Vitamin A status and ocular lesions in some rural Nigerians with onchocerciasis

The vitamin A and ocular lesions in 98 rural Nigerians who excreted microfilariae in their skin tissues and had at least one clinical manifestation of onchocerciasis were investigated. The highest prevalence rate of 18 (69.2%) occurred among adult males with leopard skin. The overall mean vitamin status of (20.3 ± 2.6 ìg/dl) was comparatively lower ( 2 = 41.0; p>0.05) than the control inhabitants (76.2.3 ± 3.8 ìg/dl). The mean vitamin status was higher among the infected children (22.7 ± 0.5 ìg/dl) than their adult counterparts (17.9 ± 6.1 ìg/dl). Also the mean vitamin A status of their infected children (22.7 ± 5.0 ìg/dl) was lower ( 2 = 31.1; p> 0.05) than their control subjects (73.5 ± 2.1 ìg/dl). The vitamin A status of the infected adults (17.9 ± 6.1 ìg/dl) was lower ( 2 = 47.2; p>0.05) than their control counterparts (78.9 ± 4.1ìg/dl). The mean microfilarial load of the different age groups of the infected volunteers showed negative correlation with the mean vitamin A status (r = -0.93). In all, five different ocular lesions namely cataract, optic atrophy, chroroidoretinitis, iriodocyclitis and sclerosing keratitis were reported. Visual impairment was absent and the ocular lesions were low among the children as they had only optic atrophy and sclerosing keratitis among the five different lesions encountered

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Short Report: The incidence of agenesis of the Palmaris Longus muscle in the Edos of Nigeria

No Abstract Available J. Expt. & Clin. Anat Vol.3(1) 2004: 48-4

Visual anatomy and the art of ancient Igbo societies of Southeastern Nigeria

No Abstract. Journal of Experimental and Clinical Anatomy Vol. 4(2) 2005: 32-3

Adiposity Patterns In Adolescents Of Southeastern Nigeria Based On Their Body Index

Anthropometrical data related to weight and heights were generated from 857 adolescents from Southeastern Nigeria. Using standard statistical packages, adiposity patterns were analyzed by delineation of the Body Mass Index (BMI = kg/m2) according to the method of WHO (1995). Result showed that 82.5% of the sample population had normal weight, 17.5% were overweight while 1.65% were obsessed. Generally, females showed a higher tendency to obesity than males. The implication of the result for the population under study was discussed. KEY WORDS: Adiposity patterns, Adolescents, Southeastern Nigeria. J.Expt. & Clin. Anat. 2(1) 2003: 21-2

The efficacy of palm oil sludge in reducing ruminal methanogenesis using rumen simulation technique

The effect of including palm oil sludge in cattle diet (silage) was conducted in vitro in order to ascertain the suppressing effect on ruminal methanogenesis. The silage used for the study was Panicum maximum, Centrocema pubscens, Bracharia decumbens and Andropogon gayanus. The silage were cut into an average size of 3 to 5 cm and ensiled for 21 days. Four treatment diets were formulated with the silage by including palm oil sludge at 0, 10, 20 and 30%, respectively. Treatments were subjected to anaerobic digestion in 10 L bio-digesters. Total gas production, percentage methane production, volatile fatty acids and microbial population of the substrate were measured. Total gas production was significantly suppressed in the treatment having 30% palm oil sludge for about 25 days while a lag phase of 16 days was observed before a significant amount of methane was detected. Acetic acid production increased only in T1 on the first week while T2, T3 and T4 decreased after which their production remained irregular until the end of the experiment. Propionic acid production also increased in T1 and T4 on the first week while T2 and T3 decreased after which their production maintained an undefined pattern as the experiment progressed. Butyric acid production increased in T1, T2, and T4 on the first week while T2 decreased after which an undefined trend of production was established. Microbial population especially methanogens also reached its peak around the same period when there was maximum gas production. It was concluded that ruminal methanogenesis can be suppressed in vitro by the inclusion of 30% palm oil sludge in the silage.Keywords: Bio-digesters, fermentation, in-vitro, methane, silag

Platelet and factor threee availability among Nigerian pregnant women

No Abstract.International Journal of Natural and Applied Sciences Vol. 4 (3) 2008: pp. 191-19