Safety of the surgeon: ‘Double-gloving’ during surgical procedures

Background. In the face of increasing HIV/AIDS prevalence in subSaharan Africa, we evaluate the effectiveness of ‘doublegloving’ during surgery as a means of protecting the surgeon operating on patients with a known or unknown HIV status.Methods. A prospective study was conducted to determine the rate of glove puncture and intraoperative injury in categories of patients with known positive, known negative or unknown HIV status.Results. The surgeon and the first assistant double-gloved in all the 1 050 procedures performed between 2009 and 2013, and a total of 8 400 surgical gloves were used. Sixty-nine patients (6.6%) were HIV-positive, 29 patients (2.8%) were HIV-negative, and the HIV status was unknown for the remaining 952 patients (90.7%). The overall glove puncture rate in the study was 14.5%. The glove puncture rate was 0%, 31% and 15% for HIV-positive, HIV-negative and HIV status unknown, respectively, and thisdifference was statistically significant. The mean operating time in the  group with glove punctures was 148 min (95% confidence interval (CI) 135 - 161), while mean operating time in the group without glove puncture was 88 min (95% CI 84 - 92).Conclusion. Double-gloving offers protection against intraoperative injury. Knowing the HIV status of the patient offers additional protection to the operating surgeon. While we recommend routine double-gloving for surgeons working in HIVprevalent patient populations, we also advocate for the routine screening for HIV in all surgical patients

A review of the management of perforated duodenal ulcers at a tertiary hospital in south western Nigeria

Background: Gastro-duodenal perforations are common and may complicate peptic ulcer disease. Management is often by surgical closure.Objective: To determine the patterns of presentation and mode of management of duodenal ulcer perforations.Methods: Retrospective review of patients with duodenal ulcer perforations seen at the Obafemi Awolowo University Teaching Hospital between June 2001 and July 2011. Patients’ records were reviewed for demography, duration of disease, probable risk factors, type of surgery and complications. Data obtained was analyzed using SPSS 15.0.Result: Forty- five patients were reviewed. There were 37 males (82.2%). Mean age was 39.7years (range 15-78years). There were 10 (22.6%) students and 8(17.8%) farmers. NSAIDs abuse (11), previous peptic ulcer disease (2), and no prior dyspeptic symptoms (20) constituted 24.4%, 4.4% and 44.4% respectively of cases. Seven (16%) patients presented less than 24 hours of onset of illness. Forty one perforations (91.1%) involved the first part of duodenum. Twenty two (49%) patients had Graham’s omental patch. We had one (2.2%) failed repair and six (13.3%) mortalities. Conclusion: Late presentation of duodenal ulcer perforation is common with high mortality. Pragmatic surgical intervention with Graham’s omentopexy with broad spectrum antibiotics is still commonly practiced.Keywords: Duodenal ulcers, perforations, management, NigeriaAfrican Health Sciences Vol 13 Issue 4 December 201

AWARENESS AND WILLINGNESS TO PAY FOR ORGANIC VEGETABLES AMONG FARMING HOUSEHOLDS IN ANAMBRA STATE, NIGERIA

The aim of the study was to analyze awareness and willingness to pay (WTP) for organic vegetables among households in Anambra State, Nigeria. Analysis of data was done using descriptive statistics such as frequency and percentages, and Contingent Valuation Method. One hundred and forty (140) respondents were utilized for the study but with a valid response rate of 85.7 percent to give one hundred and twenty (120) respondents sampled from the study area using multistage sampling procedure. Data used for the research was obtained with the aid of a well-structured questionnaire. The most commonly consumed vegetables were pumpkin (59.17%), garden egg (28.33%), cucumber (8.33%) and amaranth (4.17%). The respondents were aware (95.83%) of the health benefits of organic vegetables and also aware (71.7%) of environmental effects of using inorganic fertilizer for vegetable production. In the WTP for organic vegetables, it was observed that 21.7% of the respondents were not WTP for organic garden egg, while 78.3% of the respondents were WTP a premium for a kg of organic garden egg. About 8.3% of the respondents were not WTP for organic pumpkin while 91.7% of them were WTP a premium for organic pumpkin. The analysis showed that in households WTP for organic garden egg, factors such as age, health, education, and awareness were significant, while WTP an amount was also significantly influenced by the same set of variables. Also, while willingness to pay for organic pumpkin was significantly influenced by health, education and awareness, WTP an amount was significantly influenced by health, education and awareness. There is need for public awareness by the media and organic Non- Government Organizations to create more programmes that will educate consumers on the health and environmental advantages of organic farming and consumption patterns over conventional practices. With this, more consumers will be willing to pay a premium for organic vegetables