Determinants for hospitalization in " low-risk" community acquired pneumonia

BACKGROUND: A variable decision in managing community acquired pneumonia (CAP) is the initial site of care; in-patient versus outpatient. These variations persist despite comprehensive practice guidelines. Patients with a Pneumonia Severity Index (PSI) score lower than seventy have low risk for complications and outpatient antibiotic management is recommended in this group. These patients are generally below the age of fifty years, non-nursing home residents, HIV negative and have no major cardiac, hepatic, renal or malignant diseases. METHODS: A retrospective analysis of 296 low-risk CAP patients evaluated within a year one period at St. Agnes Hospital, Baltimore, Maryland was undertaken. All patients were assigned a PSI score. 208 (70%) were evaluated and discharged from the emergency department (E.D.) to complete outpatient antibiotic therapy, while 88 (30%) were hospitalized. Patients were sub-stratified into classes I-V according to PSI. A comparison of demographic, clinical, social and financial parameters was made between the E.D. discharged and hospitalized groups. RESULTS: Statistically significant differences in favor of the hospitalized group were noted for female gender (CI: 1.46-5.89, p= 0.0018), African Americans (CI: 0.31-0.73, p= 0.004), insurance coverage (CI: 0.19-0.63, p= 0.0034), temperature (CI: 0.04-0.09, p= 0.0001) and pulse rate (CI: 0.03-0.14, p= 0.0001). No statistically significant differences were observed between the two groups for altered mental status, hypotension, tachypnea, laboratory/radiological parameters and social indicators (p>0.05). The average length of stay for in-patients was 3.5 days at about eight time's higher cost than outpatient management. There was no difference in mortality or treatment failures between the two groups. The documentation rate and justifications for hospitalizing low risk CAP patients by admitting physicians was less than optimal. CONCLUSIONS: High fever, tachycardia, female gender, African- American race and medical insurance coverage are determinants for hospitalization among low risk CAP patients in our study. The average length of stay for in-patients was 3.5 days (3 to 5 days). The cost of in-patient care was about eight times higher than outpatient management. This study supports the recommendation of using the PSI for E.D evaluation of patients in appropriate social settings

Provision of Information to Rural Communities in Bama Local Government Area of Borno State, Nigeria

The study surveyed the provision of information services to rural  communities in Nguro-Soye district of Bama Local Government Area of Borno State, Nigeria. Objective of the study include assessing information needs profile and he existing information service providers in Soye Community. Simple random sampling method was used to obtain  proportional figures of 300 people. The instrument used for data collection was a structured interview schedule designed by the researchers referred to as Rural Community Information Service Survey (RCISS). Three hundred (300) copies of the instrument were administered and 275 copies were returned, representing 91.7%. Data collected were analysed using  descriptive statistics of frequencies and percentages. The findings of the study showed that rural people in the Soye district have identifiable information needs mainly in the areas of agriculture, health, government programmes and small scale industries. They visit the existing information service providers in the community to satisfy these needs. However, majority of them expressed that they are not satisfied with information provided to them by these agencies. Findings further revealed that majorityof the respondents are aware of ICT services – such as radio and television broadcast, and GSM, except the internet, in the provision of information dissemination and communication. Based on the findings of the study, itwas recommended among others that community participation in provision and dissemination of information should be encouraged through regular consultations, meetings and discussions between the community membersand information providers

Effect of different media on the in vitro growth of cactus (Opuntia ficus-indica) explants

The effect of media composition on the growth of cactus explants was investigated. Two media designated A and B were used in this study. Medium A contained basal Murashige Skoog salt (MS salt)and vitamins supplemented with 5% sucrose and 1% BAP (benzyl amino purines) and media B containing vitamins and MS salt supplemented with 3% sucrose, 1.25 mg/l BAP, and 0.25 mg/l IAA (indole acetic acid). These media were used to culture cactus explants over a period of 30 days, with aview to determine the effect of difference in the supplements on days to shoot emergence, shoot height, percentage survival and percentage oxidation (secretion of phenolic compounds) of the explants in. Analysis of the results indicated that there was no significant difference between the two media used in terms of the shoot height and days to shoot emergence

Serum Vitamin A and Zinc Levels of Some Preschool Children in Sokoto Metropolis of Nigeria

Serum levels of vitamin A (VA) and zinc of sixty-one randomly selected preschool children aged 4 to 60 months from Sokoto in the Northwestern Nigeria were investigated. The serum VA was assayed spectrophotometrically by ultraviolet irradiation method while Zn level was determined using atomic absorption spectrophotometer (AAS). The results obtained were analysed by correlation and regression method. The mean serum VA and Zn were 38.01 ± 18.70 and 73.24 ± 45.62 µg/dl respectively. 13% of the children had marginal VA deficiency. 26% and 9.8% of the children had moderate and severe VA deficiency (VAD) respectively. Of the 61 children studied, 37.7% had severe Zn deficiency (<50µg/dI) while 9.8% had serum Zn level of between 50 and 69 µg/dI. Analysis of the results indicated a significant (p<0.05) positive correlation(r=0.68) between serum VA and Zn levels of children with VAD. The result indicated that 66.7% of the children with VAD showed severe Zn deficiency. Only about 10% of the children with VAD were Zn adequate. The deficiencies of these micronutrients are common in both sexes and all age groups of preschool children of the study area. The results obtained indicated that the deficiencies of these micronutrients are public health problems in Sokoto, Northwestern Nigeria.Key words: Serum, Vitamin A, Zinc, preschool children, Sokoto-Nigeri

Heavy Metals Pollution on Surface Water Sources in Kaduna Metropolis, Nigeria

This study examine the effects of heavy metal pollutants to aquatic ecosystems and the environment by considering the role of urban, municipal, agricultural, industrial and other anthropogenic processes as sources of heavy metal pollution in surface water sources of Kaduna metropolis. Samples of the polluted water were collected from River Kaduna and along the Kakuri – Makera drains. The X – Ray florescence (XRF) was used as an analytical technique for the detection of heavy metals (Lead {Pb}, Arsenic {As}, Iron {Fe}, Chromium {Cr}, Copper {Cu} and Zinc {Zn}). The results shows the concentration of most of the heavy metals were higher than WHO (1997) acceptable limits. It is concluded that the water from the river is polluted and may cause serious ecological and health hazards. It is recommended among other things that there should be proper monitoring of effluents into receiving water as an integral part of water management in the river to enable verification of whether or not imposed standards and regulations are met.Keywords: Heavy Metal, Pollutant, World Health Organization (W.H.O) Standards, X – Ray florescence (XRF), Surface Water and Kadun

Effects of very low frequency electromagnetic method (VLFEM) and physicochemical change of Zango abattoir

The study examined the impact of livestock dung on ground water status in the study area. To achieve this, a very low frequency EM survey was conducted; the aim and objective was to detect fractures in the subsurface. VLF data were acquired at 5m intervals along two profiles, with maximum length of 60m in the North-South direction. The fraser filtered real component of the processed VLF data detected anomalous zones/ litho logical boundaries that may possibly serve as conduit for the movement of solid waste contaminant into the ground water. Water sample from the hand dug wells were collected in prewashed 250ml plastic container and analyzed in the Laboratory. Result obtained shows that physicochemical analysis deviate from WHO and SON standard and complement with VLF EM survey. This has shown that it is not free from certain heavy metals, as such, the water is not suitable for human and livestock consumption. It is recommended that the ground water in Zango should be treated using coagulants before use.Keywords: Abattoir, Livestock, SON, Water quality, WHO, Zang

Influence of inorganic fertilizer and spacing on growth and yield of two maize cultivars under Striga hermonthica infestation

Field experiment was conducted during the 2013 rainy season at Lapai and Mokwa in the Southern Guinea savanna of Nigeria, to evaluate the reactions of maize cultivars to nitrogen and intra-row spacing in a Striga hermonthica infested field. The treatments consisted of two maize cultivar (Local (kabako) and SAMMAZ 16), four levels of nitrogen fertilizer (0, 60, 120 and 180 kg N ha-1) and three intra-row spacing (20, 25 and 30 cm). The treatments were factorial combined and laid out in a Randomized Complete Block Design and replicated three times. Results revealed that plant height, number of leaves and days to 50 % anthesis of Local maize cultivars responded significantly with 60 kg N ha-1 at 9 WAS. 180 kg N ha-1 and 25cm intra-row spacing in combination with SAMMAZ 16 recorded the highest grain yield, 100 grain weight, stover yield, shelling percentage and harvest index. The local cultivars supported greater Striga infestation at 20 cm intra-row spacing and 180 kg N ha-1 was found remarkable for Striga suppression at 9 WAS in this study. From these findings, it could be concluded that the above combinations can be used for effective management of Striga hermonthica for optimum yield of maize.Keywords: spacing, maize cultivar, nitrogen fertilizer, Striga hermonthic

Haematological Indices and Blood Urea Nitrogen of Yankasa Ram Lambs Fed Urea, Poultry Droppings and or Urea Treated Pennisetum pedicellatum (Kyasuwa Grass)

A study was conducted to evaluate the haematological indices and blood urea nitrogen (BUN) of Yankasa ram lambs fed urea and/or poultry droppings treated Kyasuwa (Pennisetum pedicellatum). There were no significant differences (P>0.05) between control treatment (K) and other treatment means observed in the values of packed cell volume (PCV), neutrophils, lymphocytes, eosinophils and basophils. Treatments KU and KPD are significantly different (P < 0.05) from the rest of the treatments in which treatment KPD had the highest value WBC. Blood urea nitrogen from all the treatments were not significantly different (P>0.05) from each other. No ill-health was encountered as a result of feeding treated Kyasuwa with urea and or poultry droppings

The Effects of Environmental Consciousness in Public Healthcare Institutions and Community Awareness in Mokwa Local Government Area, Niger State, Nigeria

The effects of environmental consciousness in public healthcare institutions and the community awareness of the impacts were investigated. Environmental Pollution resulting from healthcare operations are a major problem in Mokwa Local Government Area LGA as the hospital material output goes directly to the environment without check. Similar situation has been reported in developing world. The objective is to find the opportunity for healthcare sector to improve on the overall environmental performance. Collated data was analyzed using simple percentage analysis. Results of the findings shows that the management of the healthcare institutions investigated have not taken into cognizance the environmental implication of the material input and output, lack effective environmental management system and poor environmental condition within and the environs. It is recommended that effective environmental management system be put in place. Also, government dedication, and collective responsibility of relevant stakeholders toward managing the environmental aspects and impacts of the health care institutions in the study area are critical for improvement. These will guarantee cleaner and healthier environment for all

Split-plot Central Composite Experimental Design Method for Optimization of Cake Height to Achieve desired Texture

In many industrial experimental situations, the levels of certain factors under investigation are much harder to change than others due to time and/or cost constraints. An appropriate approach to such situations is to restrict the randomization of the hard-to-change (HTC) factors, which leads to a split-plot structure. This work designs and conducts a split-plot central composite experiment for optimizing cake height using oven temperature(Factor A) as the HTC factor, amount of flour (B), baking powder (C), and amount of milk (D) as the easy-to-change (ETC) factors. A second-order split-plot central composite design (CCD) model was fit to the generated data and analyzed using generalized least squares (GLS). A stationary point, which gives optimum cake height, was then determined. The results show that main effects of oven temperature, flour, baking powder, and milk were highly significant on the cake height . Their quadratic effects were also significant except that of the flour. The flower/baking powder interaction effect was significant. The fitted model  accounted for about 95% of the total variability in the cake height data. The observed optimum cake height was ̂ at a stationary point: A . This study has established the potentials of response surface experiments in optimizing products in food industries. Keywords: Experiment, split-plot CCD, Cake height, Design, Stationary point.&nbsp