Perception and Healthcare seeking practices regarding dysmenorrhea among public secondary school students in Lagos, Nigeria

Objectives: Dysmenorrhea is an important health problem which may have a negative impact on female health, school activities and psychological status. This study assessed the prevalence, knowledge, perception and healthcare seeking practices of dysmenorrhea among secondary school students in Lagos State, Nigeria. The pattern of management of dysmenorrhea among respondents was also assessed. Methods: A cross-sectional descriptive survey was conducted among 420 adolescents in public secondary schools in Ikeja Local government area of Lagos State, Nigeria. Respondents were interviewed using a structured pretested questionnaire. Data was analyzed with SPSS Version 22.0. The level of statistical significance was set at p<0.05. Results: Mean ± SD age at menarche was 12.3±1.3 years. The prevalence of dysmenorrhea among respondents was 75.2%. About one-quarter 106(25.2%) had good knowledge and 209(49.8%) had good perception of dysmenorrhea. Only 10% had ever sought health care for dysmenorrhea. A statistically significant association was found between the knowledge of respondents and healthcare-seeking behavior towards dysmenorrhea (p = 0.004). Conclusion: The prevalence of dysmenorrhea was high and majority of respondents had poor knowledge. Improving adolescents’ knowledge of dysmenorrhea through health education could positively influence their health care-seeking behavior

Assessment of the effects of cadmium and lead on pH and cation exchange capacity of soil under different plant canopy in the tropical wet-and dry climate

The effects of heavy metals pollution on agricultural produce can not be over emphasize. To estimate the effect of heavy metal on pH and Cation Exchange Capacities of soil on incubation, relationships between availability of metals in soil after contamination were investigated for a range of soils and metals. Three concentrations (0 mg/kg, 2 mg/kg and 5 mg/kg) of lead and cadmium were added as nitrate solution as single and combine treatments to six soil samples under different plant canopy. The soils-metal were incubated at field capacity for 8 weeks under 250C. The exchangeable bases in soils were determined in IM ammonium acetate (pH 7.0) extract by FAAS and pH by pH meter with a combination electrode. The treatment is arranged in randomised complete design each in triplicates. The pH decreased from 7.02 to 6.70 and 6.63. Cation Exchange Capacities decreased from range of of 6.62 to range of 4.71 and 3.10 C mol kg-1 under single and combined treatments respectively for the six locations. These results enable us to understand natural attenuation of metal contamination and also to assess the risk of soil contamination by determining effects of metals reactions with CEC and pH in 8-weeks incubated soils after artificial contamination.Keywords: heavy metals, Incubation process, pH and CE

Knowledge, attitude, and utilization of HIV counseling and testing by female sex workers in Lagos State, Nigeria

Objectives: The Human Immunodeficiency Virus (HIV) epidemic continues to expand among female sex workers (FSWs) who have limited access to and utilization of HIV counseling and testing services (HCT). HCT plays a pivotal role in increasing knowledge and awareness to prevent, treat, and control HIV/AIDS. The study objective was to determine the knowledge, attitude, utilization of HCT among brothel-based FSWs (BBFSWs). Method: This was a descriptive cross-sectional study among 300 BBFSWs in Lagos State. The respondents were recruited by snowballing after a multistage sampling method was used in the selection of the brothels. The data was collected using an adapted interviewer-administered questionnaire and analyzed using IBM SPSS Statistics version 23. The level of statistical significance was set at p<0.05. Results: Majority (63.0%) of the respondents were between the ages of 21-30 years and 67.4% had good knowledge of HIV and HCT. About 75.0% had a positive attitude towards HCT and 55.6% of FSWs in this study had utilized an HCT center in the past. The main reason for not taking HIV test was the fear of a positive result (90.6%) while the main reasons given for not visiting any HCT center were lack of confidentiality (13.3%), stigmatization (14.8%), and distance to the HCT center (67.2%). Conclusion: There was a good knowledge of HCT and a positive attitude towards HCT services by the respondents. The main reasons for not taking the HIV test as indicated by respondents were fear of a positive result. HIV-stigma related issues should be adequately addressed

Variation of interception loss with different plant species at the University of Agriculture, Abeokuta, Nigeria

Interception studies of six plants groups were carried out at the campus of University of Agriculture, Abeokuta in Nigeria, using three different sample sites. These sites were the Arborea plantation, cashew plantation and College of Environmental Resources Management premises of the University. The field work was carried out between 15th June and 28th September, 2009. Of the 22 rainfall events recorded for each plant species, at least 13 produced measurable through fall and stem flow and a maximum of 18 measurable records. Through fall showed a very strong linear correlation against daily rainfall for different plant species. The r2 values varied between 0.841 (Teak) to 0.963 (Gmelina). This trend also followed for stem flow since without rainfall no stem flow. This was not the case for interception loss which showed only a moderate correlation against rainfall amount for each plant species with r2 value ranging from 0.058 (Teak) to 0.716 (Neem). This implied an inverse relationship between interception rate and rainfall amount. Interception ratio for coniferous plants was more than deciduous plants, both having average values of 32.01 and 26.54% respectively when interception loss was considered per storm or event. But when considered at the end of observation, deciduous plants had more interception ratio than the coniferous plants with average interception values of 26.54 and 32.01% respectively. At the end of the observation, the interception loss for each plant, Pinus leuceana sp, cashew, Neem, Gmelina and Teak were 18.77, 21.04, 31.96, 26.16, 11.1 and 38.05% respectively. The values changed when considering average interception loss per storm and the values for the plants species as arranged above were 28.60, 30.18, 31.96, 37.26, 17.78 and 29.89% respectively. This showed that interception loss varied from one plant species to another. With these, one will know which can best be used for conservation purpose.Key words: Through fall, stem flow, canopy

Cardiovascular responses to treadmill exercise in Nigerian hypertensives with left ventricular hypertrophy

Background: Left ventricular hypertrophy (LVH) is an independent risk factor for adverse cardiac outcomes in hypertensive patients.Objective: This study is designed to assess the cardiovascular responses to treadmill exercise among Nigerian hypertensives with echocardiographically proven LVH.Materials and Methods: Fifty hypertensive patients with LVH (27 males and 23 females) between 30 and 65 years of age were studied in Nigeria. 50 hypertensive patients without LVH and 50 normal subjects who were age and sex matched served as controls. All patients and control subjects underwent M-mode, 2-D and Doppler ECHO-studies and the Bruce protocol treadmill exercise test.Results: The study showed that the estimated maximal oxygen consumption (MVO2) in MET reduced progressively from 8.39 ± 1.26 (normotensive control) to 7.62 ± 1.33 (hypertensive without LVH), 6.27 ± 0.99 (hypertensive with LVH) (P<0.0001ANOVA). The duration of exercise (s) was also reduced in that order from 455.4 ± 79.1 to 411.6 ±8 2.3, 315.8 ± 75.6 respectively (P<0.0001). The systolic blood pressure (SBP) and pressure rate product (PRP) during maximal exercise were also increased in hypertensives with LVH and hypertensive without LVH when compared to normotensive controls. The hypertensives with LVH and hypertensives without LVH also showed significant limitation to heart rate increase with exercise compared to normotensive controls (P<0.003).Conclusion: This study demonstrated significant impairment of exercise capacity in hypertensives with or without LVH compared to normotensive subjects. Both earlier recognition and improved understanding of LVH may lead to more effective therapeutic strategies for this cardiovascular risk factor

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

Nigeria’s Fiscal Deficits: A History of its Colonial Foundations, 1899 – 1959

In the last thirty years, deficit financing has become a major impediment to fiscal balance in the administration of public expenditure in Nigeria. From the middle of the 1980s up to the present, the federal government has consistently overspent its actual revenue accruals and have even borrowed in the pursuit of projects for which she has too little revenue backing. In fact, since the beginning of democratic rule in the current fourth republic, government has increasingly failed to balance its budget with grave consequences for price levels, interest rates, inflation and macroeconomic stability. This paper shows that deficit financing of public expenditure by the Nigerian government is however not a recent issue and that it can be traced to the formative years of Nigeria’s public finance in the colonial period. The paper however argues that unlike the current practice, deficit financing was driven more in the colonial period by the need to build an infrastructure base for the economy rather than on personnel and overhead expenses manifested in the lopsided allocation of the greatest proportion of public revenues to the recurrent budget as it is the practice in Nigeria today