Omentoplasty as an effective surgical modality for managing a high risk patient with deep sternal wound infection

Poorly managed diabetes and hypertensives are risk factors for deep sternal wound infection (DSWI) following cardiac surgery; leading to increased morbidity and mortality. To reappraise the effectiveness of omental flap in the management of High risk patient with DSWI. A middle aged man with extensive mediastinitis following cardiac surgery (from outside referral). He was a known Diabetic and Hypertensive who was poorly compliant on medications. The history, physical examination, gycosylated Haemoglobin (HbA1c) and microbiological analyses showed high blood pressure, poor glycaemic control, septicaemia with staphylococcal DSWI. Resuscitation was achieved with the use of oral antihypertensives, Human insulin and antibiotics respectively. The DSWI was managed with serial debridement and subsequent wound cover with omental flap. The hospital stay was shorter and outcome was good. The management of DSWI with omental flap may be an effective surgical modality that reduces morbidity and mortality even in high risk patients

Prevalence of scientific misconduct among a group of researchers in Nigeria

BACKGROUND : There is a dearth of information on the prevalence of scientific misconduct from Nigeria. OBJECTIVES : This study aimed at determining the prevalence of scientific misconduct in a group of researchers in Nigeria. Factors associated with the prevalence were ascertained. METHOD : A descriptive study of researchers who attended a scientific conference in 2010 was conducted using the adapted Scientific Misconduct Questionnaire-Revised (SMQ-R). RESULTS : Ninety-one researchers (68.9%) admitted having committed at least one of the eight listed forms of scientific misconduct. Disagreement about authorship was the most common form of misconduct committed (36.4%) while plagiarism was the least (9.2%). About 42% of researchers had committed falsification of data or plagiarism. Analysis of specific acts of misconduct showed that committing plagiarism was inversely associated with years in research (Fisher exact p-value = 0.02); falsifying data was related to perceived low effectiveness of the institution’s rules and procedures for reducing scientific misconduct (X2 = 6.44, p-value = 0.01); and succumbing to pressure from study sponsor to engage in unethical practice was related to sex of researcher (Fisher exact p-value = 0.02). CONCLUSIONS : The emergent data from this study is a cause for serious concern and calls for prompt intervention. The best response to reducing scientific misconduct will proceed from measures that contain both elements of prevention and enforcement. Training on research ethics has to be integrated into the curriculum of undergraduate and postgraduate students while provision should be made for in-service training of researchers. Penalties against acts of scientific misconduct should be enforced at institutional and national levels.Fogarty International Center, National Institute of Health, Grant number 2R25TW0 1599-10 through the South African Research Ethics Training Initiative SARETI.http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1471-8847hb2014ay201

Misconduct in research : a descriptive survey of attitudes, perceptions and associated factors in a developing country

BACKGROUND : Misconduct in research tarnishes the reputation, credibility and integrity of research institutions. Studies on research or scientific misconduct are still novel in developing countries. In this study, we report on the attitudes, perceptions and factors related to the work environment thought to be associated with research misconduct in a group of researchers in Nigeria - a developing country. METHOD : A survey of researchers attending a scientific conference was done using an adapted Scientific Misconduct Questionnaire-Revised (SMQ-R). Initial descriptive analysis of individual items using frequencies and proportions for all quantitative data was performed. Thereafter, Likert scale responses were transformed into dichotomous responses. Fisher exact test was performed for associations as appropriate. A two-tailed p-value of less than 0.05 was accepted as significant. RESULT : Half of the respondents (50.4%) were aware of a colleague who had committed misconduct, defined as “non-adherence to rules, regulations, guidelines, and commonly accepted professional codes or norms”. Over 88% of the researchers were concerned about the perceived amount of misconduct prevalent in their institution and 96.2% believed that one or more forms of scientific misconduct had occurred in their workplace. More than half (52.7%) rated the severity of penalties for scientific misconduct in their work environment as low. Furthermore¸ the majority (56.1%) were of the view that the chance of getting caught for scientific misconduct in their work environment was low. CONCLUSION : Researchers in Nigeria perceive that scientific misconduct is commonplace in their institutions, but are however worried about the negative effects of scientific misconduct on the credibility of scientific research. We recommend that researchers be empowered with the knowledge and virtues necessary for self-regulation that advance research integrity. Research institutions should however also step into their role of fostering a responsible research ethic and discouraging misconduct.A grant from the Fogarty International Center, National Institute of Health, Grant number 2R25TW0 1599–10 through the South African Research Ethics Training Initiative SARETI.http://www.biomedcentral.com/bmcmedethicsam201

Parents’ Knowledge, Attitudes and Use of Antibiotics in Upper Respiratory Infections in Nigerian Children

Parental knowledge of antibiotic use in upper respiratory tract infections (URTI) impacts significantly in the preservation of antibiotic efficacy, yet has not been adequately studied in Nigerian settings. This present study evaluated the knowledge, attitudes and self-medicating practices of caregivers towards the use of antibiotics in URTI among children. The study was a cross-sectional and prospective survey. Parents visiting two hospitals (Nsukka General Hospital - rural and Enugu State University of Technology Teaching Hospital- urban) with their sick children (12 years and under) were approached to complete a 24-item questionnaire. The items assessed parental knowledge of, attitudes and self-medicating practices towards antibiotics in cases of URTI. Frequencies, means and inferential multivariate (chi-square, t-tests and regression) data analysis were conducted. The parents exhibited poor knowledge in most of the knowledge items. Younger parents, those visiting the urban hospital and those with higher educational status exhibited significantly better knowledge of antibiotics and URTI (p<0.05). The parents indicated marginally accepting attitudes towards antibiotics use and misuse and this was influenced largely by better antibiotic knowledge and better educational qualifications (p<0.001). However parents from both hospitals frequently self-medicated (88.6%) and acknowledged poor practices towards antibiotics such as the use of left over antibiotics. Majority (85%) of the parents also said they received antibiotics after they demanded it from their physicians. Parents in these study settings in Nigeria, possessed poor knowledge and positive attitudes of antibiotic use in their children, and exhibited poor practices when utilizing them

Natural resource rent and stakeholder politics in Africa: towards a new conceptualisation

YesThis paper critically revisits the debate on natural resource rent, curse and conflict, interrogating some of the key assumptions that have become received knowledge in extant discourses. The paper demonstrates how orthodox theories’ preoccupation with issues of resource rent and resource curse tend to be marred by slants of ahistoricity and state-centricity. Adopting a stakeholder approach to the issues of resource rent and conflict in Africa, the author argues that natural resource rents produce and attract a multiplicity of competitive stakeholders, both domestic and external, in the resource-rich states. The competition and jostling of stakeholders for access to, and appropriation of, rentier resources is too often an antagonistic process in many emerging economies that has consequences and implications for violent conflict. The paper attempts a new conceptual explanation of how natural resource rents dialectically generate stakes, stakeholders and political conflict. The paper concludes by proposing the need for the more conflict-prone African rentier states to transition to a more functional state model, the transformative state

Natural resource rent and stakeholder politics in Africa: towards a new conceptualisation

YesThis paper critically revisits the debate on natural resource rent, curse and conflict, interrogating some of the key assumptions that have become received knowledge in extant discourses. The paper demonstrates how orthodox theories’ preoccupation with issues of resource rent and resource curse tend to be marred by slants of ahistoricity and state-centricity. Adopting a stakeholder approach to the issues of resource rent and conflict in Africa, the author argues that natural resource rents produce and attract a multiplicity of competitive stakeholders, both domestic and external, in the resource-rich states. The competition and jostling of stakeholders for access to, and appropriation of, rentier resources is too often an antagonistic process in many emerging economies that has consequences and implications for violent conflict. The paper attempts a new conceptual explanation of how natural resource rents dialectically generate stakes, stakeholders and political conflict. The paper concludes by proposing the need for the more conflict-prone African rentier states to transition to a more functional state model, the transformative state

Effects of palm kernel cake supplement on fatty acid profile and milk composition of lactating wad goats fed grass silage

The scarcity of quality feed and cost-effective supplements necessitates verifiable concentrate as a supplement for goat milk production. Palm Kernel Cake (PKC), an oil palm by-product rich in protein and energy, gradually replaced Prepared Concentrate (PC) in this study. This replacement's impact on milk composition and fatty acid profile in lactating WAD goats fed grass silage basal diet was assessed. Five supplement concentrates with varying PC: PKC ratios (100:0, 75:25, 50:50, 25:75, 0:100) were fed to 25 lactating WAD goats in a randomized setting of 5 animals per group. The replacement significantly affected (p<0.05) milk fat, protein, specific gravity, ash, and fat-corrected milk. The highest milk fat (2.17%) came from 100% PKC supplementation, while the lowest (0.77%) came from 25% PKC. Total solid fat values were not significantly affected. Fat Corrected Milk results mirrored the milk fat trend. The 100% PKC group had the highest crude protein (8.22%), while 25% and 75%PKC were not different (p<0.05). Fatty acid profile, expressed as total Fatty Acid Methyl Esters (FAMEs) g/kg, showed increased medium and long-chain fatty acids as PC was replaced. In conclusion, 100% PKC supplementation enhanced milk fat, while 50% PC replacement increased long-chain polyunsaturated fatty acids in goat mil

Clinical implementation of pre-treatment DPYD genotyping in capecitabine-treated metastatic breast cancer patients

Purpose Metastatic breast cancer (mBC) patients with DPYD genetic variants linked to loss of dihydropyrimidine dehydrogenase (DPD) activity are at risk of severe capecitabine-associated toxicities. However, prospective DPYD genotyping has not yet been implemented in routine clinical practice. Following a previous internal review in which two patients underwent lengthy hospitalisations whilst receiving capecitabine, and were subsequently found to be DPD deficient, we initiated routine DPYD genotyping prior to starting capecitabine. This study evaluates the clinical application of routine DPYD screening at a large cancer centre in London. Methods We reviewed medical records for consecutive patients with mBC who underwent DPYD genotyping before commencing capecitabine between December 2014 and December 2017. Patients were tested for four DPYD variants associated with reduced DPD activity. Results Sixty-six patients underwent DPYD testing. Five (8.4%) patients were found to carry DPYD genetic polymorphisms associated with reduced DPD activity; of these, two received dose-reduced capecitabine. Of the 61 patients with DPYD wild-type, 14 (23%) experienced grade 3 toxicities which involved palmar–plantar erythrodysesthesia (65%), and gastrointestinal toxicities (35%); no patient was hospitalised due to toxicity. Conclusions Prospective DPYD genotyping can be successfully implemented in routine clinical practice and can reduce the risk of severe fluoropyrimidine toxicities