Discharge against medical advice amongst patients admitted into the Paediatric wards of the University of Port Harcourt Teaching Hospital

Objectives: To identify the characteristics of patients and factorscontributing to DAMA in paediatric patients admitted into the University of Port Harcourt Teaching Hospital and to determine waysto reduce its prevalence.Method: This was a retrospective study of children admitted into thepaediatric wards of the Hospital. Case files of affected patients over atwo year period were reviewed and relevant information obtained andanalyzed.Results: There were 150 of 3981 patients admitted over the periodgiving a prevalence rate of 3.8%. There were 86 (57.3%) males and64 females (42.7%) with a male: female ratio of 1.3:1. Neonatal sepsis,birth asphyxia and prematurity were the commonest diagnosis inneonates whilst severe malaria, meningitis and bronchopneumoniawere the commonest in other children. Most discharges (54%) occurredwithin the first week of admission. Majority of patients were from low (35.3%) and middle (41.3%) income classes. The commonestreasons for DAMA were lack of funds (26.6%) and no improvement(26.6%), necessitating need to seek alternative therapy. The discharge document was signed by the father in 61.3% of cases.Conclusion: Children who were DAMA suffered from commoncauses of childhood mortality. Lack of funds, no improvement and lack/low decision making power of mothers were contributory factors.There is need for more universal implementation of the NationalHealth Insurance Scheme; effective communication between medicalteam and parents and female empowerment to reduce rates ofDAMA in our environment

Mothers Perception of Sexuality Education for Children

Sexuality education is the process of acquiring information and forming attitudes and beliefs about sex, sexual identity, relationships and intimacy. It develops young people's skills so that they make informed choices about their behaviour, and feel confident and competent about acting on these choices. It also equips children to face developmental challenges and empowers them against the ills of abuse, exploitation, unwanted pregnancies amongst others. Mothers who are the primary caregivers should be well informed about sexuality issues. The objective of the study is to determine mothers' perception of sexuality education in children, in Port Harcourt.A structured, anonymous and selfadministered questionnaire, used as instrument for data collection, was distributed amongst a convenient sample of women attending a Christian women's convention in Port Harcourt.One hundred and fifty eight women participated in the study. Most of them were married (80.4%), and belonged to the 30-49 years age bracket. Seventy one (44.9%) of the respondents had tertiary education. Over 80% agreed that children needed sexuality education but only 15 women (9.5%) had a good knowledge of the concept of sexuality education. One hundred and eleven (70.2%) believed it was the responsibility of both parents to educate their children and over 70% acknowledged that the home was the best place for such education. 64 (40.5%) believed that 6-10 years was the ideal age for starting sex education while 49% thought that the ideal age was 11-15 years. 65% of respondents discussed sexuality issues with their children at least occasionally,the content mostly involved description of body parts and reproductive organs. The average age of menarche amongst respondents was 14.0. One hundred (63%) of the women had prior knowledge of menstruation before menarche. About half of them had received information from their mothers.  The study highlights the need for enlightenment of women on sexuality education to enable them empower their children against the ills of child abuse.

Perception of Rape Amongst Secondary School Students In Port Harcourt

Background: Rape in children is a significant public health problem and represents the least reported but most devastating major form of child abuse all over the world. It occurs when one person does not fully and freely consent to sexual intercourse. This study seeks to evaluate the perception of rape among secondary school students in Port Harcourt.Methods: This study was conducted among secondary school students during a series of debates organised by the Medical Women Association of Nigeria in Port Harcourt. Using a structured, anonymous and self-administered questionnaire, data collected included bio data, awareness information, response and practices.Results: One thousand and fifty students, 486 (46.3 %) males and 564 (53.7 %) females participated in the study. Their ages varied between 10 and 20 years with a median age of 15. 872 (83%) knew the general definition of rape but only 4% knew that intercourse between an adult and a minor is also rape. 412 (39.3%) believed that only persons between 16 and 19 years could be raped. 442 (42.1%) believed that anyone, both relatives and strangers could be the perpetrator. Only 138 (13.2%) knew that rape should be reported to the police. 48(4.6%) of them had been raped, of which 62.5% were by close acquaintances.Conclusion: The study shows that respondents had a fair general knowledge about rape but the perception of age at risk and actions to take in case of rape is poor. There is therefore need for  awareness/enlightenment campaigns about rape targeted at secondary  school students.Key words: rape, secondary schools, student

Mixed Models with n>1 and Large Scale Structure constraints

Recent data on CBR anisotropies show a Doppler peak higher than expected in CDM cosmological models, if the spectral index $n=1$. However, CDM and LCDM models with n>1 can hardly be consistent with LSS data. Mixed models, instead, whose transfer function is naturally steeper because of free--streaming in the hot component, may become consistent with data if n>1, when Omega_h is large. This is confirmed by our detailed analysis, extended both to models with a hot component whose momentum space distribution had a thermal origin (like massive neutrinos), and to models with a non--cold component arising from heavier particle decay. In this work we systematically search models which fulfill all constraints which can be implemented at the linear level. We find that a stringent linear constraint arises from fitting the extra-power parameter Gamma. Other significant constraints arise comparing the expected abundances of galaxy clusters and high-z systems with observational data. Keeping to models with Gamma \geq 0.13, a suitable part of the space parameter still allows up to \sim 30% of hot component (it is worth outlining that our stringent criteria allow only models with 0.10 \mincir Omega_h \mincir 0.16, if n \leq 1). We also outline that models with such large non--cold component would ease the solution of the so--called baryon catastrophe in galaxy clusters.Comment: 28 pages + 9 figures, uses elsart.sty, to be published in New Astronom

Periodontitis is associated with significant hepatic fibrosis in patients with non-alcoholic fatty liver disease

This work was funded by the Diabetes Research and Wellness Fund. WA is in receipt of an MRC New Investigator Award

Development of three-dimensional tissue engineered bone-oral mucosal composite models

Tissue engineering of bone and oral mucosa have been extensively studied independently. The aim of this study was to develop and investigate a novel combination of bone and oral mucosa in a single 3D in vitro composite tissue mimicking the natural structure of alveolar bone with an overlying oral mucosa. Rat osteosarcoma (ROS) cells were seeded into a hydroxyapatite/tri-calcium phosphate scaffold and bone constructs were cultured in a spinner bioreactor for 3 months. An engineered oral mucosa was fabricated by air/liquid interface culture of immortalized OKF6/TERET-2 oral keratinocytes on collagen gel-embedded fibroblasts. EOM was incorporated into the engineered bone using a tissue adhesive and further cultured prior to qualitative and quantitative assessments. Presto Blue assay revealed that ROS cells remained vital throughout the experiment. The histological and scanning electron microscope examinations showed that the cells proliferated and densely populated the scaffold construct. Micro computed tomography (micro-CT) scanning revealed an increase in closed porosity and a decrease in open and total porosity at the end of the culture period. Histological examination of bone-oral mucosa model showed a relatively differentiated parakeratinized epithelium, evenly distributed fibroblasts in the connective tissue layer and widely spread ROS cells within the bone scaffold. The feasibility of fabricating a novel bone-oral mucosa model using cell lines is demonstrated. Generating human ‘normal’ cell-based models with further characterization is required to optimize the model for in vitro and in vivo applications