Knowledge, attitude and willingness to accept Caesarean Section among women in Ogbomoso , southwest Nigeria

Introduction: Caesarean section (CS) is a common procedure in obstetrics and has contributed immensely to improving maternal and foetal outcome; there are still concerns about the knowledge, attitude and willingness to accept the procedure among women especially those in the developing world.Objective: This study seeks to assess the level of knowledge, attitude and acceptance of women about CS in Ogbomoso. These women were more educated than most of their counterparts in South Sudan but because of the political situation we are unlikely to get similar data from South Sudan and therefore this study is of interest.Methodology: This is a descriptive study which was carried out in four health facilities. Respondents were selected using the systematic random technique with a sample interval of 2. A semi-structured questionnaire was used for data collection. Data were analysed using the statistical package for social sciences (SPSS), version 16.Results: Of the 410 respondents, 63.2% of the women have a good knowledge of CS as a method of delivery. When CS was compared to vaginal delivery, 33.5% said that CS was preferable to vaginal delivery because the pain involved was much less; this view was however disagreed upon by 54.8% of the respondents. Only 75.6% of the respondents were ready to accept CS if there was a need for it.Conclusion: Mothers should be educated on the process involved in Caesarean delivery, the indication, advantages and complications in order to help them make the right informed decision.Keywords: Women knowledge, attitude, Caesarean section, Nigeri

Cassava root peel as a replacement for maize in diets for growing pigs: effects on energy and nutrient digestibility, performance and carcass characteristics

Two experiments were conducted to evaluate cassava root peel (CRP) as diet component for fattening pigs. In the first experiment, ten male pigs were used to investigate the nutrient digestibility and the nutritive value of CRP as replacement for maize in the diet at 0 %, 30 %, 40 %, 50 % and 60 %, while supplementing free amino acids (fAA). During two experimental periods, faeces were quantitatively collected and analysed for chemical composition. In the second experiment, 40 pigs received the same diets as in Experiment 1, and daily feed intake and weekly weight changes were recorded. Four pigs per diet were slaughtered at 70 kg body weight to evaluate carcass traits. Digestibility of dry and organic matter, crude protein, acid detergent fibre and gross energy were depressed (p0.05) at 60 % CRP; digestible energy content (MJ kg^(−1) DM) was 15.4 at 0 % CRP and 12.7 at 60 % CRP. In the second experiment, CRP inclusion had only a small impact on feed intake, weight gain and feed conversion ratio (p0.05) as well as on the length of the small intestine and the Longissimus dorsi muscle area. The missing correlation of daily weight gain and feed-to-gain ratio up to a CRP inclusion of 40 % indicates that negative effects of CRP on pig growth can be avoided by respecting upper feeding limits. Hence, a combined use of CRP and fAA can reduce feeding costs for small-scale pig farmers in countries where this crop-by product is available in large amounts

A five-year review of nephrectomies at the Lagos State University Teaching Hospital (Lasuth) Ikeja Lagos

Background: Nephrectomies are performed for various reasons ranging from benign to malignant renal diseases. The surgical approach for a nephrectomy also varies with location. In Nigeria and many other developing countries, the major technique of performing a nephrectomy is an open approach.Objective: The objective of the study was to evaluate the cases of nephrectomies performed over a 5-year period at the Lagos State University Teaching Hospital, Ikeja and compare the findings with those from other institutions in our region.Materials and Methods: This was a retrospective study. The clinical records of consecutive patients who had nephrectomies done over a 5-year period between January 2009 and December 2014 were reviewed. The data extracted from their record included age, sex, indication for  nephrectomy, laterality (whether right or left), surgical approach, duration of surgery, the incidence of blood transfusion, histological findings and treatment outcome.Results: The records of a total of 40 patients were available. There were 16 males (40%) and 24 females (60%) with a M:F ratio of 1:1.5. The mean age was 44.75 ± 17.16 years (range: 3-70 years). The indication in the majority of the patients was renal malignancy (n = 30, 75%) while the remaining 10 (25%) were benign cases ranging from non-functioning hydronephrotic kidneys from pelviureteric junction obstruction to staghorn calculi. A total of 25 cases (62.5%) were on the right, while 15 (37.5%) were on the left. The imaging study done for diagnosis was majorly an abdominopelvic CT scan in 32 patients (80%). Twenty-one patients (52.5%) had a flank approach, while 19 patients (47.5%) had an anterior approach for their surgery. The mean duration of surgery was 140 ± 53.2 minutes (range 60-270 minutes). 27 patients (67.5%) were transfused perioperatively. The majority (n = 14, 46.7%) of the patients with renal malignancy had a histological diagnosis of the papillary variant of renal cell carcinoma. 32 patients (80%) were followed up for at least 3 years, while the rest were lost to follow up. The quantity of blood transfused correlated with the duration of the surgery.There was no perioperative mortality.Conclusion: Renal malignancies are the most common indication for nephrectomy in our centre. Though associated with a high transfusion rate, open nephrectomy (even when performed for a malignant condition) remains a safe procedure with a good outcome. Keywords: Nephrectomy, Renal malignancies, Blood transfusio

A population-based estimation of maternal mortality in Lagos State, Nigeria using the indirect sisterhood method.

BACKGROUND: Pregnancy and delivery deaths represent a risk to women, particularly those living in low- and middle-income countries (LMICs). This population-based survey was conducted to provide estimates of the maternal mortality ratio (MMR) in Lagos Nigeria. METHODS: A community-based, cross-sectional study was conducted in mapped Wards and Enumeration Areas (EA) of all Local Government Areas (LGAs) in Lagos, among 9,986 women of reproductive age (15-49 years) from April to August 2022 using a 2-stage cluster sampling technique. A semi-structured, pre-tested questionnaire adapted from nationally representative surveys was administered using REDCap by trained field assistants for data collection on socio-demographics, reproductive health, fertility, and maternal mortality. Data were analysed using SPSS and MMR was estimated using the indirect sisterhood method. Ethical approval was obtained from the Lagos State University Teaching Hospital Health Research and Ethics Committee. RESULTS: Most of the respondents (28.7%) were aged 25-29 years. Out of 546 deceased sisters reported, 120 (22%) died from maternal causes. Sisters of the deceased aged 20-24 reported almost half of the deaths (46.7%) as due to maternal causes, while those aged 45-49 reported the highest number of deceased sisters who died from other causes (90.2%). The total fertility rate (TFR) was calculated as 3.807, the Lifetime Risk (LTR) of maternal death was 0.0196 or 1-in-51, and the MMR was 430 per 100,000 [95% CI: 360-510]. CONCLUSION: Our findings show that the maternal mortality rate for Lagos remains unacceptable and has not changed significantly over time in actual terms. There is need to develop and intensify community-based intervention strategies, programs for private hospitals, monitor MMR trends, identify and contextually address barriers at all levels of maternal care

Emergence and spread of two SARS-CoV-2 variants of interest in Nigeria.

Identifying the dissemination patterns and impacts of a virus of economic or health importance during a pandemic is crucial, as it informs the public on policies for containment in order to reduce the spread of the virus. In this study, we integrated genomic and travel data to investigate the emergence and spread of the SARS-CoV-2 B.1.1.318 and B.1.525 (Eta) variants of interest in Nigeria and the wider Africa region. By integrating travel data and phylogeographic reconstructions, we find that these two variants that arose during the second wave in Nigeria emerged from within Africa, with the B.1.525 from Nigeria, and then spread to other parts of the world. Data from this study show how regional connectivity of Nigeria drove the spread of these variants of interest to surrounding countries and those connected by air-traffic. Our findings demonstrate the power of genomic analysis when combined with mobility and epidemiological data to identify the drivers of transmission, as bidirectional transmission within and between African nations are grossly underestimated as seen in our import risk index estimates

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Number and Viability of Seeds Recovered From Faeces of Ruminant Animals

Ruminants play a significant role in the dissemination of plant seeds as a result of ingested seeds during grazing on pasture escaping digestion that are voided with the faeces and returned to the seed bank (Russi et al., 1992)

Feed value of enzyme supplemented cassava leaf meal and shrimp meal in pigs

Ten crossbred male pigs of 49.3±3.97 kg body weight were used to evaluate the digestibility, energy value and N (nitrogen) retention of two unconventional protein sources, i.e. cassava leaf meal (CLM) and shrimp meal (SM), with or without the addition of a nonstarch polysaccharide (NSP) enzyme complex (β-glucanase and xylanase). During two trial periods, each lasting 7 days, two pigs each were fed the following five experimental diets: Basal diet (BD), BD+cassava leaf meal with (CLM+E) and without enzyme addition (CLM) and BD+shrimp meal with (SM+E) and without enzyme (SM) supplementation.Total tract digestibility of Dry matter (DM) was general depressed in pigs fed diets containing the alternate protein sources. Crude protein (CP) and Gross energy (GE) digestibility were depressed in pigs fed cassava leaf meal (CLM) diet. Enzyme supplementation did not improve the digestibility of the energy and other proximate constituents. Faecal N output increased in pigs fed the alternate protein sources while Urine N and N retention were not affected (P>0.05) by the use of the alternate protein sources in the diets of pigs. There was reduced (P<0.05) conversion to ME in pigs fed diets containing the alternate protein sources. The ratio of DE/GE was lower in pigs fed diets containing CLM as compared to the basal diet. The digestibility energy values obtained for CLM, CLM+E, SM and SM+E were 10.2, 8.8, 10.1 and 10.0 MJ/kg DM respectively. Corresponding metabolizable energy were 9.8, 8.3, 9.0 and 9.3 MJ/kg DM, respectively. It was concluded that SM and CLM can be use individually be use in feeding growing pigs as partial substitute for the more expensive conventional plant protein feedstuffs, such as soybean; and can replace up to 23% of the diet of growing pigs.Keywords: Cassava leaf meal, shrimp meal, digestibility, N-retention, pig

Waiting Times for Prostate Cancer Diagnosis in a Nigerian Population

Background. Prostate biopsy remains an important surgical procedure in the diagnostic pathway for prostate cancer, but access to prostate biopsy service is poorly studied in the Nigerian population. While there has been a well-documented delay in patient presentation with prostate cancer in Nigeria, little is however known about how long patients wait to have a histological diagnosis of prostate cancer and start treatment after presenting at Nigerian hospitals. Method. This was a descriptive retrospective study to document the specific duration of the various timelines in getting a diagnosis of prostate cancer at the Lagos State University Teaching Hospital, Ikeja, Nigeria. Results. There were 270 patients. The mean age was 69.50±8.03 years (range 45-90). The mean PSA at presentation was 563.2±1879.2 ng/ml (range 2.05-15400), and the median PSA was 49.3 ng/ml. The median waiting times were (i) 10 days from referral to presentation; (ii) 30 days from presentation to biopsy; (iii) 24 days from biopsy to review of histology; (iv) 1 day from histology review to discussion/planning of treatment. The median overall waiting time from referral to treatment was 103 days. The mean time from presentation to biopsy was significantly shorter for patients with PSA of ≥50 ng/ml compared to those with PSA<50 ng/ml. p=0.048. Overall, the median time from biopsy to histology was significantly shorter for patients whose specimens were processed in private laboratories (17 days) compared to those whose specimens were processed at the teaching hospital laboratory (30 days), p≤0.001. Conclusion. There is a significant delay within the health care system in getting a prostate cancer diagnosis in the Nigerian population studied. The major points of the identified delay were the waiting time from patient presentation to having a biopsy done and the histology report waiting time