Keyword Index – Volume 65 (2005)

The paper explains the working definition of management, specifically, how it functionally deduces from the managerial performance. It concentrates on the roles of managers as found in the textbook elements, three different authors; Gavetti, Kanter and Mintzberg as well as collaborating conventional literatures. It underscores various terms that have been in use frequently; assessing how they affects corporate outcomes. The methodology is to analyze the three main articles on the role of CEOs and enumerate their functions- the attempt to evaluate few efficient methods to measure an effective enterprise performance

A Review of Causes of Mortality in an Acute Medicine of the Elderly and Acute Stroke Service

The information recorded in medical certificates of cause of death (MCCD) can influence population-based mortality and statistical reviews. Data retrieved from MCCD based studies can inform certain aspects of public health planning, health service delivery and evaluation, and could potentially impact health resource allocation. This study retrospectively reviews a total of 173 consecutive MCCD counterfoil records. This included 71 deaths from an acute stroke unit/ward (ASU), and 102 deaths from acute medicine of the elderly (acute MoE) wards of a tertiary referral hospital in a developed country. Disease/condition classification was based upon the International Statistical Classification of Diseases and Related Health Problems (Tenth Revision) (ICD-10, WHO). We describe the top five ICD-10 categories of diseases/conditions documented in Parts 1 and 2 of the MCCD during the study period. We also describe the top five underlying primary medical conditions recorded on the MCCD. A review of some other notable diseases/conditions recorded during the study period is also presented.Keywords: Cause of Death; Death Certificate; ICD-10; Medicine of the Elderly; Mortality; Strok

Transient adrenal insufficiency following treatment of rheumatoid arthritis with intramuscular methylprednisolone acetate

An 82-year-old woman presented with dizziness, a fall, and pubic fractures. She had resting severe hypertension, with marked orthostatic hypotension. She was recently diagnosed with cyclic citrullinated peptide (+) rheumatoid arthritis. She had received 120 mg intramuscular methylprednisolone (Depo-Medrone®) eight months prior, and a second dose a day preceding hospitalisation.  Two days into the admission, her Glasgow coma scale (GCS) score dropped acutely from 15/15 (E4;V5;M6) to 3/15 (E1;V1;M1). The initial differential diagnoses were: an acute stroke (a total anterior circulation syndrome-TACS or brainstem stroke), opiate toxicity (fracture pains), and possible unwitnessed seizure (in a post-ictal state). Urgent computerised tomography (CT) brain was unremarkable. She had an acute-on-chronic hyponatraemia (nadir 121 mmol/L) while on long-term proton pump inhibitor therapy, and hyperkalaemia (peak 5.8 mmol/L). Initial management included intravenous (IV) naloxone, fluids and diazepam with poor clinical response. Due to persistent low GCS, the admitting team were concerned about a potentially guarded prognosis. However, based on the history of recent high dose steroid injections, plus the evolving clinical picture and abnormal biochemistry, empirical treatment was started (IV hydrocortisone 100 mg QDS and 0.9% saline infusion) for possible adrenal insufficiency. An ‘add-on’ request for random serum cortisol was made to her admission bloods, and returned low (33 nmol/L). With treatment, her GCS improved rapidly from 3/15 to 15/15. A subsequent planned short synacthen test was abnormal (cortisol level pre-synacthen 100; 30min post-synacthen 340), suggestive of adrenal insufficiency. Following consultation with endocrinology, she was maintained on oral hydrocortisone 10 mg (am)/5 mg(teatime) with sustained clinical improvement.

QUALITY BASED ASSESSMENT FOR CONTEMPORARY LEADERSHIP – THE CASE OF STEVE JOBS

In this paper, the authors discuss different reasons for the choice of Steve Jobs as a leader. It summarizes several primary concepts that shape matter about who is a leader? In addition, it attempts to provide collaborative evidence into argument about Leadership. Overall, it is about an exhibition of leadership. The methodology is to present, evaluate and analyze several qualities of a Leader that have been identified by some scholars. Conclusively, it asserts that it is expedient to concentrate on lessons learnt from various leaders and apply such lessons in a subsequent engagement with the subject of leadership

Substance use among adolescents in sub-Saharan Africa:A systematic review and meta-analysis

Background. In sub-Saharan Africa, substance use among adolescents has continued to be a major public health concern, albeit poorly documented across many settings. Objective. To estimate the prevalence of substance use among adolescents in sub-Saharan Africa. Methods. We searched Pubmed, EMBASE, AJOL and Google Scholar for population-based studies on adolescents (age 10 - 19 years) and reporting on the prevalence of substance use across sub-Saharan Africa. Search dates were from January 2000 to December 2016. A random effects meta-analysis was conducted with pooled prevalence rates (and 95% confidence interval (95% CI)) of estimated substance abuse among adolescents in sub-Saharan Africa. Results. Twenty-seven studies across sub-Saharan Africa including 143 201 adolescents (mean age 15.6 years) were selected. The overall prevalence of ‘any substance use’ in sub-Saharan Africa was 41.6%, with the highest rate in Central Africa at 55.5%. The use of caffeinecontaining products (including coffee or kola nut) was most predominant at 41.2% (95% CI 24.3 - 58.1) but limited to West Africa. These were followed by alcohol at 32.8% (95% CI 26.0 - 39.5), tobacco products 23.5% (95% CI 17.7 - 29.3), khat 22.0% (95% CI 12.5 - 31.5) and cannabis 15.9% (95% CI 12.2 - 19.1). Other abused substances included depressants at 11.3% (95% CI 6.5 - 16.1), amphetamines 9.4% (95% CI 6.0 - 12.9), heroin 4.0% (95% CI 3.5 - 4.5) and cocaine 3.9% (95% CI 1.4 - 6.5). Conclusion. Our study reflects a high use of psychoactive substances and drugs among adolescents in sub-Saharan Africa. It is important that interventions and rehabilitation programmes are comprehensive and targeted at adolescents and parents in these settings

Levels and Trends in Household Source of Cooking Fuel in Nigeria: Implications on Under-Five Mortality

Background: Studies have shown that characteristics present in the neighbourhood where children are raised might likely influence the mortality risks of such children. Cooking fuel can be regarded as one of the environmental factors determined by the socioeconomic background of the household, but the nexus between this and the health outcome of under-five children had received little attention. Objective: This study seeks to examine the levels and trends of source of cooking fuels among households in Nigeria as implied on under-five mortality. Methods: The data used was the Nigeria Demographic and Health Survey (NDHS)-Child Recode file of 2003, 2008 and 2013. The method of analysis used was the descriptive approach which includes cross tabulation, charts and tables. The chi-square statistic was used to show the significance of the association between the variables of interest in the study. Results: The percentage of U-5 children who lived in homes where wood was used as cooking fuel was about 80 percent. The findings from this study show that there was a highly significant relationship between type of cooking fuel and under-five mortality in Nigeria (P<0.001). The poorest and the poorer represented the highest percentage among the households that used wood and agric. crop/dung for cooking. Environmental factor such as type of cooking fuel is significantly associated to socioeconomic characteristics of the household where the child lives, some of which includes wealth status and place of residence as discussed in the result. Recommendation and conclusion: The study found that, there has not been a major improvement in the source of cooking fuel in households where under-five children are raised and this contribute in determining their health outcomes. Therefore, the government of Nigeria needs to provide reliable power supply (electricity) for household consumption. Also, gas fuel must be made available and affordable for household consumption

Soymilk yield and quality as affected by soybean varieties and processing techniques

Grains of nine soybean varieties were processed into soybean milk, and their milk yield and protein (%) were determined, followed by sensory evaluations. In another experiment, grains of five soybean varieties were made into soybean milk, using five different processing techniques. In the first experiment, there was a significant difference among the varieties for milk yield and the sensory evaluation characters, but no significant difference for protein (%). In the second experiment, processing techniques. Variety and the processing technique x variety interaction all had a significant effect on milk yield

Ocimum gratissimum Ameliorates Gentamicin-Induced Kidney Injury but Decreases Creatinine Clearance Following Sub-Chronic Administration in Rats

The effects of aqueous extract of Ocimum gratissimum leaf (AOGL) on the renal function of rats with gentamicin-induced nephrotoxicity were investigated. This study involved the use of forty five (45) adult male Wistar rats (housed in separate metabolic cages) such that graded doses of OAGL were administered to the experimental groups (p.o.) for 28 days after exposure to gentamicin toxicity (100 mg/kg i.p.) for 1 week. At the end of the study, comparisons of some indices of renal function as well as antioxidant status (GSH and TBARS) were made between the control, toxic and AOGL-treated groups at P < 0.05. The result showed that gentamicin treatment caused significant increase (P < .05) in urine output, urea, creatinine, total protein, relative kidney weight, and TBARS, as well as significant decrease (P < .05) in urine creatinine and GSH levels. Post-treatment with graded doses of AOGL caused significant increase in food consumption, GSH, urine, and plasma creatinine, as well as significant decrease (P < .05) in relative kidney weight, TBARS, and urine total protein. There was an appreciable difference in the kidney histology of the AOGL-treated groups when compared with the toxic control. Hence, the extract has therapeutic potential in the management of gentamicin-induced kidney injury, although a risk profile of renal dysfunction is not unlikely from 28 days of administration as evident by the decrease in creatinine clearance