Human immunodeficiency virus infection occupational post- exposure prophylaxis

The risk of acquiring Human Immunodeficiency Virus (HIV) infection following occupational exposure to HIV- infected blood is low. It hasbeen considered that there is no risk of HIV transmission where intact skin is exposed to HIVinfected blood. However, health care workerswho are occupationally exposed to HIV infection must have immediate access to post-exposure prophylaxis (PEP). The risk of HIV transmission through the route of injury sustained must beassessed and adequate management given. Postexposure prophylaxis (PEP) should be commenced within 1-2 hours of exposure andshould last one month for it to be effective. All health care workers who report exposure to HIV at work whether given PEP or not should befollowed up for six months before a negative antibody test is used to reassure the individual that infection has not occurred. The objective ofthis article is to create awareness among health care workers, particularly resident doctors, who by the nature of their work are exposed to potentially infected body fluids so that they can present themselves rapidly for risk assessment and commencement of ART if necessary in the event of an occupational exposure to HIV

Ludwig’s Angina Following Self Application of an Acidic Chemical

Ludwig’s angina is a potentially life threatening diffuse cellulitis usually resulting from odontogenic infection. We report a case of Ludwig’s angina resulting from self administration of an acidic chemical to treat toothache.Keywords: Toothache, Acid chemical, Ludwig’s angin

Evaluation of Repeat Analysis and Dose Burdens of Patients Examined in the Radiology Department of a Medical University Teaching Hospital in Nigeria

The objectives of this study was to examine the repeated examinations carried out and dose burdens of patients examined in the radiology department of a tertiary institution teaching hospital in Nigeria. A standard daily record keeping method (accepted and rejected films compiled by Radiographers) was used to collect data after viewing by a Radiologist. Raw data collected were sorted with the aid of Tally Chart. Descriptive statistics was employed to analyze the data collected with the help of Excel software. The specific repeat rates (SRRs) for different examinations are as follows: chest PA (CXR-6.68 %); lumbosacral (LS-10.90%); skull/head (S/H-15.08 %); abdomen (ABD-12.97 %); pelvis/hip (PE/H-7.77 %); cervical spine/neck (SP/NK-5.56 %); thoracic spine (TS-7.14 %); extremities (EXT-1.64 %); shoulder joint (SHJ-2.22 %); knee joint (KNJ-2.99 %); elbow joint (ELB-2.53 %); ankle joint (ANK-2.77 %); and  hysterosalpingography (HSG-7.35 %). The highest causal reject rates (CRRs) was found to be as a result of under-penetration (34.3%) in this study. This is followed in succession by over-collimation (22.90 %) and processing artifact (20.50 %).   The excessive population doses of the exposed patients resulting from repeats for some examinations are: chest PA (CXR-103.60 mGy); lumbosacral AP (LS-23.00 mGy); skull/head PA (S/H-71.10 mGy); abdomen AP (ABD-33.48 mGy); thoracic spine AP (TS-2.52 mGy);  shoulder joint AP (SHJ-1.89 mGy); knee joint AP (KNJ-2.00 mGy); ankle joint AP (ANK-0.76 mGy);  hysterosalpingography (HSG-1.95 mGy). The selected exposure parameters could also be examined and adjusted to prevent under-penetration

The Review of the Student Industrial Work Experience Scheme (SIWES) in Four Selected Countries

Recently, SIWES has attracted studies from scholars in higher educational systems in Nigeria due to the deficiency or lack of proficiency of many graduates, mostly in the natural sciences. This shows that the scheme has not been effective in ensuring impartation of practical knowledge on students. Consequently, many employers of labour view this challenge as one of the causes of unemployment, an obstacle to achieving corporate goals and a serious obstacle to national development. Although SIWES stakeholders have been primarily indicted for its dysfunction, most especially, the Government, and the management of tertiary institutions, but none of such studies have compared SIWES in developed countries with a developing society like Nigeria with the aim of identifying the missing gap that needs to be filled to ensure students proficiency at work after graduation. Being a descriptive article, the present study used data from secondary sources to analyze and synthesize SIWES in four purposefully selected countries. By synthesizing SIWES activities in these countries, the study identifies factors responsible for the dysfunction of SIWES in Nigeria. These include poor quality of education from the elementary school to higher educational systems; short duration apportioned to SIWES in the curriculum of tertiary institutions; insufficient industries and closure of some of the few existing ones due to unfavourable environmental factors; inadequate equipment / facilities in existing few industries for effective practical training and poor leadership of SIWES stakeholders. The study concluded that SIWES in Nigeria could improve if these flaws could be effectively addressed

Effective Doses and Excess Lifetime Cancer Risks from Absorbed Dose Rates Measured in Facilities of Two Tertiary Institutions in Nigeria

This study was aimed at examining the radiation absorbed dose rate, annual effective doses and excess lifetime cancer risks of halls of residence, Radiotherapy Unit and Radiology Department of UI, UCH and UNIMEDTH respectively. Results of measurements show that the mean absorbed dose rate for male and female hall are 0.33 ± 0.05476 and 0.17 ± 0.05074 µSv h-1 respectively. The mean overall absorbed dose rates calculated for facilities studied are 0.269 ± 0.0992 µSv h-1, 0.121 ± 0.036 µSv h-1 and 0.123 ± 0.00931 µSv h-1 in UI, UCH and UNIMEDTH respectively. The mean annual effective doses recorded in both male and female halls in University of Ibadan ranges between 0.71 mSv y-1 and 2.67 mSv y-1. The mean annual effective doses obtained from the facility of University of Medical Sciences Teaching Hospital, Ondo (UNIMEDTH) ranges between 0.17 and 0.44 mSv y-1. In addition, the mean annual effective doses calculated from the measured absorbed dose rate in Radiotherapy Department of University College Hospital, Ibadan ranges between 0.20 and 1.22 mSv y-1. As regards ELCRs, the mean values  determined in various facilities examined are 6.07 x 10-3 (Male Halls, UI), 3.27 x 10-3 (Female Halls, UI), 0.57 x 10-3 (UNIMEDTH- NE), 0.99 x 10-3 (UNIMEDTH- EX), 0.65 x x 10-3 (Teletherapy, UCH) and 0.57 x 10-3 (Brachytherapy, UCH).The mean ELCRs of both halls examined are higher than the world average of 1.45 x 10-3 and the standard value of 0.29 x 10-3 by at least a factor of 1.97 units

The burden and risks of pediatric pneumonia in Nigeria: A desk‐based review of existing literature and data

Background: Pneumonia is a leading killer of children under‐5 years, with a high burden in Nigeria. We aimed to quantify the regional burden and risks of pediatric pneumonia in Nigeria, and specifically the states of Lagos and Jigawa. / Methods: We conducted a scoping literature search for studies of pneumonia morbidity and mortality in under‐5 children in Nigeria from 10th December 2018 to 26th April 2019, searching: Cochrane, PubMed, and Web of Science. We included grey literature from stakeholders' websites and information shared by organizations working in Nigeria. We conducted multivariable logistic regression using the 2016 to 2017 Multiple Cluster Indicators Survey data set to explore factors associated with pneumonia. Descriptive analyses of datasets from 2010 to 2019 was done to estimate trends in mortality, morbidity, and vaccination coverage. / Results: We identified 25 relevant papers (10 from Jigawa, 8 from Lagos, and 14 national data). None included data on pneumonia or acute respiratory tract infection burden in the health system, inpatient case‐fatality rates, severity, or age‐specific pneumonia mortality rates at state level. Secondary data analysis found that no household or caregiver socioeconomic indicators were consistently associated with self‐reported symptoms of cough and/or difficulty breathing, and seasonality was inconsistently associated, dependant on region. / Conclusion: There is a clear evidence gap around the burden of pediatric pneumonia in Nigeria, and challenges with the interpretation of existing household survey data. Improved survey approaches are needed to understand the risks of pediatric pneumonia in Nigeria, alongside the need for investment in reliable routine data systems to provide data on the clinical pneumonia burden in Nigeria

Health system challenges for improved childhood pneumonia case management in Lagos and Jigawa, Nigeria

Background: Case fatality rates for childhood pneumonia in Nigeria remain high. There is a clear need for improved case management of pneumonia, through the sustainable implementation of the Integrated Management of Childhood Illnesses (IMCI) diagnostic and treatment algorithms. We explored barriers and opportunities for improved case management of childhood pneumonia in Lagos and Jigawa states, Nigeria. / Methods: A mixed‐method analysis was conducted to assess the current health system capacity to deliver quality care. This was done through audits of 16 facilities in Jigawa and 14 facilities in Lagos, questionnaires (n = 164) and 13 focus group discussions with providers. Field observations provided context for data analysis and triangulation. / Results: There were more private providers in Lagos (4/8 secondary facilities) and more government providers in Jigawa (4/8 primary, 3/3 secondary, and 1/1 tertiary facilities). Oxygen and pulse oximeters were available in two of three in Jigawa and six of eight in Lagos of the sampled secondary care facilities. None of the eight primary facilities surveyed in Jigawa had oxygen or pulse oximetry available while in Lagos two of three primary facilities had oxygen and one of three had pulse oximeters. Other IMCI and emergency equipment were also lacking including respiratory rate timers, particularly in Jigawa state. Health care providers scored poorly on knowledge of IMCI, though previous IMCI training was associated with better knowledge. Key enabling factors in delivering pediatric care highlighted by health care providers included accountability procedures and feedback loops, the provision of free medication for children, and philanthropic acts. Common barriers to provide care included the burden of out‐of‐pocket payments, challenges in effective communication with caregivers, delayed presentation, and lack of clear diagnosis, and case management guidelines. / Conclusion: There is an urgent need to improve how the prevention and treatment of pediatric pneumonia is directed in both Lagos and Jigawa. Priority areas for reducing pediatric pneumonia burden are training and mentoring of health care providers, community health education, and introduction of oximeters and oxygen supply