A Rule-Based Higher Institution of Learning Admission Decision Support System

Higher education management is key to the development of any nation. Some of the challenges that are often managed include examination, admission, and record problem. In this work, we focused on the admission system in higher schools of learning because it is fundamental to solving other problems. We studied the application of Decision Support Systems in Schools and came up with a new Decision Support Tool for admission processing. The system relied on rules generated from information gathered from admission administrators. The significant of the work lied in the fact that uncertainty in admission process and unnecessary time wastage are eliminated

An audit of surgical site infection following open prostatectomy in a Nigerian Teaching Hospital

Background: Surgical site infections (SSI) are a potential cause of morbidity and increased cost of care after operations such as open prostatectomy.Objective: To audit the occurrence of SSI after open prostatectomy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, NigeriaMethods: A review of all patients who underwent open prostatectomy over a ten-year period (July 2005 to June 2015). Data analysis was done using the statistical package for social sciences version 21. Association between variables was determined using Chi-square or Fisher’s exact test as appropriate. A p-value < 0.05 was considered statistically significant.Results: A total of 247 open prostatectomy surgeries were reviewed, with the patients’ ages ranging from 43 – 91 years and a mean age of 67.0 ± 8.8 years. Elective procedures were 98.8% while the remaining 1.2% were emergency cases. There were 24 (9.8%) surgical site infections. The duration of admission of the patients with SSI ranged from 6 – 15 days with a mean of 9.5 ± 3.2 days, as against 4 – 9 days (mean of 5.0 ± 2.1days) for those without SSI. All the patients with SSI were successfully managed with no resultant mortality. Risk factors identified for SSI were emergency surgery (p=0.001), obesity (p<0.0001), diabetesmellitus (p=0.008), smoking (p<0.0001), pre-operative catheterization (p<0.0001), excessive haemorrhage (p<0.0001) and post-operative suprapubic bladder drainage (p<0.0001).Conclusion: SSI is a recognized complication of open prostatectomy. Identified risk factors for its occurrence from this audit are emergency operation, obesity, diabetes mellitus, smoking, pre-operative catheterization, excessive haemorrhage and post-operativesuprapubic bladder drainage. Age, approach to prostatectomy (retropubic vs transvesical), incision type (lower midline vs pfannenstiel), level of the surgeon, catheter type and modality of irrigation were however not significant risk factors for post-prostatectomy SSI in this study.Keywords: Surgical site infection, risk factors, open prostatectomy

An audit of surgical site infection following open prostatectomy in a Nigerian Teaching Hospital

Background: Surgical site infections (SSI) are a potential cause of morbidity and increased cost of care after operations such as open prostatectomy. Objective: To audit the occurrence of SSI after open prostatectomy at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC), Ile-Ife, Nigeria Methods: A review of all patients who underwent open prostatectomy over a ten-year period (July 2005 to June 2015). Data analysis was done using the statistical package for social sciences version 21. Association between variables was determined using Chi-square or Fisher\u2019s exact test as appropriate. A p-value < 0.05 was considered statistically significant. Results: A total of 247 open prostatectomy surgeries were reviewed, with the patients\u2019 ages ranging from 43 \u2013 91 years and a mean age of 67.0 \ub1 8.8 years. Elective procedures were 98.8% while the remaining 1.2% were emergency cases. There were 24 (9.8%) surgical site infections. The duration of admission of the patients with SSI ranged from 6 \u2013 15 days with a mean of 9.5 \ub1 3.2 days, as against 4 \u2013 9 days (mean of 5.0 \ub1 2.1days) for those without SSI. All the patients with SSI were successfully managed with no resultant mortality. Risk factors identified for SSI were emergency surgery (p=0.001), obesity (p<0.0001), diabetes mellitus (p=0.008), smoking (p<0.0001), pre-operative catheterization (p<0.0001), excessive haemorrhage (p<0.0001) and post-operative suprapubic bladder drainage (p<0.0001). Conclusion: SSI is a recognized complication of open prostatectomy. Identified risk factors for its occurrence from this audit are emergency operation, obesity, diabetes mellitus, smoking, pre-operative catheterization, excessive haemorrhage and post-operative suprapubic bladder drainage. Age, approach to prostatectomy (retropubic vs transvesical), incision type (lower midlinevs pfannenstiel), level of the surgeon, catheter type and modality of irrigation were however not significant risk factors for post-prostatectomy SSI in this study. DOI: https://dx.doi.org/10.4314/ahs.v19i2.30 Cite as: Salako AA, Badmus TA, Onyia CU, David RA, Adejare IE, Lawal AO, Onyeze CI, Ndegbu CU. An audit of surgical site infection following open prostatectomy in a Nigerian Teaching Hospital. Afri Health Sci.2019;19(2): 2068-2072. https://dx.doi.org/10.4314/ahs.v19i2.3

A mixed methods evaluation of an integrated training package for skin neglected tropical diseases in Kaduna and Ogun, Nigeria

Background: The overall burden of neglected tropical diseases (NTDs) affecting the skin is undetermined. Skin conditions are among the top 10 causes of disability worldwide. Affected persons seek treatment at advanced stages of the disease, resulting in morbidity and disability. We developed and evaluated an integrated training intervention for early case detection, referral and management of skin NTDs in two states in Nigeria. Methods: This was a mixed-methods study using participatory approaches to develop specific skin algorithms and training packages for community and primary level health workers. This supported the identification, referral and clinical diagnosis of suspected cases. We used Kirkpatrick's model to evaluate the training package. Results: Participants’ knowledge improved after the 2-months intervention. Across both states, knowledge retention appeared more robust for cadres at all levels: state, local government area and primary healthcare. All (100%) participants mentioned that the training assisted them in detecting, referring and managing skin NTDs. Training was understood by participants and training materials were easy to understand. Materials were also effective in educating community members about the symptoms of NTDs and supported referral to facilities for appropriate management. Conclusions: Community implementers can be trained and supervised to detect people affected by skin NTDs and support appropriate management within the existing patient care pathway

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

Summary 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 middleincome 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 lowincome 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 lowincome, 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

Bilateral Tubal Gestation Associated with Schistosomiasis in an African Woman

Background. The incidence of tubal ectopic gestation caused by schistosomiasis induced tubal pathology is undocumented in this environment, which may be due to rarity of this pathology. Bilateral tubal gestation is common in patients that have undergone in vitro fertilization. We report a hitherto undocumented case of spontaneous bilateral ectopic gestation following tubal schistosomiasis. Case Report. Mrs. OB was a 32-year-old G4P3+0 (3 alive) woman who complained of abdominal pain and bleeding per vaginam of 4 and 2 days’ duration respectively following 8 weeks of amenorrhea. A clinical impression of ruptured ectopic gestation was confirmed by ultrasound scanning. She had bilateral salpingectomy with histology of specimens showing bilateral ectopic gestation with Schistosoma haematobium induced salpingitis (findings of Schistosoma haematobium ova noted on slide). Conclusion. Schistosoma induced salpingitis is a rare but possible cause of bilateral tubal gestation

ACCESSING THE IMPACTS OF CONTEMPORARY DEVELOPMENT IN BIOFUEL ON AGRICULTURE, ENERGY AND DOMESTIC ECONOMY: EVIDENCE FROM NIGERIA

The recent volatility of the conventional energy output owning to fluctuations in the supply chain in the fossil fuel cum with its finite supply nature has necessitate the integration of biofuel into the global energy needs. Biofuel as a type of renewable energy has the ability to reduce global warming resulting from greenhouse gas (GHG) emissions, thus offers a relatively healthy energy option for both the consumers and producers in global space. This notwithstanding has some implications on agriculture and food security. This paper examined the impact of biofuels development on agriculture, energy infrastructure and domestic wellbeing in Nigeria. The study identified a potential rivalrous relationship in terms of space and cultivation mechanism when sustainability is in view. We reviewed existing policies and sustainability practices in other economies and concludes that Nigeria needs a deliberate effort aimed at developing institutional structures that will facilitate building and expansion of the biofuels sub-sector at the same time enhance rural livelihoo

Does Commercial Banking Activities Exerts on Agricultural Growth in Nigeria? Evidence from ARDL Framework

The current study examined the Impact of commercial bank loan activities on Nigeria's agricultural productivity with a focus on the impact of the agricultural sector credit guarantee scheme fund, commercial Bank credits to agricultural output, interest rate and the government recurrent expenditure on the agriculture sector. We employed the newly developed augmented regressive distributed lag to examine whether or not commercial lending activities enhances productivity. Our results shows that though a positive relationship exist between agricultural output and each of agricultural sector credit guarantee scheme fund and the government recurrent expenditure on the agriculture sector, the relationship is not significant. The result also shows that a positive but not significant relationship exists between commerci0.5 The current study examined the Impact of commercial bank loan activities on Nigeria's agricultural productivity with a focus on the impact of the agricultural sector credit guarantee scheme fund, commercial Bank credits to agricultural output, interest rate and the government recurrent expenditure on the agriculture sector. We employed the newly developed augmented regressive distributed lag to examine whether or not commercial lending activities enhances productivity. Our results shows that though a positive relationship exist between agricultural output and each of agricultural sector credit guarantee scheme fund and the government recurrent expenditure on the agriculture sector, the relationship is not significant. The result also shows that a positive but not significant relationship exists between commercial Bank credits to agricultural output, and that a negative but significant relationship exists between interest rate and agriculture output. The implication is that increase in commercial bank lending has not been able to induce positive growth in the agricultural output in Nigeria. Our results provoke insights thinking on the role of commercial banking activities in advancing agriculture in Nigeria. al Bank credits to agricultural output, and that a negative but significant relationship exists between interest rate and agriculture output. The implication is that increase in commercial bank lending has not been able to induce positive growth in the agricultural output in Nigeria. Our results provoke insights thinking on the role of commercial banking activities in advancing agriculture in Nigeria

SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study

Background: Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods: The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18-49, 50-69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results: NNVs were more favourable in surgical patients than the general population. The most favourable NNVs were in patients aged 70 years or more needing cancer surgery (351; best case 196, worst case 816) or non-cancer surgery (733; best case 407, worst case 1664). Both exceeded the NNV in the general population (1840; best case 1196, worst case 3066). NNVs for surgical patients remained favourable at a range of SARS-CoV-2 incidence rates in sensitivity analysis modelling. Globally, prioritizing preoperative vaccination of patients needing elective surgery ahead of the general population could prevent an additional 58 687 (best case 115 007, worst case 20 177) COVID-19-related deaths in 1 year. Conclusion: As global roll out of SARS-CoV-2 vaccination proceeds, patients needing elective surgery should be prioritized ahead of the general population