Retrospective analysis of mathieu’s urethroplasty for anterior hypospadias repair in circumcised children: A single center experience

Introduction: Mathieu’s technique (peri-meatal based flap) makes use of the urethral plate in the repair of anterior hypospadias, thereby creating an almost natural neo-urethra. In a circumcised baby or after previous unsuccessful repair, Mathieu’s flap may be one of the few options left torepair anterior hypospadias.Objectives: To evaluate the result of Mathieu’s flap repair for anterior hypospadias in a resource poor setting.Materials and Method: This is a retrospective review of post-circumcision anterior hypospadias managed by Mathieu’s flap repair between January 1996 and December 2006 in the paediatric surgical unit of the Obafemi Awolowo University Teaching Hospital, a tertiary hospital in theSouth Western Nigeria.Results: Mathieu’s flap repair was performed in 16 patients with isolated anterior hypospadias; 15 (93.8%) were circumcised before presentation. The complications were urethrocutaneous fistula in 3 (18.8%), wound infection in 2 (12.5%) and flap necrosis in 1 patient (6.3%). Final outcomewas satisfactory in all patients.Conclusion: Mathieu’s flap remains a viable option in the repair of anterior hypospadias even after circumcision

Socio-personal correlates of participation in livelihood activities among rural youth in Jabalpur district of Madhya pradesh, India

The increasing realization of the negative political, social and economic consequences stemming from the precariousness of youths livelihoods, underscores the need to understand their livelihood activities, which is a requisite for curbing social ills and reducing rural poverty. The paper examined the participation of rural youth in livelihood activities, their socio-personal characteristics, the relationship between their socio-personal characteristics and their participation in livelihood activities as well as the interrelationships among their socio-personal characteristics. Multi-stage random sampling was used to collect data from 247 respondents through interview schedule. Frequency counts and percentages were used to present data while Pearson product moment correction (PPMC) was used to test relationships. The results revealed that majority of the respondents were from other backward caste (66%), married (72.10%), belonged to joint (57.90%) and medium (50.60%) size families as well as families that were self-employed in agriculture (59.50%). Higher percentages of the respondents and their fathers were educated up to higher school and above. Huge majority (75.71%) of the respondents participated in cereal production while more than half of the respondents were involved in pulse production (56.28%) and petty trading (53.44%). Marital status; fathers educational attainment; family type and family size had significant relationship with participation in livelihood activities. Inter-correlations among socio-personal characteristics showed that caste was related to marital status and educational attainment. It is concluded that socio-personal attributes of rural youth are related to their participation in livelihood activities. The study recommends that socio-personal variables of present study be considered by rural development policy makers when undertaking programmes aimed at enhancing rural youths livelihoods.Int. J. Agril. Res. Innov. & Tech. 5 (1): 28-35, June, 201

Awareness and Perception of Androgen Deficiency of Aging Males (ADAM) among Men in Osogbo, Nigeria.

Background: A clinical and biochemical syndrome associated with deficiency of androgen with ageing. Increased longevity of people has rekindled interest in hormonal alterations in the aged. Awareness of the entity is still low among men especially men of African descent.Objective: To evaluate the awareness and perception about ADAM so as to provide basis for evidence based interventions addressing the subject in our environment.Methods:  A descriptive cross-sectional survey was conducted in Olorunda LGA , one of the LGAs that constitute Osogbo metropolis, the capital city of Osun State, Nigeria. A pre-tested, semi structured, interviewer administered questionnaire was applied to 400 men that had been selected using a multistage sampling technique. The sample size was calculated using fischer's formula for cross sectional descriptive surveys and the data was analysed using Statistical Package for the Social Sciences (SPSS) version 16.0 .Results:  The mean age of respondents was 42.3±14.8 years. Majority (95.5 %) of the respondents had formal education though up to variable levels. Many (43%) of them have never heard about andropause and 54.7% do not know anything about the symptoms. The commonest source of information about andropause among those who are aware is from friends (43.8%), none heard from health workers. Less than half (44.2%) of them believe it is due to aging, while majority (52%) have misconceptions like excessive sexual activity, or diabolical sources. Knowledge about andropause is better among older men (p<0.05) but educational status did not statistically affect it. (p>0.05).Conclusion:  Many men in this environment still have low levels of awareness about andropause . Among those that are aware, there are large knowledge gaps and wrong perceptions of it. Hence the need for more aggressive public education (irrespective of their educational status) about the existence, aetiology and possible negative health effects of andropause.Keywords: Andropause,Hypogonadism, Androgen, Ageing

Challenges of Surgical Repair of Hypospadias in Ile-Ife, Nigeria

Objective: To document the presentation, outcome and challenges of management of hypospadias in a resource-limited setting.Patients and Methods: For this retrospective study we analyzed the files of  all patients with hypospadias managed at the Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria between 1996 and 2006. The parameters studied were the patients’ bio-data, clinical presentation,treatment and outcome. Results: During the 10-year period under review 51 cases of hypospadias were managed. The majority of the patients (n=39, 76.5%) presented within the first year of life with a mean age atpresentation of 1 year and 8 months, though most of the repairs were done in the 2nd, 3rd and 4th years of life. Of the 51 patients 46 (90.2%) came from rural and semi-urban areas and 18 (35.3%) had been circumcised before presentation. Surgical repair consisted of preputial island flap in 22 patients (43.1%) followed by a peri-meatal based flap (Mathieu procedure) in 16 patients (31.4%). The MAGPI procedure was used in 5 patients (9.8%) and the Snodgrass procedure in 1 (2%).Staged repair was necessary in 7 patients (13.7%). Post-operative complications were encountered in 15 patients with urethrocutaneous fistula being the commonest one (11 patients, 21.6%). Conclusion: Our results show that hypospadias can be successfully managed in a low- resource setting

Challenges With the Use of Insecticide Treated Nets Among Pregnant Women in Ife-Ijesha Zone, South Western Nigeria

Background: Malaria in pregnancy cannot be controlled if there is poor compliance with preventive strategies including use of insecticide treated nets (ITN). This study examined the use of ITN during pregnancy and also identified various factors that are associated with the use /non-use among the pregnant women. Methodology: This study was carried out in antenatal clinics of Obafemi Awolowo University Teaching Hospital Complex. It employed a descriptive cross sectional study design and was conducted among 320 pregnant women who gave their consent within the four weeks study period. Data was collected using facilitated self administered, pretested, semistructured questionnaire. Univariate and bivariate analysis were done using SPSS version 16 and critical level was set at 0.05. Results: Majority of the respondents (88.1%) did not sleep under ITN. Reasons for non-compliance include ignorance (55.8%), unavailability of the product (52.7%), exorbitant price (24%), personal beliefs about the chemicals used (23.3%) and inconveniences associated with use (12%). Having treated malaria in the index pregnancy was significantly associated with sleeping under ITN as 21.1% of them slept under ITN compared to none among those that have not had treatment (Fishers p=0.001). However, none of the socio-demographic variables tested had statistically significant association with the use of ITN.Journal of Community Medicine & Primary Health vol 23 (1-2) 201

Hospital Acquired Infection in Obafemi Awolowo University Teaching Hospital, Ile-Ife, Southwest, Nigeria: A Ten Year Review (2000-2009)

Surveillance and proper hygiene have been identified as key components in the fight against HAIs and antimicrobial resistance in hospital setting. This study assesses the pattern of hospital acquired infections (HAIs) and state of hygiene in a tertiary hospital in southwest, Nigeria. Data collected routinely between January 2000 and December 2009 by the infection control committee on HAI and primary data generated on hygiene in the wards were analysed using appropriate statistical techniques. A total of 37,957 patients were admitted during the period under review and 1129 cases (3.0%) of HAI were reported. The highest prevalence of 9.0% was reported in 2006. The Intensive Care Unit (ICU) had the highest period prevalence of 14.7% followed by Orthopaedics ward (7.7%). Surgical ward contributed the highest number of cases with 433. Gram negative organisms were the most implicated (78%) of which Klebsiella species was 38% while Staphylococcus aureus was the only Gram positive organism identified (28%). Hand washing was practised universally by health workers but facilities for proper hand washing were inadequate. The pattern of HAI has not changed significantly in the past 10 years and Klebsiella was the most implicated organism in HAIs and ICU. Facilities for proper hand washing are suboptimal. We recommend the introduction of hand washing policy for the hospital and the provision of an environment conducive for its implementation by the hospital management as well as adequate support for the infection control committee in the discharge of her duties.Keywords: Hand washing, Hospital-acquired, Hygiene, Infection contro

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Socio-personal correlates of participation in livelihood activities among rural youth in Jabalpur district of Madhya pradesh, India

The increasing realization of the negative political, social and economic consequences stemming from the precariousness of youth’s livelihoods, underscores the need to understand their livelihood activities, which is a requisite for curbing social ills and reducing rural poverty. The paper examined the participation of rural youth in livelihood activities, their socio-personal characteristics, the relationship between their socio-personal characteristics and their participation in livelihood activities as well as the interrelationships among their socio-personal characteristics. Multi-stage random sampling was used to collect data from 247 respondents through interview schedule. Frequency counts and percentages were used to present data while Pearson product moment correction (PPMC) was used to test relationships. The results revealed that majority of the respondents were from other backward caste (66%), married (72.10%), belonged to joint (57.90%) and medium (50.60%) size families as well as families that were self-employed in agriculture (59.50%). Higher percentages of the respondents and their fathers were educated up to higher school and above. Huge majority (75.71%) of the respondents participated in cereal production while more than half of the respondents were involved in pulse production (56.28%) and petty trading (53.44%). Marital status; fathers’ educational attainment; family type and family size had significant relationship with participation in livelihood activities. Inter-correlations among socio-personal characteristics showed that caste was related to marital status and educational attainment. It is concluded that socio-personal attributes of rural youth are related to their participation in livelihood activities. The study recommends that socio-personal variables of present study be considered by rural development policy makers when undertaking programmes aimed at enhancing rural youth’s livelihoods

Awareness and Use of Modern Contraceptives Among Physically Challenged In-School Adolescents In Osun State, Nigeria

This study assessed awareness and use of modern contraceptives among physically challenged in-school adolescents in Osun State, Nigeria. A cross-sectional study was carried out among 215 adolescents in the special schools in the state. A pretested semi-structured questionnaire was administered by trained interviewers. Data analysis was done using SPSS 17 and statistical level of significance was set at p&lt; 0.05. The mean age of the respondents was 15.5years and more than half of them (56%) were males. Only about two fifths of them (38%) had ever heard about modern contraceptives. More males, older adolescents and visually impaired respondents had significantly heard about modern contraceptives compared with females, younger ones and those with other challenges at p-values of 0.026, 0.001 and 0.003 respectively. Only 34% of sexually experienced respondents had used a modern contraceptive method. The male condom was the most commonly used method. Afr J Reprod Health 2014; 18[2]: 87-96).Keywords: Blind, Deaf, family planning, Adolescents, Schoo

A Comparative Study of the Nutritional Status of Under-Five Children of Indigenous and Non-Indigenous Parentage in Ile-lfe, Nigeria

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