Urban Food Security in Nigeria

The challenges of urban food security in Nigeria are enormous. The unmitigated rural - urban drift or increase in urban population has made it significantly imperative to address the problem of dearth of or absolute lack of essential foods with balanced nutritional values in most of our urban centers. That apart, the burgeoning crisis of persistent lifestyle changes, the issue of greater emphasis on urban development without commensurate attention given to the important issue of food security, inadequate capacity for urban service provision and delivery, the persistent deteriorating infrastructure for urban food processing and preservation, rapid price changes, environmental contamination and other deplorable conditions that are visible in the urban centres, have made it germane to thoroughly review the problem of food insecurity in Nigeria. Under the present circumstances where urban living has become a matter of chance due to lack of political response to the issue, undue emphasis placed on individual responsibility towards addressing the food insecurity crisis deplorable rural infrastructure and persistent abandonment of well formulated policies on agricultural development, it is necessary to examine concretely these issues shaping up around the problem. The paper also attempts to lucidly locate the food security values and the formal safety nets that could be operationalized to enhance food sufficiency in Nigeria. It also provides some valid conclusions. Keywords: urban food security, Nigeria, urban drift, agricultural development, food sufficienc

Teacher Education and Technological Imperatives

A sound teacher education program is a prerequisite for a reliant education, which is the prime engine of human development, the vital transformational tool, the fulcrum around which the economic growth of the nation revolves. A nation can only develop meaningfully and professionally through a good teacher education program rooted in areas of instruction. This paper therefore, underscores the imperatives of technology in teacher education. Keywords: appropriate model teacher education, human development, technolog, teacher training

Prevalence of Anemia and Risk of Adverse Bleeding Effect of Drugs: Implication for Therapy

This study aimed to evaluate the progress in reduction of prevalence of anemia in rural Australia. It also investigates the prevalence of hypoviscosity in anaemia with a view to determine the fraction of anaemic patients at risk of drug-inducible exacerbation of anemia. Archived clinical pathology data (N = 130, 354) for the period of 1999 to 2008 were utilized. The prevalence of anemia and hypoviscosity was evaluated by working out (i) the number that fell within anemia definition as a percentage of the population and (ii) the number that fell within hypoviscosity definition as a percentage of anemic patients. The prevalence in anemic diabetes and dyslipidaemia was further determined. There was progressive reduction in anemia from 6.1% to 3.2% over the ten years period. Prevalence of anemia is statistically significantly higher in males than in females (P < 0.0001), but protein level is lower in anemic females than in anemic males (P < 0.01). The results further show that up to 75% of anemic patients may benefit from NSAID or salicylates. This paper highlights differences between genders. It suggests more concerted effort in men's health and speculates a new factor to investigate in women's health

Advancing indigenous fruits consumption to promote self-management in ill-health: a critical narrative review

Most African communities consume various edible fruits, which are important to their well-being. Some of these edible fruits are indigenous and were well-known to the rural communities. These indigenous fruits can be collected from the wild or planted in home gardens and also as intercrops with staple crops. Some indigenous fruits, wild collection is still practiced, especially in parts of eastern, western and southern Africa. However, some fruits are still imported. A casual verbal survey indicated that many people in the general population do not know that actual differences in nutritional values between these fruits. Therefore, this study was a critical review of some fruits using the USDA database. Results show, for instance, that guava has over 250% vitamin C relative to orange. Avocado yields more calories than banana and this is very likely due to the fat/fibre ratio difference. Further, the imported cucumber and watermelon do not seem to have any advantage over the indigenous products. It concluded that the hidden potential of these indigenous fruits needs to be advanced and exploited to improve their consumption as they play a pivotal role in health economics of healthy dietary habit and self-management of ill-health

Role of Colesevelam in Combination Lipid-Lowering Therapy

Hyperlipidemia is associated with an increased risk of cardiovascular events; reducing low-density lipoprotein cholesterol (LDL-C), the primary target for cholesterol-lowering therapy, lowers the risk for such events. Although bile acid sequestrants were the first class of drugs to show a mortality benefit related to LDL-C lowering, statins are now considered first-line pharmacological therapy for reducing LDL-C levels because of their potency and their remarkable record of successful outcomes studies. Nevertheless, a substantial proportion of patients do not achieve LDL-C goals with statin monotherapy. In addition, because of adverse effects (primarily myopathy), some patients may be unwilling to use or unable to tolerate statin therapy at all or may not tolerate a full therapeutic statin dose. Also, statins may increase risk of new-onset diabetes in patients at high risk for diabetes. Thus, there remains a need for other lipid-lowering drugs to be used in combination with or in place of statins. The purpose of this article is to review available data from the literature on the use of colesevelam, a second-generation bile acid sequestrant, in combination with other lipid-lowering agents. Colesevelam has been studied in combination with statins, niacin, fibrates, and ezetimibe (including some three-drug combinations). An additive reduction in LDL-C was seen with all combinations. Other observed effects of colesevelam in combination with other lipid-lowering drugs include reductions in apolipoprotein (apo) B (with statins, fibrates, ezetimibe, statin plus niacin, or statin plus ezetimibe) and high-sensitivity C-reactive protein (with statins), and increases in apo A-I (with statins, ezetimibe, or statins plus niacin). Triglyceride levels remained relatively unchanged when colesevelam was combined with statins, fibrates, ezetimibe, or statin plus ezetimibe, and decreased with the triple combination of colesevelam, statin, and niacin. Colesevelam offset the negative glycemic effects of statins and niacin in subjects with insulin resistance or impaired glucose tolerance. Colesevelam was generally well tolerated when added to other lipid-lowering therapies in clinical trials, with gastrointestinal effects such as constipation being the predominant adverse events. Since colesevelam is not absorbed and works primarily in the intestine, it has a low potential for systemic metabolic drug–drug interactions with other drugs. Colesevelam has been shown to not interact with the lipid-lowering drugs lovastatin and fenofibrate; where interaction may be anticipated, separating dosing times by 4 h reduces the impact of any interaction. Available data confirms that colesevelam has additive cholesterol-lowering effects when used in combination with other lipid-lowering therapies. Furthermore, in some patient populations, the additional glucose-lowering effect of colesevelam may be beneficial in offsetting hyperglycemic effects of other lipid-lowering drugs

Morning sickness in pregnancy: mini review of possible causes with proposal for monitoring by diagnostic methods

Nausea, vomiting in pregnancy (NVP) and hyperemesis gravidarum (HG) can have adverse effects on the mother and foetus. High risk groups for HG seem to include young women, non-smokers, non-Caucasian and women carrying multiple foetuses. Medical databases show that oestrogen, human chorionic gonadotrophin (hCG), thyroxine and insulin are associated with NVP and HG by mechanisms that are unclear. It is possible that NVP and HG may have different hormonal aetiologies. Other risk factors implicated in NVP and HG include psychological and genetic as well as external factors such as smoking status, age, bacterial infection and diet. The hypothesis hereby proposed is that hypoglycaemia, nausea and vomiting are associated with pregnancy perhaps due to disturbances in metabolic control and increased requirements for glucose by growing foetus. During overnight fasting, the resultant hypoglycaemia possibly triggers nausea and vomiting. This calls for investigations and of note is whether severities of NVP and HG correlate to blood glucose levels. This proposal reviews current thinking on the causes of NVP and HG as well as possible pathology evidence-based monitoring measures

Screening for gestational diabetes: evaluation of prevalence in age-stratified subgroups at Central hospital Warri Nigeria

Background: The prevalence of gestational diabetes depends on the method of diagnosis as well as ethnic background. Maternal age has also been identified as a factor, but has not been given much attention. The notion of gestational prediabetes has also speculated, but is equally yet to be a focus in discussion. Aim: This work aimed at evaluating the screening for gestational diabetes in Central Hospital, Warri; to determine prevalence of gestational diabetes in the general population and in stratified age groups. The other objective was to investigate the effectiveness and use of the methods of diagnosis. Materials and Methods: This was a retrospective review of laboratory data of de-identified antenatal patients. Hospital records of gestational diabetes from 2013 to 2015 were obtained from the Central Hospital, Warri. Data collected included age of the de-identified patients, blood glucose results and whether the test was fasting or random. Other information was the month/year of test. A total of 3 589 results were analyzed. Results: Averaged prevalence of 5.85% is identified. Fasting blood sugar (FBS) measurement was used more and it also identified more positives (9%) compared to random blood sugar (<2%). On a dichotomous age group, prevalence of gestational diabetes appeared low in women below 25 years compared to those ≥26 years old. In a more stratification of age groups, potential antepartum prediabetes in pregnancy was lower in women above 40 years old relative to the younger age subpopulations (p < 0.000001). No significant variation was observed in level of usage of either method between months/years. Conclusion:  There is an ongoing good practice of using affordable screening test, which is FBS. The significant finding was that there may be up to 9% prevalence of GDM and that this number may erroneously be lower if random blood glucose measurement is used. Another worthy observation was that the prevalence in stratified age groups was non-directional, especially as prediabetes appears higher in the younger age subpopulation

The odds that working women will accept cervical cancer screening and HPV vaccination

Background: Factors influencing acceptance of cervical cancer services are being investigated, and widely reported to be quite low. However, there is dearth of research investigation on the odds of women’s acceptance of this gynaecological service. Objective of this study was to investigates the odds of unwilling to accept cervical cancer services.Methods: The study was a questionnaire-based cross-sectional survey and fourth piece in a series of analysis. Details of data collection are as previously described. Odds ratio was determined using online calculator; and based on proportion of respondents who have accepted the cervical cancer service, willing to complete an incomplete process and encourage others to take up the procedure.Results: The percentage of respondents who indicated no problem with HPV vaccination (55%) is higher than cervical screening (53%), but not statistically significantly different. On average, unwillingness to vaccinate later, complete their vaccinations or encourage their daughter are one-third of those who vaccinated. Those unwilling to take up cervical screening, encourage others to screen or overcome their fears are more than (161%) the subgroup who have been screened. Results show odds of unwillingness for both procedures are less than 1, but a little greater for cervical screening.Conclusions: It has been articulated that the likelihood to take up cervical cancer services will be influenced by the beliefs. This report advances that observed low acceptance level does not translate to high likelihood of unwillingness to accept the gynaecological services. Belief and nature of work of women need to be concertedly investigated

Right Ampullary Ectopic Pregnancy Following Bilateral Tubal Ligation Using Spring Clips.

Pregnancy is unlikely to occur in women who have undergone sterilization. However when it occurs, there is a substantial risk that it will be an ectopic pregnancy. We report a case of right unruptured ampullary ectopic gestation following tubal sterilization with spring clips 6 years prior to presentation. The likely aetiology may be spontaneous reanastomosis.Keywords: Ectopic, Bilateral Tubal ligation, Spring Clips

Factors influencing the acceptance of cervical cancer screening among civil servants in Delta State Secretariat

Background: Cervical cancer is one of the top two cancers affecting Nigerian women. This has created impetus to investigate the situation. This third of a four-part series seeks to evaluate perception, acceptance and psychosocial factors of cervical screening among women who are gainfully employed in the State’s civil service within Delta State Secretariat.Methods: Based on cross-sectional descriptive survey using a structured questionnaire and ‘N=285’ participants. Statistical analysis assessed percentage proportions of respondents; as well as absolute and relative frequencies of the factors associated with acceptance of screening. Chi-squared analysis was based on no/yes response to have done cervical screening.Results: About 10% of respondents have undergone cervical screening. 16% of the lowest income earners have done the screening, compared to 8% and 10% of the mid income and high income group, respectively. Nature of work implying time constraints was an absolute factor. Knowledge of what cervical cancer is; the causes; how to detect and prevent it are significantly associated (p <0.01), while accessibility, fear of adverse effect and attitude of healthcare workers were significant psychosocial factors (p 0.01).Conclusions: This report affirms nature of work and accessibility as two of four major factors influencing acceptance of cervical screening among working class women in Delta State secretariat. It is hereby suggested to expound sites of cervical service programs