Burden and spectrum of paediatric respiratory diseases at a referral hospital in North-Central Nigeria - A five year review

Introduction: Globally respiratory diseases, comprising a broad range of disease conditions due to infectious and non-infectious causes, are a major cause of childhood morbidity and mortality. Thus, identification of the burden of respiratory illness will ensure appropriate interventions towards reducing its attendant morbidity and mortality. The study was conducted to identify the burden, spectrum and outcome of respiratory diseases in hospitalized children at University of Ilorin Teaching Hospital, North-Central Nigeria. Methods: A retrospective descriptive cross-sectional study involving children admitted through the emergency paediatric unit over five years (January 2013-December 2017) was conducted. Data on demography, diagnosis, comorbidities and complications, duration of admission, and outcome were collected and analyzed using SPSS 20. Results: Of the total 7012 children admitted, 1939(27.7%) were due to respiratory diseases with a median age of 16 (interquartile range {IQR} 7-36) months. Males were 994(51.3%) and 945(48.7%) females. Infectious diseases were the most common cause of admission. Pneumonia (50.1%) and aspiration pneumonitis (5.1%) accounted for the highest admissions due to infective and non-infective respiratory diseases respectively. Overall, respiratory diseases accounted for 20.7% (119/574) of the overall mortality among all admissions while the all respiratory disease mortality was 6.1% (119/1939). The major contributors to mortality were pneumonia, aspiration pneumonitis and tuberculosis accounting for 81(68.1%), 12(10.1%) and nine (7.6%) deaths respectively. The median duration of hospital stay was four days [IQR: 2 to 6 days]. A significantly higher proportion of the deaths occurred with four days of admission and 82.4% of the deaths occurred among those aged less than five years. A higher number of females (70, 58.8%) died compared to males (49, 41.2%), p=0.05. Conclusion: Pneumonia and aspiration pneumonitis are major contributors to morbidity and mortality due to respiratory diseases for which interventions towards improving childhood health indices should be prioritized

Psychoactive substance use among outpatients with severe mental illness: A comparative study

Background: Despite several studies on the prevalence and pattern of substance use in Nigeria, there is little information on substance use in patients diagnosed with serious mental illness (SMI) such as schizophrenia and bipolar affective disorder (BD).Aim: The aim of the study was to compare the pattern of psychoactive substance use among outpatients with BD and schizophrenia.Setting: The study was conducted in a neuropsychiatric hospital in Nigeria.Methods: Seventy five consecutive patients with a MINI-PLUS diagnosis of BD were compared with an equal number of patients obtained by systematic random sampling with a MINI-PLUS diagnosis of schizophrenia. Results: The respondents with schizophrenia were aged 18­59 years (37.2 ± 9.99) and were predominantly young adult (49, 65.3%), men (46, 61.3%), who were never married (38, 50.7%). Overall, lifetime drug use prevalence was 52%, while for current use, overall prevalence was 21.3%. Participants with BD were aged 18­63 years (36.7 ± 10.29) and were predominantly young adult (53, 70.7%), women (44, 58.7%), who were married (32, 42.7%), with tertiary education (31, 41.3%). Overall, lifetime drug use prevalence was 46.7%, while current overall prevalence was 17.3%. These rates (lifetime and current) for both diagnostic groups are higher than what was reported by the World Health Organization in the global status report of 2014 (0% ­ 16%). The statistically significant difference between the two diagnostic groups was related to their sociodemographic and clinical variables and psychoactive substance use.Conclusion: Psychoactive substance use remains a burden in the care of patients diagnosed with schizophrenia and BD. Future policies should incorporate routine screening for substance use at the outpatient department with a view to stemming the tide of this menace

Effects of Sesame Seed Enrichment on Physico-Chemical and Nutritional Characteristics of Flour from Two Cultivars of White Yam (Dioscorea rotundata Poir)

The effects of enriching two cultivars of yam (DioscorearotundataPoir) flour with sesame seed (SesamumindicumL) flour on their physicochemical and nutritional characteristics were studied. Yam flours were produced from Abujaand Efuruyams by parboiling at 60°C for 10 minutes and left overnight, followed by sun drying for four days. Enriched yam flour samples were prepared by thoroughly mixing the yam and sesame seed flour in ratios95:5, 90:10, 85:15 and 80:20 respectively. Proximate, mineral and anti-nutrientcontent, as well as functional properties of enriched flours, were determined using standard methods of AOAC. The two yam-flour samples were low in moisture, crude protein, fat and ash content, high in carbohydrate and macro minerals, while Sesame seed was very low in moisture and carbohydrate, but very high in crude protein, fat, ash and macro minerals. The moisture, crude protein, fat, ash and carbohydrate content of the yams and enriched samples ranged between 11.9-13.8g, 3.3-7.5g, 0.5-13.8g, 2.0-2.6_g and 63.3-81.8_g/100g respectively. Addition of sesame seed flour resulted in the reduction of moisture and carbohydrate content and significant increase (p=0.05) in protein, fat and ash values of enriched samples. The protein, fat and mineral content of the enriched samples increased with increased level of sesame seed flour inclusion (p=0.05). Both yam and sesame flours were low in the antinutritional factors studied. Sesame flour was high in trypsin inhibitors and polyphenols. Enrichment with sesame flour resulted in further reduction in the antinutritional factors content with increase in trypsin inhibitors and polyphenols content of the products. Efuruvariety flour with its enriched products had higher water and oil absorption capacity, loose and packed bulk density and swelling capacity than Abujavariety flour. Enriching yam flour with sesame flour can improve the nutrients and functional properties of their products which can improve the nutritional status, health and well-being of consumers

Attitudes to female genital mutilation/cutting among male adolescents in Ilorin, Nigeria

Background. The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C).Objective. To determine knowledge about and attitudes to FGM/C among male adolescents; and their preparedness to protect their future daughters from it.Methods. A cross-sectional survey among male adolescent students in Ilorin; Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents. Statistical analysis was with SPSS version 20.0 (IBM; USA). A p-value of 0.05 was taken as significant.Results. Of 1 536 male adolescents (mean age 15.09 (standard deviation 1.84) years; range 14 - 19); 1 184 (77.1%) were aware of FGM/C; 514 (33.5%) supported female circumcision; 362 (23.6%) would circumcise their future daughters; 420 (27.3%) were of the opinion that FGM/C had benefits; mostly as a necessity for womanhood (109; 7.1%); and 627 (40.8%) perceived it as wickedness against females; 546 (35.5%) were aware of efforts to eradicate FGM/C; and 42.2% recommended education as the most important intervention to achieve thisConclusion. Education and involvement in advocacy may transform male adolescents into agents for eradication of FGM/C

Spontaneous abortions (miscarriages): analysis of cases at a tertiary center in North Central Nigeria

Background: Spontaneous abortion (miscarriage) is a source of pregnancy loss globally. Its management; especially in low resource countries remains hampered by inadequate facilities for evaluation. Objectives: To assess the clinical presentation; diagnosis; and treatment of cases of spontaneous abortion at a tertiary hospital in Ilorin; Nigeria. Methodology: A descriptive study of all spontaneous abortions (miscarriages) managed at the University of Ilorin Teaching Hospital; Ilorin; Nigeria between January 1; 2007 and December 31; 2011. The records were retrieved from the medical records department and necessary information retrieved. Results: There were 603 miscarriages with a prevalence of 4.2; incomplete miscarriage was the most common 254 (42.1); 356 (59.0) had no identifiable risk factor; 434 (72) of the women were 35 years; 361 (59.9) had first trimester miscarriages; 272 (45.1) were of low parity (Para 0-1) and 223 (37) were having a repeat miscarriage. Of the 141 managed for threatened miscarriage; pregnancy was salvaged in 90 (63.8); 244 (40.5) had surgical evacuation with 100 success rate while 218 (36.2) had medical management with 90.8 success rate. The mean duration of admission was shortest with surgical management (2.03 ? 1.1 days) and post-abortion infection rate was 11 (2.6 success rate. The mean duration of admission was shortest with surgical management (2.03 ? 1.1 days) and post-abortion infection rate was 11 (2.6). Histology confirmed product of conception in 98 and molar gestation in 2 of the samples; no mortality was recorded in this study. Conclusion: More than half of women with miscarriages had no identifiable risk factors mainly due to limitation in facilities for evaluation; there is a need to improve facilities for investigating women with spontaneous abortions in developing countries to identify the causes of the losses

Physicochemical screening of Candida lusitaniae P1 during synthesis of biosurfactant from coconut shell

Aims: Fermentation and recovery are the major operating cost in biosurfactant production. Thus, the aim of this research was to synthesize biosurfactant from agricultural residues using suitable fermentation and recovery techniques in order to reduce the cost of production. Methodology and results: Biosurfactant-producing yeast strains isolated from refined oil-contaminated soil samples using yeast extract-diesel agar (YEDA) were subjected to physicochemical screening such as drop collapse test, microplate analysis, oil spreading technique, emulsification index and thermostability. Based on the preliminary screening result, Candida lusitaniae P1, C. parapsilosis P51, C. parapsilosis D3 and C. lusitaniae E1 were selected for biosurfactant production using agricultural residue such as rice bran, wheat bran and coconut shell as substrate and crude supernatant was analyzed by gas chromatography mass spectrometry. Candida lusitaniae P1 strain produced 98.96 g/L of biosurfactant from coconut shell but when subjected to mutagenesis the yield decreased to 52.24 g/L. Conclusion, significance, and impact of study: The physicochemical properties of biosurfactant produced using various carbon sources showed that coconut-shell is the best residue thus, variation in composition and concentration of biosurfactant obtained implies that the quality and quantity of biosurfactant produced depends on the carbon source and the genetic composition of the yeast isolate.

Evaluation of Antidiabetic and the Effect of Methanolic Leaf Extract of Jatropha curcas on Some Biochemical Parameters in Alloxan-induced Diabetic Male Albino Rats.

Aims: The study evaluates the antidiabetic, and the effect of methanolic leaf extract of Jatropha curcas on some biochemical parameters in alloxan-induced diabetic male albino rats (Wistar strain). Place and Duration of Study: The study was carried out for ten months in 2012 in Biochemistry Laboratory, Department of Science Laboratory Technology (Biochemistry Unit), School of Technology, Lagos State Polytechnic, Ikorodu, Lagos- Nigeria, and Department of Hematology and blood transfusion, APIN Clinic LUTH, University of Lagos, Nigeria. Methodology: Qualitative phytochemical analysis of the extract were carried out to determine the presence of secondary metabolites present in the extract of Jatropha curcas. The animals were weighed using weighing balance, there blood sugar levels were assayed using Accu-chek Active Glucometer and blood glucose test strips. The hematological parameters were determined using BC-3200 Auto Hematology Analyzer, lipid profiles, total protein, total bilirubin and liver biomarker enzymes were assayed using Randox kits. Results: The phytochemical constituents of J. curcas extract indicate the presence of secondary metabolites like tannins, saponins, flavonoids etc. The weight of diabetic untreated rats were significantly (P<0.05) reduced when compared to other groups. The animals treated with glibenclamide, 150 and 250mg/Kg body weight of J. curcas extract showed significant decrease (P<0.05) of blood sugar level compared to the untreated rats. The extract does possess hematopoietic activity and is not hematotoxic. J. curcas had hypolipidemic effect and can be used in the management of diabetes. The extract significantly reduced (P<0.05) total bilirubin and liver biomarker enzymes (AST, ALT and ALP). Conclusion: The results show that the methanolic leaf extract of Jatropha curcas can be used in the management of diabetes.

Sources of Health Care Financing among Patients at the Ahmadu Bello University Teaching Hospital; Zaria; Nigeria

Introduction: Health care financing is the mobilization of funds for health care services. This study determined the various sources of health care financing among the patients on admission at the Ahmadu Bello University Teaching Hospital (ABUTH); Shika-Zaria in 2011 and the effects of the medical bills on the patients and their family members. Methodology: A multi-staged sampling technique was used to select 100 clients for the study. The clients were stratified into the four major wards of the ABUTH; the medical; surgical; obstetrical and gynecological and the pediatric wards. A total of 25 clients were equally allocated to each ward and these were then selected by balloting. Information was sought on their socio-demographic characteristics; sources of the health care financing and the adverse effects of the medical bills on the patients and their family members. Results: Majority of the clients were married; Hausa Muslim housewives who earned N5;000/month (less 1 $/day). Most were aged between 20 and 29 (34) with a mean age of 36.7 years. Patients' relatives paid for the medical bill in most of the cases (48); 37 paid through out of pocket; while 11 used the National Health Insurance Scheme (NHIS) respectively. The medical expenses affected family feeding (29.3); while 16 of the patients could not get full medical services due to lack of funds; 8.8 could not pay school fees of their children and 12.2 were indebted. There were no significant association between the age; sex; marital status; monthly income; occupational status and the clients' sources of health care financing. Majority of the clients (65) were not aware of the NHIS. Most (80) of the patients would want to use the health insurance scheme (NHIS) if they have access to the opportunity. Conclusions: The main source of health care financing in this tertiary center was through out of pocket expenditure by patients and their relatives. Recommendation: There is a need for the urgent implementation of the community health insurance scheme in Nigeria for the benefit of the less privileged

Indications and Indings at Colonoscopy in Ilorin; Nigeria

Colonoscopy is a safe and effective means of visual inspection of the large bowel from the distal rectum to the caecum. It may be carried out for diagnostic and or therapeutic reasons. There is a paucity of data on this procedure in Nigeria. We; therefore; determined the indications; findings; and diagnostic yield in Nigerians at colonoscopy. Materials and Methods: This was a hospital-based cross-sectional study carried out at the Endoscopy unit of Crescent hospital; Ilorin from January 2010 to May; 2012. The endoscopy register was reviewed; and the biodata; indications and colonoscopic findings were recorded on a pro forma. Results: A total of 103 patients had colonoscopy. Seventy (68.0) were males while 33 (32.0) were females. The indications for colonoscopy were rectal bleeding 41 (39.8); suspected colon cancer 32 (31.1); chronic constipation and chronic diarrhoea nine each (8.7); abdominal/anal pain five (4.9); suspected anorectal cancer and enterocutaneous fistula two each (1.9); faecal incontinence; occult gastrointestinal bleeding; post-colostomy for Hirschsprung disease one each (1.0). Endoscopic findings were normal findings 21 (20.4); diverticulosis 17 (16.5); polyps 16 (15.5); haemorrhoids 16 (15.5); anorectal cancer 13 (12.6); angiodysplasia 12 (11.7); colon cancer eight (7.8); colitis 7 (6.8); anorectal ulcer 4 (3.9); anal warts two (1.9); anal fissure; caecal tumour; faecal impaction and proctitis one each (1.0). The diagnostic yield was 79.6. Conclusions: The commonest indication for colonoscopy was rectal bleeding; while the most frequent pathology was diverticulosis. The diagnostic yield was high

Fatores de risco de apneia obstrutiva do sono entre pacientes ambulatoriais nigerianos / Risk factors of obstructive sleep apnea among nigerian outpatients

Apneia obstrutiva do sono (SAOS) é uma condição médica com consequências adversas. OBJETIVOS: Descrever os fatores de risco associados com OSA em adultos atendidos em uma clínica especializada ambulatorial. Forma de estudo: Estudo clínico prospectivo, entre pacientes ambulatoriais adultos em uma clínica especializada. MÉTODO: Os dados foram coletados por meio de questionário incorporando o BQ e os pacientes foram divididos em riscos de baixa e alta da OSA. Os fatores de risco associados com OSA na análise univariada foram submetidas a um modelo multivariado de regressão logística binária. Odds ratio ajustados com intervalo de confiança de 95% foram calculados para as seguintes variáveis independentes. RESULTADOS: Cento e nove e cinco pacientes participaram do estudo (sexo masculino 56,4%; idade 43,5 ± 15,6 anos; não roncadores habituais 81,5%, risco de alta OSA 17,4%, IMC 24,1 ± 4,6 kg/m²; obesos 12,9%). Seis fatores, incluindo o estado civil e a pressão arterial, foram significativamente associados com SAOS usando análise bivariada, no entanto, idade, horas de trabalho, tabagismo e IMC permaneceu preditivo da OSA na análise de regressão logística. CONCLUSÕES: SAOS é comum entre pacientes nigerianos, pode ser sub-reconhecida e está associada a fatores de risco que são passíveis de estratégias preventivas.

Obstructive sleep apnea (OSA) is a medical condition with adverse consequences. OSA is credited to be a sleep disorder that disproportionately affects blacks. The Berlin Questionnaire (BQ) is a screening questionnaire for OSA. OBJECTIVE: To describe the risk factors associated with OSA among adults attending an out-patient specialist clinic. Study design: Prospective, clinical study including adult outpatients attending a specialist clinic. METHOD: Data was collected using a questionnaire incorporating the BQ and patients were divided into low and high risks of OSA. The risk factors associated with OSA in the univariate analyses were subjected to a multivariate binary logistic regression model. Adjusted odds ratios with 95% confidence intervals were calculated for these independent variables. RESULTS: One hundred and ninety five patients participated in the study (Males 56.4%; Age 43.5 ± 15.6 years; Non-habitual snorers 81.5%; High risk OSA 17.4%; BMI 24.1 ± 4.6 kg/m²; Obese 12.9%). Six factors including marital status and blood pressure were significantly associated with OSA using bivariate analysis nevertheless age, hours at work, smoking status and BMI remained predictive of OSA on logistic regression analysis. CONCLUSIONS: OSA is common among Nigerian outpatients, may be under-recognized and is associated with risk factors that are amenable to preventive strategies.

Ocular Manifestations in HIV-AIDS Patients in a Nigerian Community

Background: The aim of this study was to determine the ocular manifestations of human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) among the study population.Method: A cross-sectional descriptive study was conducted among HIV-AIDS patients at the Federal Medical Centre; Owo; Nigeria. Ethics clearance was obtained from the ethics review committee of the hospital. Informed consent was obtained from all the respondents. This study was conducted over a period of nine months; from October 2010-June 2011; at the medical outpatient centre and the eye clinic of the hospital. The obtained information included the socio-demographics of the respondents; World Health Organization clinical stage of AIDS; CD4 count; duration of HIV-positive status; history of ocular problems and the treatment sought.Results: A total of 112 consenting respondents participated in this study. Not many respondents (36; 32.1) were aware of eye complications that relate to HIV-AIDS. Most informed respondents had been enlightened by health workers (20; 55.6). Few respondents (16; 14.3) had HIV-AIDS ocular manifestations. Squamous cell carcinoma was the most common ocular manifestation.Conclusion: Efforts should be made to promote the ocular health of HIV-AIDS patients to prevent blinding ocular manifestation

Structure, control and regulation of the formal market for medicinal plants' products in Nigeria

Abstract: There are informal and formal markets for medicinal plants' products in Nigeria. The formal market is subject to the national regulatory framework for Food and Drug Administration and Control. It is relatively new and underdeveloped. This study was designed to appraise this market with special emphasis on the market participants, market structure, marketing functions performed, conduct of sellers in the market and; standards and regulations to which the market is subject. Information used for this study was collected through personal interviews and interactions with key participants in the market; especially the officials of regulatory agency. The market structure was analysed in terms of the share of market controlled by participants and product types. Concentration Ratios (CR2 and CR4) were used to assess the market share. Marketing functions being performed were described in terms of the exchange, physical and facilitating functions while the conduct was described in terms of pricing and promotional strategies. The regulatory framework under which the market operates was appraised. The market was highly concentrated with a CR2 and CR4 of 58.5% and 80.8 %; respectively. Imported products accounted for only 12.3% of the market. The predominant modes of presentation of the product were capsule (41.6%) and liquid (36.2%). About 20.77% of the products were classified as multivitamins, 13.85% were antibiotics while 10.77% addressed sexual dysfunctional problems. These products were regulated under the Food and Drug Administration and Control (NAFDAC) decrees, 1993-1999. Only 2.3% of the products have received full registration status while the others were only listed

Intestinal helminthiasis among school children in Ilie, Osun State, Southwest, Nigeria

A cross sectional study of intestinal helminthiasis among school pupils was undertaken in three primary schools in Ilie in Olorunda Local Government Area of Osun state in order to determine the prevalence and intensity of helminthic infections. The relationship between intestinal helminths and anthropometric indices and the factors that could favour the infection were also studied. Faecal samples from three hundred and four (304) randomly selected out of the four hundred and seven (407) school children in the study area were collected and analysed with the semi-quantitative Kato Katz technique and concentrated method. The intensity of infection was classified into light; moderate or high according to World Health Organisation (WHO) thresholds. The overall prevalence rate was 52.0 while five species of intestinal helminths were identified. Ascaris lumbricoides (36.2) was the most common; followed by Hookworm (10.5); Schistosoma mansoni (4); Strongyloides stercoralis (0.7) and Hymenolepis nana (0.7). Multiple helminthic infection were recorded with Ascaris -Hookworm (6.58) having the highest prevalence among the children. Female (56.6) were more infected than male (46.4) and the difference was statistically significant (P=0.0019). Seventeen percent (17) of the children were below the third percentile for weight (wasted) while fourteen percent (14) were below the third percentile for height (stunted). There was a relationship between intensity of infection and wasting since there were fewer underweight pupils (13) with normal stool than those moderately infected (35) (P0.05). There was statistically significant association between type of latrine use and prevalence of infection; and also between water treatment and infection. Periodic surveillance of school children for intestinal helminthiasis should be part of the public health activities while periodic deworming programme should be done routinely as this would reduce intensity of intestinal worm infection among school children