Traumatic chylothorax from a suprascapular stab wound

Reports are few of chylothorax complicating stab wounds to the left suprascapular region. We report a case of traumatic chylothorax following a stab wound to the suprascapular region in a 14-year-old boy. He presented with progressive dyspnoea and signs of a pleural effusion. This was confirmed by radiology and thoracocentesis to be a hemothorax. The hemothorax was drained by tube thoracostomy. He developed chylothorax on the third day after inserting the chest tube. Biochemical analysis confirmed chylothorax, which was managed conservatively. The chest tube was removed after it stopped draining. We discuss the pathogenesis of this form of chylothorax and the management options.Keywords: Chylothorax, Poirier’s triangle, Stab, Traum

Digital and Home Healthcare Survey among Nigerians: Assessing Awareness, Preferences, and Willingness to Pay for an Integrated Healthcare Ecosystem to achieve Universal Health Coverage

Introduction: The COVID-19 pandemic highlighted the need for evolving an integrated healthcare ecosystem that will connect patients to digital and home healthcare to achieve universal health coverage. The survey aims to assess perceptions and preferences about digital and home healthcare services and develop an integrated healthcare ecosystem. Methods: A survey of 254 Nigerians was conducted to assess their awareness, preferences, and willingness to pay for digital and home healthcare services using electronic questionnaires, and the data were analysed using SPSS 16.0. Results: Males constituted 70.9%, and 61.4% were aged ≤35 years. Two-third were clients, and a third were healthcare providers. Although about 71% patronized public hospitals, there was poor satisfaction (31.7%) than those attending private hospitals that were more satisfied. The male gender, private hospital utilization, and age of ≤35 years were associated with the satisfaction with OR 1.19 (95% CI 0.69-2.05), OR 1.22 (95% CI 0.73-2.04), and OR 2.41 (95% CI 1.38-4.20) respectively. Thirty minutes was the acceptable delay in receiving care by most respondents.  Only 39.4% were aware of digital health, and 52.8% were aware of home healthcare.  Male gender was associated with DH awareness, while being a healthcare provider was associated with both DH and home healthcare awareness. The respondents' median amount was willing to pay for DH and HH respondents is $1.64 -$6.56 and $3.28 –$6.56, respectively. Conclusion: In response to the survey result, we designed an integrated hospital, digital, and home healthcare project named eDokta, to leapfrog the attainment of universal health coverage in Nigeria

Digital and Home Healthcare Survey among Nigerians: Assessing Awareness, Preferences, and Willingness to Pay for an Integrated Healthcare Ecosystem to achieve Universal Health Coverage

Introduction: The COVID-19 pandemic highlighted the need for evolving an integrated healthcare ecosystem that will connect patients to digital and home healthcare to achieve universal health coverage. The survey aims to assess perceptions and preferences about digital and home healthcare services and develop an integrated healthcare ecosystem. Methods: A survey of 254 Nigerians was conducted to assess their awareness, preferences, and willingness to pay for digital and home healthcare services using electronic questionnaires, and the data were analysed using SPSS 16.0. Results: Males constituted 70.9%, and 61.4% were aged ≤35 years. Two-third were clients, and a third were healthcare providers. Although about 71% patronized public hospitals, there was poor satisfaction (31.7%) than those attending private hospitals that were more satisfied. The male gender, private hospital utilization, and age of ≤35 years were associated with the satisfaction with OR 1.19 (95% CI 0.69-2.05), OR 1.22 (95% CI 0.73-2.04), and OR 2.41 (95% CI 1.38-4.20) respectively. Thirty minutes was the acceptable delay in receiving care by most respondents.  Only 39.4% were aware of digital health, and 52.8% were aware of home healthcare.  Male gender was associated with DH awareness, while being a healthcare provider was associated with both DH and home healthcare awareness. The respondents' median amount was willing to pay for DH and HH respondents is $1.64 -$6.56 and $3.28 –$6.56, respectively. Conclusion: In response to the survey result, we designed an integrated hospital, digital, and home healthcare project named eDokta, to leapfrog the attainment of universal health coverage in Nigeria

Digital and Home Healthcare Survey among Nigerians: Assessing Awareness, Preferences, and Willingness to Pay for an Integrated Healthcare Ecosystem to achieve Universal Health Coverage

Introduction: The COVID-19 pandemic highlighted the need for evolving an integrated healthcare ecosystem that will connect patients to digital and home healthcare to achieve universal health coverage. The survey aims to assess perceptions and preferences about digital and home healthcare services and develop an integrated healthcare ecosystem. Methods: A survey of 254 Nigerians was conducted to assess their awareness, preferences, and willingness to pay for digital and home healthcare services using electronic questionnaires, and the data were analysed using SPSS 16.0. Results: Males constituted 70.9%, and 61.4% were aged ≤35 years. Two-third were clients, and a third were healthcare providers. Although about 71% patronized public hospitals, there was poor satisfaction (31.7%) than those attending private hospitals that were more satisfied. The male gender, private hospital utilization, and age of ≤35 years were associated with the satisfaction with OR 1.19 (95% CI 0.69-2.05), OR 1.22 (95% CI 0.73-2.04), and OR 2.41 (95% CI 1.38-4.20) respectively. Thirty minutes was the acceptable delay in receiving care by most respondents.  Only 39.4% were aware of digital health, and 52.8% were aware of home healthcare.  Male gender was associated with DH awareness, while being a healthcare provider was associated with both DH and home healthcare awareness. The respondents' median amount was willing to pay for DH and HH respondents is $1.64 -$6.56 and $3.28 –$6.56, respectively. Conclusion: In response to the survey result, we designed an integrated hospital, digital, and home healthcare project named eDokta, to leapfrog the attainment of universal health coverage in Nigeria

Vertical Profile Of Heavy Metal Concentration In Sediments From Sadong River, Sarawak, Malaysia

Several sources of heavy metals in the environment include biological, geochemical, geological and anthropogenic sources. A total of eighteen core sediments were taken from Sadong river, Sarawak, Malaysia. These samples were digested by acid extraction and thereafter subjected to atomic absorption spectrometry (AAS). This paper aims to determine the vertical profile of heavy metals in core sediments, infer the accumulation history and assess the possible sources of pollution. The results showed that Fe was the most abundant element while Cd had the lowest concentration. Sediment pollution assessment was carried out for the top layer using geoaccumulation index (Igeo), enrichment factor and contamination factor. EF values showed moderate to significant enrichment of heavy metals

Review of the Sedimentological and Geochemical Approaches for Environmental Assessment of River Sadong, Samarahan-Asajaya District Sarawak, Malaysia

This paper presents an overview of the implication of geomorphology and sedimentology on the chemical characteristics of sediments of River Sadong, Malaysia. There is limited published work on the effect of topography, climate, soil and geology on the sediments lying in the River Sadong. Studies have been undertaken around Kota Samarahan and Asajaya areas whereby some heavy metal constituents and their environmental effects were determined. The study entails the description of the depositional processes alonggside with physical and geochemical changes, without neglecting natural and anthropogenic effects

Distribution and Sources of Aliphatic Hydrocarbons in Sediments from Sadong River, Sarawak, Malaysia

Twenty-one surface sediment samples collected from Sadong River, Sarawak were analysed for aliphatic hydrocarbons. These hydrocarbons were recovered from sediment by Soxhlet extraction and then analysed using gas chromatography equipped with mass spectrometer (GC-MS). The sediments collected from Sadong River have high concentrations of total aliphatic hydrocarbons which ranged from 310.41 to 1296.43 g/g. Evaluation of various n-alkane indices such carbon preference index (CPI: 1.32 to 1.98) and average chain length (ACL: 26.26-27.19) showed that there was a predominance of petrogenic sources of n-alkanes in the river and biogenic origin n-alkanes from vascular plants. The petrogenic source of n-alkanes are predominantly heavy and degraded oil with fresh oil inputs. It is believed that the hydrocarbons originated from both natural and anthropogenic sources. The hydrocarbons were mostly transferred by lateral input than atmospheric movements

Phytoremediation of Heavy Metals Spiked Soil by Polyscias fruticose

This study was to assess the phytoremediation potential of Polyscias fruticose in the removal of heavy metals from spiked soil. P. fruticose cuttings were transplanted then grown on 2.00 kg soil spiked with several heavy metals in polyethylene bags. The experiment was conducted for 300 days and concentrations of heavy metals in plant and soil over the growth period were determined. Appreciable concentrations of heavy metals in P. fruticose parts were obtained. The indices used to show the ease of heavy metals uptake and translocation indicated that Co, Cr, Mn, Ni and Pb displayed the greatest ease of absorption while Zn, Fe and Cu were accumulated in the root but not translocated to the shoot. The results obtained shows that this study pioneered the use of P. fruticose in the phytoremediation of several heavy metals spiked soil at a greenhouse level

Hibiscus sabdariffa L. - A phytochemical and pharmacological review

Hibiscus sabdariffa L. (Hs, roselle; Malvaceae) has been used traditionally as a food, in herbal drinks, in hot and cold beverages, as a flavouring agent in the food industry and as a herbal medicine. In vitro and in vivo studies as well as some clinical trials provide some evidence mostly for phytochemically poorly characterised Hs extracts. Extracts showed antibacterial, anti-oxidant, nephro- and hepato-protective, renal/diuretic effect, effects on lipid metabolism (anti-cholesterol), anti-diabetic and anti-hypertensive effects among others. This might be linked to strong antioxidant activities, inhibition of α-glucosidase and α-amylase, inhibition of angiotensin-converting enzymes (ACE), and direct vaso-relaxant effect or calcium channel modulation. Phenolic acids (esp. protocatechuic acid), organic acid (hydroxycitric acid and hibiscus acid) and anthocyanins (delphinidin-3-sambubioside and cyanidin-3-sambubioside) are likely to contribute to the reported effects. More well designed controlled clinical trials are needed which use phytochemically characterised preparations. Hs has an excellent safety and tolerability record. © 2014 The Authors. Published by Elsevier Ltd

Management of chest drains: A national survey on surgeons-in-training experience and practice

Background: Chest tube insertion is a simple and sometimes life-saving procedure performed mainly by surgical residents. However with inadequate knowledge and poor expertise, complications may be life threatening. Objective: We aimed to determine the level of experience and expertise of resident surgeons in performing tube thoracostomy. Methodology: Four tertiary institutions were selected by simple random sampling. A structured questionnaire was administered to 90 residents after obtaining consent. Results: The majority of respondents were between 31 and 35 years. About 10% of respondents have not observed or performed tube thoracostomy while 77.8% of respondents performed tube thoracostomy for thefirst time during residency training. The mean score was 6.2 ± 2.2 and 59.3% of respondents exhibited good experience and practice. Rotation through cardiothoracic surgery had an effect on the score (P = 0.034). About 80.2% always obtained consent while 50.6% always used the blunt technique of insertion. About 61.7% of respondents routinely inserted a chest drain in the Triangle of safety. Only 27.2% of respondents utilized different sizes of chest tubes for different pathologies. Most respondents removed chest drains when the output is <50 mL. Twenty-six respondents (32.1%) always monitored air leak before removal of tubes in cases of pneumothorax. Superficial surgical site infection, tube dislodgement, and tube blockage were the most common complications. Conclusion: Many of the surgical resident lack adequate expertise in this lifesaving procedure and they lose the opportunity to learn it as interns. There is a need to stress the need to acquire this skill early, to further educate and evaluate them to avoid complications