Evaluation of lumbar angles and their clinical correlates in a Nigerian population

Background: There is paucity of data on the geometric angles of the lumbosacral spine in Nigeria and other African countries. The objective was to study the lumbar angles in our population and causes of variations if any.Methods: The lateral views of the lumbosacral spine radiographs of 300 Nigerian subjects were studied. The lumbar angles measured were lumbosacral angle (LSA), Lumbar lordosis angle (LLA), Sacral inclination angle (SIA) and lumbosacral disc angle (LSDA). The demographics and anthropometric measurements of the subjects such as weight, height, body mass index (BMI), hip circumference (HC), waist circumference (WC) and waist-hip ratio (WHR) were also recorded.Results: The mean values of the angles were as follows: LSA=37.80±9.20; LLA=40.40±11.20; SIA=38.70±8.90 and LSDA=14.60±3.40. There was a positive correlation between the weight, BMI, HC and WC of the subjects and LSA. A significant association was noted between the height, weight, BMI, HC, WC and WHR of the subjects and LLA. Whereas SIA was significantly affected by sex, weight, BMI, HC and WC of the subjects, LSDA was determined by age, BMI, WC and WHR.Conclusion: The mean values of these angles may form the reference values for the Nigerian population. Overweight and obesity were associated with increased lumbar angles

Factors associated with low rate of exclusive breastfeeding among mothers in Enugu, Nigeria

Background: Exclusive breastfeeding has proven to be beneficial both maternal and child health hence its adopted as a policy for infant feeding in most countries especially developing nations. Its practice has remained low despite the high levels of awareness of exclusive breastfeeding. The study set out to find out the possible reasons that have limited the translation of knowledge of exclusive breastfeeding to action by nursing mothers in an urban city in Nigeria.Methods: A self-administered structured questionnaire was used to collect data from 304 mothers attending immunization clinics of the Institute of maternal and child health in Enugu, Southeast Nigeria.Results: Awareness of exclusive breastfeeding was 98% with an exclusive breastfeeding rate of 26%. The commonest non-human milk given to infant was water- given in the first week of life. Post-natal support from lactation experts and family, beliefs about the sufficiency of human milk and subsequent refusal of complementary foods were major challenges to successful exclusive breastfeeding. Maternal age and education did not determine exclusive breastfeeding.Conclusions: Exclusive breastfeeding rates have remained low in Nigeria. Lack of family support and the belief that human milk is not sufficient food for the less-than-six-months-old infant were major challenges to exclusive breastfeeding

Project Selection and Transparency Factors in Housing Public-Private Partnerships in Nigeria

The application of Public-Private Partners (PPPs) in housing provisioning is on the increase across the world. However, there is a paucity of empirical studies on the specific factors considered at the initiation, and measures taken to ensure transparency at the procurement stages, of PPP housing projects. This study examined project selection factors and transparency measures in PPP housing projects using data sourced from oral interviews with 27 experts in nine PPP housing schemes in Nigeria. Results of the content analysis revealed that the top two selection factors considered by both the public and private sector operators of PPP housing projects in Nigeria are the availability of land and viability of the funding arrangements. Whereas the public-sector partners also consider the availability of competent private sector to deliver the projects, the private developers are concerned with the location of proposed projects. It was also found that the two key measures taken to ensure transparency at the procurement stage of the projects are transparent and competitive bidding and open advertisements of tender opportunities. These imply that before embarking on PPP housing projects, operators should ensure that there is available land in good locations, sound funding arrangements, and measures for achieving transparency in the schemes

Tenofovir-silver nanoparticles conjugate ameliorates neurocognitive disorders and protects ultrastructural and cytoarchitectonic properties of the prefrontal cortex in diabetic rats

Tenofovir disoproxil fumarate (TDF) is the highly recommended antiretroviral drug in human immunodeficiency virus management. Although research has shown the neurological and metabolic disorders associated with TDF administration, the effect of TDF-silver nanoparticles conjugate (TDF-AgNPs) on the disorders has not been fully elucidated. Thus, this study evaluated the neuroprotective effects of TDF-AgNPs on ultrastructural and cytoarchitectonic properties of the prefrontal cortex (PFC) in diabetic rats. Forty-two adult male Sprague-Dawley rats (250 ± 13 g) were randomly divided into non-diabetic groups (1-3) and diabetic groups (4-6), each administered distilled water (0.5 ml/100g, p.o), TDF (26.8 mg/kg/bw, p.o) or TDF-AgNPs (6.7 mg/kg, i.p). After eight weeks of administration, cognitive function, oxidative injury and tissue inflammation were evaluated. Also, PFC ultrastructure was observed using transmission electron microscopy, Nissl staining and immunohistochemistry. Diabetic rats administered TDF exhibited cognitive deficits; and increases in blood glucose, malondialdehyde and interleukin-1 beta (IL-1β) levels, which correlate with decreases in glutathione level, and superoxide dismutase (SOD) and catalase activities. Furthermore, loss of PFC astrocytes and neuronal organelles was observed. Conversely, TDF-AgNPs administration to diabetic rats improved cognitive deficits; and increased glutathione, SOD, and catalase, but reduced PFC malondialdehyde and IL-1β concentrations. Notably, TDF-AgNPs prevented loss of PFC neurons and astrocytic cells, and morphology aberration of neuronal organelles. This study suggests that TDF-AgNPs attenuated cognitive deficits via silver nanoparticles' antioxidant and anti-inflammatory properties, preventing the loss of PFC astrocytes and neurons. The TDF-AgNPs may be utilized to ameliorate the neurological dysfunction caused by prolonged TDF administration

A scoping review comparing two common surgical approaches to the hip for hemiarthroplasty

Hemiarthroplasty for hip fracture is a common surgical procedure. A number of distinct approaches are used to access the hip joint. The most commonly used are the direct lateral approach (DLA), and the posterior approach (PA). Internationally there is little consensus on which of these approaches to use. Current guidance is based on a limited selection of evidence and choice of approach is frequently based on surgeon preference. Historically, recommendations have been made based on dislocation rates. In light of technical advancements and greater recognition of patient priorities, outcomes such as post-operative function and pain may be considered more important in the modern context. The aim of this scoping review was to summarise the literature pertaining to the comparison of common surgical approaches to the hip for hemiarthroplasty.This article is freely available via Open Access. Click on the Additional Link above to access the full-text via the publisher's site.Publishe

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

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

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