A Conceptual Framework for Community Pediatrics Using Knowledge Management

Knowledge management, the management of corporate and individual knowledge, has been adopted by many organizations,including medicine. However, Knowledge management in community pediatrics, an arm of public health, has not been fullyresearched. Although, medical information systems have been developed over the past decade, they have not fully solved thecapture, retrieval and reuse of medical knowledge. This is because most of the information systems deal with informationtechnologies excluding intellectual resources, which in reality is the most important part of knowledge management. Thispaper proposes a conceptual framework for knowledge management in community pediatrics. First, it gives a high-leveloverview of medical knowledge and knowledge management. Next, it discusses knowledge in the media domain. It explainsthe conceptual framework proposed, giving details of the various knowledge management components. The paper isconcluded with a brief discussion on other application areas of the framework.Keywords: knowledge management; community pediatrics; public health; medical knowledge; medicine.

Correlation between faecal indicator bacteria in diarrheagenic stools and hospital wastewaters: Implication on public health

Background: Hospital wastewaters contain blends of inorganic, natural constituents and contaminants that carry significant health risk when released directly into the environment. The aim of this study is to investigate the correlation between faecal indicator bacteria in diarrheagenic stools and wastewaters generated in University of Medical Sciences Teaching Hospital complex, Akure, Nigeria.Methodology: Quantification of faecal indicator bacteria was carried out on diarrheagenic faecal samples collected from 55 hospitalized patients and 68 wastewater samples from the medical laboratory science and laundry units of the hospital over of period of 12 weeks. Standard membrane filtration technique was performed using membrane intestinal enterococcus (m-ENT), membrane faecal coliform (m-FC), membrane lauryl sulphate (MLSA), eosin methylene blue (EMB) and Salmonella-Shigella (SS) agar plates, which were incubated at 37ºC for 24 hours (MLSA, EMB and SSA), 44ºC for 24 hours (m-FC); and 37ºC for 48 hours (m-ENT). Bacterial colonies on agar plates were counted and expressed as colony forming units (CFU) per 100ml of diarrheagenic stool and wastewater. Pearson’scorrelation analysis was used to determine the relationship between the level of faecal indicator bacteria in diarrheagenic stools and wastewaters at p<0.05 level of significance (and 95% confidence interval).Results: The faecal coliform counts (log 10 CFU/100ml) ranged from 1.18 to 1.54 in diarrheagenic stools, 1.32 to1.64 in laboratory wastewater and 1.08 to 2.19 in laundry wastewater. Escherichia coli count (log 10 CFU/100ml) ranged from 1.08 to 1.40 in diarrheagenic stools, 1.20 to 1.86 in laboratory wastewater and 0.30 to 1.81 in laundry wastewater. Intestinal enterococci count (log 10 CFU/100ml) ranged from 0 to 0.30 in diarrheagenic stools, 0.78 to 0.90 in laboratory wastewaters and 0.48 to 1.11 in laundry wastewaters. Pearson’s correlation co-efficient showed that all the faecal indicator bacteria count in diarrheagenic faecal samples exhibited positive correlation with those in laboratory wastewaters, but not with those from laundry wastewaters.Conclusion: The findings suggest that diarrheagenic stools should be properly disinfected after the performance of laboratory tests to prevent transmission of potential pathogens, and wastewater generated from hospitals should be treated prior to discharge into the environment, to prevent possible infections in the community. Keywords: Correlation, faecal indicator bacteria, public health, transmission, wastewate

COMPARATIVE EVALUATION OF GENOTYPING AND CULTURE-BASED TECHNIQUES FOR FUNGAL KERATITIS DETECTION

The study aims to compare the direct polymerase chain reaction with microbial culture for the detection and fungal pathogens in infectious keratitis.  A total of 81 corneal ulcers were culture and analyzed prospectively. PCR was performed with all corneal scrapping with fungal and bacteria specific primers. PCR products were analysed and compared with the culture results using standard methods. Of the 81 samples, 80 were positive by PCR, 51 for fungi and 29 for bacteria. Out of 51 PCR positive samples, 22 samples were culture positive and 29 were culture negative. The majority of PCR genotyped samples matched the positive culture results. The positive detection rate of 80/81 (98.8%) with high suspicion of fungal keratitis and positive detection rate of direct PCR 50/51(98.0%) were observed. The sensitivities for the diagnosis of fungal keratitis with direct PCR and culture were 98.0% (50/51) and 43.1% (22/51) (p< 0.001) whereas the specificities were 100.0% (2/2) and 100.0% (1/1) respectively. The time required to complete the direct PCR was only 3 hours. The direct PCR assay is a rapid diagnostic technique with high sensitivity and specificity for infectious keratitis and it is expected to have impact on the diagnosis and treatment of infectious keratitis. &nbsp

Application of Linear Programming in optimization of parking slot: A case study of Tamale-Bolgatanga lorry station in Ghana

This paper deals with optimization of parking slot via linear programming of Tamale/Bolgatanga main lorry station at the Tamale Metropolis in the Northern region of Ghana. It examined the maximum parking capacity of the Terminal and how it will be optimized to avoid traffic congestion in the metropolis and determined the best parking slot allocation to be distributed among different types of vehicle on limited parking space

Distribution and Speciation of Heavy Metals in Soils around Some Selected Auto Repair Workshops in Oghara, Delta State, Nigeria

Soil contamination by heavy metals is a worldwide environmental problem. Hence determining the chemical forms of a metal in soils is important to evaluate its mobility and bioavailability. This study determined the distribution and speciation of some heavy metals (Fe, Cu, Zn, Pb and Cd) in soils around some selected auto repair workshops in Oghara, Delta State, Nigeria. Soil samples were collected with the aid of soil Augar within a depth of 0 – 15 cm from the vicinity of the four selected auto repair workshops in Oghara, Delta State, Nigeria. The control samples were taken from a site free from auto repair and commercial activities. The soil samples were assessed for some physico-chemical properties, total heavy metal concentration, chemical speciation, mobility and some metal assessment indices of the heavy metals as a function of soil properties. The mean concentration of Fe, Cu, Zn, Pb and Cd in all the sites analyzed were 550.54, 31.08, 36.15, 4.21 and 1.11 mg/kg respectively. Site B and the control had the highest and lowest total concentration of the five metals analyzed respectively. The levels of Cu were above the DPR target value in sites A and B, while the levels of Cd were above the target value in all the sites except in the control site. All the metals were found to be mostly concentrated in the residual fraction except Zn which was found mostly in the carbonate fraction. The mobility factors revealed that Zn is the most mobile element with an average mobility factor of 41.54% while Cd is the least mobile element with an average mobility factor of 16.51%. Contamination factors, index of geoaccumulation and pollution load index were also calculated. This study showed that mechanic workshop is one of the major sources of anthropogenic heavy metals concentration in the environment

Cassava trait preferences of men and women farmers in Nigeria: implications for breeding

Nigeria is the world’s largest cassava producer, hosting a diverse array of cassava farmers and processors. Cassava breeding programs prioritize “common denominator” traits in setting breeding agendas, to impact the largest possible number of people through improved varieties. This approach has been successful, but cassava adoption rates are less than expected, with room for improvement by integrating traits in demand by farmers and processors. This paper aims to inform breeding priority setting, by examining trait and varietal preferences of men and women cassava farmer/processors. Men and women in eight communities in Southwest and Southeast Nigeria were consulted using mixed methods. Women and men had significantly different patterns of cassava use in the Southwest. Fifty-five variety names were recorded from the communities demonstrating high genetic diversity maintained by growers, especially in the Southeast. High yield, early maturity, and root size were most important traits across both regions, while traits women and men preferred followed gender roles: women prioritized product quality/cooking traits, while men placed higher priority on agronomic traits. Trait preference patterns differed significantly between the Southeast and Southwest, and showed differentiation based on gender. Patterns of access to stem sources were determined more by region and religion than gender

Prevalence of symptoms, comorbidities, fibrin amyloid microclots and platelet pathology in individuals with Long COVID/Post-Acute Sequelae of COVID-19 (PASC)

BackgroundFibrin(ogen) amyloid microclots and platelet hyperactivation previously reported as a novel finding in South African patients with the coronavirus 2019 disease (COVID-19) and Long COVID/Post-Acute Sequelae of COVID-19 (PASC), might form a suitable set of foci for the clinical treatment of the symptoms of Long COVID/PASC. A Long COVID/PASC Registry was subsequently established as an online platform where patients can report Long COVID/PASC symptoms and previous comorbidities.MethodsIn this study, we report on the comorbidities and persistent symptoms, using data obtained from 845 South African Long COVID/PASC patients. By using a previously published scoring system for fibrin amyloid microclots and platelet pathology, we also analysed blood samples from 80 patients, and report the presence of significant fibrin amyloid microclots and platelet pathology in all cases.ResultsHypertension, high cholesterol levels (dyslipidaemia), cardiovascular disease and type 2 diabetes mellitus (T2DM) were found to be the most important comorbidities. The gender balance (70% female) and the most commonly reported Long COVID/PASC symptoms (fatigue, brain fog, loss of concentration and forgetfulness, shortness of breath, as well as joint and muscle pains) were comparable to those reported elsewhere. These findings confirmed that our sample was not atypical. Microclot and platelet pathologies were associated with Long COVID/PASC symptoms that persisted after the recovery from acute COVID-19.ConclusionsFibrin amyloid microclots that block capillaries and inhibit the transport of O2 to tissues, accompanied by platelet hyperactivation, provide a ready explanation for the symptoms of Long COVID/PASC. Removal and reversal of these underlying endotheliopathies provide an important treatment option that urgently warrants controlled clinical studies to determine efficacy in patients with a diversity of comorbidities impacting on SARS-CoV-2 infection and COVID-19 severity. We suggest that our platelet and clotting grading system provides a simple and cost-effective diagnostic method for early detection of Long COVID/PASC as a major determinant of effective treatment, including those focusing on reducing clot burden and platelet hyperactivation

Patient characteristics associated with COVID-19 positivity and fatality in Nigeria: retrospective cohort study

Objective: Despite the increasing disease burden, there is a dearth of context-specific evidence on the risk factors for COVID-19 positivity and subsequent death in Nigeria. Thus, the study objective was to identify context-specific factors associated with testing positive for COVID-19 and fatality in Nigeria. Design Retrospective cohort study. Setting: COVID-19 surveillance and laboratory centres in 36 states and the Federal Capital Territory reporting data to the Nigeria Centre for Disease Control. Participants: Individuals who were investigated for SARSCoV-2 using real-time PCR testing during the study period 27 February–8 June 2020. Methods: COVID-19 positivity and subsequent mortality. Multivariable logistic regression analyses were performed to identify factors independently associated with both outcome variables, and findings are presented as adjusted ORs (aORs) and 95% CIs. Results: A total of 36 496 patients were tested for COVID-19, with 10 517 confirmed cases. Of 3215 confirmed cases with available clinical outcomes, 295 died. Factors independently associated with COVID-19 positivity were older age (p value for trend<0.0001), male sex (aOR 1.11, 95%CI 1.04 to 1.18) and the following presenting symptoms: cough (aOR 1.23, 95% CI 1.13 to 1.32), fever (aOR 1.45, 95% CI 1.45 to 1.71), loss of smell (aOR 7.78, 95% CI 5.19 to 11.66) and loss of taste (aOR 2.50, 95% CI 1.60 to 3.90). An increased risk of mortality following COVID-19 was observed in those aged ≥51 years, patients in farming occupation (aOR 7.56, 95% CI 1.70 to 33.53) and those presenting with cough (aOR 2.06, 95% CI 1.41 to 3.01), breathing difficulties (aOR 5.68, 95% CI 3.77 to 8.58) and vomiting (aOR 2.54, 95% CI 1.33 to 4.84). Conclusion: The significant risk factors associated with COVID-19 positivity and subsequent mortality in the Nigerian population are similar to those reported in studies from other countries and should guide clinical decisions for COVID-19 testing and specialist care referrals