Hegar uterine dilator as an unusual cause of small bowel obstruction: a case report

<p>Abstract</p> <p>Introduction</p> <p>The unusual event of surgical instrument retention in the abdominal cavity usually occurs after laparotomy.</p> <p>Case presentation</p> <p>A 45-year-old African woman from Cameroon with no previous abdominal surgery presented with a three-day history of colicky abdominal pain. Abdominal X-ray showed an opaque, linear object in the lower abdomen. Exploratory laparotomy revealed a Hegar uterine dilator that was lost during a dilatation and curettage performed seven years prior to the present admission.</p> <p>Conclusions</p> <p>The trans-uterine route should be included as a rare and unusual source of surgical instruments retained in the abdomen.</p

Empirical Assessment of Water, Sanitation and Hygiene Practices in a Semi-Urban Setting: A Socio-Economic and Cultural Mirror

Insufficient water, weak sanitation and poor hygiene practices create a serious burden of diseases in low-income regions and is affecting susceptible groups such as the poor. Although water and sanitation programs have been initiated in many local communities; Water, Sanitation and Hygiene (WaSH) promotion still receives little attention and funding. This study focuses on the socioeconomic and cultural factors influencing Ota residents, a semi-urban town in South West Nigeria on WaSH services. The study uses structured questionnaire as one of the major research instruments. The method of data analysis utilized descriptive analysis with illustrative data representations. Analysis of the data reveals that literacy level and age group play a significant role in housing settlements while source of water and quality significantly affect health, and its quantity affects sanitation practices. The evidence from the study confirmed that cultural practices and access to water sources had no direct relationship. Hence, the problem of good water supply was seen to be more of economic and financial challenges that require timely government intervention. Financially, the economic context does not permit the implementation of a real water management policy. In most houses, income does not favor the subscription of some households to water distribution network. Therefore it is recommended that a concerted effort on the part of the government be focused on maximizing welfare policy programmes that would ameliorate the sufferings in the communities as it relates to access to clean water sources and other basic social infrastructure that could enhance people’s living standar

Public health risk status of the water supply frame work at Kwame Nkrumah (Postgraduate) Hall, University of Nigeria, Nsukka and environs

The aim of the study is to assess the public health risk status of the potable water supply framework at the Kwame Nkurumah Postgraduate Residence (PG) Hall, University of Nigeria, Nsukka, (UNN), Enugu State, Nigeria, and environs. Four potable water supply frame-works at the PG Hall, UNN, and exposed stagnant water were sampled and analysed in accordance with the Association of Official Analytical Chemists (AOAC) Official Method of Analysis to detect their limits of chemical and microbial constituents with high public health risk. The samples comprised of tap water (A), tap-to-reservoir water (B), commercial sachet water (C) commercial bottled water (D) and exposed stagnant water (E). The nitrate levels of all the sources (except &lsquo;B&rsquo;) were above the World Health Organisation (WHO) limit (10.00 mg/L). Thus they could cause methaemoglobinemia in infants. Nitrate content of &lsquo;B&rsquo; (6.99 mg/L) was significantly (p &lt; 0.05) low, relative to that of &lsquo;A&rsquo; (23.08 mg/L); and indicated microbial action. The physicochemical and microbial quality of the tap water differed significantly (p &lt; 0.05) from that of the tap-to-reservoir water. All the pH, except that of &lsquo;D&rsquo;, were below WHO recommended pH range (6.5 to 8.5) for drinking water. &lsquo;D&rsquo; was more or less a mineral concentrate, as its chemical constituents were significantly (p &lt; 0.05) higher than those of other samples. Total viable count (TVC) and coli form count of the reservoir water and sachet water (0.17 to 0.20 and 0.11 to 0.09 cfu/ml, respectively), indicated heavy microbial contamination. While &lsquo;D&rsquo;, was devoid of biological contamination. Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa were among the bacteria isolated. Taken together, the sampled potable water (except &lsquo;A&rsquo; and &lsquo;D&rsquo;) was generally, of poor chemical and microbial quality; and may be considered unacceptable.Key words: Public health risk, potable water, physicochemical and microbial water quality, water pollution

Case-Detection Rate of Direct Sputum Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Abia State, Nigeria

The accuracy of sputum smear microscopy, the tuberculosis case-finding method in the Abia State TB Control Programme has never been assessed due to lack of culture facilities. To assess the accuracy of sputum smear microscopy in routine control programme conditions in Abia State, sputum samples from patients undergoing investigation for tuberculosis were analyzed using Ziehl-Neelsen staining technique for sputum smear  microscopy and culture on Löwenstein-Jensen medium as reference standard. Out of 150 participants tested, 51 were smear –positive for acid fast bacilli (positivity rate, 34.0 %, 51/150) while 79 were culture positive for Mycobacterium tuberculosis complex and 12 for non-tuberculous mycobacteria (NTM). Thirty-seven of the 79 culture positive for M. tuberculosis were smear positive giving a ratio of smear to culture positivity of 46.84%. Forty-two (42.4%) of the 99 smear negative cases were culture positive for M. tuberculosis. The sensitivity of smear microscopy was 50.0%(95%CI=39.0-61.0) and specificity was 92.3% (95% CI=86.4-98.2). The prevalence of HIV/TB coinfection among the study participants was 48% (12/25). Although the case- detection rate of smear microscopy was moderate in this study, the large proportion of TB patients missed by smear microscopy is a cause for concern and requires concerted effort to improve the sensitivity of smear microscopy. Introduction of more sensitive diagnostic methods like culture also need to be considered. La précision des frottis, la méthode la recherche de cas de tuberculose  dans le programme de lutte contre la tuberculose dans l’Etat d'Abia n'a jamais été évalué en raison du manque d'installations de culture. Pour évaluer la précision des frottis dans les conditions du programme de  contrôle de routine dans cet Etat , les expectorations de patients subissant une enquête de la tuberculose ont été analysées à l'aide de technique de coloration de Ziehl-Neelsen pour la microscopie des frottis de crachats etde la culture sur milieu de Löwenstein- Jensen en tant que norme de  référence . Sur les 150 participants testés, 51 étaient à frottis positif pour les bacilles acido rapide (taux de positivité, 34,0%, 51/150), tandis que 79 étaient positifs à la culture pour complexe Mycobacterium tuberculosis et 12 pour les mycobactéries non tuberculeuses (NTM). Trente-sept de la culture 79 positive pour M.tuberculosis étaient à frottis positif donnant un ratio de frottis de positivité de la culture de 46,84 %. Quarante-deux  (42,4%) des 99 cas à frottis négatifs étaient positifs à la culture pour M. tuberculosis. La sensibilité de la microscopie des frottis était de 50,0 % (IC à 95% = 39,0 à 61,0) et la spécificité était de 92,3 % (IC à 95% = 86,4 à 98,2). La prévalence du VIH / TB coïnfection parmi les participants à l'étude était de 48% (12 /25). Bien que le taux de microscopique des  frottis de dépistage des cas ait été modéré dans cette étude, la forte proportion de patients atteints de tuberculose manqués par examen microscopique des frottis est un sujet préoccupant et exige un effort concerté pour améliorer la sensibilité de la microscopie des frottis. La présentation des méthodes de diagnostic plus sensibles comme la culture doivent aussi être pris en considération

Does low dose oral ketamine have oxytocic effect?

Objectives: To evaluate if low dose oral Ketamine has oxytotic effect on term pregnant uterus.Methodology: This is a cross sectional double blind placebo control prospective study. A total of 745 parturients were studied, 261 had low dose oral Ketamine in active phase of labour (group A), 227 had Oxytocin augmentation (group B) and 257 had none of these medication (control group C). Their age, parity, gestational age, duration of labour and APGAR score were determined and all data analyzed using Epi Info.Results: The parturients were predominantly within the age group 26 – 35 years and their mean gestational age at delivery was 39.1weeks. The mean (± S.D.) duration of labour ( first stage of labour) was found to be shortest in group A 5.80 ± 2.06 hours, while it was 8.03 ± 3.37 hours in group B and 7.01 ± 3.25 hours in group C. Foetal outcome was comparable in all the three groups.Conclusion: Low dose oral Ketamine probably has an Oxytocic effect which needs to be explored in future research. And if this be the case, then it will be a suitable and safe single agent for labour analgesia and augmentation and for extended use in repairs of episiotomy and perineal tears.Key words: Oral Ketamine, low dose, oxytocic effect, labour duration, foetal outcome

Innovative Strategies for improving Special Educational Needs for Students with Learning Disabilities in Nigerian Schools: An Analytical Study

This study was designed to determine innovative strategies for improving special educational needs for students with learning disabilities in Nigerian Schools. The study used descriptive research design and was conducted in ten selected secondary schools in Ebonyi State Nigeria. The researchers selected 100 teachers in the sampled schools and 65 senior secondary school students were also selected using simple random sampling from 214 students with learning disabilities. Three principals and four (4) special need education teachers were selected through sampling. The data sources were teachers, students, and principals. The main data gathering instrument for the study was questionnaire. Interview and observation were also used to supplement the information obtained through the questionnaire items. However, out of 172 people that formed the study population and were given study questionnaire items, the researchers randomly selected 80 items, which was used for data analysis. Data collected were analyzed using mean and percentage. Based on the data collected, the reliability of questionnaire was computed using Cronbach alpha method at 0.76. This coefficient indicates that the tool was consistent. Findings among others revealed that developing alternative activities and to use less of the traditional method of teaching and learning processes will improve supports for students with learning disabilities. Also, Students with learning disabilities are highly neglected with little or no understanding of their conditions. The study concluded by recommending that special educators should focus on the abilities of students with learning disabilities and not on their physical or behavioural disabilities.   Keywords: behavioural disabilities, Learning Disabilities, Special Educational Need

Beyond The Call of Duty: Realities of Work-Life Balance in the United Arab Emirates Education Sector

Previous research have been intrigued to assess the mechanisms used by employees to cope with tedious work schedules and other areas of their non-work lives. While there are yet to be sufficient studies that explore the countries in the Middle East, this paper aimed to explore the realities of WLB among professionals in the education sector in the United Arab Emirates (UAE). We further considered the implications of workplace and family support, and organisational culture on employees’ WLB and productivity. The study employs the use of qualitative data generated from semi-structured interviews of 41 lecturers across seven higher education institutions in Dubai, UAE aimed at investigating the various contexts of WLB

ASSESSMENT OF THE EFFECTS OF FIRMS’ CHARACTERISTICS ON EARNINGS MANAGEMENT OF LISTED FIRMS IN NIGERIA

This study assessed the effects of firms’ characteristics on earnings management of listed companies in Nigeria. To achieve the objectives of this study, a total of 20 listed firms in the Nigerian stock exchange market were selected and analyzed for the study using the judgmental sampling technique. The corporate annual reports for the period 2006-2010 were used for the study. In testing the research hypothesis, the study adopted the use of both descriptive statistics and econometric analysis using the pooled ordinary least square regression for the listed sampled firms. Findings from the study revealed that while firm size and firms’ corporate strategy have a significant positive impact on earnings management (proxied by discretionary accruals); on the other hand, the relationship between firms’ financial leverage and discretionary accruals of the sampled firms in Nigeria was not significant. Thus, the study concludes that large firms tend to have higher motivations and more prospects to engage in the manipulation earnings and exaggerate earnings due to the intricacy of their operations and the complexity for users to identify overstatemen

Circular Production and Maintenance of Automotive Parts:An Internet of Things (IoT) Data Framework and Practice Review

The adoption of the Circular Economy paradigm by industry leads to increased responsibility of manufacturing to ensure a holistic awareness of the environmental impact of its operations. In mitigating negative effects in the environment, current maintenance practice must be considered for its potential contribution to a more sustainable lifecycle for the manufacturing operation, its products and related services. Focusing on the matching of digital technologies to maintenance practice in the automotive sector, this paper outlines a framework for organisations pursuing the integration of environmentally aware solutions in their production systems. This research sets out an agenda and framework for digital maintenance practice within the Circular Economy and the utilisation of Industry 4.0 technologies for this purpose

IS THE MEDIA A FRIEND OR ENEMY OF THE STATE?

The mass media have always been huge blessings to any society they are found. They are agents of socialisation and education as well as development. The important roles of the media earned them the title of the ‘Fourth Estate of the realm’ which implies that after the three arms of government; executive, legislature and the judiciary, the media are the next. The media socialise the people, get them informed of happenings around them, analyse issues of national importance to them and help them to take right decisions and at the same time, help to transmit the norms of values of the society from one generation to another. Mass media is the vehicle through which government developmental messages and ideas get to the people and on the other hand, the people use it to express their feelings, motives, dissatisfactions and needs to the governments or representing bodies. It is used by the government or people to set agenda on important issues relating to the public for either the government to be aware and take actions or for the people to know and be informed. The mass media surveys the environment for news, interprets issues to the people, provide entertainment and also help the propagation of the societal cultural norms and values. The media not only transmit cultural values and norms from one generation to another, they help to enforce such values and norms through the mental pictures they establish in our minds. This study however seeks to find out how the media can be use to propagate developmental course, be more effective in playing the watchdog role as well as serving as agents of cultural transmission. This study also will reveal ways on how the media can keep to it social responsibility functions by putting honesty, truthfulness, fairness and balance up above any personal interest and also adhere to the ethics of the profession in their performance. The media should establish high trust level with the people for smooth interactions and collaborations for effective outputs