Article size distribution and control on Bitumen saturation of some Tar Sand Deposits in parts of South-Western Nigeria

Sedimentological analysis of some Afowo oil sands was carried out with the aim of characterising the reservoirs vis-à-vis their bitumen saturation and recovery efficiencies. Fourty-four samples of tar sands of the Afowo formation (collected at three different localities namely; Idiobilayo, Idiopopo and Igbotako) were subjected to granulometric and petrological analyses to determine the particle size distribution as well as other textural characteristics. The bitumen saturation analysis was carried out with the use of toluene. The result of sedimentological and particle size distribution studies showed that the sands are medium grained, moderately sorted and mesokurtic. The grain morphology can be described as having low to high sphericity, with shapes generally sub-angular to sub-rounded indicating a fairly long period of transportation. The result of bitumen saturation analysis showed that both Idiobilayo and Idiopopo oil sands have an average oil saturation of 17.2% and 16.9% respectively, while Igbotako sands have an average oil saturation of 12.3%. Consequently, Idiobilayo and Idiopopo oil sands deposits are therefore expected to have better reservoir quantities and possibly good oil recovery efficiencies. Keywords: Article size, distribution, Bitumen, Tar Sand Deposits, South-western Nigeria.Global Journal of Pure and Applied Sciences Vol. 14 (3) 2008: pp. 307-31

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

The ratio of roughage to concentrate on milk secretion rate in goats fed Stylosanthes hamata hay

An experiment was conducted to evaluate the effect of roughage to concentrate ratio (R:C) on milk secretion rate (g/h) in goats using a cross-over design in which each goat passed sequentially through all the treatments in random order. The treatments (R: C) were: A = 70 percent roughage : 30 percent concentrate; B = 50 percent roughage : 50 percent concentrate e and C = 30 percent roughage : 70 percent concentrate. In the experiment, seven goats were milked once a day, from the 2nd to 8th week of lactation, thrice per week for 2 weeks per treatment. The animals were fed at 4 percent body weight (DM basis). The feed consisted of Stylosanthes hamata hay (S. hamata hay) and a 17.2 percent CP concentrate ration. Data were analysed using the treatments as main effect with live weight and week of lactation as covariates. There was no significant treatment effects on milk secretion rate (P&gt;0.05). Overall milk secretion rate was 5.23g/h. Week of lactation also had no significant effect (P&gt;0.05). However, live weight of doe at time of milking had a highly significant effect (P&gt;0.001) with milk secretion rate increasing by 0.41g/h per kilogram live weight. The R2 values for the predictive mathematical relationship for goats fed Stylosanthes hamata hay at 4 percent body weight in the dry season was R2 = 0.888. It can therefore be deduced that for a lactating doe in the 5th week of lactation at 20kg body weight fed at 4 percent with Stylosanthes hamata hay to concentrate ratio at 70 percent roughage : 30 percent concentrate would give a milk secretion rate of 6.717g/h while at 50 percent roughage : 50 percent concentrate it would give 6.662g/h and 30 percent roughage : 70 percent concentrate level would give 7.054g/h. Keywords: Stylosanthes hamata hay, concentrate, goats, milk secretio

Determinants of morbidity and mortality following emergency abdominal surgery in children in low-income and middle-income countries

Background: Child health is a key priority on the global health agenda, yet the provision of essential and emergency surgery in children is patchy in resource-poor regions. This study was aimed to determine the mortality risk for emergency abdominal paediatric surgery in low-income countries globally. Methods: Multicentre, international, prospective, cohort study. Self-selected surgical units performing emergency abdominal surgery submitted prespecified data for consecutive children aged &lt;16 years during a 2-week period between July and December 2014. The United Nation's Human Development Index (HDI) was used to stratify countries. The main outcome measure was 30-day postoperative mortality, analysed by multilevel logistic regression. Results: This study included 1409 patients from 253 centres in 43 countries; 282 children were under 2 years of age. Among them, 265 (18.8%) were from low-HDI, 450 (31.9%) from middle-HDI and 694 (49.3%) from high-HDI countries. The most common operations performed were appendectomy, small bowel resection, pyloromyotomy and correction of intussusception. After adjustment for patient and hospital risk factors, child mortality at 30 days was significantly higher in low-HDI (adjusted OR 7.14 (95% CI 2.52 to 20.23), p&lt;0.001) and middle-HDI (4.42 (1.44 to 13.56), p=0.009) countries compared with high-HDI countries, translating to 40 excess deaths per 1000 procedures performed. Conclusions: Adjusted mortality in children following emergency abdominal surgery may be as high as 7 times greater in low-HDI and middle-HDI countries compared with high-HDI countries. Effective provision of emergency essential surgery should be a key priority for global child health agendas