Assessing the levels of Pb, Cd, Zn and Cu in biscuits and home-made snacks obtained from vendors in two tertiary institutions in Lagos, Nigeria

The modern day busy schedule of an average individual in Nigeria has made the consumption of snacks inevitable. This study assessed the concentrations of Zn, Cu, Pb and Cd in some common snacks sold in two tertiary institutions in Lagos, Nigeria, using Perkin AAS Elmer model 460. The mean levels of Zn, Cu, Pb and Cd found in plantain chips obtained from the University of Lagos main campus were 2.15 ± 0.13, 0.27 ± 0.03, 0.83 ± 0.04 and 0.10 ± 0.03 mg/kg respectively, while the mean levels of the same metals found in plantain chips obtained from Yaba College of Technology were 1.77 ± 0.57, 0.11 ± 0.04, 1.23 ± 0.61 and 0.08 ± 0.06 mg/kg respectively. Independent-samples t-test analysis revealed that the differences between the mean metal levels in snacks obtained from the two institutions were not significant (P > 0.05). Though the levels of most metals in snacks obtained from the two institutions were within the upper limits of the range specified by the World Health Organization, the consumption of snacks with such metal loads over a long period of time may result in metal accumulation in the body beyond tolerable limit. These findings may be a reflection of what obtains in other educational institutions in the country. The authorities of tertiary institutions and other levels of education in Nigeria are therefore called upon to strengthen and widen their internal control mechanisms to guarantee the quality and safety of snacks sold to students and other people on their campuses.Keywords: Contaminants, Contamination, FAO/WHO, food, snacks, campuse

Regression Analysis of Biogas Production from the Co-Digestion of Water Hyacinth and Pig Dung

The aim of this study is to determine the best mix of water hyacinth (WH) to be co-digested with pig dung (PD) in order to maximize biogas production in terms of quantity. 11 mix ratios of WH to PD were evaluated and each experimental run was assessed over a period of 40 days. The data obtained were analyzed using regression analysis and non-linear parameter estimation model. From the results obtained, 3 WH: 7 PD co-digestion mix recorded the highest daily yield of 9.5 L of biogas on the 20th day, starting its gas production on the 3rd day and ending on the 34th day. The results also showed that WH single-substrate digestion produced a cumulative biogas volume of 32.18 L which corresponds to 5.14 L/kg of WH and PD single-substrate digestion produced a cumulative gas volume of 94.47 L corresponding to 15.1 L/kg of PD. 3 WH: 7 PD had the highest cumulative gas volume of 140 L which corresponds to 22.45 L/kg. Similarly, the highest maximum biogas production rate of 9.874057 L/day was observed for the 3 WH: 7 PD co-digestion mix and this was recorded on the 17th day of digestion. From the results obtained the best mix of the PD-aided WH digestion is 3 WH: 7 PD.Keywords— Biogas, Co-digestion, Cumulative, Pig Dung, Water Hyacint

Treatment outcomes among pulmonary tuberculosis patients at treatment centers in Ibadan, Nigeria

Objective : To assess treatment outcomes and determinants of outcome among tuberculosis patients. Design : A longitudinal study design involving a cohort of sputum smear-positive pulmonary tuberculosis patients at initiation of therapy, who were followed up to the end of treatment at eighth month. Setting : Tuberculosis treatment centers in Ibadan, Nigeria Results : A total of 1,254 patients were followed up with a mean age of 35.0\ub13.3 years. The percentages of patients with treatment outcomes assessed in the study were as follows: cure (76.6%), failure (8.1%), default (6.6%), transferred out (4.8%), and death (1.9%). The cure rate varied significantly between treatment centers from 40 to 94.4% (P< 0.05). The treatment centers located within the specialist health centers at Jericho and the University College Hospital had 50 and 75% cure rates, respectively. The mean age of cured patients was 31.2\ub13.1 years, which was significantly lower than the mean age of those with poor treatment outcomes (36.7\ub13.5 years; P< 0.05). Males had a higher risk of a poor treatment outcome (RR=1.8; 95% CI: 1.02-1.94) than females. Also, patients with a poor knowledge of tuberculosis had a higher risk of having a poor treatment outcome (RR=1.35; 95% CI: 1.25-1.62) compared to those with a good knowledge. Conclusion : Variations in health center treatment outcomes and poor knowledge of tuberculosis among patients suggest that poor program implementation quality may be a major modifiable determinant of treatment outcomes in our environment

New-Onset Seizures in HIV Patients on Antiretroviral Therapy at a Tertiary Centre in South-West, Nigeria

Background: Seizures are associated with neurological manifestations of HIV. They may be the presenting symptom and can occur at any disease stage. Aim: To determine the frequency and clinical aspects of new-onset seizures in patients with human immunodeficiency virus (HIV) infection. Methods: A study of an HIV-infected patient cohort on highly active anti-retroviral therapy (HAART) in the out-patients clinic of the Lagos state university teaching hospital, Nigeria. In a cross-sectional design, 308 HIV infected patients were recruited over a period of 1 year. Cases with a first seizure during this period were further examined. Details of demographic data, the first seizure date, seizure characteristics, neurologic complications and CD4 count at the time of the seizure were documented. Results: A total of 20 (6.5%) had new-onset seizures during the study period. 6/20 (30%) were males and 14/20 (70%), females. Their ages ranged between 22 - 51 years with a mean of 34.2 ± 8.7 years. The seizure was focal in 2/20 (10%) of cases and generalised in 90% (18/20) of cases. A total of 13/20 (65%) had recurrence of their seizures. None of the cases had focal neurological deficit at the time of the first seizure. The mean CD4 count was 165.3 ± 145.7. The mean duration on HAART was 19.5 ± 12.7 months. Cases with CD4 counts ≤200 cells/mm3 constituted 70% (14/20) whilst those with CD4 counts >200 made up 30% (6/20) [p = 0.666]. Conclusions: Seizures remain a significant neurological manifestation of HIV infection and has a high recurrence rate. It occurs more commonly in the advanced stage with severe immune suppression and may be attributable to HIV encephalopathy. Early treatment would reduce the burden and improve patient’s quality of life

Geophysical Survey for Groundwater Resource Appraissal in a basement Complex Terrain for Agricultural Purposes; Case Study of ABUAD Teaching and Research Farm, Ado Ekiti, Southwest Nigeria.

A combined geophysical survey involving the Very Low Frequency Electromagnetic and the Electrical resistivity survey has been carried out in the Teaching and Research Farm of the Afe Babalola University along Ado – Ikare road, Ado Ekiti with a view to determining the subsurface layers and thickness of the overburden as a means to appraising the ground water potential in the study area. Seventeen (17) west east traverses were established from which VLF –Electromagnetic data were acquired at a station interval of 5m each, the modeling and interpretation results from these were used to delimit the farm area into a total of 29 points from where vertical electrical soundings were carried out for further detailed survey using the Schlumberger electrode array configuration. The sounding data was processed and interpreted using WINRESIST interpretation software

Geophysical Survey for Groundwater Resource Appraissal in a basement Complex Terrain for Agricultural Purposes; Case Study of ABUAD Teaching and Research Farm, Ado Ekiti, Southwest Nigeria

A combined geophysical survey involving the Very Low Frequency Electromagnetic and the Electrical resistivity survey has been carried out in the Teaching and Research Farm of the Afe Babalola University along Ado – Ikare road, Ado Ekiti with a view to determining the subsurface layers and thickness of the overburden as a means to appraising the ground water potential in the study area. Seventeen (17) west east traverses were established from which VLF –Electromagnetic data were acquired at a station interval of 5m each, the modeling and interpretation results from these were used to delimit the farm area into a total of 29 points from where vertical electrical soundings were carried out for further detailed survey using the Schlumberger electrode array configuration. The sounding data was processed and interpreted using WINRESIST interpretation software

Evaluation of patients with suspected obstructive sleep apnea in a low-middle income country: Lagos experience

Obstructive sleep apnea (OSA) is a common chronic disorder that decreases the quality of life of patients. It is an underdiagnosed medical condition in Nigeria. This study aimed to describe the clinical presentations and validate the sleep apnea screening questionnaires with a home sleep study for the diagnosis of patients with suspected OSA seen in Lagos. This was a descriptive cross sectional study carried out on adult patients with suspicion of OSA referred to the Respiratory Clinic of Lagos State University Teaching Hospital. A proforma was used to obtain information and also data from home polysomnography was obtained for each patient. We selected 22 patients. The commonest presentations include snoring (20 or 90.9%), daytime somnolence (16 or 72.7%) and choking while sleeping (12 or 54.5%). The commonest comorbidities were hypertension (16 or 72.7%) and obesity (6 or 27.3%). The STOP-Bang  score identified more patients with a high clinical probability for OSA than the Epworth score (20 and 12 patients respectively). Polysomnography showed evidence of sleep apnea in most suspected patients with severity ranging from mild, to moderate to severe disease (3 or 13.6%, 3 or 13.6%, and 10 or 45.5% respectively). The use of combined Epworth and STOP-Bang questionnaires combination is great tool in identifying patients with suspected cases of OSA based on clinical presentations that will eventually benefit in a resource-limited environment like Lagos. There should be increased awareness of the use of this readily available and cheap questionnaire among physicians in Lagos for ease of OSAS diagnosis for many patients

Mineralogy, Physicochemical Characteristics and Industrial Potential of Some Residual Clay Deposits within Ekiti State, Southwestern Nigeria

Residual clay deposits overlying Precambrian Basement Complex situated at Orin, Igbara Odo, Ikere and Ado Ekiti were investigated using several analytical techniques. Field evidence supported by mineralogical and physicochemical analyses suggests that the kaolinitic clay deposits is a product of hydrothermal and in-situ weathering of aplite, and granite. Kaolinite is the predominant clay mineral of the studied clay deposits with subordinate quartz, potassium iron oxide and aluminium phosphatic minerals. There is localised occurrence of halloysite. The absence of vanadium in the EDS data of rolled into tubes kaolinite sheets of Ado Ekiti clay match up with XRF data. This result trend combined with field observation suggests that clay bodies formed from weathering of feldspar is deficient in vanadium. The study suggests that morphology of kaolinitic minerals is influenced by the kind of parent material (i.e. feldspars or micas) and degree of chemical weathering. The pH values of pore water from clay samples range from 7.14 - 9.08. The electrical conductivities (EC) of the clay/water slurries (S/L ratio) range from 0.004mS/cm – 3.02mS/cm.  The oxidation reduction potential (ORP) values range between -62.4 and – 6.8 for the solids or slurries prepared with water. The dissolved oxygen (DO) values range from 6.73ppm – 7.26ppm for solids or slurries prepared with water. The loss on ignition ranges from 2.24-13.39. The SiO2/Al2O3 molar ratio of 1.40 and 1.50 for Orin and Ikere clay bodies indicated that a 1:1 clay mineral was the dominant component. The high chemical index of alteration (CIA = 77.97~98.64) and chemical index of weathering (CIW = 97.21~99.93) values probably indicated the complete weathering of feldspars to kaolinite. The weathering index of Parker (WIP) values grouped the analysed clay samples into moderate to intense degree of weathering. This observation is confirmed by the absence of detrital feldspar in the XRD spectra peak. Factor analysis showed enrichment and depletion of major and trace elements which could be attributed to moderate to intense leaching conditions of the presumed parent material. The data shows explicit relationship between the clayeyness value (Al2O3/SiO2 ratio), the relative base loss (RBL) and the cation exchange capacity (CEC). Cluster analysis of major and trace elements showed two groups of chemical differences amongst the elements in the clays; moderate and intense degree of weathered clays. Nevertheless, the variations in the degree of weathering or leaching process have greater contribution to clay deposits differentiation. Assessment of the industrial potential of the studied clay bodies based on their physical and chemical characteristics revealed that they are suitable for the production of refractory bricks and ceramics. Suitable processing would be compulsory if they are to meet the requirements for other industrial applications, such as rubber, paper, paint, cosmetics, and fertilizer industries. Keywords: Clay; Mineralogy; Physicochemical characteristics; Weathering indices; Pore water; Multivariable analysis; Igbara Odo Ekiti; Ikere Ekiti; Ado Ekiti

Mixed-methods evaluation of integrating female genital schistosomiasis management within primary healthcare: a pilot intervention in Ogun State, Nigeria

Background: Detection and management of female genital schistosomiasis (FGS) within primary healthcare is crucial for achieving schistosomiasis elimination, however, current technical strategies are not feasible in many settings. In Nigeria, there are currently no established standard operating procedures to support front-line health workers. This article presents an evaluation of piloting an FGS care package in two LGAs of Ogun State, Nigeria. Methods: We used quantitative and qualitative analysis, including 46 interviews with patients, health workers and the quality improvement team; observations of training, learning sessions and supervision across 23 heath facilities; and records of patients detected and managed. Results: Of 79 women and girls who were screened, 66 were treated and followed up. Health workers assimilated knowledge of FGS and effectively diagnosed and managed patients, demonstrating the feasibility of using symptomatic screening and treatment tools to diagnose and care for women or girls with suspected FGS. Challenges included establishing a referral pathway to tertiary care for patients with complications, insecurity, gender norms that limited uptake and sensitization, the limited capacity of the workforce, conflicting priorities and praziquantel acquisition. Conclusions: Simple tools can be used in primary healthcare settings to detect and manage women and girls with FGS. Contextual challenges must be addressed. Sustainability will require political and financial commitments

Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial

Background Post-partum haemorrhage is the leading cause of maternal death worldwide. Early administration of tranexamic acid reduces deaths due to bleeding in trauma patients. We aimed to assess the effects of early administration of tranexamic acid on death, hysterectomy, and other relevant outcomes in women with post-partum haemorrhage. Methods In this randomised, double-blind, placebo-controlled trial, we recruited women aged 16 years and older with a clinical diagnosis of post-partum haemorrhage after a vaginal birth or caesarean section from 193 hospitals in 21 countries. We randomly assigned women to receive either 1 g intravenous tranexamic acid or matching placebo in addition to usual care. If bleeding continued after 30 min, or stopped and restarted within 24 h of the first dose, a second dose of 1 g of tranexamic acid or placebo could be given. Patients were assigned by selection of a numbered treatment pack from a box containing eight numbered packs that were identical apart from the pack number. Participants, care givers, and those assessing outcomes were masked to allocation. We originally planned to enrol 15 000 women with a composite primary endpoint of death from all-causes or hysterectomy within 42 days of giving birth. However, during the trial it became apparent that the decision to conduct a hysterectomy was often made at the same time as randomisation. Although tranexamic acid could influence the risk of death in these cases, it could not affect the risk of hysterectomy. We therefore increased the sample size from 15 000 to 20 000 women in order to estimate the effect of tranexamic acid on the risk of death from post-partum haemorrhage. All analyses were done on an intention-to-treat basis. This trial is registered with ISRCTN76912190 (Dec 8, 2008); ClinicalTrials.gov, number NCT00872469; and PACTR201007000192283. Findings Between March, 2010, and April, 2016, 20 060 women were enrolled and randomly assigned to receive tranexamic acid (n=10 051) or placebo (n=10 009), of whom 10 036 and 9985, respectively, were included in the analysis. Death due to bleeding was significantly reduced in women given tranexamic acid (155 [1·5%] of 10 036 patients vs 191 [1·9%] of 9985 in the placebo group, risk ratio [RR] 0·81, 95% CI 0·65–1·00; p=0·045), especially in women given treatment within 3 h of giving birth (89 [1·2%] in the tranexamic acid group vs 127 [1·7%] in the placebo group, RR 0·69, 95% CI 0·52–0·91; p=0·008). All other causes of death did not differ significantly by group. Hysterectomy was not reduced with tranexamic acid (358 [3·6%] patients in the tranexamic acid group vs 351 [3·5%] in the placebo group, RR 1·02, 95% CI 0·88–1·07; p=0·84). The composite primary endpoint of death from all causes or hysterectomy was not reduced with tranexamic acid (534 [5·3%] deaths or hysterectomies in the tranexamic acid group vs 546 [5·5%] in the placebo group, RR 0·97, 95% CI 0·87-1·09; p=0·65). Adverse events (including thromboembolic events) did not differ significantly in the tranexamic acid versus placebo group. Interpretation Tranexamic acid reduces death due to bleeding in women with post-partum haemorrhage with no adverse effects. When used as a treatment for postpartum haemorrhage, tranexamic acid should be given as soon as possible after bleeding onset. Funding London School of Hygiene & Tropical Medicine, Pfizer, UK Department of Health, Wellcome Trust, and Bill & Melinda Gates Foundation