Cervical cancer screening and practice in low resource countries: Nigeria as a case study

Cervical cancer is the most common female genital tract malignancy in Nigeria and majority of the patients present with advanced disease. It is a preventable cancer as there are well‑defined treatable premalignant phases. The objective of the study is to review the burden of cervical cancer, its screening modalities, and practice of screening and treatment in low resource countries with emphasis on Nigeria. This is a review involving internet and literature search. While developed countries have recorded significant reduction in the incidence of cervical cancer owing to organizedscreening programs, treatment of premalignant cervical lesions, and follow‑up of treated cases, developing countries including Nigeria are yet to optimally utilize screening services due to lack of organized population‑based screening programs with only pockets of screening services which are at best opportunistic. This has not reduced the incidence of cancer because only a fraction of the target population is covered. Apart from this, loss to follow‑up is rampant. The level of awareness of cervical cancer and its preventive strategies are low among the population and policymakers in Nigeria. There is no organized screening program, and the few services available are only opportunistic with little or no impact. Development of cervical cancer screening policy and institution of organized screening program targeted at covering ≥80% of population at risk is fundamental. There is also a need for widespread education of the populace on the burden of cervical cancer and the public health importance of the disease using the mass media, counseling at antenatal clinics, and the involvement of men will contribute immensely to reduction in the incidence of cervical cancer. Decentralization of services by incorporation of cervical screening and treatment in primary health care programs will ensure adequate rural‑urban coverage.Keywords: Cervical cancer screening; human papillomavirus, low resource countries; Nigeria; premalignant diseas

Evaluation of lactic acid bacteria viability and anti-diarrhoeagenic Escherichia coli activities of non-alcoholic fermented beverage ‘Kunu’

Kunu is a non-alcoholic fermented cereal beverage consumed primarily as a refreshing drink. This study investigated the effects of storage conditions on viability of Lactic Acid Bacteria (LAB) in kunu and the antibacterial effects of Kunu against diarrhoea caused by Escherichia coli strains. Kunu was prepared according to local traditional method. Viability counts of LAB in kunu stored at two different conditions, cold (4 ℃ average) and room temperature (26 ℃ average), were evaluated. Isolated LAB from kunu were identified by partial sequencing of 16S rRNA gene. Five pathotypes of diarrhoea caused by E. coli strains were co-cultured with kunu to evaluate its antimicrobial activities. Viable LAB count in kunu ranged from 5.0 x 109 to 1.0 x 1011 cfu/mL. Pediococcus pentosaceus, Lactobacillus plantarum and Leuconostoc pseudomesenteroides were identified from kunu. There is a drastic decrease (2-5 log reduction) in E. coli strains co-cultured with kunu. The observed high viable counts of beneficial LAB in kunu with its antimicrobial activities against diarrhoeaogenic E. coli strains indicates that kunu is not just a refreshing drink, but it also has antimicrobial potential against diarrhoea caused by E. coli

Marketing strategies used by librarians in a state university libraries

Academic libraries are currently experiencing changes in the new information age, due to rapidly changing media technologies, increasing users’ preferences and expectations, competition from other information providers such as internet and dwindling library budgets. These necessitate library and information science professionals leverage on competitive marketing approaches to strategically reorient themselves and libraries as information superhighways that individuals cannot do without. This study therefore investigated marketing strategies employed by librarians in a state university library in Nigeria. The study adopted survey research design of ex-post facto type. A validated questionnaire with Cronbach alpha reliability coefficient of 0.69 was used to gather information from all the librarians. The results revealed that user survey studies, books, interlibrary loan services and improved burrowing privileges were prevalent marketing strategies used by librarians. Unstable Internet connectivity and inadequate funding were identified as major challenges to effective marketing of library products and services. The study recommended use of ICT and social media tools; teaching of innovative marketing concepts and principles in Nigerian Library schools and aggressiveness on the part of librarians.Keywords: Library marketing, Promoting library services and information products; Nigerian librarians; Nigerian universitie

Live birth after laparotomy for ruptured heterotopic cornual and intrauterine twin gestation in a Spontaneous cycle: A case report and literature review

Background: Heterotopic pregnancy is the coexistence of an intrauterine and extrauterine gestation.It is a rare occurrence especially in a natural conception. Its incidence is however increasing with the advent of  assisted reproductive techniques.Case Presentation: A rare case of triplet heterotopic cornual gestation involving twin intrauterine and a cornual gestation in a spontaneous conception.She presented with an acute abdomen and she had laparotomy with cornual resection.The intrauterine pregnancy remained uneventful till term.Conclusion: Heterotopic pregnancy is a life threatening  condition.Management with laparotomy can result in the survival of the intrauterine gestation till term without adverse outcome.Keywords: Heterotopic gestation,cornual ectopic gestation,term  gestation

In vitro Anticancer Screening of 24 Locally Used Nigerian Medicinal Plants

Background: Plants that are used as traditional medicine represent a relevant pool for selecting plant candidates that may have anticancer properties. In this study, the ethnomedicinal approach was used to select several medicinal plants native to Nigeria, on the basis of their local or traditional uses. The collected plants were then evaluated for cytoxicity. Methods: The antitumor activity of methanolic extracts obtained from 24 of the selected plants, were evaluated in vitro on five human cancer cell lines. Results: Results obtained from the plants screened indicate that 18 plant extracts of folk medicine exhibited promising cytotoxic activity against human carcinoma cell lines. Erythrophleum suaveolens (Guill. & Perr.) Brenan was found to demonstrate potent anti-cancer activity in this study exhibiting IC50 = 0.2-1.3 $\mu$g/ml. Conclusions: Based on the significantly potent activity of some plants extracts reported here, further studies aimed at mechanism elucidation and bio-guided isolation of active anticancer compounds is currently underway.Chemistry and Chemical Biolog

Traditional Symbols of Yoruba Pattern Designs As Insignia of Cultural Identity On Indigenous Clothing

This article looks into the tradition symbols of Yoruba designs and the suggested intent of anonymous indigenous draught man, whose crafts works are represented on the surface design such as textile products with the aim to the promote the Yoruba identity. Apart from textile surface, there are also other objects from the cultural angle are referred symbolic objects such as woods, metals that keep memoire of signs, symbols and sketches functional. These perhaps reflect in the contemporary designs’ crafts present on the surface textile design, which makes a synergy between Yoruba art and culture possible. The study was conducted to determine the traditional symbols on textile (batik) as insignia of cultural identity among the Yoruba people

Contributions of uterine fibroids to infertility at Ile‑Ife, South‑Western Nigeria

Background: Uterine fibroid is the most common tumor of the female genital tract. The benign tumors often grow into large sizes and assume unsightly shapes with concomitant symptoms and signs. Being a predominantly reproductive age disease, concurrent infertility and symptomatic uterine fibroids pose management challenges. Individualization of the patient is thus essential to the success of the reproductive outcome.Objectives: This study determined the prevalence, trend, management modalities, pregnancy outcome, and exposition of factors affecting pregnancy outcome among patients presenting with uterine fibroids and infertility at the Obafemi Awolowo University Teaching Hospitals Complex (OAUTHC).Materials and Methods: This is a retrospective study of case records of 106 women managed for uterine fibroids and infertility over a 5‑year period (January 1, 2012, to December 31, 2016) at the OAUTHC. The outcome measure is the pregnancy rate among those who had a myomectomy.Results: About a quarter of women with infertility had symptomatic uterine fibroids and this represents about 35%–40% of the overall number of women presenting as uterine fibroid within the study. About 84.9% had uterine size >12 weeks at presentation. Two‑third of the patients had open myomectomy alone with 43.9% achieving conception thereafter. Conception rate for myomectomy with tuboplasty was 31.3% whereas myomectomy with subsequent in vitro fertilization (IVF) was 50%. Pregnancy rate decreased with increasing size of the uterus before myomectomy.Conclusion: Symptomatic fibroid was significantly prevalent among women with infertility. Myomectomy improves fertility potential and success rate of IVF. Uterine fibroid has both direct and indirect effect on infertility and pregnancy rate in this group of the patient can be improved through routine screening for uterine fibroids and early removal of the fibroids before they grow into giants size.Keywords: Infertility; myomectomy; pregnancy outcome; uterine fibroid

Effects of hospital facilities on patient outcomes after cancer surgery: an international, prospective, observational study

Background Early death after cancer surgery is higher in low-income and middle-income countries (LMICs) compared with in high-income countries, yet the impact of facility characteristics on early postoperative outcomes is unknown. The aim of this study was to examine the association between hospital infrastructure, resource availability, and processes on early outcomes after cancer surgery worldwide.Methods A multimethods analysis was performed as part of the GlobalSurg 3 study-a multicentre, international, prospective cohort study of patients who had surgery for breast, colorectal, or gastric cancer. The primary outcomes were 30-day mortality and 30-day major complication rates. Potentially beneficial hospital facilities were identified by variable selection to select those associated with 30-day mortality. Adjusted outcomes were determined using generalised estimating equations to account for patient characteristics and country-income group, with population stratification by hospital.Findings Between April 1, 2018, and April 23, 2019, facility-level data were collected for 9685 patients across 238 hospitals in 66 countries (91 hospitals in 20 high-income countries; 57 hospitals in 19 upper-middle-income countries; and 90 hospitals in 27 low-income to lower-middle-income countries). The availability of five hospital facilities was inversely associated with mortality: ultrasound, CT scanner, critical care unit, opioid analgesia, and oncologist. After adjustment for case-mix and country income group, hospitals with three or fewer of these facilities (62 hospitals, 1294 patients) had higher mortality compared with those with four or five (adjusted odds ratio [OR] 3.85 [95% CI 2.58-5.75]; p<0.0001), with excess mortality predominantly explained by a limited capacity to rescue following the development of major complications (63.0% vs 82.7%; OR 0.35 [0.23-0.53]; p<0.0001). Across LMICs, improvements in hospital facilities would prevent one to three deaths for every 100 patients undergoing surgery for cancer.Interpretation Hospitals with higher levels of infrastructure and resources have better outcomes after cancer surgery, independent of country income. Without urgent strengthening of hospital infrastructure and resources, the reductions in cancer-associated mortality associated with improved access will not be realised