Associations of social determinants of health and childhood obesity. A cross-sectional analysis of the 2021 National Survey of Children’s Health

Background: Childhood obesity is a growing health problem in the United States, with those affected having an increased likelihood of developing chronic diseases at a younger age. Social determinants of health (SDOH) are known to influence overall health. Children with low socioeconomic status (SES) have been shown to be overweight and have poor health outcomes. Therefore, our primary objective was to use the National Survey of Children’s Health (NSCH) 2021 data to determine current associations between childhood obesity and social determinants of health (SDOH).Methods: We conducted a cross-sectional analysis of 2021 NSCH to extract data from questions related to the SDOH domains. We extracted sociodemographic variables to use as controls and constructed bivariate and multivariable logistic regression models to determine associations, via odds ratios, between SDOH and child obesity.Results: Within the binary regression models, we found that children identified as having obesity were more likely than non-obese children to experience SDOH in all domains. After controlling for race/ethnicity, household income (%FPL), parental education, and child sex, children identified as having obesity were significantly more likely to experience food insecurity when compared to non-obese children (AOR = 1.39; 95% CI: 1.13-1.17).Conclusion: Our study found that the food insecurity domain of SDOH was significantly associated with childhood obesity. Improving policies for programs such as SNAP as well as addressing lack of access to nutritious foods, especially within food deserts, may help alleviate some food insecurity. Improving access to adequate amounts of nutritious foods is critical in addressing childhood obesity and thus, decreasing risk of chronic disease and poor long-term health outcomes

Spontaneous Rupture of the Bladder Complicating a Massive Benign Prostatic Hyperplasia

A 76-year-old man presented with acute urinary retention due to a huge benign prostatic hyperplasia. Although 1.5 litres of turbid urine was initially drained through a urethral catheter, the suprapubic mass persisted and subsequently increased in size. He developed acute retention due to blood clot. Even after the catheter was changed, he remained in retention necessitating emergency prostatectomy. Rupture of the bladder with extravasation of urine and necrotising fasciitis was found at surgery. The prostate gland was very large. It was also located so low and posteriorly that the index finger was unable to enucleate the adenoma. The recti had to be divided transversely to improve access. A metal urethral dilator was used to complete the enucleation. The specimen weighed 246 gm and on histology showed BPH. He recovered to void urine satisfactorily (Nig J Surg Res 2000; 2:152-154) KEY WORDS: Spontaneous bladder rupture, massive benign prostatic hyperplasi

The Altemeier repair - a form of repair for complete rectal prolapse

The problem of full-thickness rectal prolapse is formidable. The operations proposed are broadly divided into transabdominal and perineal procedures with no clear choice of superiority. The aim of the study is to report a series of perineal sigmoidectomy (Altemeier's modification) for full thickness rectal prolapse. A retrospective review of all cases of rectal prolapse operated upon over a period of 15 years (1990-2005) by the same surgeon using hospital records. The setting is at the University of Port Harcourt Teaching Hospital. Port Harcourt and Seaside Specialist Surgery, Port Harcourt. Data extracted included: name, age, presenting symptoms, signs, investigations, diagnosis, co-morbidities, procedure, outcome and follow-up. Fifty two adults comprising 40 (76.9%) females and 12(23.1%) males with a mean age of 62.6 years were treated for full thickness rectal prolapse for a period of 15 years. They all presented with rectal prolapse and other associated symptoms. Following the surgery, they were all satisfied as there was no longer visible prolapse and they enjoyed varying improvement of other symptoms. Altemeier's mode of repair of rectal prolapse is safe and can be carried out in elderly patients with multiple co-morbidities.Key Words: Complete rectal prolapse; Altemeier repair; OutcomeNigerian Hospital Practice Vol. 2 (3) 2008: pp. 60-6

Microbial Diversity in the Sawmill Environment: Implications on the Health of Sawmill Workers and Merchants, Nigeria

There is an increasingly high suspicion of occupational health diseases amongst workers in sawmill factories. Hence this study aimed to determine the microbial diversity in some sawmill factories in Okada, Edo State, Nigeria to evaluate potential implications of the factory’s processing area on the health of the workers and wood merchants. Bacteria and fungi count in the bioaerosols within the processing area of each factory was performed with the passive air sampling technique. While in the sawdust samples, microbial counts were carried out with the pour plate technique. Identification of the microbes was performed with macroscopic and microscopic examinations as well as standard phenotypic tests. Mean total viable count (TVC) and total fungi count (TFC) of bioaerosols in the air within the processing area of the sawmill factories were found to be greater than 4162.99 CFU/m3 while mean total coliform count (TCC) was reported as 756.28 CFU/m3. Fisher (F) one-way ANOVA test of the TVC and TCC dataset of bioaerosols from the four sawmill factories indicated no significant difference (p = 0.77 and 0.83 for TVC and TFC respectively) in the mean TVC and TFC of the bioaerosols. Bacterial (Micrococcus, Staphylococcus, Bacillus, Klebsiella and Serratia) and fungal (Saccharomyces, Aspergillus, Cladosporium and Penicillium) species were isolated from the bioaerosols and sawdust samples. Results of this study indicated that workers in the sawmill factories and other wood merchants who visit sawmill processing area are most likely exposed to airborne contaminants that may cause occupational diseases such as ophthalmic irritations and dermatitis. Hence it is recommended that sawmill workers and other visitors wear personal protective gadgets in the processing area of the sawmill factories

Anaesthetic challenges in surgical excision of phaeochromocytoma

Background: Phaeochromocytoma is a rare tumour, which is benign but metabolically active, with a potential for malignancy. This tumour of adrenal or extra adrenal origin usually presents as hypertension, which can be sustained or paroxysmal and with lethal complications. Aim: To present an anaesthetic experience during the surgical resection of a phaeochromocytoma. Method: A 26-year old woman with phaeochromocytoma of the right adrenal gland is presented. The tumour was excised under general anaesthesia. The anaesthesia involved the use of continuous infusion of esmolol (an ultra short-acting intravenous cardioselective beta-antagonist) and propofol. The resected tumour was sent for histopathological examination. Results: The tumour was completely excised under general anaesthesia. The haemodynamic changes that occurred during tumour handling were controlled with fentany1,propofol/esmolol infusion. Histopathological findings confirmed phaeochromocytoma. Conclusion: Although, the anaesthetic and surgical management of a phaeochromocytoma could be an uphill task, it is possible in an environment with limit laboratory and intensive care facilities. Port Harcourt Medical Journal Vol. 1(1) September 2006: 71-7

Microbiological Contamination Associated with the Proximity of A Refuse Dumpsite to a River Situated in Okada, Edo State, Nigeria

This study was performed to evaluate the potential contamination of the Okponha river situated near a dumpsite in Okada, Edo State, Nigeria. Water samples were collected and analyzed for bacteriological and parasitological quality using standard procedures. Isolation and enumeration of bacterial colonies were performed by pour plate technique and the isolated bacteria were identified by standard phenotypic tests. Helminths and protozoa were screened by the direct smear technique. The values of HPC (3.79 ± 0.12 log10 CFU/ml) and TCC (2.20 ± 0.14 log10 CFU/ml) obtained from the river water samples exceeded WHO and NAFDAC recommended limits (≤ 2 log10 CFU/ml and ≤ 1 log10 CFU/ml for HPC and TCC respectively). Bacillus spp., Enterobacter spp., Staphylococcus aureus and Chromatium spp. were the bacteria that were found in the river water samples. Except for the Chromatium spp., the same bacteria present in the river water were also found in the dumpsite soil, thus indicating a potential runoff from the dumpsite. Ascaris lumbricoides and Trichuris trichiura were the main helminth species that were seen in the river water and dumpsite samples, while the main protists that were identified included Entamoeba coli and Giardia lamblia. The high bacterial load seen in the river water is a source of concern because the water is used for a wide range of domestic purposes by inhabitants. Therefore, health authorities should make the public aware of the potential danger in using untreated water as a source of drinking water and also encourage in-house treatment of the raw water

Post-operative Anaemia and Prevalence of Blood Transfusion In Surgical Patients at The Rivers State University Teaching Hospital

Blood transfusion following surgical procedures may be a life saving venture especially in anaemic patients. Even though there is no universal accepted consensus on blood transfusion in surgical patients there should be clear cut indications prior to blood transfusion. The prevalence varies from centers and regions in the world. To determine post-operative anaemia and prevalence of blood transfusion in surgical patients at the Rivers State University Teaching Hospital (RSUTH). This was a six-month retrospective study of post-operative patients at the Surgery and Obstetrics/Gynaecology department of the Rivers State University Teaching Hospital. Ethical clearance was obtained from ethical committee of the Rivers State Hospital Management Board. The cut- off for anaemia was 33% in line with the World Health Organisation (WHO). Structured profoma was used to extract information from patients case notes and analysed using SPSS version 25. The subjects for the study were 370, comprising of 146 (39.5%) males and 224 (60.5%) females. The mean age was 31 years of which 194 (52%) were obstetrics and gynaecological surgeries while 176 (47.6%) were non-gynaecological surgeries. The commonest indication for surgery was ceasaren section representing 126 (34.1%) of the subjects; 259 (70%) had anaemia, of which 168 (64.8%) were females while 91 (35.2%) were males. Eighty-four (22.7%) of the subjects had blood transfusion. The prevalence of post-operative anaemia and blood transfusion in surgical patients at the RSUTH were 70% and 22.7% respectively. Optimizing surgical patients prior to operative procedures as well as taking measures to reduce blood loss intra-operatively cannot be overemphasized.&nbsp

Relationship between urban planning and flooding in Port Harcourt city, Nigeria; insights from planning professionals

Flooding is widely recognised as a global problem which has worsened in recent years due to climate change. In Nigeria, flooding remains the most widespread environmental disaster with the population of 200 million suffering numerous threats from perennial flooding. Port Harcourt in Southern Nigeria experiences annual flooding on a significant scale. While research has linked the flooding in Port Harcourt to poor urban planning, little research has engaged with planning professionals to investigate this relationship. This paper fills this gap. It explores how urban planning is linked to flooding in Port Harcourt and reports on qualitative research undertaken with five urban planners in Port Harcourt. The findings affirm that poor planning and/or lack of compliance with planning regulations are the main factors contributing to the flooding of Port Harcourt. The urban planners gave their expert opinions on how to control the flooding and unanimously agreed that improved planning practices could control the endemic flooding problem in the city. This implies that the government needs to work more closely with urban planners and other stakeholders to effectively control and find a lasting solution to the flooding problem in Port Harcourt city