Circumcision mishaps: A continuing challenge in the developing countries

Objective: Circumcision has been described as the most commonly performed surgical operation in the boys and is probably the oldest surgical procedure in man. This prospective study was aimed at establishing the pattern, treatment outcome and cost of major complications of neonatal circumcision seen in a tertiary center in Nigeria.Methods: Consecutive cases of complications of circumcision presenting at the Paediatric Outpatient Department in a tertiary centre in Nigeria were prospectively studied over a period of 3 and half years from July 2003 to December 2006. Information regarding the age of the patient, time of circumcision, the surgeon, place of circumcision was recorded as well as the type of mishap; outcome and cost of management were noted.Results: Forty five patients with major complications of circumcision representing 6.2% of the patients. Their age at presentation ranged between 2 weeks to 10 years (Median = 3months). All the patients were circumcised during the neonatal period. The commonest complication reported is urethro-cutaneous fistula in 25 (56%), Meatal Stenosis in 4(8.9%), Severe bleeding in 4(8.9%), Epidermoid cyst in 3 (6.7%), and 2 (4.4%) cases each of Buried penis, penile amputation, penile degloving with glans amputation, glanular adhesions and redundant prepuce respectively. The cost of treatment for the repairs varies from 4500 -35,000NGN (40-305 Dollars)Conclusion: The prevalence of complications of circumcision is high in our environment

DEVELOPMENT AND PERFORMANCE EVALUATION OF A RICE DE-STONING MACHINE USING VIBRATING SIEVES

A rice de-stoning machine using vibrating sieves was designed, fabricated with locally sourced materials and tested. The performance of the machine was evaluated and the results obtained showed that the feed regulator opening has significant effects on the de-stoning rate, de-stoning efficiency and rice losses. The best performance was obtained at feed regulator opening of 20 mm. Above 20 mm opening, the higher the feed regulator opening the higher the de-stoning rate and grain losses, and the lower the de-stoning efficiency. The average capacity of the machine was found to be 31.84 g/sec. and the average efficiency also was 98.3%.     &nbsp

An analytics-based heuristic decomposition of a bilevel multiple-follower cutting stock problem

This paper presents a new class of multiple-follower bilevel problems and a heuristic approach to solving them. In this new class of problems, the followers may be nonlinear, do not share constraints or variables, and are at most weakly constrained. This allows the leader variables to be partitioned among the followers. We show that current approaches for solving multiple-follower problems are unsuitable for our new class of problems and instead we propose a novel analytics-based heuristic decomposition approach. This approach uses Monte Carlo simulation and k-medoids clustering to reduce the bilevel problem to a single level, which can then be solved using integer programming techniques. The examples presented show that our approach produces better solutions and scales up better than the other approaches in the literature. Furthermore, for large problems, we combine our approach with the use of self-organising maps in place of k-medoids clustering, which significantly reduces the clustering times. Finally, we apply our approach to a real-life cutting stock problem. Here a forest harvesting problem is reformulated as a multiple-follower bilevel problem and solved using our approachThis publication has emanated from research conducted with the financial support of Science Foundation Ireland (SFI) under Grant Number SFI/12/RC/228

GROWTH AND YIELD OF OKRA VARIETIES AS AFFECTED BY RATES OF ORGANO-BASED FOLIAR FERTILIZERS IN RAINFOREST AND RAINFOREST/SAVANNA TRANSITION AGRO-ECOLOGY OF NIGERIA

A field experiments were conducted at the Directorate of University Farms, Federal University of Agriculture, Abeokuta (FUNAAB) and National Horticulture Research Institute (NIHORT), Ibadan between May and August 2015 to assess the effect of different f organo-based fertilizer (fertilizer applied on the leaves) and their rate on growth and yield of two Okra Varieties: LD88 (Late Maturity), and NHAe–47 (Early Maturity). The experiment was laid out in randomized complete block design and replicated three times. The experiment was a 2 × 2 × 5 factorial combinations laid out in a Randomized Complete Block Design in a split-split-plot arrangement, with three replicates at both locations. Factors were okra varieties (LD88 and NHAe–47), the fertilizer types (D.I grow green ® and D.I grow red®) and four rate of foliar applications (0, 300, 600 and 900 ml/ha) while NPK 15:15:15 served as check were applied at 4,6, and 8 Weeks After Sowing (WAS). Agronomic data were obtained from growth and yield variables. Results showed that varieties had significant (P≤ 0.05) effect on growth and yield variables. Variety of LD88 had higher plant height and more leaves than NHAe-47 at both locations. Foliar fertilizer had significant (P≤ 0.05) effect on growth and yield variables. The D.I Grow Green® produced significantly numbers of leaves (11, 9). Application rate of 300 ml/ha and 600 ml/ha D.I.Grow Green® gave a better performance. The LD88 variety produced significantly (P< 0.05) longer pod length (4.68 cm), fresh fruit weight (4.84 t/ha) and dry fruit weight (0.31 t/ha) than NHAe-47. Application rate of 600 mls/ha D.I.Grow Red® produced significantly fresh fruit weight (5.79 t/ha) compared to control (1.32 t/ha). In conclusion, okra variety LD88 had superior growth and yield performance. Application of D.I.Grow Red® at the rate of 300 ml/ha  at Funaab and 600ml/ha at Nihort enhance fruit yield performance on okra. Therefore, 300ml/ha and 600ml/ha could be recommended to farmers in Rainforest/Savanna transition (Abeokuta) and Rainforest agro-ecology (Ibadan), respectively   , , ,

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

Retroperitoneal and Genital Lymphangioma Therapeutic Challenges in a Developing Country

Background: Lymphangiomas occur most commonly in the head and neck region, while other sites are rarely affected. A combination of retroperitoneal and genital lymphangioma is very rare indeed. Though congenital, it may persist into adulthood due to missed diagnosis and inadequate or total lack of treatment. Materials and methods: A report of a 22-year-old male student who presented with recurrent multiloculated genital, thigh, groin and retroperitneal lymphangioma. He underwent surgical excision and adjuvant sclerotherapy using ethylene-diamine tetra acetic acid. Results and Conclusions: There was an initial recurrence after surgery which responded satisfactorily to sclerotherapy. Complete surgical excision of lymphangioma may be precluded by vital structures but sclerotherapy produces satisfactory resolution. The difficulties in management with limited facilities for diagnosis and treatment are highlighted

Ergo-effects of designed school furniture and sitting positions on students behaviour and Musculo-Skeletal Disorder in Nigerian tertiary institutions

Improper design of school furniture is one of the contributing factors to back pain among students as indicated in some studies. In the case of designing school furniture where sitting constitutes a considerable time in the school, seat becomes important for comfort. This study is carried out in three selected institutions in Nigeria to determine level of musculoskeletal disorder in students’ and the furniture that they use. 720 questionnaires with 240 students (120 boys and 120 girls) drawn from each participating institutions were administered and 675 responses were received. The results show that the number of students having MSD, accounted for 93.75%. However, the distributions of pain in the body parts in each school were different. The musculoskeletal pain, mostly concentrated on neck, right shoulders right elbow right wrist right hand, upper back and lower back. The result also reveals that most of the students are sitting on chairs with seat that are too high and too deep or too shallow and of tables that are too high. However, it is recommended that further study on effect of designed school furniture and sitting position in larger sample of students’ representative in Nigeria tertiary institutions should be carried out in order to reduce the effect of body pains

Wound Complications Following Laparoscopic Surgery in a Nigerian Hospital

Background: Different complications may occur at laparoscopic port sites. The incidence of these varies with the size of the ports and the types of procedure performed through them. Objectives: The aim was to observe the rate and types of complications attending laparoscopic port wounds and to identify risk factors for their occurrence. Patients and Methods: This is a prospective descriptive study of all patients who had laparoscopic operations in one general surgery unit of a University Teaching Hospital in Nigeria between January 2009 and December 2012. Results: A total of 236 (155 female and 81 male) patients were included. The laparoscopic procedures include 63 cholecystectomies, 49 appendectomies, 62 diagnostic, biopsy and staging procedures, 22 adhesiolyses, six colonic surgeries, eight hernia repairs and 22 others. Port site complications occurred in 18 (2.8%) ports on 16 (6.8%) patients including port site infections in 12 (5.1%) and hypertrophic scars in 4 (1.7%) patients, while one patient each had port site bleeding and port site metastasis. Nine of 11 infections were superficial, while eight involved the umbilical port wound. Conclusion: Port site complications are few following laparoscopic surgeries in our setting. We advocate increased adoption of laparoscopic surgeries in Nigeria to reduce wound complications that commonly follow conventional open surgeries.Keywords: Laparoscopy, Nigeria, wound complication

Posterior urethral valves in fraternal twins: case report and review of the literature

We report a pair of dizygotic twins with type 1 posterior urethral valves. Concomitant and discordant presentation of posterior urethral valves in twins is rare, with a handful of cases in the literature. The occurrence of identical pathology in dizygotic twins probably suggests the possibility of an inherited trait as it does exist in monozygotic twins.Keywords: fraternal twins, identical pathology, inherited trait, posterior urethral valve

Anthropometric design of furniture for use in tertiary institutions in Abeokuta, South-western Nigeria

Students sit for most of the time on school furniturein the classroom. However, the design of schoolfurniture in Nigeria using the anthropometric dataof the users has yet to be given adequate attention.This study was carried out to obtainanthropometric data of students in higherinstitutions of learning in Nigeria for the design ofergonomics chairs and tables for use by students inthose institutions. Seven hundred and twenty (720)students in three selected institutions participatedin the study. Various body dimensions (sittingelbow height, shoulder height, knee height,popliteal height, buttock-popliteal length, statureand body weight) of the students were measuredusing standard anthropometer and 5 th, 50th, and95 th percentiles of the data obtained werecomputed using a SPSS 16.0 statistical package.The existing furniture dimensions in the selectedinstitutions were also measured. Based on theobtained anthropometric data, this paper proposesfurniture design dimensions for seat height, seatdepth, seat width, backrest height (upper), armrestand desk height for students in the selected tertiaryinstitutions. The present study may be a pointer tothe effect that in the design of tables and chairs foruse in higher institutions, the anthropometric dataof the Nigerian students were not considered. It ishereby recommended that similar study should becarried out in other sections of the country