Medical ethics in sub-Sahara Africa: closing the gaps.

Background: Health care providers are expected to have the skills and knowledge relevant to their field and should also be familiar with the ethical and legal expectations that arise out of the standard practices.Objectives: To elucidate the practice of the health care providers in relation to healthcare ethics in Nigeria.Methods: A self-administered structured questionnaire was devised and distributed to staff of two tertiary health care facilities in Northern Nigeria. The questionnaire comprised of detailed questions regarding day-to-day aspects of Medical ethical issues.Results: A total of 307(76.2% ) out of 403 health care providers responded to the questionnaire. The median age of the respondents was 34 years. More than half 168(54.7%) of the respondents disagreed as to whether “Ethical conduct is important only to avoid legal action. Many respondents 135 (44.0%) agreed to adhering to “patient’s wishes”, on the other hand over two-third of the respondents 211 (68.7%) agreed that “doctor should do what is best” irrespective of the patient’s opinion. There were significant differences (p<0.05) between the perception of physicians and non-physicians on many ethical issues.Conclusion: This study has shown gap in knowledge and practice of healthcare ethics among health care providers. There is a need for periodic education on clinical ethics in our hospitals.Keywords: Medical ethics, sub-Sahara Africa

Investigating Asphaltenes Composition in Crude Oil Samples using Iatroscan TLC-FID Method.

This research was carried out to investigate the percentage composition of asphaltenes by Iatroscan analysis using Thin Layer Chromatography-Flame Ion Detection method (Iatroscan TLC-FID) The percentage composition of asphaltenes by Iatroscan TLC-FID method was compared with the weight% of asphaltenes precipitated. The results from the two methods nearly agreed with each other which revealed that the amount of asphaltene recovered by precipitation is analogous to Iatroscan analysis carried out prior to precipitation. The insignificant difference observed between the two results could be associated to some slight unavoidable experimental and analytical errors which were slightly encountered and instantly addressed. Based on the results obtained from Iatroscan analysis and % composition by weights of asphaltenes recovered, the non-degraded oil tagged 8676 was observed to comparatively have higher asphaltene composition (1125 mg, 11.22 %) than its counterpart which is very slightly degraded oil and tagged 6661 (608.5 mg, 6.085 %). This is not commonly reported in literature. Probably, this indicates that biodegradation may possibly not increase asphaltene composition of oil as widely reported.Keywords: Asphaltenes, Biodegradation, Iatroscan TLC-FID, Oi

Beamforming Design for Wireless Information and Power Transfer Systems: Receive Power-Splitting Versus Transmit Time-Switching

© 1972-2012 IEEE. Information and energy can be transferred over the same radio-frequency channel. In the power-splitting (PS) mode, they are simultaneously transmitted using the same signal by the base station (BS) and later separated at the user (UE)'s receiver by a power splitter. In the time-switching (TS) mode, they are either transmitted separately in time by the BS or received separately in time by the UE. In this paper, the BS transmit beamformers are jointly designed with either the receive PS ratios or the transmit TS ratios in a multicell network that implements wireless information and power transfer (WIPT). Imposing UE-harvested energy constraints, the design objectives include: 1) maximizing the minimum UE rate under the BS transmit power constraint, and 2) minimizing the maximum BS transmit power under the UE data rate constraint. New iterative algorithms of low computational complexity are proposed to efficiently solve the formulated difficult nonconvex optimization problems, where each iteration either solves one simple convex quadratic program or one simple second-order-cone-program. Simulation results show that these algorithms converge quickly after only a few iterations. Notably, the transmit TS-based WIPT system is not only more easily implemented but outperforms the receive PS-based WIPT system as it better exploits the beamforming design at the transmitter side

Exposure to NO<inf>2</inf> in occupationalbuilt environmnets in urban centre in Lahore

Increased economic growth, urbanisation and substantial rise in automobile vehicles has contributed towards the elevated levels of air pollution in major cities in Pakistan. Aone week study was conducted by using passive samplers to assess NO2 concentration in occupational built environments at two most congested and populated sites of Lahore. Both sites were locatedon the busy roads of Lahore. At Site-I the highest concentration was in outdoors followed by corridor and indoor. While at Site II all the sampling location wereindoors and level were comparable to that of outdoor levelsat Site I. The results suggest the likely contribution of ambient sources in exposure to indoor NO2 in educational and other occupational built environments in urban centres

Importance of oil shocks and the GCC macroeconomy: A structural VAR analysis

This study is an endeavour to analyse the influence of oil price shocks on the macroeconomy of the Gulf Cooperation Council (GCC) member countries (Bahrain, Kuwait, KSA, Oman, Qatar and UAE). By employing a structural Vector auto-regression (SVAR) model for period 1980–2016, our key findings suggest that there are significant positive effects of oil price shocks on the GDP, inflation and trade balance of those countries. The findings, however, show substantial heterogeneities in the responses of the GCC members to oil shocks, which suggests the presence of idiosyncrasies in the underlying structure of their economies and differences in the degree to which these economies are dependent on oil revenues. In terms of inflation, there are also major differences in the intensity of the impact of oil shocks on the overall price, which implies that the GCC monetary policies might face a different genre of challenges to attain price stability in the face of those shocks. Our findings have profound policy implications in terms of diversifying the economies of the GCC countries and efforts to decrease the sole dependence on oil revenues

Portal Vein Thrombosis after Restorative Proctocolectomy for Familial Adenomatous Polyposis and Sigmoid Cancer

Postoperative portal vein thrombosis (PVT) is rare, but has been described after various open as well as minimal access abdominal operations, especially splenectomy and colorectal surgical procedures. We report the case of a 39-year-old female who underwent restorative proctocolectomy and ileal pouch-anal anastomosis for familial adenomatous polyposis with sigmoid cancer. She presented 14 days later with vague upper abdominal pain, nausea, vomiting and high output stoma. Doppler ultrasonography confirmed PVT and therefore anticoagulant therapy was started. Her condition improved dramatically and she underwent closure of ileostomy after finishing adjuvant chemotherapy. She remained well at 3-year follow-up with good pouch function and no local or distant recurrence. A high index of suspicion is essential for early diagnosis and prompt treatment of postoperative PVT after restorative proctocolectomy. Early anticoagulation is essential to avoid subsequent complications

Cooperative In-Vivo Nano-Network Communication at Terahertz Frequencies

Nano devices have great potential to play a vital role in future medical diagnostics and treatment technologies because of its non-invasive nature and ability to reach delicate body sites easily as compared to conventional devices. In this paper, a novel concept of cooperative communication for in-vivo nano network is presented to enhance the communication among these devices. The effect on the system outage probability performance is conducted for various parameters including relay placement, number of relays, transmit power, bandwidth and carrier frequency. Results show approximately a 10-fold increase in the system outage performance whenever an additional relay is included in the cooperative network, hence shows a great potential of using cooperative communication to enhance the performance of nano-network at terahertz frequencies

Pediatric day case surgery: Experience from a tertiary health institution in Nigeria

Background : The general observation that children achieve better convalescence in the home environment supports the need for adoption of day case surgery, which is gaining considerable acceptance in developing countries. Pediatric surgical service is in great demand in developing countries, and in-patient beds and surgical supplies are insufficient. Method : A prospective collection of data on all pediatric day surgeries (PDSs) by the pediatric surgical unit University of Ilorin Teaching Hospital (UITH, Ilorin, was done. Parents had pre-operative outpatient briefing and postoperative interviews on the second and ninth days for consultation regarding post-operative complications and events at home. Study period was between April 2005 and September 2007 (2\ubd years). Results : Of the 660 elective cases, 449 (68.02%) children were recruited as day cases. The male-to-female ratio was 14.3:1. Age ranged between 20 days and 15 years with a mean of 37.6 months and standard deviation (SD) of 34.4 months. Congenital hernias/ hydroceles were the highest indications (71.2%), followed by lump/ masses (12.9%), undescended testes (8.7%), umbilical hernias (4.8%) and thyroglossal duct cyst (2.5%). In 98.9% of cases, the parents resided within 20 km radius of the hospital, and 91.5% of them could reach the hospital within 1 hour. Fathers and mothers of 80.1% and 77.1% of children, respectively, had above-primary education. More than half of the fathers (55%) were civil servants, while 30% were self-employed. The mothers were civil servants in 37.3% of cases, and 34% were self-employed. The average number of outpatient clinic visits before surgery was 2-3 visits (41.2%) with mean interval to surgery of 4-5 weeks (60.3%). Logistics (investigations and availability of operation list) and patient\u2032s fitness for surgery were statistically significant delay factors (P= 0.001). Conclusion : Parents reported 14 children to be irritable at home due to pain, while the others reported satisfactory day case experience. No unplanned admission or mortality was recorded, and only 3 (0.8%) parents would not recommend day case surgery to other people. Conclusion: Pediatric day case surgery is feasible for well-selected and monitored cases in our environment. Term neonates with informed parents are suitable for pediatric day case surgery. There is a need for a day case center to reduce waiting list at UITH.Arri\ue8re-plan: Le observation g\ue9n\ue9rale que les enfants atteindre convalescence mieux \ue0 la maison environnement prend en charge la n\ue9cessit\ue9 d\u2019adoption de la chirurgie affaire jour qui gagne plus d\u2019acceptations dans les pays en d\ue9veloppement. Service Chirurgie p\ue9diatrique est en grande demande aux pays en d\ue9veloppement et de lits de remboursement des soins et de fournitures chirurgicales sont insuffi santes. M\ue9thode: UN prospective collecte de donn\ue9es sur tous les enfants PDS par le p\ue9diatrique chirurgicale unit\ue9 de UITH, Ilorin a \ue9t\ue9 faite. Parents avaient pr\ue9op\ue9ratoire externe briefi ng et entrevues post op\ue9rationnels sur le deuxi\ue8me et le neuvi\ue8me jour pour post-operative les complications et les \ue9v\ue9nements \ue0 la maison. P\ue9riode d\u2019\ue9tude a \ue9t\ue9 entre avril 2005 et Septembre 2007 (2,5 ans). R\ue9sultats: De les 660 enfants (68.02 %) de 449 \ue9lectif cas ont \ue9t\ue9 recrut\ue9s comme cas de la journ\ue9e. UN m\ue2le \ue0 ratio f\ue9minin de 14,3: 1. \uc2ge varie entre 20 jours et 15 ans avec signifi e mois 37.6 et SD 34,4 mois. Cong\ue9nitales hernias/ hydroceles ont \ue9t\ue9 les indications plus \ue9lev\ue9es (71.2 %) suivies par forfaitaire/masses (12,9 %), undescended testes (8,7 %), ombilical hernias (4,8 %) et thyroglossal canaux kyste (2,5 %). Dans 98.9 % des cas les parents r\ue9sident dans le rayon de 20 km de l\u2019h\uf4pital et 91,5 % d\u2019entre eux pourrait atteindre l\u2019h\uf4pital dans 1 heure. Les p\ue8res et m\ue8res avaient au-dessus de l\u2019enseignement primaire dans % 80.1 et 77.1 % respectivement. Plus de la moiti\ue9 des p\ue8res (55 %) \ue9taient des civile fonctionnaires, alors que 30 % \ue9taient travailleurs autonomes. Les m\ue8res ont \ue9t\ue9 des fonctionnaires en 37,3 % cas et 34 % \ue9taient travailleurs autonomes. Moyenne clinique externe visites avant une intervention chirurgicale est 2-3times (41.2 %) avec intervalle moyenne \ue0 la chirurgie de 4-5 semaines (60,3 %). Logistique (enqu\ueates et la disponibilit\ue9 de liste de l\u2019op\ue9ration) et les patients de l\u2019ad\ue9quation \ue0 une intervention chirurgicale \ue9taient statistiquement facteurs de retard signifi catif (valeur p = 0.001). Parents a signal\ue9 14 enfants d\u2019\ueatre irritable chez eux en raison de douleur pendant les autres signal\ue9 exp\ue9rience affaire jour satisfaisante. Aucune admission non planifi \ue9e ou la mortalit\ue9 enregistr\ue9e et seulement 3 parents (0,8 %) ne recommanderaient pas une intervention chirurgicale jour affaire \ue0 autres personnes. Conclusion: P\ue9diatrie Chirurgie affaire jour est possible pour les cas bien s\ue9lectionn\ue9s et surveill\ue9s dans notre environnement. Neonates \ue0 terme, avec les parents inform\ue9s sont adapt\ue9es pour p\ue9diatrique Chirurgie affaire de jour. Il est n\ue9cessaire pour un centre d\u2019affaire de jour r\ue9duire la liste d\u2019attente