Perceived Indications, Safety and Efficacy of Perinatal Use of Traditional and Spiritual Remedies among Mothers of Under-Five Children in Kano, North- Western Nigeria

Background: Herbal and spiritual remedies are increasingly being used in the management of perinatal conditions. Objectives: To determine the pattern of use of herbal and spiritual remedies during perinatal period, and the perceived indications, efficacy and safety of these remedies among mothers of under-five children in Kano. Subjects and Methods: A descriptive crosssectional design was used to study a random sample of 189 mothers. Data were analyzed using IBM SPSS statistics 22. The chi-square test and Fisher’s exact test were used for univariate analysis.Result: The means of respondents’ age and their number of children were 33.3 ± 9.2 years and 4.7 ± 2.6 respectively. Three-quarters of the mothers (76.2%) used herbal and/or spiritual remedies within the perinatal period, mostly orally (97.9%); 63.2% used them in combination with orthodox medicines. The main indications were maintaining good health during pregnancy (39.6%); easy labour and safe delivery (39.6%); and treatment of common ailments (28.5%). Majority believed that herbal (66.1%) and spiritual (70.9%) remedies are very effective on pregnancy related problems; 57.1% and 78.8% believed that herbal and spiritual remedies are very effective on problems of labour and pueperium respectively. Most believed that spiritual remedies are safe during pregnancy (94.2%) and in labour and pueperium (97.9%); and herbs are safe during labour and pueperium (91.0%). Conclusion: Health authorities in Nigeria should institutionalize structures for censoring, training, regulation of TM practice and safety of remedies used.Keywords: Indications, Safety, Perinatal use, Traditional remedies, Northwestern Nigeri

Cardiovascular responses and perceived exertion of young adults to head and shoulder load carriage

Objective: To determine the cardiovascular responses and perceived exertion of young adults walking and carrying a load of 10 kg on shoulder and the head.Method: Healthy participants (n=50) between the ages of 21 and 27 were subjected to three testing sessions at self-selected normal pace without load, and carrying a 10 kg load on the shoulder and on the head for 10 minutes. Cardiovascular parameters and their ratings of perceived exertion (RPE) were measured before and after testing at each session.Results: Higher pulse pressure (correlates of stroke volume) and rate pressure product (index of myocardial oxygen uptake) values were observed following load on shoulder testing compared to no load testing values and a higher RPE value was observed for load on shoulder testing when compared to load on head testing.Conclusion: It is conceivable that carrying load on the head can potentially be more economical than carrying load on the shoulder for this cohort of young adults. Keywords: Cardiovascular responses, perceived exertion, load carrying, rural communitie

Optical and structural properties of rice husk silicate incorporated borotellurite glasses doped with erbium oxide nanoparticles

A system of erbium oxide nanoparticles doped rice-husk-silicate borotellurite glasses with compositional formula, {[(TeO2)0.7 (B2O3)0.3]0.8 (SiO2)0.2}1−y (Er2O3 NPs)y with y = 0.01, 0.02, 0.03, 0.04 and 0.05 was fabricated using the method of melt-quenching. Various characterizations and measurement techniques such as density and molar volume, X-ray diffraction, Fourier transform infrared, transmission electron microscopy and UV–Vis spectroscopy were carried out to study the structural, morphological and optical properties of the fabricated glasses. The density values for the glasses increased from 4.1900 to 4.6003 g cm−3 with the addition of 1% to 5% of Er2O3 NPs in the glass structure. The increase can be ascribed to increase in the overall molar weight of the glass caused by the higher molecular weight of erbium. The microstructural nature revealed in the glass morphological evidence of nanoparticle agglomerations in the glasses. From the UV–Vis spectra both direct and indirect energy band gap decreased with Er2O3 NPs increased 0.01 to 0.02 mol and then increased thereafter up to 0.05 mol%. The refractive index was found to be high, in the range of 2.6050 to 2.6794, metallization criterion ranged from 0.3268 to 0.3414 which according to Berwal et al. (J Mol Struct 1127:636–644, 2017), is an indication that the glass has good optical non-linearity and also suggests the glass has good potential for non-linear optical application. The molar polarizability ranged from 7.7041 to 7.4515 Å3 while the optical transmission coefficient values ranged from 0.6551 to 0.6691. The high refractive index, good metallization criterion, polarizability and transmission coefficient values suggest that the erbium oxide nanoparticles doped Rice husk silicate borotellurite glasses studied has some good potential for optical fibre amplifier application

The impact of rural residence and HIV infection on poor tuberculosis treatment outcomes in a large urban hospital: a retrospective cohort analysis.

BACKGROUND: Successful tuberculosis (TB) treatment is essential to effective TB control. TB-HIV coinfection, social determinants and access to services influenced by rural residence can affect treatment outcome. We examined the separate and joint effects of rural residence and HIV infection on poor treatment outcome among patients enrolled in a large TB treatment centre in Kano, Nigeria. METHODS: We retrospectively analysed a cohort of patients with TB enrolled in a large urban TB clinic in northern Nigeria, from January 2010 to December 2014. Poor treatment outcome was defined as death, default or treatment failure. We used Poisson regression to model rates and determine the relative risks (and 95% confidence intervals, CI) of poor treatment outcomes. RESULTS: Among 1381 patients included in the analysis, 28.4% were rural residents; 39.8% were HIV-positive; and 46.1% had a poor treatment outcome. Approximately 65 and 38% of rural and urban residents, respectively, had a poor treatment outcome. Rural residents had 2.74 times (95% CI: 2.27-3.29) the risk of having a poor treatment outcome compared to urban residents. HIV-positive patients had 1.4 times (95% CI: 1.16-1.69) the risk of poor treatment outcome compared to HIV-negative patients. The proportion of poor treatment outcome attributable to rural residence (population attributable fraction, PAF) was 25.6%. The PAF for HIV infection was 11.9%. The effect of rural residence on poor treatment outcome among HIV-negative patients (aRR:4.07; 95%CI:3.15-5.25) was more than twice that among HIV-positive patients (aRR:1.99; 95%CI:1.49-2.64). CONCLUSION: Rural residents attending a large Nigerian TB clinic are at increased risk of having poor treatment outcomes, and this risk is amplified among those that are HIV-negative. Our findings indicate that rural coverage of HIV services may be better than TB services. These findings highlight the importance of expanding coverage of TB services to ensure prompt diagnosis and commencement of treatment, especially among rural-dwellers in resource-limited settings

Clinical case of caseous lymphadenitis in a goat: case management

Corynebacterium pseudotuberculosis is the causative agent of caseous lymphadenitis (CLA) a contagious and infectious disease in small ruminants. This report describes a case of CLA in a Boer cross goat infected with Corynebacterium pseudotuberculosis. The manifestation of abscess in the superficial lymph node presented as a mass of approximately 5cm by 5cm in diameter at the base of the ear. The mass was solid and non-movable upon palpation. The mass was incised and the caseous material was aspirated and sent to the bacteriology laboratory where Corynebacterium pseudotuberculosis was isolated. The wound was cleaned and flushed with diluted chlorhexidine and iodine solutions daily. This procedure aids in the complete healing of the wound after a few weeks. However, the agent of the disease persists in the animal in its entire life and culling is recommended to prevent the spread of the disease in the herd

Clinical case of pregnancy toxaemia in a goat - a case report on veterinary medicine approach

A pregnant Jamnapari doe was presented with primary complaint of inappetance and recumbency for a week. The most prominent abnormality during physical examination was weakness in both hind limbs typified by difficulty in standing. Ultrasonography revealed that the doe were carrying three viable foetuses that were about 4-months old. Hemato-biochemistry findings showed hypocalcaemia (1.98mmol/L) and hypoglycaemia (2.2mmol/L). Besides that, ketone bodies were also detected from the urine (3+ or 8mmol/L). The doe was treated vigorously for pregnancy toxaemia with 1L of Glucose 20% (G-20) and 5L of 0.9% NaCl, administered intravenously BID for 3 days as glucose replacement and rehydration respectively. 30mL of propylene glycol was also given orally BID for 7 days as glucose precursor. Flunixin meglumine 2.2mg/kg was administered intramuscularly SID for 3 days as non-steroidal anti-inflammatory. In addition, 20mL of theracalcium was given intramuscularly SID for two days and 5mL of Catosal® was given intramuscularly SID for 6 days for calcium supplement and to stimulate body metabolism respectively. One vial (2ml) of methylcobalt was administered intramuscularly SID for 3 days as a nerve supplement and physiotherapy was performed after caesarean section for 10 minutes TID for 6 days in order to increase blood circulation and prevent muscle atrophy. However, the does’ condition started to deteriorate on Day 7 and caesarean was performed on the same day where three foetuses were saved. The doe’s condition improved tremendously and was discharged after a week of caesarean section. This clinical case reports the clinical management of pregnancy toxaemia in a goat, which is a common problem in small holder farms in Malaysia

Global, regional, and national burden of disorders affecting the nervous system, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BackgroundDisorders affecting the nervous system are diverse and include neurodevelopmental disorders, late-life neurodegeneration, and newly emergent conditions, such as cognitive impairment following COVID-19. Previous publications from the Global Burden of Disease, Injuries, and Risk Factor Study estimated the burden of 15 neurological conditions in 2015 and 2016, but these analyses did not include neurodevelopmental disorders, as defined by the International Classification of Diseases (ICD)-11, or a subset of cases of congenital, neonatal, and infectious conditions that cause neurological damage. Here, we estimate nervous system health loss caused by 37 unique conditions and their associated risk factors globally, regionally, and nationally from 1990 to 2021.MethodsWe estimated mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs), with corresponding 95% uncertainty intervals (UIs), by age and sex in 204 countries and territories, from 1990 to 2021. We included morbidity and deaths due to neurological conditions, for which health loss is directly due to damage to the CNS or peripheral nervous system. We also isolated neurological health loss from conditions for which nervous system morbidity is a consequence, but not the primary feature, including a subset of congenital conditions (ie, chromosomal anomalies and congenital birth defects), neonatal conditions (ie, jaundice, preterm birth, and sepsis), infectious diseases (ie, COVID-19, cystic echinococcosis, malaria, syphilis, and Zika virus disease), and diabetic neuropathy. By conducting a sequela-level analysis of the health outcomes for these conditions, only cases where nervous system damage occurred were included, and YLDs were recalculated to isolate the non-fatal burden directly attributable to nervous system health loss. A comorbidity correction was used to calculate total prevalence of all conditions that affect the nervous system combined.FindingsGlobally, the 37 conditions affecting the nervous system were collectively ranked as the leading group cause of DALYs in 2021 (443 million, 95% UI 378–521), affecting 3·40 billion (3·20–3·62) individuals (43·1%, 40·5–45·9 of the global population); global DALY counts attributed to these conditions increased by 18·2% (8·7–26·7) between 1990 and 2021. Age-standardised rates of deaths per 100 000 people attributed to these conditions decreased from 1990 to 2021 by 33·6% (27·6–38·8), and age-standardised rates of DALYs attributed to these conditions decreased by 27·0% (21·5–32·4). Age-standardised prevalence was almost stable, with a change of 1·5% (0·7–2·4). The ten conditions with the highest age-standardised DALYs in 2021 were stroke, neonatal encephalopathy, migraine, Alzheimer's disease and other dementias, diabetic neuropathy, meningitis, epilepsy, neurological complications due to preterm birth, autism spectrum disorder, and nervous system cancer.InterpretationAs the leading cause of overall disease burden in the world, with increasing global DALY counts, effective prevention, treatment, and rehabilitation strategies for disorders affecting the nervous system are needed

Evaluation of Integrated HIV/AIDS and Primary Health Care Services in Northern Nigeria

Background This study assessed the performance of HIV/AIDS integrated care approach delivered as part of routine PHC service in Nigeria. The study further examined the factors that influence the service delivery, performance and impact. Methods A concurrent mixed methods design involving quantitative and qualitative methods was adopted. The quantitative study used a retrospective cohort design to collect and analyse medical records of service users. This was followed by a survey conducted with 241 randomly selected HIV positive and HIV negative patients. The qualitative study used focus groups and key informant interviews to explore the views/perceptions of service users and their providers regarding why and how the integrated care worked or did not work. Quantitative data were analysed using IBM SPSS statistics 22. Regression analysis was performed to assess trend in uptake of HIV services, while interrupted time series analysis was used to assess the effect of the integrated care on non-HIV services. The normal approximation test for two proportions and confidence intervals were used to test the difference in proportions of satisfied respondents between the HIV positive and HIV negative patients. Qualitative data were transcribed and analysed using the framework approach. Findings Medical records of 125,844 patients comprising 78,351 (62.3%) adults and 47,493 (37.7%) children (0-60 months old) were sampled and analysed. The mean age (SD) of the satisfaction survey respondents was 32.8 (9.1) years for the HIV positive patients and 26.5 (7.2) years for the HIV negative patients. Majority of the respondents were married (81.6%), females (78.8%) who have not had secondary level of education (72.0%). The qualitative participants were between 19 to 65 years old, and majority had at least secondary school level of education. The study found that HIV counselling [Change/annum (95% C.I): 2.11 (1.19, 3.04), p = 0.0001], testing [Change/ annum (95% C.I): 1.89 (1.02, 2.76), p= 0.0001] and collection of test results [Change/ annum (95% C.I): 1.90 (1.03, 2.76), p = 0.0001] significantly increased over time. Uptake of ART on follow up increased over time [Change/ annum (95% C.I): 8.51 (6.95, 10.08), p = 0.0001]. ART enrolment decreased over time [Change/ annum (95% C.I): -0.02 (-0.28, 0.23, p = 0.855]. Fear of confidentiality and stigmatisation resulted in poor clinic attendance. HIV counselling and testing for pregnant mothers increased over time [Change/ annum (95% C.I): 24.32 (16.70, 31.95), p = 0.0001]. The number of HIV exposed babies decreased with time [Change/ annum (95% C.I): -0.09 (-0.19, 0.012), p = 0.08]. Use of maternal health services improved over time: antenatal care service [Effect/ month (95% C.I): 6.6 (4.55 to 8.65), p = 0.0001], family planning service (Effect/ month (95% C.I): 1.3 (0.26 to 2.26), p = 0.014] and delivery service [Effect/ month (95% C.I): 0.9 (0.39 to 1.45), p = 0.0009]. Child health services showed a moderate increase over time: BCG [Effect/ month (95% C.I): 1.8 (0.64 to 2.88), p = 0.002], and DPT1/ Penta 1 vaccinations [Effect/ month (95% C.I): 1.0 (0.20 to 1.73), p = 0.013]. Paediatric out-patient attendance improved [Effect/ month (95% C.I): -7.7 (-21.27 to 5.91), p = 0.264] but in-patient attendance decreased over time [Effect/ month (95% C.I): -0.04 (-0.17 to 0.08), p = 0.487]. Adult out-patient attendance improved [Effect/ month (95% C.I): 13.2 (9.88 to 16.44), p = 0.0001]. Majority of the HIV positive patients (98.4%) and HIV negative patients (99.2%) were satisfied with the quality of services they received. Qualitative participants reported improved access to health care, reduction of stigma and discrimination against HIV service users, maintenance of privacy and confidentiality of patients among providers, improved satisfaction with services, and knowledge of prevention of transmission of HIV from mother to an unborn baby. Barriers to integrated care reported included, inadequate funding, inadequate staffing, knowledge gap, and inadequate infrastructure and facility. Facilitators of service delivery were identified as available infrastructure, facility and services, as well as efficiency of PHC facility management. Conclusion The findings suggest that the integrated care improved access, outcomes and quality of both HIV and non-HIV services. However, poorly managed programme may affect desired quality negatively. A system wise approach to integrated care is therefore critical for ensuring success of the programme

Personal and food hygiene practices of subsistence food vendors operating in Kano metropolis, northwestern Nigeria

Background: Foodborne diseases are on the increase throughout the world due to poor attention given to personal and food hygiene measures by both lawmakers and people in charge of food preparation, especially in the developing countries. Objective: To examine the knowledge and practices of food vendors operating in urban Kano on personal and food hygiene. Materials and Methods: We used a descriptive cross-sectional design to study a random sample of 380 food vendors in Kano metropolis. Data were collected using pretested interviewer administered semi-structured questionnaire. Data were analyzed using Epi Infos software, version 3.5.1. Results: The mean age of the food vendors was 27.78 ± 7.63 years. The majority (61.1%) of them were men (53.2%), married (61.8%), and had at least secondary education (51.1%). More than two-thirds (89.7%) had fair knowledge of personal hygiene, although there were deficiencies in some of the key hygiene areas, but 62.4% and 36.6% had good and fair knowledge of food hygiene, respectively. Most of the food vendors had good practices of personal hygiene (93.2%). Paradoxically, only 17.1% had good practice of food hygiene. Furthermore, more than half (54.2%) showed bad workplace hygiene practices. Conclusion: Food vendors operating in Kano generally knew about personal and food hygiene, but this was not reflected in their hygienic practices. It is the statutory responsibility of the environmental health officers to safeguard and implement food hygiene laws in Nigeria. But despite the available structure and personnel at the local government area level, the laws are still inactive. The health authorities at the state and federal levels should empower the environmental health officers with the necessary policy and logistic support they require to fully implement the laws in Kano and Nigeria as a whole. The laws should also be reviewed to ensure more severe penalty for offenders

Perceptions about Eclampsia, Birth Preparedness, and Complications Readiness among Antenatal Clients Attending a Specialist Hospital in Kano, Nigeria

Background. Eclampsia is a reliable indicator of poor birth preparedness and complications readiness. We determined perceptions about eclampsia, birth preparedness, and complications readiness among antenatal clients in Kano, Nigeria. Materials and Method. A cross-sectional design was used to study 250 randomly selected antenatal clients. Data was analyzed using SPSS 16.0. Result. The mean age of the respondents was 26.1 ± 6.4 years. The majority perceived that eclampsia is preventable through good ANC (76.4%) and hospital delivery (70.8%). Overall, 66.8% had good perception about eclampsia. Having at least secondary school education and multigravidity were associated with good perception about eclampsia on multivariate analysis. About a third (39.6%) of the mothers was less prepared. On binary logistic regression, good perception about eclampsia and multigravidity were associated with being very prepared for birth. Up to 37.6% were not ready for complications. Half (50.4%) knew at least three danger signs of pregnancy, and 30.0% donated blood or identified suitable blood donor. On multivariate analysis, having at least secondary school education, being very prepared for birth, and multigravidity emerged as the only predictors of the respondents’ readiness for complications. Conclusion and Recommendations. Health workers should emphasize the practicability of birth preparedness and complications readiness during ANC and in the communities, routinely review plans, and support clients meet-up challenging areas. The importance of girl-child education to at least secondary school should be buttressed