The outcome of growth and development assessment of under-fives using a new tool, the SMAT Score

Background: The death of growth and development screening tools in developing countries has grave implications for child health outcomes. The aim of the study was to determine the effectiveness of a novel screening tool in a rural Nigerian community.Method: Speech and language, Motor, Appearance and Temperament (SMAT) parameters of under- fives were queried using a novel tool, the SMAT Score. The effectiveness of the tool was assessed in three phases. In the first two phases the tool was administered to 210 under- fives (Subjects) independently. Those screened as having anomalies are classified as NOT SMAT while those screened otherwise as SMAT. In the third phase all NOT SMAT subjects and a number of randomly selected SMAT subjects were clinically evaluated. Outcomes of SMAT Score administration and clinical evaluation were subjected to psychometric assessments.Results: There were 210 subjects with age range of 0.5 to 4.9 years (mean 2.3 ± 1.3 years) studied. Out of these 34 (16.2%) were screened as NOT SMAT. All the 90 (51.1%) randomly selected SMAT subjects as against 1 (2.9%) of the NOT SMAT subjects were clinically evaluated as normal. Inter rater and test – retest agreement rate in SMAT Score administrators was 100%. SMAT Score sensitivity and negative predictive value was 100% respectively in all age groups. The specificity was 98.9% overall and 96.3% among infants. Higher SMAT Score positive predictive value (97.1%) was observed with the entire study population as against 87.5% among infants.Conclusion: SMAT Score effectively identified subjects with growth and developmental disorders. Its use has potential for improving health systems and consequently child health outcomes in developing countries.Keywords: Growth, Development, Assessment, Tool, Under-five

Landscape Features and Tourism Development in Nigeria

Tourism in Nigeria is still down the ladder in policy formulation for economic growth and development. Tourism sector needs advocates and researchers that would work towards repositioning tourism on the Zenith level of budgetary allocation to enable the sector contribute maximally to the economic development of Nigeria. Based on this, this paper examined landscapes and tourism development in Nigeria. Therefore, the objectives considered are: Some specific landscape features for tourism development across Nigeria, development strategies and relevance for promoting tourism and the sustainability of landscape features that are tourism based. However, suggestions were made on the need for library and research centers for tourism development, encouraging both private and corporate organizations to invest in tourism industry, the need for Federal, State and Local Governments to give tourism priority position in their economic pursuits among others. Key words: Springs, Beaches, Relief, Waterfalls and Economy

The Impact of Climate Change on Landforms in Nigeria

This paper examined the impact of climate change on landforms in Nigeria. Today, different landforms are changing from one state to another as a result of human activities, weathering and soil erosion brought about by agents of denudation and fluvial processes. Therefore, the objectives for which this study was carried out are: .To examine whether or not there is actually climate change in Nigeria in terms of rainfall, examine the different relief regions in Nigeria, examine causes of climate change and to determine the consequences of climate change in Nigeria. For this reason, the data used for the study were collected from both the primary and secondary sources of data collection. The primary data used were erosion pins to determine the level of sediments that are eroded from most of the steep slopes associated with highlands. The secondary data used were collected from articles in journals and related text books analyzed descriptively and statistically. The different relief regions in Nigeria were looked at. It was discovered that as the highlands are getting reduced as a result of climatic elements especially rainfall the lowland areas are filled up with the loads and sediments that are deposited on them. And recommendations were therefore made on the need for proper land use zoning systems to curtain elements of climate and the need for everyone to protect the environment and not by destroying it in the name of human activities through agriculture, construction and services. Key words: Relief, Erosion, Flood and Tectoni

Factors associated with treatment gap in children and adolescents with epilepsy in a rural Nigerian community.

Background: The campaign against epilepsy is hampered by the difference between those with the active disorder and the number of them receiving appropriate treatment (treatment gap) in sub-Saharan Africa. Identifying the determinants of this gap is crucial to providing and achieving optimal care.Objective: To identify the determinants of epilepsy treatment gap (ETG) in children and adolescents (Subjects) with epilepsy in a rural community.Methods: Subjects were identified through a community house to house survey. Information obtained from Subjects and their care givers included: sociodemographic characteristics, type and frequency of epileptic seizures,current and past treatment options utilized, reasons for treatment options used, and treatment options utilized for other health complaints.Results: Twenty three Subjects (6.4/1000 of the child and adolescent population) were identified as having epilepsy. Their age range was 4-19 years (mean 14.3±4.7 years). Most were males (82.6%) and adolescents (78.3%). Seizures were mostly generalized (95.7%) and occurred most frequently daily. Current treatment modalities were use of traditional medication (100%) and prayers (34.8%).None was currently on orthodox medical therapy (ETG, 100%) but 5(21.7%) had utilized orthodox medical therapy in the past. The main determinants of the ETG were strong cultural belief, weakness in the health system to epilepsy treatment and low socioeconomic status. Fever was the commonest other health complaint and use of orthodox medical therapy was significantly (p˂ 0.05) the main (16, 69.6%) treatment option utilized.Conclusion: Cultural belief, weak health system and low socioeconomic status were determinants of an absolute ETG. It highlights the need to strengthen initiatives that enhance accessibility to standard epilepsy treatment.Key words: Epilepsy treatmentgap, determinants, children, adolescents, rural communit

Diagnostic challenges and psychosocial impacts of hypersomnia in a Nigerian adolescent: A case report

Hypersomnia, a disorder of sleep characterized by excessive quantity of sleep and excessive daytime sleepiness (EDS), could adversely affect health outcomes in childhood. To highlight diagnostic challenges and the impact of childhood hypersomnia in a resource limited setting, a 14year old Nigerian who presented with a seven year history of hypersomnia was studied. Screening for sleep disorder using BEARS sleep algorithm and assessment for EDS using the Epworth Sleepiness Scale were both positivefor EDS. The assessment of sleep hygiene using the Adolescent Sleep Hygiene Scale was normal and the use of Raven’s Progressive Matrices to assess intelligence was also normal. There was no contributory pastmedical history or demonstrable etiology. Magnetic Resonance Imaging (MRI) of the brain, Electro Encephalogram (EEG), assay of serum electrolytes were all normal while screening test for trypanosomiasis was negative. Poor level of awareness, high cost of evaluation and limited facilities for diagnosis of sleep disorder were the major diagnostic challenges. Depression, poor academic performance, suicidal ideation andstigmatization were all associated with hypersomnia in the patient.Keywords: Hypersomnia, adolescence, depression, sleep disorders, diagnostic challenges

Legal and Regulatory Reforms of Forest Resources Conservation in Edo South, Edo State, Nigeria

This paper examined the legal and regulatory reforms of forest resources conservation in Edo South, Edo State, Nigeria. This is because most of the forest reserves have been seriously encroached in the area without strong recourse to the environmental consequences. The objectives for which this study was carried out are: To identify and assess forest resources in the study area, examine the relationship between law and forest resources in Edo South, Edo State laws on the use of forest resources and then determine deforestation and its environmental impacts. Data were therefore collected from both the primary and secondary sources of data collection to meet these objectives of study. The result shows that the laws enacted through legislation to protect forest resources are there but a number of factors like coordination problem, lack of comprehensive policies on environmental laws and issues, inadequate legal framework and lack of implementation of the forest Act of 1999 are some of the major reasons why people still encroach our forest lands. Recommendations are made on the need to update forest laws and the implementation carried out by relevant agencies of government to make sure that those who go against the laws are made to account for their actions. There is the need for forest monitoring teams to apprehend tree loggers for appropriate sanctions. The communities need to also be involved in the control and management of forest resources depletion. There is need for sustained management of forests, intensified reforestation and forest concession owners should be involved in forest regeneration. There should be equivalent replacement for every tree removed from the forest. Emphasis needs to be put in finding alternative sources of energy and sustainable farming practices adhered to

Thinlayer Chromatography (TLC) and GC-MS Analysis of Somes Medicinal Plants Used in the Treatent of Haemorrhoids

Medicinal plant is one in which, one or more of its organs contains substances that can be used for therapeutic purposes or which are precursors for the synthesis of useful drugs The present study aimed at investigating the lipid composition of Axonopus compressus, Anogeiessus leiocarpus and Senna fistula commonly used in the management of haemorrhoids. The lipid analysis of the three plants was determined by TLC and GC-MS and the GC-MS analysis revealed the presence of some saturated fatty acids such as myristic, palmitic, linoleic, stearic, oleic and lauric acid in all the three extracts. In addition A. compressus contained linoleic and palmitoleic acids, S. fistula contained linolenic acid and A. leiocarpus contained linoleic, linolenic and behenic acids. However, palmitic (C16:0)) and stearic acid (C18:0) were observed to be the predominant fatty acids present in all the three plan extracts. The results showed that many active principles are present in the three plants which could contribute to their usefulness in the management of haemorrhoids. Keywords: Haemorrhoids,Medicinal plants,lipids, TLC,GC-M

Effect of Boiling on the Nutritional Composition and Antioxidant Properties of Beniseed (Sesamum indicum L.)

Beniseed has been considered to be a valuable oilseed, not only because of its high oil content, but also because of its medical effects. The present study sought to investigate the effect of boiling on the proximate and mineral composition of beniseed. In addition, the effect of boiling on the antioxidant properties of beniseed extract was evaluated. Proximate and mineral composition of raw beniseed and beniseed boiled for 5, 10, 20 and 30 min were assessed. The amount of phenols, flavonoids and vitamin C were determined in the aqueous extracts of raw and boiled beniseed. In addition, the antioxidant mechanisms of the extracts of raw and boiled beniseed were assessed by measuring their reducing property, iron (II) chelating ability and their ability to scavenge 1, 1-diphenyl-2-picryhydrazyl (DPPH) radicals. Results showed that boiling significantly (p < 0.05) improved the crude fat (49.23 to 56.78%) and calcium content (757.13 to 975.54 mg/100g). However, boiling caused a significant (p < 0.05) reduction in levels of protein (18.87 to 14.12%), fiber (6.17 to 4.45%) and potassium (831.47 to 727.42 mg/100g) while iron levels were unchanged. The total phenolics levels of the raw beniseed (0.15 mg/g) showed a remarkable increase as the boiling time was increased to 30 min with a level of 0.35 mg/g. In addition, boiling caused a significant (p < 0.05) increase in the total flavonoid levels from 0.22 mg/g to 0.55 mg/g while a decrease in the vitamin C content of raw beniseed was observed within the period of boiling. Furthermore, the aqueous extracts of boiled beniseed exhibited greater antioxidant properties than that of the raw seeds. It was concluded that boiling for 30 min caused a significant loss of some nutrients but potentiated the antioxidant activities of the aqueous extract of the seed. Keywords: Antioxidant, beniseed, boiling, radicals, nutritional, oilsee

Predictors of Loss to Follow‑up Among HIV‑infected Patients in a Rural South‑Eastern Nigeria Hospital: A 5‑year Retrospective Cohort Study

Background: Patient attrition has been a challenge in managing HIV programs in resource‑limited settings. Aim: This study reviews the predictors of loss to follow‑up (LTFU) in our hospital and suggests the best practices for dealing with the issue. Subjects and Methods: A 5‑year retrospective cohort study of 1256 HIV‑infected patients. Baseline CD4 counts, age, gender, year of enrolment, and antiretroviral therapy combination regimen were considered in this study. Kaplan–Meier models were used to estimate the univariate time‑to‑LTFU and Cox proportional hazards models to identify the multivariate predictors of LTFU. Results: Twenty‑four percent (23.9% [301/1256]) of patients were lost to follow‑up. Baseline CD4 count, year of enrolment, and drug combination were significant predictors of LTFU. Patients enrolled earlier (2008/2009) were twice as likely to be LTFU compared with those enrolled later (2010–2013). Gender and age did not significantly predict LTFU nor confound other predictors. Conclusion: The program showed higher LTFU rates than most studies in Nigeria and Africa, maybe due to difficulties with the access to the hospital and possible treatment fatigue. This study recommends the provision of transportation subsidies and proactive patient follow‑up with “peer‑tracking” to reduce LTFU among HIV infected patients, especially in resource‑limited settings.Keywords: Cohort studies, HIV infections, Loss to‑follow‑up, Nigeria, Transportatio

Impact of childhood mental health disorders on the family: A Case report

Background: Care of the children with mental health disorders is fraught with challenges particularly in developing countries and, where the family isthe major source of care. Consequently assessing the impact of these disorders on the family is relevant to providing these children with optimal care.Objective: To assess the impact of childhood mental health disorderson family function and parental burden.Method: A monogamous family that had 3 children diagnosed as having childhood onset schizophrenia using the International Classification of Disease version 10(ICD 10) Classification was studied. Family function was assessed using the Family APGAR Score and the Zarit Burden Interview(ZBI) Score used in assessing parental burden.\Results: The Family APGAR Scores were low (highly dysfunctional family) and the ZBI Scores high (highly burdened) in the family. Areas of serious dysfunction in the family were in adaptation, partnership and growth.In the ZBI Scores feelings about quality and cost of care offered, stress and other negative attributes associated with providing care, inability to meet other parental obligations and uncertainty about the future, were the major contributors to the highly burdensome outcome.Conclusion: The study highlights significant family burden and dysfunctionin a family who had three children with schizophrenia. It underscored the need for provision of more comprehensive health and social support  services to children with mental health disorders and their families.Key Words: Childhood, Schizophrenia, Parent, Burden, Family functio