Cervical cancer screening and practice in low resource countries: Nigeria as a case study

Cervical cancer is the most common female genital tract malignancy in Nigeria and majority of the patients present with advanced disease. It is a preventable cancer as there are well‑defined treatable premalignant phases. The objective of the study is to review the burden of cervical cancer, its screening modalities, and practice of screening and treatment in low resource countries with emphasis on Nigeria. This is a review involving internet and literature search. While developed countries have recorded significant reduction in the incidence of cervical cancer owing to organizedscreening programs, treatment of premalignant cervical lesions, and follow‑up of treated cases, developing countries including Nigeria are yet to optimally utilize screening services due to lack of organized population‑based screening programs with only pockets of screening services which are at best opportunistic. This has not reduced the incidence of cancer because only a fraction of the target population is covered. Apart from this, loss to follow‑up is rampant. The level of awareness of cervical cancer and its preventive strategies are low among the population and policymakers in Nigeria. There is no organized screening program, and the few services available are only opportunistic with little or no impact. Development of cervical cancer screening policy and institution of organized screening program targeted at covering ≥80% of population at risk is fundamental. There is also a need for widespread education of the populace on the burden of cervical cancer and the public health importance of the disease using the mass media, counseling at antenatal clinics, and the involvement of men will contribute immensely to reduction in the incidence of cervical cancer. Decentralization of services by incorporation of cervical screening and treatment in primary health care programs will ensure adequate rural‑urban coverage.Keywords: Cervical cancer screening; human papillomavirus, low resource countries; Nigeria; premalignant diseas

Live birth after laparotomy for ruptured heterotopic cornual and intrauterine twin gestation in a Spontaneous cycle: A case report and literature review

Background: Heterotopic pregnancy is the coexistence of an intrauterine and extrauterine gestation.It is a rare occurrence especially in a natural conception. Its incidence is however increasing with the advent of  assisted reproductive techniques.Case Presentation: A rare case of triplet heterotopic cornual gestation involving twin intrauterine and a cornual gestation in a spontaneous conception.She presented with an acute abdomen and she had laparotomy with cornual resection.The intrauterine pregnancy remained uneventful till term.Conclusion: Heterotopic pregnancy is a life threatening  condition.Management with laparotomy can result in the survival of the intrauterine gestation till term without adverse outcome.Keywords: Heterotopic gestation,cornual ectopic gestation,term  gestation

Assessment of Work Practices and Health Problems Among Filling Station Attendants in Ile Ife

Background: Filling Station Attendants are exposed to hazards in their workplaces, which could be physical, chemical, ergonomic, biological, mechanical, or psychosocial. The study aimed to assess the work practices and health problems among filling station attendants in Ile-Ife. Methods:  This study was conducted in Ile Ife, Osun State, Nigeria using a descriptive cross-sectional study design. There are 218 filling stations in Ile Ife. The total sampling method was used for selection and a sample size of 200 was obtained. Data was collected via Interviewer administered questionnaires with sections assessing sociodemographic characteristics, work practices, occupational hazards, and health problems using close-ended questions. An observational Checklist assessing the safety measures put in place by the management was also obtained. Data were analyzed using Statistical Package for Social Sciences (SPSS) and a p-value of 0.5 was found to be statistically significant. Results: Majority of the filling station attendants (74%) were not aware of workplace safety practices. Of those that were aware, 78% were aware of PPE while the commonest available PPE was working clothes (36%). One hundred and twelve attendants (56%) indicated that the PPEs available for them were not adequate. Concerning training, about 62.5% had prior safety training of which only 66% and 56% of them could use fire extinguishers and spill kits respectively. Regarding occupational hazards,74.5% of the attendants were aware of the various hazards, the commonest being fire outbreak (69.5). The commonest work-related problem was musculoskeletal disorders (60.5%) while the least common was gastro-intestinal tract problems (8%). There was a significant association between age, working durations of the respondents, and skin problems with p-values of 0.021 and 0.035 respectively. There was also a significant association between BMI and respiratory problems with a p-value of 0.029.  Conclusion: This study assessed work practices and health problems among filling station attendants. There was poor availability of PPE, inadequate use of PPE as well as poor work safety practices among filling station attendants. Regarding health problems, neurological and eye problems were found to be the commonest among filling station attendants in Ile Ife. There were also significant associations between some sociodemographic characteristics and some health         &nbsp

Mixed-methods evaluation of integrating female genital schistosomiasis management within primary healthcare: a pilot intervention in Ogun State, Nigeria

Background: Detection and management of female genital schistosomiasis (FGS) within primary healthcare is crucial for achieving schistosomiasis elimination, however, current technical strategies are not feasible in many settings. In Nigeria, there are currently no established standard operating procedures to support front-line health workers. This article presents an evaluation of piloting an FGS care package in two LGAs of Ogun State, Nigeria. Methods: We used quantitative and qualitative analysis, including 46 interviews with patients, health workers and the quality improvement team; observations of training, learning sessions and supervision across 23 heath facilities; and records of patients detected and managed. Results: Of 79 women and girls who were screened, 66 were treated and followed up. Health workers assimilated knowledge of FGS and effectively diagnosed and managed patients, demonstrating the feasibility of using symptomatic screening and treatment tools to diagnose and care for women or girls with suspected FGS. Challenges included establishing a referral pathway to tertiary care for patients with complications, insecurity, gender norms that limited uptake and sensitization, the limited capacity of the workforce, conflicting priorities and praziquantel acquisition. Conclusions: Simple tools can be used in primary healthcare settings to detect and manage women and girls with FGS. Contextual challenges must be addressed. Sustainability will require political and financial commitments

Next Generation Nanochitosan Applications in Animal Husbandry, Aquaculture and Food Conservation

Studies have identified the properties of enzymes, functionalized molecules, and compounds in food industry applications as edible coatings and encapsulations, that assure prolonged food quality and standards. These molecules present benefits of longer shelf-life by delayed deterioration and inhibition of the proliferation of spoilage and mycotoxigenic microorganisms. However, challenges of reduced nutrient levels, miniaturized size, and low chemical stability remain concerning. Chitosan polymers naturally formed from the deacetylation of shellfish shells and exoskeletons of aquatic arthropods and crustaceans offer improved benefits when functionalized into nanoparticles as nanochitosans. These polysaccharides produced by the alkalescent deacetylation of chitin, comprise a series of 2-deoxy-2 (acetylamino) glucose linked by ß-(1- 4) glycosidic linkages. This chapter considers the health impacts and microbiological health hazards associated with animal feeds quality and the enzyme immobilization potentials of nanochitosans in animalbased food and feed packages. Thereafter, nanochitosan properties and benefits are compared against traditional preservatives from microbes and plants; with highlights on current challenges in the application of nanochitosan for enzyme immobilization

Chapter 21 - Utilization of nanochitosan in the sterilization of ponds and water treatment for aquaculture

Water pollution constitutes the leading cause of infant mortality, neonatal deformities, and shrinkage of man’s average life expectancy. Pollutants come from point and nonpoint sources; and water pollution arises from the discharge of wastewater containing undesirable impurities used for domestic, agricultural, and industrial purposes. More so, high nutrient and wastewater runoffs from fish production systems contribute to the fouling and eutrophication of recipient water bodies. Hence, aquaculture which is inextricably linked to the natural environment is challenged by the dearth of appropriate water quantity and quality, militating against fish, and fishery production. Nanochitosans as polysaccharides produced by the alkalescent deacetylation of chitin, comprise a series of 2-deoxy-2 (acetylamino) glucose linked by ß-(1-4) glycosidic linkages. They are naturally formed from the deacetylation of shellfish shells and exoskeletons of aquatic arthropods and crustaceans. The unique attributes of chitin confer a wide range of biotechnological applications on the polymer, observed in flocculation as a wastewater treatment and purification route initiated by chitosan. This chapter highlights nanochitosan properties of aquaculture relevance; and elucidates the purification potentials of nanochitosan, compared to inorganic coagulants and organic polymeric flocculants. Effects of chitosan on contaminants and microorganisms, as well as applications in fish pathogens detection, fish disease diagnosis, and control are discussed

Utilization of nanochitosan for enzyme immobilization of aquatic and animal-based food packages

Studies have identified the properties of enzymes, functionalized molecules, and compounds in food industry applications as edible coatings and encapsulations, that assure prolonged food quality and standards. These molecules present benefits of longer shelf-life by delayed deterioration and inhibition of the proliferation of spoilage and mycotoxigenic microorganisms. However, challenges of reduced nutrient levels, miniaturized size, and low chemical stability remain concerning. Chitosan polymers naturally formed from the deacetylation of shellfish shells and exoskeletons of aquatic arthropods and crustaceans offer improved benefits when functionalized into nanoparticles as nanochitosans. These polysaccharides produced by the alkalescent deacetylation of chitin, comprise a series of 2-deoxy-2 (acetylamino) glucose linked by ß-(1-4) glycosidic linkages. This chapter considers the health impacts and

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Exchange Characteristics of Lead, Zinc, and Cadmium in Selected Tropical Soils

Conducting binary-exchange experiments is a common way to identify cationic preferences of exchangeable phases in soil. Cation exchange reactions and thermodynamic studies of Pb 2+ /Ca 2+ , Cd 2+ /Ca 2+ , and Zn 2+ /Ca 2+ were carried out on three surface (0-30 cm) soil samples from Adamawa and Niger States in Nigeria using the batch method. The physicochemical properties studies of the soils showed that the soils have neutral pH values, low organic matter contents, low exchangeable bases, and low effective cation exchange capacity (mean: 3.27 cmolc kg −1 ) but relatively high base saturations (≫50%) with an average of 75.9%. The amount of cations sorbed in all cases did not exceed the soils cation exchange capacity (CEC) values, except for Pb sorption in the entisol-AD2 and alfisol-AD3, where the CEC were exceeded at high Pb loading. Calculated selectivity coefficients were greater than unity across a wide range of exchanger phase composition, indicating a preference for these cations over Ca 2+ . The eq values obtained in this work were all positive, indicating that the exchange reactions were favoured and equally feasible. These values indicated that the Ca/soil systems were readily converted to the cation/soil system. The thermodynamic parameters calculated for the exchange of these cations were generally low, but values suggest spontaneous reactions