliform and yeast while Water Guard was most effective for removal of phosphate, potassium, E-Coli and Fungi. In addition, boiling and water guard were most effective for removal of turbidity while boiling was most effective for removal of chlorine. Furthermore, Water Guard was found to be the cheapest with an estimated monthly household cost of N240. Use of Water Guard for disinfecting household groundwater sources utilized for drinking and cooking is highly encouraged among the rural populace to safeguard their health against waterborne diseases.http://dx.doi.org/10.4314/njt.v34i4.33

Single Dose of Dexamethasone for Prevention of Nausea and Vomiting After Major Gynaecological Surgery

BACKGROUND: Post-operative nausea and vomiting (PONV) is a common complications following general anaesthesia and is a leading cause of morbidity following surgery . The mainstay of management them is by the use of antiemetic.METHOD: It was a randomized double blind placebo controlled study. The sample size was calculated as 90 from previous study with 10% attrition to make the 100. They were randomly divided into two groups; group Breceived dexamethasone prophylactically at induction while group A received placebo also at induction. All patients had balanced general anaesthesia and were taken to the recovery room postoperatively whereincidences of postoperative nausea and vomiting were recorded. Patients with incidences of nausea and vomiting were treated with 10mg metoclopramide intravenously while postoperative complications thatmay be associated with dexamethasone prophylaxis were also noted.RESULTS: The groups were comparable with respect to demographic characteristics. More patients in group A(placebo group)) had incidence of nausea than group B (dexamethasone group) with p value of 0.01 and also more patients in group A had vomiting than group B with p value of 0.02; which was significant. The duration of stay in the recovery room for both groups A and B were however comparable with no statistical difference.CONCLUSION: Dexamethasone when given prophylactically at induction reduces incidence of postoperative nausea and vomiting after  gynaecological surgeries.KEYWORDS: Postoperative nausea (PONV), Dexamethasone, prophylaxis, gynaecology

Awareness and practice of breast screening and its impact on early detection and presentation among breast cancer patients attending a clinic in Lagos, Nigeria

Background: Breast cancer is  the most common malignancy among females in Nigeria. The concept of breast screening (BS) is that it would result in presentation at earlier stages. We evaluated the impact of BS on early detection and presentation of breast cancer and determined the aspects BS need improvement.Patients and Methods: All patients with a diagnosis of malignant breast lump attending clinics at a tertiary hospital in Nigeria were recruited into the study over a 2‑year period. Self‑administered questionnaires were given to patients. Data collected were demographics, knowledge about BS, practice of BS, the motivation to practice BS and the source of information on BS.Results: Of 218 patients seen, 147 (67.4%) patients presented at the surgical outpatient clinic and 71 (32.6%) at the radiotherapy clinic, with age 48.01 ± 0.80 years. A total of 156 (71.6%) were aware of BS, while 62 (28.4%) were not aware. A logistic regression analysis showed that only the level of formal education predicted awareness of BS, P = 0.001 Nagelkerke’s R2 = 0.126. Awareness of BS was mainly from electronic media 87 (55.7%). There was no significant difference in the ages of those aware and practicing BS 48.03 ± 1.05 years, and those not practicing BS 46.32 ± 1.94 years, P = 0.446. There was no significant difference in presentation for those practicing BS 7.41 ± 1.30 months, and those not practicing BS 11.38 ± 2.91 months, P = 0.175, with 64% practicing BS presenting late, while 77% not practicing BS presenting late, χ2 = 2.432, P = 0.488. A logistic regression analysis did not show any demographic or clinical parameters as predictive P = 0.225 Nagelkerke’s R2 = 0.126.Conclusion: The high level of awareness and practice of BS was not translated into the presentation with early breast cancer.Key words: Breast screening, mammography, physician clinical examination, self‑breast examinatio

An Estimate of the Incidence of Prostate Cancer in Africa: A Systematic Review and Meta-Analysis

Prostate cancer (PCa) is rated the second most common cancer and sixth leading cause of cancer deaths among men globally. Reports show that African men suffer disproportionately from PCa compared to men from other parts of the world. It is still quite difficult to accurately describe the burden of PCa in Africa due to poor cancer registration systems.We systematically reviewed the literature on prostate cancer in Africa and provided a continentwide incidence rate of PCa based on available data in the regio

Global diversity and antimicrobial resistance of typhoid fever pathogens: Insights from a meta-analysis of 13,000 Salmonella Typhi genomes

Background: The Global Typhoid Genomics Consortium was established to bring together the typhoid research community to aggregate and analyse Salmonella enterica serovar Typhi (Typhi) genomic data to inform public health action. This analysis, which marks 22 years since the publication of the first Typhi genome, represents the largest Typhi genome sequence collection to date (n=13,000). Methods: This is a meta-analysis of global genotype and antimicrobial resistance (AMR) determinants extracted from previously sequenced genome data and analysed using consistent methods implemented in open analysis platforms GenoTyphi and Pathogenwatch. Results: Compared with previous global snapshots, the data highlight that genotype 4.3.1 (H58) has not spread beyond Asia and Eastern/Southern Africa; in other regions, distinct genotypes dominate and have independently evolved AMR. Data gaps remain in many parts of the world, and we show the potential of travel-associated sequences to provide informal ‘sentinel’ surveillance for such locations. The data indicate that ciprofloxacin non-susceptibility (>1 resistance determinant) is widespread across geographies and genotypes, with high-level ciprofloxacin resistance (=3 determinants) reaching 20% prevalence in South Asia. Extensively drug-resistant (XDR) typhoid has becomedominant in Pakistan (70% in 2020) but has not yet become established elsewhere. Ceftriaxone resistance has emerged in eight non-XDR genotypes, including a ciprofloxacin-resistant lineage (4.3.1.2.1) in India. Azithromycin resistance mutations were detected at low prevalence in South Asia, including in two common ciprofloxacin-resistant genotypes. Conclusions: The consortium’s aim is to encourage continued data sharing and collaboration to monitor the emergence and global spread of AMR Typhi, and to inform decision-making around the introduction of typhoid conjugate vaccines (TCVs) and other prevention and control strategies

A review of stroke admissions at a tertiary hospital in rural Southwestern Nigeria

Background: Stroke is a common neurological disorder and is the third leading cause of death and a major cause of long-term disability. The disease is expected to increase in low- and middle-income countries like Nigeria. There is no information on stroke in rural Nigeria. Objectives: To review the clinical patterns, risk-factors, and outcome of stroke in a tertiary hospital in rural Nigeria and examine the rural-urban variation of stroke hospitalization in Nigeria. Materials and Methods: We carried out a retrospective study of patients who had a clinical diagnosis of stroke at the Federal Medical Centre, Ido-Ekiti, South-western Nigeria between November 2006 and October 2009. Results: A total of 101 patients who had stroke were admitted during this review period, accounting for 4.5% of medical admission and 1.3% of total hospital admission. Women accounted 52.5% of cases, with a male to female ratio of 1 : 1.1. Their mean age was 68 ± 12 years. Stroke occurrences increased with age, as almost half (49.5%) of the cases were aged ≥70 years and majority (84.2%) of them were in low socioeconomic class. The mean hospital stay for stroke treatment was 12 ± 9 days, Glasgow coma score on admission was 11 ± 4. Ischemic stroke was 64.4%; hemorrhagic stroke, 34.7%; and indeterminate, 1.0%. Hypertension (85.2%), diabetes mellitus (23.8%), and tobacco smoking (22.8%) were the common identifiable risk factors for stroke. Of all the patients, 69% had ≥2 risk factors for stroke. Thirty-day case fatality was 23.8%; it increases with age and was higher among men than women (29.2 vs 18.9%) and in patients with diagnosis of hemorrhagic stroke (34.3 vs 18.5%). The numbers of identifiable risk factors of stroke has no effect on the 30-day case fatality. When compared with stroke in urban areas of Nigeria, we found no differences in frequency of hospitalization (1.3 vs 0.9 - 4%) and the major risk factor (hypertension). Hemorrhagic stroke was more common in urban than in the rural community (45.2 - 51 vs 34.7%) and the 30-day case fatality was lower in the rural community (23.8 vs 37.6 - 41.2%). Conclusion: Stroke is also a common neurological condition in rural Nigeria, in view of the fact that almost 70% of the patients had ≥2 risk factors of stroke. We recommend that, sustainable, community-friendly intervention programmes are incorporated into the health care system for the early prevention, recognition, and modification of the risk factors in persons prone to the disease.DOI: 10.4103/1596-3519.8206

Patterns of drugs prescribed for dental outpatients in Nigeria: findings and implications.

There are concerns with inappropriate prescribing of medicines among dentists especially antimicrobials. It is more concerning if this increases resistance rates. This study aimed to address this by assessing patterns of drugs prescribed for outpatients attending a hospital dental clinic in Nigeria. The findings will be used to plan future interventions, particularly around antimicrobial prescribing, where there are concerns.Medical records of patients attending the dental clinic of a leading teaching hospital in Nigeria were evaluated. Patients referred for admission, without a prescription, or prescribed medicines without a documented diagnosis were excluded.Overall, 607 prescriptions were analysed, 314 (51.7%) were for females. Periodontal and gum diseases (414; 68.1%) were the most frequent diagnoses, followed by pulpitis (49; 8.2%), and dentoalveolar abscess (43; 7.1%). A total of 1798 medicines were prescribed for all patients with a mean of 3.0 ± 0.48 medicines per prescription. Antimicrobials (1178; 65.5%) and analgesics (620; 34.5%) were the two drug classes prescribed. Ascorbic acid and vitamin B complex were prescribed for 361 (59.5%) patients. Among antimicrobials, amoxicillin (564; 95.1%) either alone or combined with clavulanic acid was the most frequently prescribed, followed by metronidazole (561; 94.6%). Brand name prescribing was also appreciably higher than WHO recommendations.Polypharmacy, brand name prescriptions, and the frequent prescription of antimicrobials were common practices at the dental clinic of this teaching hospital in Nigeria. We suggest a review of the current standard treatment guidelines in Nigeria to guide dentists on current knowledge- and evidence-based treatment of common oral diseases