Multiple fractures and iatrogenic burns in a newborn due to unskilled delivery: A case report

High neonatal mortality is the hallmark of developing countries. Most of the deaths are preventable by good antenatal care with risk identification and access to safe delivery. However, only about a third of births are attended by skilled personnel in Nigeria. The case of a newborn (one of a set of twins) delivered by breech in a church maternity, who sustained multiple fractures and thermal burns from resuscitation is presented. The mother had received antenatal care in an orthodox health facility but opted to deliver in the church maternity. We discuss the problems associated with delivery by unskilled birth attendants while reviewing the literature to highlight the roles and mechanisms of church birth attendants. Reproductive health education for women, their families and communities is advocated to enable birth preparedness. Training, supervision, monitoring and regulation of practice of church birth attendants will also be required to improve outcomes (Afr J Reprod Health 2008; 12[3]:197-206)

Assessment of Factors Responsible for Encroachment on Public Land in Ajoda New Town in Oyo State, Nigeria

Public land is crucial for the execution of developmental projects in many nations. However, studies have indicated that most of the time, public land is often being encroached. The issue of concern in this paper is: why do people encroach on public land? A contextual investigation approach was embraced for this study and residents of Ajoda New Town (ANT) - a scheme of Oyo State Government, Nigeria were involved as respondents to a structured questionnaire prepared on a five-point Likert scale format. Respondents were randomly selected, and, a total of 322 completed copies of the questionnaire were found valid for data analysis. The study employed Weighted Mean Score and Principal Component Analysis in determining the factors that led to the land encroachment in the community. Results indicate that faulty administrative/implementation, the hostile attitude of original settlers, and excessive land acquisition by the government are the major factors responsible for land encroachment in the study area. It was recommended that during the acquisition process, the government should imbibe the culture of acquiring a reasonable portion of land which will not be far more than what is required to avoid encroachment, and adequate compensation paid to the affected persons

Assessment of Factors Responsible for Encroachment on Public Land in Ajoda New Town in Oyo State, Nigeria

Public land is crucial for the execution of developmental projects in many nations. However, studies have indicated that most of the time, public land is often being encroached. The issue of concern in this paper is: why do people encroach on public land? A contextual investigation approach was embraced for this study and residents of Ajoda New Town (ANT) - a scheme of Oyo State Government, Nigeria were involved as respondents to a structured questionnaire prepared on a five-point Likert scale format. Respondents were randomly selected, and, a total of 322 completed copies of the questionnaire were found valid for data analysis. The study employed Weighted Mean Score and Principal Component Analysis in determining the factors that led to the land encroachment in the community. Results indicate that faulty administrative/implementation, the hostile attitude of original settlers, and excessive land acquisition by the government are the major factors responsible for land encroachment in the study area. It was recommended that during the acquisition process, the government should imbibe the culture of acquiring a reasonable portion of land which will not be far more than what is required to avoid encroachment, and adequate compensation paid to the affected persons

Landscape of team-based care to manage hypertension: Results from two surveys in low/middle-income countries

OBJECTIVES: Team-based care is essential for improving hypertension outcomes in low-resource settings. We assessed perceptions of country representatives and healthcare workers (HCWs) on team-based hypertension care in low/middle-income countries. DESIGN: Two cross-sectional surveys. SETTING: The first survey (Country Profile Survey) was conducted in 17 countries and eight in-country regions: Algeria, Bangladesh, Burundi, Chile, China (Beijing, Henan, Shandong), Cuba, Ethiopia, India (Kerala, Madhya Pradesh, Maharashtra, Punjab, Telangana), Nepal, Nigeria, Philippines, Saint Lucia, Sri Lanka, Thailand, Turkey, Uganda and Vietnam. The second survey (HCW Survey) was conducted in four countries: Bangladesh, China, Ethiopia and Nigeria. PARTICIPANTS: Using convenience sampling, participants for the Country Profile Survey were representatives from 17 countries and eight in-country regions, and the HCW Survey was administered to HCWs in Bangladesh, China, Ethiopia and Nigeria. OUTCOME MEASURES: Country-level use of team-based hypertension care framework, comprising administrative, basic and advanced clinical tasks. Current practices of different HCW cadres, perspectives on team-based management of hypertension, barriers and facilitators. RESULTS: In the Country Profile Survey, all (23/23, 100%) countries/regions surveyed integrated team-based care for basic clinical hypertension management tasks, less for advanced tasks (7/23, 30%). In the HCW Survey, 854 HCWs participated, 47% of whom worked in rural settings. Most HCWs in the sample acknowledged the value of team-based hypertension care. Although there were slight variations by country in the study sample, overall, barriers to team-based hypertension care were identified as inadequate training (83%); regulatory issues (76%); resistance by patients (56%), physicians (42%) and nurses (40%). Facilitators identified were use of treatment algorithms (94%), telehealth/m-health technology (92%) and adequate compensation for HCWs (80%). CONCLUSIONS: Our findings revealed key lessons for health systems and governments regarding team-based care implementation. Specifically, policies to facilitate additional training, optimise HCWs\u27 roles within care teams, use of hypertension treatment protocols and telehealth/m-health technology will be essential to promote team-based care

HEPATOPROTECTIVE ACTIVITY OF CHRYSOPHYLLUM ALBIDUM AGAINST CARBON TETRACHLORIDE INDUCED HEPATIC DAMAGE IN RATS

The leaf extract of Chrysophyllum albidum was studied for hepatoprotective activity against rats with induced liver damage by carbon tetrachloride (CCl4). The rats were divided into five groups of eight rats per group. Animals of group A served as normal and were given only vehicle (distilled water) for 7 days. Animals of group B (positive control) were administered with vehicle on the first four days, and with the vehicle and CCl4 on the fifth, sixth and seventh day. The animals of groups C, D and E were respectively administered with 500, 1000 and 1500 mg/kg of extract & distilled water for the first four days, and with distilled water, extract and CCl4 on the last three days. Animals were subsequently anaesthetized and blood samples were collected for alanine amino transferase (ALT), aspartate amino transferase (AST), alkaline phosphatase (ALP), total bilirubin, total protein and albumin assays; liver organ was isolated and processed for histopathological studies. The results showed that the levels of AST, ALT, ALP and total bilirubin were significantly higher in rats treated with CCl4 indicating liver injury, while these parameters were reduced significantly (p < 0.05) after treatment of rats with the extract. The hepatoprotective activity of C. albidum was also supported by histopathological studies of liver tissue. The liver tissue of rats in the group treated with CCl4 showed marked centrilobular fatty degeneration and necrosis while the groups treated with plant extract showed signs of protection against this toxicant as evidenced by the absence of necrosis

Medication Adherence Interventions for Cardiovascular Disease in Low- and Middle-Income Countries: A Systematic Review.

Purpose: The burden of cardiovascular diseases (CVD) is high in low- and middle-income countries (LMICs). Medications are integral to the management and control of CVD; however, suboptimal adherence impacts health outcomes. This systematic review aims to critically examine interventions targeted at improving medication adherence among persons with CVD in LMICs. Methods: In this systematic review, we searched online databases PubMed, Embase, and CINAHL for studies that evaluated a medication adherence intervention for CVD, reported adherence as an outcome measure, were conducted in LMICs and reported the strategy or tool used to measure adherence. We included articles published in English, available in full text, peer-reviewed, and published between 2010 and 2020. Results: We included 45 articles in this review. The majority of the studies implemented counseling and educational interventions led by nurses, pharmacists, or community health workers. Many of the studies delivered medication-taking reminders in the form of phone calls, text messages, short message services (SMS), and in-phone calendars. Multi-component interventions were more effective than unifocal interventions. Interventions involving technology, such as mobile phone calls, electronic pillboxes, and interactive phone SMS reminders, were more effective than generic reminders. The outcomes reported in the studies varied based on the complexity and combination of strategies. When interventions were implemented at both the patient level, such as reminders, and at the provider level, such as team-based care, the effect on medication adherence was larger. Conclusion: In LMICs, medication adherence interventions among persons with CVD included a combination of patient education, reminders, fixed-dose combination therapy and team-based care approach were generally more effective than singular interventions. Among patients who had CVD, the medication adherence interventions were found to be moderately effective. Future studies focusing on improving medication adherence in LMICs should consider non-physician-led interventions and appropriately adapt the interventions to the local context

In vitro study on the hypoglycemic potential of Nicotiana tabacum leaf extracts

Inhibition of some carbohydrate metabolizing enzymes is one of the modes of action of antihyperglycemic agents. The aim of this study was to investigate the in vitro inhibition of α-amylase and α-glucosidase by extracts of N. tabacum leaf. Powdered leaves were extracted with acetone, ethanol and water, and tested for their ability to inhibit α-amylase from Aspergilus oryzae and α-glucosidase from Saccharomyces cerevisae. The results revealed that aqueous extract of the plant was most effective inhibitor of α-amylase (IC50 5.70 mg/mL) while acetone extract exhibited the best inhibitory potential on α-glucosidase (IC50 4.50 mg/mL). Kinetic studies showed that the mode of inhibition of α-amylase by aqueous extract was non-competitive while that of the acetone extract on α-glucosidase was competitive. The observed inhibitions of α-amylase and α-glucosidase suggest that the leaf extracts of N. tabacum may be useful in the management of Diabetes mellitus, which may due to the presence of phytochemicals

eHealth literacy was associated with anxiety and depression during the COVID-19 pandemic in Nigeria: a cross-sectional study

BackgroundElectronic health (eHealth) literacy may play an important role in individuals’ engagement with online mental health-related information.AimTo examine associations between eHealth literacy and psychological outcomes among Nigerians during the Coronavirus disease-2019 (COVID-19) pandemic.MethodsThis was a cross-sectional study among Nigerians conducted using the ‘COVID-19’s impAct on feaR and hEalth (CARE) questionnaire. The exposure: eHealth literacy, was assessed using the eHealth literacy scale, and psychological outcomes were assessed using the PHQ-4 scale, which measured anxiety and depression; and the fear scale to measure fear of COVID-19. We fitted logistic regression models to assess the association of eHealth literacy with anxiety, depression, and fear, adjusting for covariates. We included interaction terms to assess for age, gender, and regional differences. We also assessed participants’ endorsement of strategies for future pandemic preparedness.ResultsThis study involved 590 participants, of which 56% were female, and 38% were 30 years or older. About 83% reported high eHealth literacy, and 55% reported anxiety or depression. High eHealth literacy was associated with a 66% lower likelihood of anxiety (adjusted odds ratio aOR, 0·34; 95% confidence interval, 0·20–0·54) and depression (aOR: 0·34; 95% CI, 0·21–0·56). There were age, gender, and regional differences in the associations between eHealth literacy and psychological outcomes. eHealth-related strategies such as medicine delivery, receiving health information through text messaging, and online courses were highlighted as important for future pandemic preparedness.ConclusionConsidering that mental health and psychological care services are severely lacking in Nigeria, digital health information sources present an opportunity to improve access and delivery of mental health services. The different associations of e-health literacy with psychological well-being between age, gender, and geographic region highlight the urgent need for targeted interventions for vulnerable populations. Policymakers must prioritize digitally backed interventions, such as medicine delivery and health information dissemination through text messaging, to address these disparities and promote equitable mental well-being

Global impacts of Covid-19 on lifestyles and health and preparation preferences: an international survey of 30 countries

Background: The health area being greatest impacted by coronavirus disease 2019 (COVID-19) and residents' perspective to better prepare for future pandemic remain unknown. We aimed to assess and make cross-country and cross-region comparisons of the global impacts of COVID-19 and preparation preferences of pandemic. Methods: We recruited adults in 30 countries covering all World Health Organization (WHO) regions from July 2020 to August 2021. 5 Likert-point scales were used to measure their perceived change in 32 aspects due to COVID-19 (-2 = substantially reduced to 2 = substantially increased) and perceived importance of 13 preparations (1 = not important to 5 = extremely important). Samples were stratified by age and gender in the corresponding countries. Multidimensional preference analysis displays disparities between 30 countries, WHO regions, economic development levels, and COVID-19 severity levels. Results: 16 512 adults participated, with 10 351 females. Among 32 aspects of impact, the most affected were having a meal at home (mean (m) = 0.84, standard error (SE) = 0.01), cooking at home (m = 0.78, SE = 0.01), social activities (m = -0.68, SE = 0.01), duration of screen time (m = 0.67, SE = 0.01), and duration of sitting (m = 0.59, SE = 0.01). Alcohol (m = -0.36, SE = 0.01) and tobacco (m = -0.38, SE = 0.01) consumption declined moderately. Among 13 preparations, respondents rated medicine delivery (m = 3.50, SE = 0.01), getting prescribed medicine in a hospital visit / follow-up in a community pharmacy (m = 3.37, SE = 0.01), and online shopping (m = 3.33, SE = 0.02) as the most important. The multidimensional preference analysis showed the European Region, Region of the Americas, Western Pacific Region and countries with a high-income level or medium to high COVID-19 severity were more adversely impacted on sitting and screen time duration and social activities, whereas other regions and countries experienced more cooking and eating at home. Countries with a high-income level or medium to high COVID-19 severity reported higher perceived mental burden and emotional distress. Except for low- and lower-middle-income countries, medicine delivery was always prioritised. Conclusions: Global increasing sitting and screen time and limiting social activities deserve as much attention as mental health. Besides, the pandemic has ushered in a notable enhancement in lifestyle of home cooking and eating, while simultaneously reducing the consumption of tobacco and alcohol. A health care system and technological infrastructure that facilitate medicine delivery, medicine prescription, and online shopping are priorities for coping with future pandemics