Effects of Dimethoate Insecticide on Serum Biochemistry of African Catfish (Clarias gariepinus) Juveniles

The present study was designed to investigate acute toxicity of  dimethoate on juvenile Clarias gariepinus. Catfish with mean weight and length of 24.01 ± 11.60 g and 13.98 ± 5.66 cm respectively were exposed to sub-lethal levels of dimethoate in static bioassay system for 28 days and mortality data was statistically evaluated using Finney’s Probit analysis. The 96-hour LC50 value for C. gariepinus was estimated as 29.05 mg/l. The value for the LC50 was used in deducing the sub-lethal concentrations (0.01, 0.15and 0.29 mg/l). Biochemical changes in the serum such as glycogen, total protein, cholesterol, urea and creatinine were analyzed after the exposure period (28 days). The glycogenlevel decreased in all sublethal exposures. An increase in cholesterol at lower exposure concentration, followed by slight increase in urea and creatinine among treated groups was recorded. Behavioural changes which includes changes in skin colour, jerking, restlessness, erratic swimming, among others were observed. Based on the result of this study, it was concluded that C. gariepinus juveniles are very sensitive to low concentration of dimethoate. Dimethoate is highly toxic to juvenile catfishes and as such measures must be taken to avoid its run-off into our aquatic environment thus jeopardizing the recruitment of juvenile catfishes into the fishery

Informed Consent among Hansen’s Disease Patients – A Nigerian Perspective

Background: Informed consent entails providing potential participants with adequate information needed to decide whether or not to participate in research. In Nigeria, Hansen's disease has remained a disease of public health importance. The associated stigmatization often renders patients vulnerable and prone to exploitation. The act of obtaining informed consent from these patients remain an issue of ethical importance. The study aimed to determine the willingness of Hansen's disease patients to give consent to use their data in the form of pictures, videos and/or oral interviews by a third party. Materials and Method: This descriptive cross-sectional study was carried out in three states in Nigeria; Ebonyi, Ogun and Cross River States. Data was collected from consenting participants using researcher-administered semi-structured questionnaires. Results: The study included 93 respondents with a mean (SD) age of 44.9 (20.1) years. The majority 57 (61.29%) of the respondents were farmers while the majority 67 (72.04%) attained primary education. A total of 26 (27.96%) respondents had suffered discrimination in the course of their disease. In their responses, 83 (89.2%) would allow the use of their pictures, 80 (86.0%) their videos and 86 (92.5%) their recorded oral interviews. Among those who would not give consent, the commonest reasons adduced were an intrusion into privacy and lack of trust. Conclusion: Though a majority of the patients would give consent for use of their data intrusion into privacy and lack of trust were major constraints for those not willing to give consent. Caregivers and stakeholders should put more effort into trying to win patients' trust before seeking informed consent

Peripheral venous cutdown procedure: survey of residents' knowledge and practice

Background: Peripheral venous cutdown procedure (PVCD) is a live-saving procedure that should be taught as part of core skills in undergraduate medical curricula. Every doctor should be able to perform it for administration of fluid and blood in emergency situations. However, it is doubtful that the knowledge of trainees is adequate as referral to surgical units to perform this procedure is quite high.Objectives: This study aims at determining the most common indications and the knowledge of trainees in our centre in performing PVCD.Methods: It is a cross-sectional questionnaire based study conducted amongst one-hundred trainees in the various clinical sub-specialties. The semi-structured selfadministered questionnaire was divided into segments on their experience, knowledge and indications for PVCD. The filled questionnaires were collected, collated and analyzed using the statistical package for the social sciences (version 16). Level of significance was determined using Chi square with p value of <0.05 considered statistically significant.Results: There were 81 respondents consisting of 55 males and 26 females with a median age of 33 years and mean age in residency programme of 2.5 years. Sixty (74%) of the respondents have assisted in the procedure before while only seven (33.3%) have performed PVCD on their own. There was statistically difference in the performance of PVCD between surgical and non-surgical trainees (p=0.003). The commonest indication for PVCD in our centre is difficult venopuncture in patients who require fluid or blood replacements. All but one respondent agree that PVCD is a sterile procedure but only 30 (37%) trainees submitted that draping was necessary. An average of 14-15 (17.3-18.5%) residents did not answer questions on the technical details of PVCD.Conclusion: Surgical residents have better experience and knowledge than their colleagues from other clinical departments. Efforts should be made to improve the teaching of this procedure at both undergraduate and postgraduate levels to address this knowledge gaps.Keywords: venous cut down, trainees/residents, knowledge, practic

Surgical site infection in posterior spine surgery

Background: Surgical site infections (SSIs) in spine surgery remain a significant cause of morbidity and prolonged hospitalization. Factors affecting SSI includes patient’s comorbidities, duration of surgery, type and indication for surgery among others. We intend to document our experience in our center and highlight possible factors influencing SSI in posterior spine surgery.Methodology: All consecutive patients who had posterior spine surgeries between January 2012 and July 2014 were recruited into the study. All patients who had wound infection were noted and culture sensitivities were documented as well. Results were analysed to get the infection rate, reasons for prolonged stay on admission as well as possible contributing factors to wound infections.Results: A total of 62 patients’ records were reviewed with 34 males and 28 females (male:female = 1.2:1). SSI was classified as deep or superficial to the fascia. Ten (16.1%) patients were found to have an SSI with 7 (11.3%) patients having deep infections and 3 (4.8%) had superficial infection. Vertebral level operated, etiology, and diagnosis were not statistically significant for SSI. However, spinal instrumentation, surgery on cervical region and wound inspection on or before postoperative day 5 were associated with an increase in the rate of SSI. Comorbidities such as diabetes mellitus, obesity, and anemia were significant risk factors. The organisms cultured were Pseudomonas and Staphylococcus species.Conclusions: Wound infection is a significant complication of posterior spine surgery. This causes distress for both patient and surgeons alike. Uncontrolled diabetes, spine instrumentation and long duration of surgery are significant risk factors for SSI. Practices of early wound inspection, frequent wound dressing changes and not keeping to nontouch technique for changing and removing dressings are important risk factors for SSI in posterior spine surgeries that need to be changed to reduce the burden of SSI.Keywords: Delayed wound exposure, diabetes, posterior spine surgery, spine instrumentation, surgical site infectio

Surgical decompression for traumatic spinal cord injury in a tertiary center

Background: There are controversies regarding the importance and timing of spinal cord decompression following trauma. Documented evidence shows that early decompression in the setting of acute spinal cord injury (SCI) improves neurologic outcomes. Our objective was to evaluate the outcome of posttraumatic spinal cord decompression with or without spinal stabilization in our region.Methodology: We performed a cross-sectional study on adult patients who presented with acute spinal cord compression of traumatic etiology within a 2-year period. The primary outcome was change in Frankel’s grading 6 months after surgery. Secondary outcomes were complication rates and mortality.Results: A total of 35 patients made up of 24 (68.6%) males and 11 (31.4%) females were recruited into the study. The spectrum of injuries included cervical 27 (77.1%), thoracic 7 (20.0%), and lumbar vertebrae 1 (2.9%). The outcome as measured by Frankel’s grade at 6 months after surgery showed improvement in 9 (25.7%) patients following intervention. All patients who presented with Frankel’s Grade C and D improved to Grade E while none of those who presented with Frankel’s Grade E deteriorated. The common complications of spine decompression and fixation in this series were surgical site infections (11.4%) and chest infections (11.4%), especially in high cervical injury.Conclusion: Spinal cord decompression with spinal stabilization enhances the rehabilitation of patients with unstable spine and completes spinal cord injuries. Our experience shows improvement in neurological function in patients with spinal cord decompression despite the challenges of instrumentation in Sub-Saharan Africa.Keywords: Anterior cervical discectomy and fusion, lateral mass fixation, spinal decompression, traumatic spinal cord injur