Organic Fertilizer: The Underestimated Component in Agricultural Transformation Initiatives for Sustainable Small Holder Farming in Nigeria

Emphasis on increase agricultural productivity of small holder rural peasants from the perspective of soil conditioning has been on chemical fertilizer while the impact of the bio-organic input has been neglected. This paper examines this issue through a combination of review of available literature and a micro survey of 120 farmers purposively selected from Sabon-gari local government area of Kaduna state, Nigeria. Using a checklist of questions, data were collected for three farming seasons and simple descriptive techniques were employed in data analysis. The study reveals that acreage among the respondents was very small (2-5 acres mostly) and this has no significant impact on chemical fertilizer utilization. Organic fertilizers used include soil from waste dumpsite, cattle and poultry waste and crop residues. These nonchemical fertilizers are consistently used (>50%) and the costs are cheaper than the chemical fertilizers though with some drawbacks such as not being readily available in required quantity and longer duration of releasing nutrients required by plants. To maximise overall socioeconomic and environmental benefits of organic fertilizers, the recommendations proffered include developing an integrated multidisciplinary soil fertility restoration that will incorporate farmers’ perception into mainstream research; implementing a reward system for farmers and researchers who utilize inorganic fertilizers.Key words: Organic input, environmental remediation, food security, small-holder rural farmers, sustainable agriculture, agricultural transformatio

Interactive Effect of Air-Water Ratio and Temperature on the Air Stripping of Benzene

High cost of pilot scale studies has led engineers to use simulation to study the factors that affect process performance. This study focuses on the interactive effect of air-water ratio and temperature on the removal of volatile organic compounds from polluted water using packed column air stripper taking benzene as a case study. The process governing equations developed based on two-film model of mass transfer were solved using MATLAB and a surface response plot was done. The mass transfer coefficient increased from 0.1237x10-5 to 0.1932x10-5 s-1 as the temperature was raised from 293 to 323 K. Also, the Henry’s constant increased from 228.59 to 883.36 K as the temperature was raised from 293 to 323 K. Benzene removal efficiencies of over 99% were obtained for all combinations of temperature and air-water ratio. The result also indicated that air stripping of benzene from wastewater is most dependent on temperature and moderately on air-water ratio.KEYWORDS: Interactive effect, air-water ratio, temperature, volatile organic compounds, removal efficienc

Cardiovascular and renal outcomes of renin-angiotensin system blockade in adult patients with diabetes mellitus: a systematic review with network meta-analyses

Medications aimed at inhibiting the renin-angiotensin system (RAS) have been used extensively for preventing cardiovascular and renal complications in patients with diabetes, but data that compare their clinical effectiveness are limited. We aimed to compare the effects of classes of RAS blockers on cardiovascular and renal outcomes in adults with diabetes

Management of cardiac health in trastuzumab-treated patients with breast cancer: updated United Kingdom National Cancer Research Institute recommendations for monitoring

More women are living with and surviving breast cancer, because of improvements in breast cancer care. Trastuzumab (Herceptin®▾) has significantly improved outcomes for women with HER2-positive tumours. Concerns about the cardiac effects of trastuzumab (which fundamentally differ from the permanent myocyte loss associated with anthracyclines) led to the development of cardiac guidelines for adjuvant trials, which are used to monitor patient safety in clinical practice. Clinical experience has shown that the trial protocols are not truly applicable to the breast cancer population as a whole, and exclude some women from receiving trastuzumab, even though they might benefit from treatment without long-term adverse cardiac sequelae. Consequently, five oncologists who recruited patients to trastuzumab trials, some cardiologists with whom they work, and a cardiovascular lead general practitioner reviewed the current cardiac guidelines in the light of recent safety data and their experience with adjuvant trastuzumab. The group devised recommendations that promote proactive pharmacological management of cardiac function in trastuzumab-treated patients, and that apply to all patients who are likely to receive standard cytotoxic chemotherapy. Key recommendations include: a monitoring schedule that assesses baseline and on-treatment cardiac function and potentially reduces the overall number of assessments required; intervention strategies with cardiovascular medication to improve cardiac status before, during, and after treatment; simplified rules for starting, interrupting and discontinuing trastuzumab; and a multidisciplinary approach to breast cancer care

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Epidemiology of neurodegenerative diseases in sub-Saharan Africa: a systematic review

BACKGROUND:Sub-Saharan African (SSA) countries are experiencing rapid transitions with increased life expectancy. As a result the burden of age-related conditions such as neurodegenerative diseases might be increasing. We conducted a systematic review of published studies on common neurodegenerative diseases, and HIV-related neurocognitive impairment in SSA, in order to identify research gaps and inform prevention and control solutions. METHODS: We searched MEDLINE via PubMed, 'Banque de Donnees de Sante Publique' and the database of the 'Institut d'Epidemiologie Neurologique et de Neurologie Tropicale' from inception to February 2013 for published original studies from SSA on neurodegenerative diseases and HIV-related neurocognitive impairment. Screening and data extraction were conducted by two investigators. Bibliographies and citations of eligible studies were investigated. RESULTS: In all 144 publications reporting on dementia (n=49 publications, mainly Alzheimer disease), Parkinsonism (PD, n=20), HIV-related neurocognitive impairment (n=47), Huntington disease (HD, n=19), amyotrophic lateral sclerosis (ALS, n=15), cerebellar degeneration (n=4) and Lewy body dementia (n=1). Of these studies, largely based on prevalent cases from retrospective data on urban populations, half originated from Nigeria and South Africa. The prevalence of dementia (Alzheimer disease) varied between <1% and 10.1% (0.7% and 5.6%) in population-based studies and from <1% to 47.8% in hospital-based studies. Incidence of dementia (Alzheimer disease) ranged from 8.7 to 21.8/1000/year (9.5 to 11.1), and major risk factors were advanced age and female sex. HIV-related neurocognitive impairment's prevalence (all from hospital-based studies) ranged from <1% to 80%. Population-based prevalence of PD and ALS varied from 10 to 235/100,000, and from 5 to 15/100,000 respectively while that for Huntington disease was 3.5/100,000. Equivalent figures for hospital based studies were the following: PD (0.41 to 7.2%), ALS (0.2 to 8.0/1000), and HD (0.2/100,000 to 46.0/100,000). CONCLUSIONS: The body of literature on neurodegenerative disorders in SSA is large with regard to dementia and HIV-related neurocognitive disorders but limited for other neurodegenerative disorders. Shortcomings include few population-based studies, heterogeneous diagnostic criteria and uneven representation of countries on the continent. There are important knowledge gaps that need urgent action, in order to prepare the sub-continent for the anticipated local surge in neurodegenerative diseases

Global, regional, and national progress towards Sustainable Development Goal 3.2 for neonatal and child health: all-cause and cause-specific mortality findings from the Global Burden of Disease Study 2019

Background Sustainable Development Goal 3.2 has targeted elimination of preventable child mortality, reduction of neonatal death to less than 12 per 1000 livebirths, and reduction of death of children younger than 5 years to less than 25 per 1000 livebirths, for each country by 2030. To understand current rates, recent trends, and potential trajectories of child mortality for the next decade, we present the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 findings for all-cause mortality and cause-specific mortality in children younger than 5 years of age, with multiple scenarios for child mortality in 2030 that include the consideration of potential effects of COVID-19, and a novel framework for quantifying optimal child survival. Methods We completed all-cause mortality and cause-specific mortality analyses from 204 countries and territories for detailed age groups separately, with aggregated mortality probabilities per 1000 livebirths computed for neonatal mortality rate (NMR) and under-5 mortality rate (USMR). Scenarios for 2030 represent different potential trajectories, notably including potential effects of the COVID-19 pandemic and the potential impact of improvements preferentially targeting neonatal survival. Optimal child survival metrics were developed by age, sex, and cause of death across all GBD location-years. The first metric is a global optimum and is based on the lowest observed mortality, and the second is a survival potential frontier that is based on stochastic frontier analysis of observed mortality and Healthcare Access and Quality Index. Findings Global U5MR decreased from 71.2 deaths per 1000 livebirths (95% uncertainty interval WI] 68.3-74-0) in 2000 to 37.1 (33.2-41.7) in 2019 while global NMR correspondingly declined more slowly from 28.0 deaths per 1000 live births (26.8-29-5) in 2000 to 17.9 (16.3-19-8) in 2019. In 2019,136 (67%) of 204 countries had a USMR at or below the SDG 3.2 threshold and 133 (65%) had an NMR at or below the SDG 3.2 threshold, and the reference scenario suggests that by 2030,154 (75%) of all countries could meet the U5MR targets, and 139 (68%) could meet the NMR targets. Deaths of children younger than 5 years totalled 9.65 million (95% UI 9.05-10.30) in 2000 and 5.05 million (4.27-6.02) in 2019, with the neonatal fraction of these deaths increasing from 39% (3.76 million 95% UI 3.53-4.021) in 2000 to 48% (2.42 million; 2.06-2.86) in 2019. NMR and U5MR were generally higher in males than in females, although there was no statistically significant difference at the global level. Neonatal disorders remained the leading cause of death in children younger than 5 years in 2019, followed by lower respiratory infections, diarrhoeal diseases, congenital birth defects, and malaria. The global optimum analysis suggests NMR could be reduced to as low as 0.80 (95% UI 0.71-0.86) deaths per 1000 livebirths and U5MR to 1.44 (95% UI 1-27-1.58) deaths per 1000 livebirths, and in 2019, there were as many as 1.87 million (95% UI 1-35-2.58; 37% 95% UI 32-43]) of 5.05 million more deaths of children younger than 5 years than the survival potential frontier. Interpretation Global child mortality declined by almost half between 2000 and 2019, but progress remains slower in neonates and 65 (32%) of 204 countries, mostly in sub-Saharan Africa and south Asia, are not on track to meet either SDG 3.2 target by 2030. Focused improvements in perinatal and newborn care, continued and expanded delivery of essential interventions such as vaccination and infection prevention, an enhanced focus on equity, continued focus on poverty reduction and education, and investment in strengthening health systems across the development spectrum have the potential to substantially improve USMR. Given the widespread effects of COVID-19, considerable effort will be required to maintain and accelerate progress. Copyright (C) 2021 The Author(s). Published by Elsevier Ltd

Fertilizer inaccessibility, rural livelihood and sustainable agriculture in Kaduna State: a participatory appraisal

Inaccessibility of chemical fertilizer results in low level of productivity among farmers, Apart from low productivity it has other impacts on rural livelihood and the environmental dynamics, which have not been thoroughly investigated. Inorganic fertilizers have become a major source of soil nutrient improvement for many farmers but its high cost usually makes it inaccessible to many farmers. The main purpose of the study is to analyse the socio-economic inaccessibility of chemical fertilizer and itsconsequences on sustainable rural and environment development. A participatory appraisal methodology was adopted. The analysis shows that inaccessibility to chemical fertilizer has negative impact on rural livelihood by causing low yield. However, it has a positive effect by inducing the adoption of organic fertilizer, which is deemed environment-friendly agriculture. The conclusion is that although the environmentfriendly, organic fertilizer-supported agriculture has taken root, it still faces enormous challenges when compared to chemical fertilizers. The study recommends adopting participatory approach to educate, and enlighten farmers as well as to evaluate agricultural and livelihood system of farmers; motivation of farmers who adopt environment-friendly practices; and a gradual substitution of chemical fertilizer with organic nutrient for sustainable agriculture among others

Severe Snakebite Envenomation: A Near-fatal Case Of Probable Antivenom Inefficacy

Snakebite envenomation constitutes a major healthcare problem in Nigeria and the outcome of this medical emergency may be influenced by the prompt administration of efficacious antivenom. The carpet viper (Echis ocellatus) is responsible for majority of snakebite envenomation in Nigeria and the clinical manifestation includes coagulopathy, local swelling, pain and sometimes tissue necrosis. Snake antivenoms are the mainstay of treatment and the use of ineffective brands may lead to untoward outcomes. We present a 21 year old female student who had snake bite to the foot and subsequently developed systemic envenomation characterized by severe bleeding disorder. She was treated with a total of 30 vials of Asna Antivenom C (brand of antivenom by Bharat Serum and Vaccines Ltd, India) over five days without improvement. She was then switched to EchiTab-Plus-ICP (brand of antivenom by Instituto Clodomiro Picado, Costa Rica), following which coagulopathy rapidly resolved with 8 vials of EchiTab-Plus-ICP. This case describes the potential harm of antivenom inefficacy and suggests an urgent need for a study on the comparative potencies of available snake antivenoms in Nigeria.Keywords: Snakebite, Envenomation, Echis ocellatus, Coagulopathy, Antiveno