Inclusive Growth in Tourism-led Growth Hypothesis: Evidence from Nigeria

This study investigates the direction of causality between tourism and inclusive growth in Nigeria using quarterly data between 1995Q1 and 2018Q4. The study uses four indicators of tourism; tourist arrivals, tourism receipts and expenditures, and a tourism activity index, generated with the Principal Component Analysis, from the first three indicators. The study employs the Toda-Yamamoto granger causality test. The results validate the tourism-led inclusive growth hypothesis using tourist arrivals and tourism activity index, while the neutrality hypothesis of no causality is accepted for inclusive growth and each of tourism receipts and expenditures. The findings have implications for policymakers in Nigeria. These include promoting tourism, by means of appropriate measures, in the economy in order to create jobs and reduce income inequality and poverty; putting in place measures to reduce corruption to avoid mismanagement of tourist receipts; and making sure that there is a necessary due process towards tourism expenditures

Effect of Oscillating Magnetic Field on Heart Parameters of Malaria Parasite Infected Wistar Rats

Studies on the effect of oscillating magnetic field (OSMF) have shown that this field can be used as an alternative therapy to malaria. Still, its impact on the heart parameters is yet to be ascertained. The influence of OSMF was investigated on Heart triglycerides, high-density lipoprotein, and total cholesterol of three weeks old Plasmodium falciparum-infected Wistar rats. Sixty-two Wistar rats were obtained, out of which Forty-nine were infected with plasmodium falciparum, equally divided into seven experimental groups (A, B, C, D, E, G & H) containing seven rats each.

Suprasellar Clear Cell Meningioma in an Infant : Case report

Clear cell meningiomas are an uncommon subtype of meningioma rarely seen in infancy. We report a case of clear cell meningioma in an 8-month-old male infant. He presented at the Lagos University Teaching Hospital, Lagos, Nigeria, in 2015 with persistent vomiting, poor feeding and failure to thrive over a four month period. Generalised hypertonia and hyperreflexia were noted on examination. Computed tomography of the brain revealed a huge largely isodense suprasellar mass with a hypodense core. The tumour, which measured 6 x 5 x 4 cm, enhanced non-uniformly with contrast injection and extended to occlude the third ventricle. The patient underwent a bifrontal craniotomy with subtotal tumour excision. Six hours postoperatively, he went into cardiac arrest and could not be resuscitated. A histological diagnosis of clear cell meningioma was made as the tumour cells were immunoreactive to epithelial membrane antigen, S100 protein and vimentin. This case of clear cell meningioma was unusual due to its early occurrence and supratentorial location

Comparison of the predictive strength of total white blood cell count within 24 hours on the outcome of traumatic brain injury with cranial computed tomography scan in a resource-limited tertiary health centre in sub-Saharan Africa

Background: The enormous disease burden of patients with traumatic brain injury (TBI) remains a huge source of concern to the patient and caregivers. Computed tomography (CCT) scan is a valuable investigative tool in patients with traumatic brain injury which can be used to predict the outcome of TBI. The use of total white blood cell as a predictive parameter in patients with TBI is still at a primordial stage. This study aimed to compare the predictive strength of total WBC count within 24 hours of TBI with cranial computed tomography scan. Methods: This research was done over one-year period at the Lagos University Teaching Hospital, Lagos. One hundred and fifty-eight patient who met the inclusion criteria were studied and the male to female ratio of 3.6:1. Results: The mean total WBC count was 14,279.94 and the area under the curve of total WBC count and CCT scan was 0.633 and 0.855 respectively. Conclusion: Our conclusion was that despite both parameters been a predictor of the outcome of TBI, the total white blood cell is a weaker predictor of outcome compared to cranial computerize tomography scan

Calvarial hemangioma causing seizure disorder: A case report with review of literature

Calvarial hemangiomas are rare benign tumours of the skull bone for which seizure as a presentation is unusual; neurological deficits are uncommon.We report a case of cavernous hemangioma of the parietal bone causing seizure disorder in a 47 year old man. The tumor was removed enbloc with satisfactory methylmethacrylate cranioplasty. Pathological examination confirmed the diagnosis. Patient received short course of antiepileptic drugs with satisfactory recovery. This case demonstrates that seizure disorder can occur in Calvarial haemangiomas as a rare complication. A review of relevant literature is included herein

Armoured brain: A case of bilateral calcified chronic subdural haematoma complicating infantile hydrocephalus

Chronic Subdural haematoma is one of the late complications of shunting procedures. Calcified Chronic Subdural haematoma (CCSDH) which is very rare, follows untreated or asymptomatic Chronic subdural haematomas. When it occurs bilaterally it gives the typical appearance of an “armoured brain” also known as “Matrioska head”. The authors present a case of bilateral CCSDH found on follow-up CT brain scan 15 years after the shunt procedure. The parents had objected to surgical drainage at the time the initial diagnosis was made. The patient is neurologically stable with functional ventriculoperitoneal shunt. The discussion includes a review of relevant literature and treatment options

Exploring barriers to guideline implementation for prescription of surgical antibiotic prophylaxis in Nigeria.

Background: In Nigeria, the prescription of surgical antibiotic prophylaxis for prevention of surgical site infection tends to be driven by local policy rather than by published guidelines (e.g. WHO and Sanford). Objectives: To triangulate three datasets and understand key barriers to implementation using a behavioural science framework. Methods: Surgeons (N = 94) from three teaching hospitals in Nigeria participated in an online survey and in focus group discussions about barriers to implementation. The theoretical domains framework (TDF) was used to structure question items and interview schedules. A subgroup (N = 20) piloted a gamified decision support app over the course of 6 months and reported barriers at the point of care. Results: Knowledge of guidelines and intention to implement them in practice was high. Key barriers to implementation were related to environmental context and resources and concern over potential consequences of implementing recommendations within the Nigerian context applicable for similar settings in low-to-middle-income countries. Conclusions: The environmental context and limited resource setting of Nigerian hospitals currently presents a significant barrier to implementation of WHO and Sanford guidelines. Research and data collected from the local context must directly inform the writing of future international guidelines to increase rates of implementation

Prevalence of surgically correctable conditions among children in a mixed urban-rural community in Nigeria using the SOSAS survey tool:Implications for paediatric surgical capacity-building

BackgroundIn many low- and middle-income countries, data on the prevalence of surgical diseases have been derived primarily from hospital-based studies, which may lead to an underestimation of disease burden within the community. Community-based prevalence studies may provide better estimates of surgical need to enable proper resource allocation and prioritization of needs. This study aims to assess the prevalence of common surgical conditions among children in a diverse rural and urban population in Nigeria.MethodsDescriptive cross-sectional, community-based study to determine the prevalence of congenital and acquired surgical conditions among children in a diverse rural-urban area of Nigeria was conducted. Households, defined as one or more persons 'who eat from the same pot' or slept under the same roof the night before the interview, were randomized for inclusion in the study. Data was collected using an adapted and modified version of the interviewer-administered questionnaire-Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey tool and analysed using the REDCap web-based analytic application.Main resultsEight-hundred-and-fifty-six households were surveyed, comprising 1,883 children. Eighty-one conditions were identified, the most common being umbilical hernias (20), inguinal hernias (13), and wound injuries to the extremities (9). The prevalence per 10,000 children was 85 for umbilical hernias (95% CI: 47, 123), and 61 for inguinal hernias (95% CI: 34, 88). The prevalence of hydroceles and undescended testes was comparable at 22 and 26 per 10,000 children, respectively. Children with surgical conditions had similar sociodemographic characteristics to healthy children in the study population.ConclusionThe most common congenital surgical conditions in our setting were umbilical hernias, while injuries were the most common acquired conditions. From our study, it is estimated that there will be about 2.9 million children with surgically correctable conditions in the nation. This suggests an acute need for training more paediatric surgeons

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance

INTRODUCTION Investment in Africa over the past year with regard to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) sequencing has led to a massive increase in the number of sequences, which, to date, exceeds 100,000 sequences generated to track the pandemic on the continent. These sequences have profoundly affected how public health officials in Africa have navigated the COVID-19 pandemic. RATIONALE We demonstrate how the first 100,000 SARS-CoV-2 sequences from Africa have helped monitor the epidemic on the continent, how genomic surveillance expanded over the course of the pandemic, and how we adapted our sequencing methods to deal with an evolving virus. Finally, we also examine how viral lineages have spread across the continent in a phylogeographic framework to gain insights into the underlying temporal and spatial transmission dynamics for several variants of concern (VOCs). RESULTS Our results indicate that the number of countries in Africa that can sequence the virus within their own borders is growing and that this is coupled with a shorter turnaround time from the time of sampling to sequence submission. Ongoing evolution necessitated the continual updating of primer sets, and, as a result, eight primer sets were designed in tandem with viral evolution and used to ensure effective sequencing of the virus. The pandemic unfolded through multiple waves of infection that were each driven by distinct genetic lineages, with B.1-like ancestral strains associated with the first pandemic wave of infections in 2020. Successive waves on the continent were fueled by different VOCs, with Alpha and Beta cocirculating in distinct spatial patterns during the second wave and Delta and Omicron affecting the whole continent during the third and fourth waves, respectively. Phylogeographic reconstruction points toward distinct differences in viral importation and exportation patterns associated with the Alpha, Beta, Delta, and Omicron variants and subvariants, when considering both Africa versus the rest of the world and viral dissemination within the continent. Our epidemiological and phylogenetic inferences therefore underscore the heterogeneous nature of the pandemic on the continent and highlight key insights and challenges, for instance, recognizing the limitations of low testing proportions. We also highlight the early warning capacity that genomic surveillance in Africa has had for the rest of the world with the detection of new lineages and variants, the most recent being the characterization of various Omicron subvariants. CONCLUSION Sustained investment for diagnostics and genomic surveillance in Africa is needed as the virus continues to evolve. This is important not only to help combat SARS-CoV-2 on the continent but also because it can be used as a platform to help address the many emerging and reemerging infectious disease threats in Africa. In particular, capacity building for local sequencing within countries or within the continent should be prioritized because this is generally associated with shorter turnaround times, providing the most benefit to local public health authorities tasked with pandemic response and mitigation and allowing for the fastest reaction to localized outbreaks. These investments are crucial for pandemic preparedness and response and will serve the health of the continent well into the 21st century

Improvised intracranial pressure monitoring devices for traumatic brain injury management in a low-income environment: A single-centre randomised study demonstrating feasibility

Background: The high cost and non-availability of standard ICP monitoring devices limit their use in low- and middle-income countries like Nigeria. This study aims to demonstrate the use of an improvised intraventricular ICP monitoring device as a feasible alternative. Research question: Are improvised ICP Monitoring devices feasible and effective in resource-constrained settings? Materials and methods: The study was a prospective single-institution investigation involving 54 adult patients that presented with severe TBI (GCS of 3–8) within 72 ​h of injury and required operative intervention. All patients underwent craniotomy or primary decompressive craniectomy (DC) to evacuate traumatic mass lesions. 14-day in-hospital mortality was used as a primary endpoint of the study. 25 patients had ICP monitoring postoperatively using the improvised device. Results: The modified ICP device was replicated using a feeding tube and a manometer with 0.9% saline as a coupling agent. Based on hourly ICP recording (up to 72 ​h), patients were observed as having high ICP (>27 ​cm H2O) and normal ICP (27 ​cm H2O). In the ICP-monitored group, raised ICP was detected more than in the clinically assessed group (84% vs 12% p= <0.001). Discussion and conclusion: There was a 3-time higher mortality rate among the non-ICP monitored participants (31%) compared to the ICP-monitored participants (12%), although this did not reach statistical significance due to the small sample size. This preliminary study has shown that this modified ICP monitoring system is a relatively feasible alternative for diagnosing and treating elevated ICP in severe TBI in resource-constrained environments