Suicide risk among psychiatric in-patients in north-central Nigeria

Background: Over the last 45 years, mortality due to suicide has increased in some developed and developing countries among both adults and young people. Suicide has also been reported to be high for individuals with substance abuse, mood and personality disorders, and relatively low rates were reported for patients with anxiety disorders. This study was therefore to determine the socio-demographic and clinical factors associated with the risk of suicide among psychiatric in-patients in North-Central Nigeria.Objective: The aim of this study is to look at the socio-demographic and clinical correlates of having suicide risk among psychiatric in-patients.Method: This is a cross-sectional descriptive study conducted on 112 in-patients admitted in the psychiatric wards of BSUTH Makurdi, FMC Makurdi and JUTH Jos during the study period of July to September, 2017. Every consecutive in-patient who consented for the study was assessed with a proforma carefully designed bythe authors to measure socio-demographic and clinical attributes. Suicide risk was determined using the 'Suicidality Module' of Mini International Neuropsychiatric Interview (M.I.N.I.).Results: Forty-five (40.2%) were males while 67(59.8%) were females. The mean age was 36.98 ±11.09 years, fifty- four (48.2%) subjects were still married at the time of the study. Eighty subjects representing 71.4% of the respondents reported having low (46), moderate (16) or high (18) suicide risk. Having a risk of suicide was significantly associated with the history of default (p=0.001), previous episodes of illness (p=0.005), co-morbid diagnosis (p=0.001), long duration of illness (p=0.001), and not having a good relationship with sexual partner (p=0.002).Conclusion: The study justifies the need for the assessment of suicide risk among in-patients with high degree of suspicion.Keywords: Suicide risk, in-patient, correlate

Global prevalence and genotype distribution of hepatitis C virus infection in 2015 : A modelling study

Publisher Copyright: © 2017 Elsevier LtdBackground The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of—and expansion on—the 2014 analysis, which reported 80 million (95% CI 64–103) viraemic infections in 2013. Methods We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. Findings Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8–1·1) in 2015, corresponding to 71·1 million (62·5–79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). Interpretation The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. Funding John C Martin Foundation.publishersversionPeer reviewe

Economics of traditional method of oil palm fruits processing in Ogbadibo L.G.A. of Benue state

The study was conducted to determine the profitabillty of traditional. method of processing palm fruits in Ogbadibo local government area of Banue State. Data on socio-economic characteristics, -costs and returns -were obtained from · sixty (60) processors-in the study area selected i.ising simple random sampling-technique. The data were analysed using_descriptive statistics artdJa.tm budgeting techniques. The results· of the study indicated thaf majority of the respondents were young with mean age of 26 years and average years of processing expe1ience of 8.7 years. The results-also showed that labour contributed the major (60.23%) cost component and sales of palm oiVis the major ( 65 .5 % ) revenue · component. According -to the results, the venture; is ·profitable . with returns per naira invested of 0.6. However, high cost of labour and lack of modem processing equipments were found to be the major constraints of the activity as reported by 75% and 58.75% of the respondents respectively. Based on the 'findirigs, it can be concluded that while the, venture is profitable, more can be desired· fo improve performance. Thus,: the study recommends that processors should form· c:'ooperativ~ groups to pool their res0urces _and have. easy access to lban -so a.s to obtain modern . '.- - ' - processing equipments

Cryptic Miliary (Disseminated) Tuberculosis: A Case Report

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Urological Tumours in Jos University Teaching Hospital, Jos, Nigeria

This is a hospital based retrospective histopathological study of urological tumours in 10 years. Specimens consisted of all surgical excisions, trucut and fine needle biopsies of kidney, prostate, urinary bladder, testis and penis. Urological tumours accounted for 11.45% of all malignant tumours during the period of study. Prostate cancer accounted for 44.1%, urinary bladder 31.7%, kidney 17.3%, testis 5.8% and penis 1%. The study also showed that urinary bladder tumour and malignant tumours of the kidney were found predominantly in males in the ratio of 3:1. There was a high rate of prostate cancer, changing pattern of urinary bladder cancer from squamous cell carcinoma to transitional cell carcinoma. This finding is in contrast to what has been reported in some African countries. Urological tumours appear common in our surgical specimens and constitute significant proportion of malignancies in Jos University Teaching Hospital. This study forms the bases for further evaluation and epidemiological studies (Nig J Surg Res 2000; 2:108-113) KEY WORDS: Urological tumours, prostate, urinary bladder, changing patter

Vesico-vaginal fistula repair: experience with first twenty-three patients seen at a tertiary hospital in north-central Nigeria

Background: Vesico-vaginal fistula (VVF) has been a recurrent challenge to Obstetricians and Gynaecologists in many hospitals in Nigeria. The objective of this study was to determine the causes of VVF, site and size and the success of surgery in VVF patients.Methods: This was a prospective descriptive study of the first 23 cases of VVF repair at the Federal Medical Centre, Makurdi, from January, 2012 to December, 2014. The clinical records of all patients who had VVF repair were reviewed and analysed.Results: The main cause of VVF in this study was prolonged obstructed labour accounting for 52.1% followed by iatrogenic causes such as gynaecological procedures (30.4%). Anterior vaginal wall fistula was the commonest defect accounting for 91.3%. Most of the fistulas were less than 5cm and surgery was successful in 80.9% of the cases. Most of the cases (76.2%) were done under regional anaesthesia. Majority (94.1%) of the successful repairs were done under spinal anaesthesia. Most of the patients were discharged after three weeks.Conclusion: Prolonged obstructed labour was still the leading cause of VVF, though the percentage is lower compared to most reviews across the country. Majority of the cases had successful surgery because of the sizes and the uncomplicated nature of the fistulae. Iatrogenic causes account for about a third of the cases of VVF indicating the need for extra vigilance on the part of the practitioners. Spinal anaesthesia can be used beneficially for VVF repair.Keywords: Vesico-vaginal fistula, repair, iatrogenic, outcomes

Historical epidemiology of hepatitis C virus in select countries-volume 4

Due to the introduction of newer, more efficacious treatment options, there is a pressing need for policy makers and public health officials to develop or adapt national hepatitis C virus (HCV) control strategies to the changing epidemiological landscape. To do so, detailed, country-specific data are needed to characterize the burden of chronic HCV infection. In this study of 17 countries, a literature review of published and unpublished data on HCV prevalence, viraemia, genotype, age and gender distribution, liver transplants and diagnosis and treatment rates was conducted, and inputs were validated by expert consensus in each country. Viraemic prevalence in this study ranged from 0.2% in Hong Kong to 2.4% in Taiwan, while the largest viraemic populations were in Nigeria (2 597 000 cases) and Taiwan (569 000 cases). Diagnosis, treatment and liver transplant rates varied widely across the countries included in this analysis, as did the availability of reliable data. Addressing data gaps will be critical for the development of future strategies to manage and minimize the disease burden of hepatitis

Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study.

Background The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate viral hepatitis by 2030. Although no virological cure exists for hepatitis B virus (HBV) infection, existing therapies to control viral replication and prophylaxis to minimise mother-to-child transmission make elimination of HBV feasible. We aimed to estimate the national, regional, and global prevalence of HBsAg in the general population and in the population aged 5 years in 2016, as well as coverage of prophylaxis, diagnosis, and treatment. Methods In this modelling study, we used a Delphi process that included a literature review in PubMed and Embase, followed by interviews with experts, to quantify the historical epidemiology of HBV infection. We then used a dynamic HBV transmission and progression model to estimate the country-level and regional-level prevalence of HBsAg in 2016 and the effect of prophylaxis and treatment on disease burden. Findings We developed models for 120 countries, 78 of which were populated with data approved by experts. Using these models, we estimated that the global prevalence of HBsAg in 2016 was 3\ub79% (95% uncertainty interval [UI] 3\ub74\u20134\ub76), corresponding to 291992000 (251513000\u2013341114 000) infections. Of these infections, around 29 million (10%) were diagnosed, and only 4\ub78 million (5%) of 94 million individuals eligible for treatment actually received antiviral therapy. Around 1\ub78 (1\ub76\u20132\ub72) million infections were in children aged 5 years, with a prevalence of 1\ub74% (1\ub72\u20131\ub76). We estimated that 87% of infants had received the three-dose HBV vaccination in the first year of life, 46% had received timely birthdose vaccination, and 13% had received hepatitis B immunoglobulin along with the full vaccination regimen. Less than 1% of mothers with a high viral load had received antiviral therapy to reduce mother-to-child transmission. Interpretation Our estimate of HBV prevalence in 2016 differs from previous studies, potentially because we took into account the effect of infant prophylaxis and early childhood vaccination, as well as changing prevalence over time. Although some regions are well on their way to meeting prophylaxis and prevalence targets, all regions must substantially scale-up access to diagnosis and treatment to meet the global targets