Ecological assessment of a coastal shallow lagoon in Lagos, Nigeria: A bio-indicator approach

Benthic macro-invertebrates of the Northern axis of metropolitan segment of Lagos Lagoon sediments, Nigeria were investigated for six months (April – September, 2010). The study was aimed at using benthic macro-invertebrates to assess the water quality of this part of the Lagoon. A total of ten taxa belonging to three major animal phyla from a total of 2,672 individuals were encountered. The dominant taxa throughoutthe study and stations were Pachymelania aurita, Aloidis trigona, and Neritina glabrata. Station A (Ikorodu port) had seven taxa, station B (Ibese) had five while stations C (Ofin) and D (Oreta) had eight taxa each.Stations A(Ikorodu port), B(Ibese), C(Ofin) and D(Oreta) accounted for 8.19%, 0.94%, 79.83% and 11.04% respectively in all the individuals collected. Gastropoda was highest and accounted for 54.83% of all individuals collected from all stations contributing 2.58% at station A and 0.49%, 48.39% and 3.37% respectively at stations B, C and D, while Polychaeta had the least (0.97%) with station A, B, C and D constituted 0.82%, 0.04%, 0.04% and 0.07% respectively. Sediment type of the study areas was predominantly muddy sand. The presence of more pollution tolerant species (Nereis spp, Capitella capitata and Polydora ciliata) in station A may serve to confirm that the community has been impacted by pollution. The low faunal abundance and diversity observed in station B could be attributed to stress imposed by effluents from industrial sources. The information of this study will be very useful in formulating policies and regulatory framework for sustainable management of Lagos Lagoo

Subacute combined degeneration of the spinal cord in a Nigerian child: a need for a high index of suspicion

Background: Vitamin B12 deficiency has been reported to be associated with a spectrum of neurological disorders among which is subacute combined degeneration of the spinal cord.Method: We report a case of subacute combined degeneration of the spinal cord secondary to vitamin B12 deficiency and discussed the clinical presentation and management challenge.Result: The diagnosis was made through a high index of suspicion when the clinical presentation ranked highly with the mode of presentation of Vitamin B12 deficiency. Patient responded well to parentheral vitamin B12 preparation but subsequently defaulted from follow up for 8 years after which he represented with paraparesis and urinary incontinence. He was managed again with parentheral vitamin B12 preparations with good outcome and total resolution of symptoms at discharge.Conclusion: A high index of suspicion is needed in identifying vitamin B12 deficiency related paraparesis in paediatric practice while the need for indefinite treatment and follow up is hereby emphasized.Keywords: Vitamin B12 deficiency; myelinopathy; paraparesis; subacute combined degeneratio

Prognostic Significance Of QT Interval Prolongation In Adult Nigerians With Chronic Heart Failure.

Prognostic survival studies for heart-rate corrected QT interval in patients with chronic heart failure are few; although these patients are known to have a high risk of sudden cardiac death. This study was aimed at determining the mortality risk associated with prolonged QTc in Nigerians with heart failure. Ninety-six consecutive patientswith heart failurewere recruitedwith 90 age and sexmatched controls.All the subjects had a 12-lead electrocardiogramat a paper speed of 25mm/sec and a rhythm strip (lead II) at 50mm/sec.The latterwas used to calculate theQTc using the Bazett\'s formula. Left ventricular systolic and diastolic functions were assessed using 2D guided M-mode and Doppler echocardiogram respectively.Theywere followed-up for sixmonths. Ninety-one patients and 90 controls completed the study. Five patients were lost to follow-up. The mean age (51.9±16 years) of the patientswas similar to that of the controls (50.3±15) (P= 0.475).Twenty-eight (30.8%) patients died after 6months of follow-up against none of the controls.The mean QTc was significantly longer in the non-survivors (0.494±0.027) than in the survivors (0.462±0.035) (P = 0.0001). The percentage mortality in patients with prolonged QTc against those with normal QTc was 41% and 14% respectively (P = 0.001). In the stepwise regression analysis, QTc was an independent predictor of mortality (R = 0.412, R = 0.17, P= 0.001). QTc prolongation is a predictor of mortality in CHF and may be an important adjunct in risk stratification of patientswith heart failure. Keywords: Chronic Heart Failure, QTc Prolongation, Mortality Nigerian Journal of Clinical Practice Vol. 11 (4) 2008: pp. 336-34

Prediction of breast self-examination in a sample of Iranian women: an application of the Health Belief Model

<p>Abstract</p> <p>Background</p> <p>Iranian women, many of whom live in small cities, have limited access to mammography and clinical breast examinations. Thus, breast self examination (BSE) becomes an important and necessary approach to detecting this disease in its early stages in order to limit its resultant morbidity and mortality. This study examined constructs arising from the Health Belief Model as predictors of breast self examination behavior in a sample of women living in Bandar Abbas, Iran.</p> <p>Methods</p> <p>This study was conducted in eight health centers located in Bandar Abbas, Iran. The sample consisted of 240 eligible women who were selected from referrals to the centers. The inclusion criteria were as follows: aged 30 years and over; and able to read and write Farsi. Women with breast cancer, who were pregnant, or breast feeding, were excluded from the study. Data were collected by using a self administered questionnaire which included demographic characteristics and Champion's Health Belief Model Scale. This instrument measures the concepts of disease susceptibility (3 items), seriousness (6 items), benefits (4 items), barriers (8 items) and self-efficacy (10 items).</p> <p>Results</p> <p>The subjects' mean age was 37.2 (SD = 6.1) years. Just under a third of the subjects (31.7%) had performed BSE in the past and 7.1% of them performed it at least monthly. Perceived benefits and perceived self-efficacy of the women who performed BSE were significantly higher compared with women who did not practice BSE (p < 0.03). Furthermore, perceived barriers were lower among those who had performed BSE (p < 0.001). Logistic regression analysis indicated that women who perceived fewer barriers (OR: 0.70, 95% CI: 0.63-0.77, p < 0.001) and had higher self-efficacy (OR: 1.08, 95% CI: 1.02-1.13, p = 0.003) were more likely to perform BSE (R²= 0.52).</p> <p>Conclusion</p> <p>Findings from this study indicated that perceived barriers and perceived self-efficacy could be predictors of BSE behavior among the sample of women. Therefore, BSE training programs that emphasize self-efficacy and address perceived barriers are recommended.</p

Characterisation of heart failure with normal ejection fraction in a tertiary hospital in Nigeria

<p>Abstract</p> <p>Background</p> <p>The study aimed to determine the frequency and characteristics of heart failure with normal EF in a native African population with heart failure.</p> <p>Methods</p> <p>It was a hospital cohort study. Subjects were 177 consecutive individuals with heart failure and ninety apparently normal control subjects. All the subjects underwent transthoracic echocardiography. The group with heart failure was further subdivided into heart failure with normal EF (EF ≥ 50) (HFNEF) and heart failure with low EF(EF <50)(HFLEF).</p> <p>Results</p> <p>The subjects with heart failure have a mean age of 52.3 ± 16.64 years vs 52.1 ± 11.84 years in the control subjects; p = 0.914. Other baseline characteristics except blood pressure parameters and height were comparable between the group with heart failure and the control subjects. The frequency of HFNEF was 39.5%. Compared with the HFLEF group, the HFNEF group have a smaller left ventricular diameter (in diastole and systole): (5.2 ± 1.22 cm vs 6.2 ± 1.39 cm; p < 0.0001 and 3.6 ± 1.24 cm vs 5.4 ± 1.35 cm;p < 0.0001) respectively, a higher relative wall thickness and deceleration time of the early mitral inflow velocity: (0.4 ± 0.12 vs 0.3 ± 0.14 p < 0.0001 and 149.6 ± 72.35 vs 110.9 ± 63.40 p = 0.001) respectively.</p> <p>The two groups with heart failure differed significantly from the control subjects in virtually all echocardiographic measurements except aortic root diameter, LV posterior wall thickness(HFLEF), and late mitral inflow velocity(HFNEF). HFNEF accounted for 70(39.5%) of cases of heart failure in this study.</p> <p>Hypertension is the underlying cardiovascular disease in 134(75.7%) of the combined heart failure population, 58 (82.9%) of the subjects with HFNEF group and 76(71%) of the HFLEF group. Females accounted for 44 (62.9%) of the subjects with HFNEF against 42(39.3%) in the HFLEF group (p = 0.002).</p> <p>Conclusion</p> <p>The frequency of heart failure with normal EF in this native African cohort with heart failure is comparable with the frequency in other populations. These groups of patients are more likely female, hypertensive with concentric pattern of left ventricular hypertrophy.</p

The future of African nowcasting

Nowcasting (weather forecasting predictions from zero to several hours) has enormous value and potential in Africa, where populations and economic activity are highly vulnerable to rapidly changing weather conditions. Timely issuing of warnings, a few hours before an event, can enable the public and decision-makers to take action. Rainfall radar estimates are not widely available in Africa, nor likely to be in the coming years, and numerical weather prediction (NWP) currently has low skill over the African continent. Therefore, for the delivery of nowcasting in Africa, satellite products are the best practical option and needed urgently (Roberts et al., 2021). Fifteen minute (or faster) updates of MSG (Meteosat Second Generation) images and NWC-SAF (Nowcasting Satellite Applications Facility) products are crucial for nowcasting to warn users (e.g. fisherfolk on Lake Victoria, flooding in urban areas, etc.) on pending severe storms. The possibility to have such products every 10 minutes, as well as data from the forthcoming MTG (Meteosat Third Generation) lightning imager, would be highly beneficial to all African countries, saving lives and livelihoods where high population growth and the most extreme impacts of climate change combine

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

Influence of breed and environmental factors on litter parameters of rabbits raised in a semi-humid environment

The influence of breed and environmental factors such as season, temperature, relative humidity, sunshine hours and wind speed on litter parameters of rabbits raised in a semi-humid environment was investigated using two hundred and twenty four (224) litter records collected between 1991 and 1997. New Zealand White does kindled significantly (P&lt;0.05) larger and heavier litter at birth than the other breeds. Crossbred does produced kits with significantly higher preweaning daily gain and lower neonatal mortality compared with the purebred does. Chinchilla and Crossbred does raised kits with significantly (P&lt;0.05) heavier weaning weights than New Zealand White and Californian does. There was a non-significant effect of season on litter site at birth, kits alive at birth and neonatal mortality. Does that kindled in the cool-wet season had significantly (P&lt;0.05) higher litter birth weight and average kit birth weight compared with does that kindled in the cold-dry and hot-dry seasons. Kits kindled in the hot-dry season had significantly higher preweaning litter daily gain and lower preweaning mortality than those kindled in the other seasons. Does that kindled in the hot-dry and cool-wet seasons weaned more kits than those that kindled in the cold-dry season. There was a significant (P&lt;0.05) negative correlation between maximum temperature and litter size alive at birth, litter birth weight, litter weaning weight, average weaning weight and litter size at weaning. Rainfall and relative humidity had significant positive correlation with average birth weight, while, wind speed was positively correlated with average weaning weight. This study indicates that the best season for rabbit breeding in the semi-humid environment is the hot-dry (February-May) season. Maximum temperature was also observed to be more critical to rabbit reproduction as it influenced negatively more litter parameters than other environmental factors studied.Keywords: Environment, Season, Litter parameters, Rabbits

Antimicrobial activity of the aqueous and methanolic extracts of Sesamum radiatum (Schum and Thonn.)

Sesamum radiatum (Schum and Thonn.) is a leafy vegetable belonging to the family Pedialiaceae, it is used traditionally in the treatment of conditions such as diarrhoea, dysentery and fungal infections.This study investigated the phytochemical constituents and the antimicrobial activity of Sesamum radiatum (Schum and Thonn.). The pulverized plant material was subjected to cold marceration using distilled water and methanol for the aqueous and methanolic extracts, respectively. The plant extracts were further subjected to phytochemical screening using standard procedures and in vitro antibacterial sensitivity tests using the disc diffusion method. Zones of inhibition, minimum inhibitory concentrations (MIC) and minimum bactericidal concentrations (MBC) were determined. Flavonoids, terpenoids, cardiac glycosides and cardenolides were found in both the aqueous and methanolic extracts. The results of the in vitro antimicrobial susceptibility test showed that the aqueous extract inhibited the growth of Candida albicans at the highest concentration of 600 mg/ml with a zone of inhibition of 8.00±0.00 mm while the remaining microorganisms were resistant at all the concentrations. The methanolic extract inhibited the growth of Salmonella typhi at concentrations of 200 mg/ml, 400 mg/ml and 600 mg/ml and Pseudomonas aeruginosa at concentrations of 400 mg/ml and 600 mg/ml. In conclusion, the aqueous extract of Sesamum radiatum showed antifungal activities which may justify its folkloric use and the methanolic extract inhibited the growth of S. typhi which also justifies its use traditionally, in the treatment of dysentery and diarrhea.Keywords: Antimicrobial, Phytochemical constituents, Sesamum radiatum, MIC, MB