Assessment of the implementation of respectful maternity care charter in North Central Nigeria (Federal Capital Territory and Kwara State): study protocol

Respectful Maternity Care (RMC) charter is one of the tools for ensuring quality of care in maternity services. Nigeria is a signatory to RMC charter; therefore, the charter is expected to be the standard of care. However, in Nigeria and other countries, reports of disrespectful maternity care abound; this discourages women from accessing facility-birth. Therefore, to improve the quality of care towards increase in uptake, it is expedient to assess the level of implementation of the RMC charter by key stakeholders for sustainability, impact and scale-up of charter-compliant maternity care in Nigeria. The study aims to assess the implementation of RMC charter in North-central Nigeria. The study is a mixed-method, cross-sectional study; the expected participants are key stakeholders in healthcare (Healthcare workers, Healthcare Administrators, Project Managers, Policy makers) in North-Central Nigeria (Federal Capital Territory and Kwara state). A multistage sampling technique would be used to enroll participants from 18 healthcare facilities (Primary, Private, Secondary and Tertiary) in rural and urban areas and Ministries of Health officials at local and state government levels. Expected outcomes: The study is expected to provide information on the current status of knowledge and implementation of the RMC charter in Nigeria. It would also identify the enablers and barriers to the implementation process and provide evidence for effective scale-up of the process in Nigeria. The outcomes will be widely disseminated to healthcare workers, health administrators and decision-makers in healthcare services through post-study meetings, conference presentations, journal publications and policy briefs for effective RMC charter implementation in Nigeria.

Rutin forestalls dysregulated cardiac bioenergetics in bisphenol A and dibutyl phthalate-exposed rats through PPAR? and AMPK modulation

Objectives: Proper cardiac function is greatly dependent on adequate supply and metabolism of energy substrates. Environmental pollutants exposure including plasticizers can trigger adverse cardiac metabolic events. This study was designed to investigate the ameliorative effect of rutin (Rt) on dysregulated cardiac energy metabolism in plasticizer-exposed rats. Materials and Methods: Forty-two rats were randomised into seven groups (n = 6): Control (0.1% dimethyl sulfoxide), bisphenol A (BPA, 25 mg/kg, p.o), dibutyl phthalate (DBP, 25 mg/kg, p.o), BPA + Rt 25 mg/kg, Rt 50 mg/kg, DBP + Rt (25 mg/kg, Rt 50 mg/kg), BPA + DBP and BPA + DBP + Rt, daily for 21 days. Results: BPA and DBP exposure increased plasma glucose, reduced insulin, and increased plasma and cardiac free fatty-acid. Cardiac glucose-6-phosphate level, hexokinase and pyruvate dehydrogenase activities increased in DBP while BPA reduced these variables. Cardiac glucose transporter-4 expression was reduced in BPA group, while cardiac peroxisome proliferator-activated receptor-alpha (PPAR?) and AMP-activated protein kinase (AMPK) expression increased in BPA and DBP-treated rats. However, Rt administration prevents impaired cardiac bioenergetics and glucometabolic regulation. Conclusion: Summarily, Rt improves BPA and DBP-impaired cardiac bioenergetics through PPAR? and AMPK modulation.

Prevalence of oral mucosal lesions and oral health related quality of life among adolescents in a rural Nigerian population

Background: Oral mucosal lesions affect people of all age groups, and vary in presentation; from asymptomatic to severely debilitating. Studies reporting the prevalence and effects of these lesions in adolescents are generally few compared to those describing the demography of dental caries and other oral diseases. Objective: To determine the prevalence of oral mucosal lesions, factors that contribute to the prevalence, and the association with the oral-health related quality of life (OHRQoL) of adolescents in the population. Methods: A cross-sectional survey was done on 240 secondary school students aged 10-19 from three secondary schools selected using multi-stage cluster random sampling. A pre-designed questionnaire was used to collect demographic information, presence of systemic illness, and oral habits. Oral-health related quality of life was assessed using the oral-health impact profile (OHIP-14), and intraoral examination was performed within the school premises by a single trained investigator. Results: A total of 33 participants (13.7%) had oral mucosal lesions. Overall, commissural lip pits (5.0%) were the most prevalent, while geographic tongue and irritation fibroma (0.4% each) were the least prevalent lesions. The mean OHIP-14 score of the participants in this study was 7.17+8.64. Participants with systemic diseases and cheek biting habits had statistically significant worse scores than those without either. Conclusion: The most prevalent oral mucosal lesions in the adolescent age group are those of developmental origin. Quality of life was negatively impacted by the presence of systemic diseases as well as cheek biting habit.

Access, perceived quality and uptake of antenatal services in urban communities of Osun state, Southwest Nigeria

Quality antenatal care (ANC) is one of the key interventions to improve intrapartum care uptakes and to reduce the menace of maternal deaths globally. Yet, ANC coverage has remained low in many developing countries like Nigeria. It becomes imperative to contextually understand factors associated with ANC uptake in Nigeria. The study assessed level of utilization, perceived quality, level of satisfaction and determinants of ANC utilization among women of reproductive age-group in Oshogbo, South-west Nigeria. Cross-sectional study design was employed and cluster sampling method was used to recruit 420 consenting respondents. Data were collected using pretested interviewer-administered, semi-structured questionnaire. Both descriptive and inferential statistics were done at p<0.05. The mean (±SD) age of the respondents was 30.84±6.0 years. Almost three-quarters (73.9%) of the respondents had at least 4 ANC visits. Main reasons for non-ANC usage were high cost of care, long waiting time at the clinic, long distance to the clinic and unsatisfactory service quality. Only 59.9% of respondents were satisfied with services received while 63.1% of them rated the service quality as excellent. Main determinants of ANC uptake were respondents' age (AOR=2.35;95%CI=1.34-5.89), level of education (AOR=0.56;95% CI= 0.42-0.71), socio-economic status (AOR=5.22; 95%CI=2.02-6.65) and monthly family income (AOR=0.89; 95%CI=0.02-0.90). Although the rate of ANC use was high in the study setting, the proportion of women who were satisfied with service quality was sub-optimal. There is need for implementation of multi-pronged intervention to make ANC services more available, accessible, affordable and acceptable to the Nigerian women

Socio-economic drivers and effects of contraceptive usage on breast cancer among women in Nigeria

Certain types of contraceptives might have adverse effects on women's health including the possibility of causing breast cancer (BC). Furthermore, the types of contraceptives used might depend on the socioeconomic status of women. The triangular linkage of socioeconomic factors, contraceptives, and some factors causing BC among women are scarce in the literature, especially in developing countries. Consequently, the objectives of the study are to investigate the socio-economic drivers of BC and assess effects of contraceptive on BC among women in Nigeria. Cross-sectional data were collected on a one-off participant at a particular point in time using questionnaires on 200 women with confirmed cases of BC in Southwest, Nigeria, on a continuous visitation to the hospitals over six months. Structural equation modeling (SEM) with strong evidence from path analysis was adopted to achieve the objectives. Exploratory factors analysis was adopted to identify the socio-economic factors. The study analysed certain socioeconomic pre-determinants of BC through the use of contraceptives among women in Southwest Nigeria. The study provided evidence that some tested socioeconomic factors influence women in the use of contraceptive implants (C2) and oral contraceptives (C3), at a 1% level of significance. While about 76.8% of variations in socio-economic factors cause women to adopt a contraceptive implant, 81.1% of socioeconomic factors cause women to adopt oral contraceptives. Again, the result further provided evidence that socioeconomic factors (CCT) are strong determinants of BC at a 1% level of significance. Given the women-specific peculiarities, implanted contraceptives and oral contraceptives should be carefully administered by medical scientists.

C-reactive Protein is an Independent Predictor of Left Ventricular Mass in Offspring of Hypertensive Subjects in Nigeria

Offspring of hypertensive parents have been shown to be at increased risk of developing systemic hypertension and adverse cardiovascular events later in life. The pathological antecedents of this are thought to be alterations in the structure and function of left ventricle. However, it is currently unclear if these abnormalities are due to genetic factors or a result of higher biomarker levels such as highly sensitive C reactive protein (hsCRP). An improved understanding of the associations of hsCRP with left ventricular structure may offer additional insight. Therefore, this study aims at determining the correlation of left ventricular mass with hsCRP among offspring of hypertensive parentscomparedwith controls Methodology:A cross sectional Hospital based study, with 100 subjects and 100 controls. A questionnaire was administered to obtain relevant history, physical examination, blood tests, ECG, Echocardiography were done for the two groups. The results were analysed using SPSS 20.Results:The left ventricular mass and mass index wassignificantly elevated in the subjects compared with the control group. The median hsCRP was significantly higher in the subjects [1.85 (0.28-10.20) vs. 1.34 (0.17-8.49) mg/L: P<0.010]. It progressively increases significantly as the number of parent with hypertension increases [1.34(0.17-8.49), 2.00(0.28-9.66) and 2.54(0.91-10.20) mg/L P<0.001] from zero, to single and both parent respectively. There was a significant correlation between hsCRP levels, blood pressure, left ventricular mass and left ventricular mass index (R= 0.165, 0.316, 0.274: P= 0.021, 0.004, 0.014) respectively.Conclusion:The study shows that offspring of hypertensive parents had higher echocardiographic left ventricular mass, left ventricular mass index and hsCRP levels compared with controls and this hsCRP increases as the number of parents with hypertension increases. Blood pressure and left ventricular mass index increase with increasing Plasma hsCRP: This may suggest possible role of hsCRP in the development of hypertension and cardiac remodeling

Health Insurance and Healthcare Quality: A Comparative Study between Insured and Uninsured Patients at a Teaching Hospital in Northeast Nigeria

Objective:Patients’ perception of the quality of care is essential in assessing health services and feedbacks from patient satisfaction surveys are useful in healthcare quality improvements.Methods:A descriptive cross-sectional study was doneto evaluate satisfaction with the quality of care among insured patients under the National Health Insurance Scheme (NHIS) and uninsured (Out-of-Pocket paying) patients at University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Borno State, Nigeria. Data were collected from 115 respondents from each groupselected by systematic random sampling; using self-administered questionnaires. Analysis was done using IBM SPSS Statistics 20.0.Results: The overall mean satisfaction for the uninsured group (73.1 ± 7.2) was higher than that of the insured group (71.2 ± 7.5). However, the difference was not statistically significant, p = 0.063.The observed satisfaction levels in the various areas of services accessed among the insured and uninsured group in this study are comparable, except for the significant differences observed in satisfaction with hospital facilities and the availability of prescribed drugs, suggesting the need for the improvement of hospital facilities and availability of drugs.Conclusion: Despite complaints about the NHIS, it is still generally preferred to out-of-pocket payment by both groups.Therefore, more efforts should be made to expand the population coverage of health insurance to allow the inclusion of more people, while the need for continuous improvement of quality health services cannot also be overemphasized

Evaluation of prescription pattern of analgesic use among ambulatory elderly in South-Western Nigeria

Inappropriate prescribing of analgesics has a global impact on the health of elderly patients and the society. Empirical evidence on the prescription of analgesics among elderly Nigerians is scarce. Objectives: The objective of the study was to evaluate the prescription pattern of analgesics and describe the co-prescribing of gastroprotective agents with non-steroidal anti-inflammatory drugs (NSAIDs) among elderly patients at the geriatric center, University College Hospital, Ibadan. Methods: A retrospective cross-sectional, hospital-based study was carried out among elderly patients (≥60 years) who were prescribed analgesics. Using a data extraction sheet, information on demographic characteristics, drug utilization pattern, and morbidities was obtained from patients' case files via electronic health records. Results: A total of 337 patients case files were reviewed, the mean age was 72 ± 8.8 years, and 210 (62.3%) were females. There were a total of 2074 medications prescribed, with 733 (35.3%) being analgesics. Majority of the elderly patients (259, 76.9%) were on nonopioids, with 252 (74.8%) on NSAIDs. Paracetamol was the most commonly prescribed analgesics (181, 24.6%), followed by diclofenac/misoprostol (177, 24.1%), opioid analgesic prescribed was 88 (12.0%), with paracetamol/codeine 58 (65.9%), and tramadol 16 (18.2%) being the most prescribed opioid. A significant proportion of the hypertensive elderly patients (160, 78.8%; P < 0.036) were on NSAIDs. The oral route of administration (302, 89.6%) was the most common route of administration. Majority (310, 92%) of elderly patients taking NSAIDs had a co-prescription for gastroprotective agents. Conclusions: Majority of hypertensive patients were on NSAIDs. This calls for prompt awareness of rational analgesic use among the elderly to improve management and their survival

Plasma levels of total cholesterol, high-density lipoprotein-cholesterol, low-density lipoprotein-cholesterol, triglyceride, Apo A-1, and Apo B in patients with Stroke in Ogbomoso, Southwestern Nigeria

Hyperlipidemia is a strong factor in the development of stroke, but this may differ from one region to anotherdue to geographic, ethnic, and sociocultural practices. This is designed to determine plasma levels of totalcholesterol, high-density lipoprotein (HDL)-cholesterol, low-density lipoprotein (LDL)-cholesterol, triglyceride,Apoprotein A-1, and Apoprotein B in Nigerian patients with stroke. 50 newly diagnosed stroke patients wereconsecutively recruited into the study. 50 apparently healthy, age- and sex-matched volunteers were recruited fromOgbomoso community as controls. The data obtained were analyzed using the Statistical Package for the SocialSciences (SPSS) version 20. Higher and lower significant levels (P < 0.001), respectively, were observed in theplasma total cholesterol (4.5 ± 1.41 vs. 3.90 ± 0.91 mmol/l), LDL-cholesterol (3.32 ± 1.41 vs. 2.19 ± 0.82 mmol/l),HDL-cholesterol (0.76 ± 0.32 vs. 1.27 ± 0.38 mmol/l), and Apo A1 (0.87 ± 0.73 vs. 4.56 ± 2.40) in stroke patientswhen compared with controls. There was a lower significant difference in plasma level of Apo A1 in patients withischemic stroke (0.734 ± 0.64 vs. 1.31 ± 0.84) when compared with hemorrhagic stroke (P < 0.005). The meanplasma level of Apo B (1.70 ± 1.05 vs. 1.09 ± 0.40) in ischemic stroke was higher than patients with hemorrhagicstroke, though difference was not statistically significant (P ≥ 0.005). We concluded that apoproteins remain thesignificant biochemical markers that may be deranged in patients with stroke. There are associations between ApoA1 and Apo B. It is encouraged that plasma apoproteins estimation should be added to routine investigations doneon stroke patients in this environment.

Knowledge of blood donation among adults in north-central Nigeria

Background: About half of the population in Nigeria is medically fit for blood donation but only four in one thousand are voluntary donors. The low level of blood donation has been attributed to poor knowledge, misconceptions, myths, bias, poverty, fear, malnutrition among the population. Therefore, this study assessed the knowledge of blood donation among adults in two selected North Central States of Nigeria.Methods: It was a descriptive cross-sectional study. A total of 3104 respondents comprising of adults between 18 and 60 years were involved in the study. A multistage sampling technique was used and the research tool was interviewer-administered questionnaire. The data generated were entered into the computer and subjected to appropriate statistical analysis using EPI INFO computer software package (version 3.5.3). Pearson Chi Square (χ2) was used to test statistical significance and p-value was set at < 0.05.Results: Majority of the respondents 2565 (82.5%) knew that blood donation save lives. More than three-quarters, 2468 (79.5%), knew where to go for voluntary blood donation. About one-third, (37.1%), demonstrated good knowledge of voluntary blood donation. Older respondents (>60 years) had poor knowledge of blood transfusion compared with younger age groups (p<0.001). Respondents' occupation and educational status were significantly associated with knowledge of blood transfusion (p<0.001)Conclusion: Periodic awareness programme on voluntary blood donation in rural and urban areas across Nigeria is needed. In addition, sensitization of the informal sector on the significance of non-remunerated voluntary blood donation should be given priority

Knowledge of blood donation among adults in north-central Nigeria

Background: About half of the population in Nigeria is medically fit for blood donation but only four in one thousand are voluntary donors. The low level of blood donation has been attributed to poor knowledge, misconceptions, myths, bias, poverty, fear, malnutrition among the population. Therefore, this study assessed the knowledge of blood donation among adults in two selected North Central States of Nigeria. Methods: It was a descriptive cross-sectional study. A total of 3104 respondents comprising of adults between 18 and 60 years were involved in the study. A multistage sampling technique was used and the research tool was interviewer-administered questionnaire. The data generated were entered into the computer and subjected to appropriate statistical analysis using EPI INFO computer software package (version 3.5.3). Pearson Chi Square (χ2) was used to test statistical significance and p-value was set at < 0.05. Results: Majority of the respondents 2565 (82.5%) knew that blood donation save lives. More than three-quarters, 2468 (79.5%), knew where to go for voluntary blood donation. About one-third, (37.1%), demonstrated good knowledge of voluntary blood donation. Older respondents (>60 years) had poor knowledge of blood transfusion compared with younger age groups (p<0.001). Respondents' occupation and educational status were significantly associated with knowledge of blood transfusion (p<0.001). Conclusion: Periodic awareness programme on voluntary blood donation in rural and urban areas across Nigeria is needed. In addition, sensitization of the informal sector on the significance of non-remunerated voluntary blood donation should be given priority

Effects of methanolic extract of Brassica juncea seeds on biochemical parameters and histological integrity of the heart and liver of albino rats / Efectos del extracto metanólico de las semillas de Brassica juncea sobre los parámetros bioquímicos y la integridad histológica del corazón y el hígado de ratas albinas

SUMMARY: Brassica juncea (Indian mustard) seeds are consumed in treatment of high blood pressure, headache and prevention of heart disease. The aim of the present study was to investigate the effects of methanol extract of Brassica juncea seeds [BJME] on the heart and liver of adult Albino Wistar rats. A total of 24 albino rats of both sexes were divided into 6 groups [I - VI] of 4 rats per group. Groups I to IV received graded doses of the methanol extract by oral gavage while groups V and VI (controls) received 2 ml/kg body weight of 3 % Tween 80 and water respectively via oral gavage once daily. Treatment lasted for four weeks and the serum levels of aspartate transaminase (AST), alanine transaminase (ALT) and alkaline phosphatase (ALP) were estimated. The animals were sacrificed and the heart and liver tissues were excised for further histological processing for light microscopy. There was significant increase in AST and ALT levels following BJME treatment when compared to the controls. ALP activity did not differ significantly among the treatment and control groups. Histopathological changes consistent with toxic injury were observed in the heart and liver tissues of BJME- treated rats. In conclusion, the results of this study show that sub-acute administration of methanol seed extract of Brassica juncea can exert cardiotoxic and hepatotoxic effects in rats.

RESUMEN: Las semillas de Brassica juncea (mostaza india) se consumen en el tratamiento de la hipertensión arterial, el dolor de cabeza y la prevención de enfermedades del corazón. El objetivo del presente estudio fue investigar los efectos del extracto de metanol de semillas de Brassica juncea [BJME] en el corazón y el hígado de ratas Albino Wistar adultas. Un total de 24 ratas albinas de ambos sexos se dividieron en 6 grupos [I - VI] de 4 ratas por grupo. Los grupos I a IV recibieron dosis del extracto de metanol por sonda oral progresivamente, mientras que los grupos V y VI (control) recibieron 2 ml / kg de peso corporal de 3 % de 80 y agua, respectivamente, por sonda oral una vez al día. El tratamiento duró cuatro semanas y se estimaronlos niveles séricos de aspartato transaminasa (AST), alanina transaminasa (ALT) y fosfatasa alcalina (ALP). Los animales se sacrificaron y fueron analizados los tejidos del corazón y el hígado, para un procesamiento histológico adicional con microscopía óptica. Hubo un aumento significativo en los niveles de AST y ALT después del tratamiento con BJME en comparación con los controles. La actividad de ALP no difirió significativamente entre los grupos de tratamiento y control. Se observaron cambios histopatológicos compatibles con lesiones tóxicas en los tejidos del corazón y el hígado de ratas tratadas con BJME. En conclusión, los resultados de este estudio muestran que la administración subaguda de extracto de semilla de metanol de Brassica juncea puede ejercer efectos cardiotóxicos y hepatotóxicos en ratas.

Histo-morphological Effects of Carica papaya on Cadmium Induced Prefrontal-Cortex Damage in Adult Wistar Rats

Background: This research investigated the recuperative (restorative) effect of aqueous extract of Carica papaya fruit on cadmium induced prefrontal-cortex damaged in adult Wistar rats (Rattus norvegicus). Previous research reports have confirmed that cadmium toxicity results in cellular damage which is due to an increase in production of reactive oxygen species and prevention of the activities of antioxidant enzymes. Various parts of the brain (prefrontal cortex, hippocampus and so on) are majorly affected by cadmium as its induced damage. Methods: 30 Wistar rats (70 g-190 g) were used for this research. The rats were randomly selected into six groups of five animals each. A single dose of 3CdSO4.8H2O (Cadmium sulphate octahydrous) 3.5 mg/kg body weights was administered intraperitoneally to three of these groups against control a group that was not exposed to Cadmium. Two groups were treated with different doses of Carica papaya fruit extract for the period of four weeks. After four weeks, the rats were sacrificed and organs excised, weigh and fixed in fixative for histological processing. The photomicrographs of the normal control, induced control and treated groups were observed and compared for histomorphological similarities and differences. Results: Cadmium was observed to have caused a distortion, disruption and calcification in the cells and tissue of the prefrontal cortex. There was shrinkage of nuclei of the neurons in cadmium induced rats. It was also observed that cadmium caused a loss in function of cell in the process of protein biosynthesis. The morphology of the neuronal cells of rats treated with high and low doses of Carica papaya extract was found to be slightly normal with increased viable neuronal cells as compared with the neurons of the normal control group 1 animals, though the restorative effects of the high dose treated rats were more pronounced. Also, it was observed that the damage to the brain section neurons treated with vitamins C and E before induction was not pronounced. Moreso, loss in body weight were observed in cadmium induced group animals and over treatment with Carica papaya, gain in the rats body weight was observed in the treatment animal groups as compared with the body weight of rats in normal control. Animal body weight before cadmium inoculation, after inoculation and before animal sacrifice were compared across all the groups and it was found that, there was a progressive increase in rats body weight (99±2,35≤ 150 ±3.21), (120±2.32≤189±3.21) and (135±1.35≤175±2.15) respectively which was significant at P ≤ 0.05. Conclusion: It can be ascertained from this present study that Carica papaya has ameliorative properties against deleterious effects of cadmium on the neurons and neuroglia of the prefrontal-cortex in Wistar rats which is dose dependent.

Antioxidant Properties of Carica papaya on Cadmium Toxicity on Prefrontal-Cortex of Adult Wistar Rats

Background: Cadmium is a carcinogenic agent in humans, and therefore, a cancer causing substance. In the body it is extensively circulated, but it is bound mainly to erythrocytes. Though cadmium binds to various macromolecules and proteins in the body, it is not well metabolized. Cadmium intensifies oxidative damage in the nervous system (and various other organ systems) thereby causing harm. The damage results from an increase in production of reactive oxygen species and inhibition of antioxidant enzymes as shown by previous researches. This study investigated possible effects of Carica papaya as an antioxidant in the damage of the brain caused by cadmium. Methods: Thirty Wistar rats weighing between 120 g-180 g of both sexes were divided into six groups of five animals each and used in this study. Six groups were induced intraperitoneally with a single dose of 3.5 mg/kg body weight of cadmium sulphate. Two out of these six groups were treated with high and low doses of Carica papaya, 250 mg/kg and 400mg/kg body weight respectively for the period of four weeks. After sacrifice, enzyme assays were carried out on the tissue supernatant homogenates. Results: The investigation showed that MDA level of activities decreased in the prefrontal cortex supernatant of groups 1, 2 and 6 animals and an increase in the MDA level of activities were observed in groups 4 and 5 rats which was significant at p<0.05. There was a decrease in catalase activities in groups 2 and 3 rats, also, an increase in CAT activities in groups 4 and 5 rats, the decrease was significant in groups 2 and 3 animals as compared with the control group 1 rats. GST activities decreased in groups 2, 3, 4, 5 and 6 rats and the decreased activities were significant at p<0.05 when compared with control group 1 animals. Progressive increase in the superoxide dismutase was observed in groups 1, 2, 3, 4, 5 and 6 rats and this increase in activities was found significant at p<0.05 in groups 4, 5 and 6 rats when compared with the control group 1 rats. Conclusion: The present study has justified the ameliorative properties of Carica papaya in scavenging the free oxygen radicals and supplement the cellular antioxidant systems.

Attention deficit hyperactivity disorder in Ilorin: screening with the conner's teachers' rating scale

Background: The prevalence of Attention Deficit Hyperactivity Disorder (ADHD) or its risk in North Central Nigeria has not been adequately reported. The consequences of missing the disorder and its co-morbidities are usually costly to the society. Method: Using a multi-stage sampling technique, nine primary schools from where a total of 1,480 pupils were selected across the three local government areas within Ilorin metropolis (two public and one private school from each LGA) we selected. An ADHD assessment tool - the short version of Conner's Teacher Rating Scale was administered on the pupils through their respective class teachers after training the teachers on how to administer the tool. They were classified into Inattention ADHD and Hyperactive/impulsive ADHD. Results: Of the 1480 (741 males and 739 female) pupils recruited, public schools contributed 1033 (69.8%) pupils while 447(30.2%) were from the private schools. A prevalence of 15.8% was found for ADHD risk. Statistically significant differences were present in the male to the female distribution of the Inattention ADHD, Hyperactivity ADHD (each with p< 0.05) but not in the overall ADHD index(p> 0.05). The ADHD Index was higher in the public schools. Conclusion: Prevalence of primary pupils aged 6-12 years in Ilorin at risk of ADHD is 15.8%, no significant gender variation was found. It is hereby recommended that Pre-primary school entry screening for ADHD should be instituted considered to enhance early recognition and prompt intervention so as to save the country from bad childhood that develops into bad adulthood with its myriads of anti-social and behavioural consequences

Impact of Single Dose Praziquantel Treatment on Schistosoma haematobium Infection among School Children in an Endemic Nigerian Community

Schistosomiasis is prevalent in Nigeria, and the foremost pathogen is Schistosoma haematobium, which affects about 29 million people. Single dose of the drug praziquantel is often recommended for treatment but the efficacy has not been documented in certain regions. Therefore, this study was designed to assess the impact of single dose praziquantel treatment on S. haematobium infection among school children in an endemic community of South-Western Nigeria. Urine samples were collected from 434 school children and 10 ml was filtered through Nucleopore filter paper before examination for egg outputs by microscopy. The prevalence was 24.9% at pre-treatment. There was no statistically significant difference for the prevalence of infection between males (14.7%) and females (10.2%), although the mean egg count for the females (9.87) was significantly more (P < 0.05) than the males (6.06). At 6 and 12 months post-treatment there was 74.4% and 86.4% reduction in the mean egg count, respectively. Interestingly, an increased prevalence of infection from 2.1% at 6 months to 7.7% at 12 months post-treatment was observed, nonetheless the mean egg count was reduced to 0.27 at 12th month from 1.98 at 6 months post-treatment. Resurgence in the prevalence rate between 6 and 12 months post-treatment with praziquantel is herein reported and the need for a follow-up treatment in endemic areas for adequate impact on schistosomiasis control is discussed.

A Survey of Plants used in Treatment of Hypertension and Diabetes Mellitus in Ilorin, Kwara State, Nigeria

Background: Hypertension and Diabetes mellitus have emerged as the leading non-communicable disease worldwide, thus, the increasing need to continuously explore more and better ways of treating these diseases.Objectives: To carry out a survey of plants used in the treatment of hypertension and Diabetes mellitus in Ilorin, Kwara State, Nigeria. Materials and methods: Interview was conducted among respondents using semi-structured questionnaires and asking open-ended questions. Descriptive statistics were used for data analysis.Result: A total of 30 respondents comprising of 60.0% male and 40.0% female with the highest distribution of age range at above 50 years old (50.0%) was reported. Forty (40) medicinal plant species belonging to thirty-one (31) plant families were cited with the Apocynaceae family having the highest number of medicinal plants, followed by Asteraceae. For hypertension, 32 plant species were reported of which the most cited were Allium sativum (4) and Ficus asperifolia (2) while for Diabetes mellitus, 20 plant species were mentioned, of which the most cited were Hunteria umbellata (10) and Vernonia amygdalina (9). Of particular interest in this study were the plants that appeared for both hypertension and Diabetes treatment.Conclusion: This survey has helped to increase available medicinal plants knowledge and documentation in the management of hypertension and Diabetes. However, further work on the pharmacological activity of these plants as well as formulation in proper dosage form is recommended

Medicine use among HIV/AIDS Patients in public hospitals, Kwara State

Background: The prognosis of HIV/AIDS and HIV-related comorbidities has been revolutionized by the use of medicines. However, World Health Organization reported that 50% of patients do not use their medicines as prescribed.Objective: To assess HIV/AIDS patients' knowledge of the use of medicines dispensed to them.Method: This study was conducted in seven public hospitals in six local government areas, Kwara State. Exit interviews of 780 eligible HIV/AIDS patients were conducted through use of structured questionnaire. Additionally, there were exit observational checks of medicines dispensed to these patients. Descriptive statistics and Fisher Exact test were used for data analyses.Results: Of the 780 study participants, 36.1% had no formal education, 99.9% knew the 'quantity' of medicines to be administered, while 99.2% knew the frequency of administration. All the patients knew the route of administration, 96.7% and 94.3% knew the general precautions to avoid concomitant use of dispensed medicines with alcohol or herbal products respectively, while 93.7% of those who received co-trimoxazole knew of the precaution to use "plenty of water" as the vehicle for its administration. There were no significant associations between the patients' knowledge of these precautions and duration of antiretroviral therapy (P>0.05). However, the patients lacked knowledge of specific precautions of some dispensed medicines.Conclusion: Most of the patients knew of the administration and the general precautions of dispensed medicines. However, lack of knowledge of specific precautions of some dispensed medicines calls for intervention

Age-specific nomograms for follicle stimulating hormone and anti-Mullerian hormone: a pilot study in Ile-Ife, Nigeria

Background: Assessment of ovarian reserve is one of the steps in the management of infertile couples. Follicle Stimulating hormone [FSH] and anti-Mullerian hormone [AMH] are commonly used ovarian reserve markers in Africa. However, there is paucity of age-specific reference values for FSH and AMH among the African population

Objective: This study aimed at conducting a pilot study for generation of age-specific nomograms for FSH and AMH among fertile women in Ile-Ife, Nigeria

Materials and Methods: A pilot cross-sectional study that involved 65 fertile women within the age range of 18-45 yr were prospectively and consecutively recruited from November 2014 to January 2015. Peripheral blood samples were taken for basal serum FSH and random serum AMH. The samples were processed using enzyme linked immunosorbent [ELISA] assays

Results: Age-specific FSH nomogram showed a gradual increase which became steeper at age 35 yr with an average yearly increase of 0.2 IU/L in basal serum FSH, while age-specific AMH nomogram showed a peak at 25 yr and then; an average yearly decrease of 0.11 ng/ml in random serum AMH from 25 yr

Conclusion: The age-specific nomograms generated by this pilot study suggest that AMH may be an earlier marker of reduced ovarian reserve; which if validated by future multicenter population based studies may facilitate counseling of women on their reproductive potentials

Energy Performance and Improvement Potentials for Selected Heritage Building Adaptation in England.

Public heritage buildings (PHBs) were evaluated with the aim to determine their operational energy performance and the objectives of identifying improvement potentials for their long term sustainable reuse. Six listed churches initially used for worship and later converted to community uses were selected and surveyed as case study buildings using purposive sampling technique. A qualitative analytical approach based on ranking the performance of the surveyed building’s energy consumption assessment compared to others within the same geographical region was adopted. Findings show that a greater number of the surveyed buildings are low-performing with their energy use being exacerbated by the combination and interplay of multiple factors such as building use pattern, efficiency of services and lighting etc. Results of the findings imply that potential and identifiable prospects for efficiency improvements and CO2 emissions reduction exists within the operation of the buildings. Recommended actions for wide-scale improvements in the form of capital replacement, retrofit/refurbishment, behavioural and improved operational management and control were suggested. The study concluded wider opportunities towards achieving energy saving such as energy management programme, building energy refurbishment scheme and use of energy efficient equipment could enhance stainable reuse of PHBs.