Predictors Of Risky Health Behaviours Among Secondary School Students With Hearing Impairment In South -West, Nigeria

Like every adolescent, students with hearing impairment engaged in Risky Health Behaviour (RHB) such as alcohol consumption, cigarette consumption, drug abuse, inadequate physical activities, unhealthy dietary behaviour as well as indiscriminate sexual acts. These activities have therefore become issues of public health concern. Previous studies have focused majorly on the academic performance, emotional stability and psychological adjustment of students with hearing impairment than on their RHB and its socio-economic predisposing factors. This study, therefore, examined social (discrimination, home, health awareness, peer influence and false belief) and economic (poverty and purchasing power) factors as predictors of RHB among Secondary School Students with Hearing Impairment (SSSHI) in south-west, Nigeria.. The study adopted a descriptive survey design. Purposive sampling technique was used to select 980 students with hearing impairment from some secondary schools in southwest Nigeria. Five hypotheses were tested at 0.05 level of significance. Data was analysed using descriptive statistics, multiple regression. Social and economic factors had significant composite contribution to RHB (F(7,973)=22.80; R=0.37) and accounted for 17.0% of the variance of RHB. The relative contributions of the independent variables to risky health bebehaviour are: Peer influence (β=0.25), Purchasing power (β=0.23), discrimination (0.15), poverty (β=0.10) home (β=0.08), false belief (β=0.07) )and health awareness(0.02). Unfriendly home situation, negative peer influence, false beliefs, poverty and low purchasing power predicted risky health behaviour among secondary school students with hearing impairment Therefore, government should organise periodic health and sensitization programmes on health issues for students, parents and teachers

Determination of Fuel Properties of Biodiesel from Sand Apple Seed Oil with Automotive Gas Oil Blend

The objective of this study was to determine the fuel properties of Sand Apple Ethyl Ester (SAEE) and its blends with Automotive Gas Oil (AGO).using eggshell as catalyst. Sand apple seed oil (SASO) obtained was characterized based on America Society for Testing and Material (ASTM D6751) to determine acid value, saponification, iodine content, density, kinematic viscosity, flash point, cloud point and pour point. Sand Apple fruits were processed and oil extracted using solvent extraction method. Raw eggshells were calcined at 800oC for 120 min in the muffle furnace. SAEE was blended with AGO at 5 – 25 % mix. Data obtained was analyzed using ANOVA at P < 0.05 significant level. Cloud and pour points obtained for SASO are 4.68 and 3.09℃ . Flash point was 103℃ which fell within ASTM D93 range indicating that SASO is safe for handling and storage. Heating value was 42.61 MJ/kg, slightly lower than that of diesel oil of 44.8 MJ/kg shows that AGO has ability to produce heat of combustion than SASO. Iodine value was 80.71 g I/100g while acid value was determined to be 2.62 mgKOH/g, which was higher than that of ASTM D6751 of 0.5 mgKOH/g. Sulphur contents for AGO and SASO–AGO blends were 0.006, 0.009, 0.014, 0.016 and 0.004%, respectively. Low sulphur values indicates that hazardous sulphur dioxide emission of SAEE has reduced. This study established that all the properties obtained, except acid value, fell within the ASTM specification and could suitably be compared with those of fossil diesel

Underutilization of the Clinical Microbiology Laboratory by Physicians in Nigeria

Background: Clinical laboratories are critical to correct diagnosis of medical conditions to ensure appropriate management. Point prevalence survey (PPS) of antimicrobial use and resistance performed in Nigeria in 2015 and 2017 showed high rates of antibiotic use, but poor laboratory utilization for definitive diagnosis of the infections for which the antimicrobials were prescribed. This study investigated the reasons for clinicians‟ poor utilization of the clinical laboratory for definitive diagnosis and treatment of infections.Methods: A cross sectional survey of clinicians attending the 2018 annual scientific conference and general meeting of the National Postgraduate Medical College of Nigeria (NPMCN) in Owerri, Southeastern Nigeria, was conducted using self-administered structured questionnaire to obtain information on the sub-optimal utilization of the clinical microbiology laboratory. Results: Of 283 respondents, 14.8% were general practitioners and 85.2% were specialists who have been in practice for a median period of 20 years (range 3 – 48 years). The specialists included surgeons (26%), family physicians (19.8%), internists (14.3%), pathologists (13.9%), paediatricians (8.8%), obstetricians and gynecologists (8.1%), community medicine physicians (6.2%), and dental surgeons (2.6%). Majority of the respondents (90.8%) work in public, 88.3% work in tertiary and 9.9% in secondary care hospitals. For diagnosis of infections, 16% and 49.8% reported using laboratory “always” and “very often” respectively. Among these, the most commonly utilized investigations were microscopy, culture and sensitivity (62.4%), DNA detection (18.3%), GeneXpert for tuberculosis (17.2%), and antigen detection (16.7%). Among clinicians that “hardly make use” of the laboratory, their reasons for non-use were; clinical diagnosis being sufficient (39.7%), delayed results (17.2%), having knowledge of „potent‟ antibiotics (15.5%), lack of access to microbiology laboratory (13.8%), absence of pathologists to assure quality of tests (12.1%), and no need of the laboratory to manage patients with infections (8.6%).Conclusion: These findings indicate that poor use of the microbiology laboratory seems mainly associated with perception and attitude of the physicians to the relevance of the laboratory, and perceived inadequacy of microbiology practice in some others. There is need to raise physicians‟ awareness on the relevance and what constitutes optimal use of the clinical microbiology laboratory for accurate diagnosis of infections and appropriate antimicrobial use.Key words: utilization, microbiology laboratory, diagnosis, antimicrobials, infectious disease

Roll out of a successful antimicrobial stewardship programme in Lagos University Teaching Hospital Nigeria using the Global-Point Prevalence Survey

Background: Antimicrobial resistance (AMR) has become a public health emergency with increasing rates and spread globally. Antimicrobial stewardship (AMS) has been advocated to reduce the burden of antimicrobial resistance, promote rational and appropriate use of antibiotics and improve clinical outcomes. Education and training are one of the AMS interventions to improve antimicrobial use. We present the roll out of a successful AMS programme with education and training using the Global-PPS as data collection tool to measure AMS interventions and impact.Methodology: This was a cross sectional study on the implementation of an AMS programme at the Lagos University Teaching Hospital. Global PPS was conducted in 2015 to collect baseline data which was used to identify targets for quality improvement in AMS and was repeated in 2017 and 2018 to measure impact of AMS interventions. AMS interventions included education, feedback of Global-PPS result and writing of the hospitalwide antibiotic policy based on the baseline data.Results: Out of the 746 inpatients surveyed, 476 (68.3%) had received at least one antimicrobial on the days of Global-PPS. The antimicrobial prescribing rates reduced significantly over the three time periods. In 2015, 82.5% were placed on antimicrobials, 65.5% in 2017 and 51.1% in 2018 (p<0.00001). The documentation of indication for treatment significantly improved from 53.4% in 2015 to 97.2% in 2018 (p<0.0001). Stop review date also significantly improved from 28.7% to 70.2% in 2018 (p<0.00001). Surgical prophylaxis for more than 24 hours reduced significantly from 93.3% in 2015 to 65.7% in 2018 (p=0.002) even though the prevalence was still high. The three most commonly administered antimicrobial groups were third generation cephalosporins, imidazole derivatives and quinolones. The most commonly prescribed antibiotics for surgical prophylaxis were ceftriaxone and metronidazole in 2015 and ceftriaxone in 2017.Conclusion: The use of education and training as AMS intervention in a limited resource setting clearly made impact on antimicrobial prescribing patterns in the hospital. Global-PPS is useful to set quality improvement targets and for monitoring, evaluation and surveillance of an AMS programme. Keywords: Antibiotic, Stewardship, Resistance, Education, Global-PP

Point prevalence survey of antimicrobial consumption and resistance: 2015-2018 longitudinal survey results from Nigeria

Background: Nigeria joined the global community in monitoring antimicrobial prescribing practices since 2015. Results of individual hospital Global Point Prevalence Survey (Global-PPS) have stimulated efforts at instituting hospital-based antimicrobial stewardship (AMS) programmes. We report the trends of antimicrobial prescribing rates and quality indicators for 3 surveillance periods; 2015, 2017 and 2018.Methodology: The web-based Global-PPS for surveillance of antimicrobial use in hospitals (www.globalpps.com) was completed by each participating hospital site for all inpatients receiving antimicrobials on a selected day in 2015, 2017 and 2018. Data included details on antimicrobial agents, reasons and indications for treatment and a set of quality prescribing indicators. Data were validated by the web-based data management system of University of Antwerp, exported into Microsoft Excel and analyzed with EPI INFO version 7.2.Results: Thirteen hospitals participated in the survey involving a total of 5,174 inpatients. Mean weighted overall antimicrobial prescribing prevalence was 70.7% which declined over the years from 71.7% in 2015 to 59.1% in 2018 (p<0.001). The rate of documentation of date for post prescription review improved from 27.9% in 2015 to 48.5% in 2018 (p<0.001) while the rates of targeted treatment declined from 12.0% in 2015 to 5.2% in 2018 (p<0.001). There was no significant change in the choice of parenteral drug administration (64.5% in 2015, 65.1% in 2017 and 62.6% in 2018; p=0.6803), and but there was significant increase in documentation of reasons for prescription in case notes (62.2% in 2015, 74.5% in 2017, and 70.9% in 2018; p=0.008). Overall, the main indications for therapeutic prescribing were skin and soft tissue infections (20.8%), sepsis (15.9%) and pneumonia (11.6%). The top three antibiotics for therapeutic use were ceftriaxone (18.2%), metronidazole (15.3%) and ciprofloxacin (10.4%).Conclusions: The survey showed reduction in the overall antimicrobial prescribing rate especially in hospitals that had introduced AMS programmes. Among the quality prescribing indicators, documentation of post prescription review date showed improvement. The Global-PPS serves as a cost effective, flexible and userfriendly tool in instituting AMS programmes in hospitals. Keywords: antimicrobial prescribing, hospital, global-point prevalence survey, quality indicator

Aflatoxin biocontrol effectiveness in the real world-Private sector-led efforts to manage aflatoxins in Nigeria through biocontrol-centered strategies

Open Access Journal; Published online: 02 Sep 2022Aflatoxins are toxic compounds produced by several Aspergillus species that contaminate various crops. The impact of aflatoxin on the health of humans and livestock is a concern across the globe. Income, trade, and development sectors are affected as well. There are several technologies to prevent aflatoxin contamination but there are difficulties in having farmers use them. In Nigeria, an aflatoxin biocontrol product containing atoxigenic isolates of A. flavus has been registered with regulatory authorities and is now being produced at scale by the private company Harvestfield Industries Limited (HIL). The current study reports results of biocontrol effectiveness trials in maize conducted by HIL during 2020 in several locations across Nigeria and compared to untreated maize from nearby locations. Also, maize was collected from open markets to assess levels of contamination. All treated maize met tolerance thresholds (i.e., <4 ppb total aflatoxin). In contrast, most maize from untreated fields had a higher risk of aflatoxin contamination, with some areas averaging 38.5 ppb total aflatoxin. Maize from open markets had aflatoxin above tolerance thresholds with even an average of up to 90.3 ppb. Results from the trials were presented in a National Workshop attended by key officers of Government agencies, farmer organizations, the private sector, NGOs, and donors. Overall, we report (i) efforts spearheaded by the private sector to have aflatoxin management strategies used at scale in Nigeria, and (ii) deliberations of key stakeholders to ensure the safety of crops produced in Nigeria for the benefit of farmers, consumers, and industries

Dexamethasone suppression tests in liver cirrhosis - abnormalities in patients with primary hepatocellular carcinoma.

[Extract] Primary hepatocellular carcinoma (PHC), an important cause of morbidity and mortality in many African and Asian countries [1-4], has protean manifestations. Aside from its classical clinical and biochemical presentation, PHC is associated with a variety of paraneoplastic phenomena, including increased erythropoietin production, hypoglycaemia, hypercholesterolaemia and hypercalcaemia [5,6]. The terminal patient with PHC in Nigeria may have a variety of fluid and electrolyte abnormalities, particularly resistant ascites and hypokalaemia

Postítulo

Otorgar reconocimiento oficial y validez nacional al Postítulo de Formación Universitaria en Arte Escénica con Mención Teatro y Mención Expresión Corporal-Danza, que articula con el título de grado de Profesor en Arte Escénica Mención Teatro y Mención Expresión Corporal-Danza y con articulación al título de grado de Licenciado en Arte Escénica Mención Teatro, que expide la Universidad Nacional de Rosario, cuyo planes de estudio obran como Anexo de la presente resolució

SPECTRUM AND OUTCOME OF CLINICAL DISEASES IN ADULTS LIVING WITH AIDS AT THE OGUN STATE UNIVERSITY TEACHING HOSPITAL

ABSTRACTObjectives: To evaluate the changing frequency of HIV/AIDS amongst medical admissionsas well as the spectrum and outcome of clinical diseases among these patients.Design: Retrospective study.Setting: Tertiary hospital in Nigeria.Participants: Two hundred and six People Living With AIDS (PLWA) admitted at themedical wards during the period 1992 to 2002.Intervention: Treatment was symptomatic in all patients and where appropriate, specifictreatment was administered for indicator diseases. Highly Active Anti-retroviral Therapy(HAART) was not used.Main outcome measures: Mortality within six months of diagnosis.Results: PLWA constituted 4.2% of all medical admissions. The frequency increasedfrom 0% in 1992 to 7.6% in 2001, and dropped to 5% by the year 2002. Seventy patients(34%) died within six months of diagnosis.Results: This study has demonstrated an increasing frequency of HIV/AIDS amongstour medical in-patients from none in 1992 to 7.6% in 2001, and thereafter, a declinein 2002. We suspect that this decline could be a reflection of the health education onHIV, its increasing awareness and the widespread utilisation of effective controlmeasures. Furthermore, the administration of highly active anti retroviral therapy(HAART) to a segment of PLWA in Sagamu by the community medicine departmentcould be contributory.Conclusion: A community based study would be needed to assess the efficacy or otherwiseof these current control measures. The advent of saliva and urine tests for HIV detectionwould ease specimen collection and increase compliance and participation at thecommunity level