Major extremity amputations: Indications and post surgery challenges in a Nigeria tertiary institution

Amputation is an ancient procedure which has been practiced for centuries for a variety of indications. The goal of the procedure is to eliminate potential threat to the patient while producing a viable stump for easy rehabilitation.Objective: To identify the indications, postoperative complications and peculiarities of patients with amputation in a native African population.Materials and Methods: This was a prospective study carried out on all consenting patients who had extremity amputation at Federal Medical Centre, Birnin Kebbi, from June 2015 to May 2016. Results: During the study period, there were 47 amputations in 47 patients (34 males and 13 females). The mean age of the patients was 35.73 ± 19.43 years. The most common indication for amputation was traditional bone setter's (TBS) gangrene accounting for 44.7% of cases, followed by diabetic foot syndrome at 25.5%. Camel bites accounted for 6.4% of the amputations. The most common type of amputation was below­knee amputation (46.8%), followed by above­knee amputation (25.5%). Five (10.7%) patients had surgical site infection and only 2.1% of the patients developed phantom limb sensation. None of these patients was fitted with a prosthesis due to the high cost or nonavailability of the prosthesis.Conclusion: Complications of TBS intervention were the leading cause of amputation in this study. Gangrene following camel bites was also found to be a peculiar cause for amputation in this environment. Appropriate public health interventions are necessary to reduce the incidence of preventable gangrene. Provision of prosthesis with adequate technical support is essential to proper rehabilitation of the amputees

Malnutrition among Children with Non-syndromic Cleft Lip and Palate: A Case – Control Study in Ile – Ife, Nigeria.

Background: Children with cleft lip and palate (CLP) face lots of difficulties in the society. They tend to suffer malnutrition due to lack of standard care especially from their parents and society at-large. The potential risk of malnutrition is particularly high during early childhood. There is paucity of indigenous data on the prevalence of malnutrition in children with CLP. The aim of the study was to assess the influence of non sydromic CLP on the nutritional status of children. Methods: Anthropometric parameters weight for age z score (WAZ), height for age z score (HAZ), weight for height z score (WHZ) of children with CLP were compared with age matched controls. Results: Prevalence of underweight, wasting and stunting for cleft group were 26%, 18% and 14% respectively compared to 18%, 14% and 10% for the control. Differences in the underweight, wasting and stunting between the two groups were not statistically significant (p value = 0.334, 0.585, and 0.538 respectively). There was significant difference in the bottlefeeding and breastfeeding rates of the two groups. (p= 0.000 and 0.000 respectively). Conclusion: There is no statistically significant difference in the occurrence of malnutrition in children with non- syndromic Cleft lip and Palate compared with control.

Abilities of Trichoderma Species to Persist within Maize (Zea mays) Stem Long after Inoculation.

Different Trichoderma species were examined for their abilities to persist within the maize (Zea mays) stem at different points above and below inoculation points. Different Trichoderma species were isolated from different parts of the maize (Z. mays) plant and its rhizosphere. They were later sent to International Mycological Institute, England for identification. Maize seeds (DMR-LSRW) were planted in pots in the screenhouse. Four weeks after planting, each of the Trichoderma species was inoculated into the stems of the potted plants at the 2nd internodes using the toothpick method. Toothpicks dressed with sterile distilled water served as control. Cut sections of the inoculated stems were examined for presence or absence of the inoculated Trichoderma species at different points far from the inoculated point in the upper and lower internodes after 2, 3, 4, 5 and 6 weeks of inoculation. Ten Trichoderma species were identified; these include five strains of T. pseudokoningii, three strains of T. harzianum, T. hamatum and T. longibrachiatum. All the Trichoderma species were able to move within the stem tissues into the upper and lower internodes. All of them were re-isolated at distant points from inoculation point in the upper and lower internodes even after 6 weeks of inoculation. T. pseudokoningii strain 2 and T. harzianum strains 1 to 3 had the best endophytic movement into the upper and lower internodes. T. hamatum and T. longibrachiatum had the weakest movement into the upper and lower internodes. All the Trichoderma species could thus be said to possess the abilities to persist (endophytic capability) within the maize (Z. mays) stem. T. pseudokoningii and T. harzianum could also be said to be among the best species in the genus Trichoderma with good prospect of biocontrol potential.

Utility and Effectiveness of Computerised Motion Sensitivity Screening Tests in Rural Onchocercal Community Survey

BACKGROUND: Non-invasive tool of community diagnosis for onchocercal endemicity needs to be identified and ascertained for their utility and effectivity in order to facilitate the control of onchocerciacis in sub-Saharan Africa OBJECTIVE: To determine the utility and effectiveness of the Wu-Jones Motion Sensitivity Screening Test (MSST) in detecting optic nerve diseases in onchocercal-endemic rural Africa. METHODS: MSST was applied to sampled subjects in the selected communities of Raja in Sudan; Bushenyi in Uganda; Morogoro in Tanzania; and of Ikom; Olamaboro and Gashaka in Nigeria. Basically; six points within the central field of vision were repeatedly tested at 1/3 meter from the screen of a laptop computer in a room darkened. Motion sensitivity was expressed as a percentage of motion detected in the individual eye and this was averaged for the community. RESULTS: A total of 3;858 eyes of 2;072 patients were examined. Seventy-six percent of the subjects completed the test; at an average test time of 120.4 (66.7) seconds. The overall mean motion sensitivity of all eyes tested was 88.49 (17.49). At a cut-off point of 50; 6.4of all subjects tested were subnormal; while at 70cutoff; 13.3were subnormal. The highest proportion of 50cutoff sub-normality was recorded at Morogoro at 12.7. CONCLUSION: Motion Sensitivity Screening Test was widely accepted and easily administered to the rural and largely illiterate subjects studied. Our data suggest that the proportion of severe field defects by MSST in a community; with cutoff at 33; best correlates with optic nerve disease prevalence; while proportion of defect from a higher cut-off level at about 50; best correlates with overall ocular morbidity

Pharmacists and Nurses Perception of Medication Errors in a Nigerian University Teaching Hospital

Purpose: To investigate the type and frequency of all medication dispensing and administration errors as perceived by pharmacists and nurses respectively; and the factors associated with such errors in a Nigerian university teaching hospital. Methods: The study was conducted at the Obafemi Awolowo University Teaching Hospitals; Ile-Ife and Ilesa; Nigeria. Data was collected by the use of pre-tested questionnaire administered to 35 pharmacists and a stratified sample of 130 nurses over a period of 2 weeks. The questionnaires were sorted and analysed. Results: The pharmacists that responded (80) cited incorrect drug; incorrect strength of drug (70) and wrong dose of drug (60) as the most common dispensing errors. Fifty percent of pharmacists put the estimated frequency of occurrence of these dispensing errors at 1 per 100 prescriptions dispensed. Most of the nurses (65) identified administration of wrong drug; administration of wrong dose (63) and wrong time of drug administration (57) as the most frequently occurring medication administration errors in the teaching hospital. All the pharmacists and 78of nurses identified excess workload as the most important factor contributing to errors in medication dispensing and administration respectively. Conclusion: The fundamental factor perceived to be contributing to errors in medication dispensing and administration was excess workload resulting from insufficient members of staff

Pharmacists and Nurses Perception of Medication Errors in a Nigerian University Teaching Hospital

Purpose: To investigate the type and frequency of all medication dispensing and administration errors as perceived by pharmacists and nurses respectively; and the factors associated with such errors in a Nigerian university teaching hospital. Methods: The study was conducted at the Obafemi Awolowo University Teaching Hospitals; Ile-Ife and Ilesa; Nigeria. Data was collected by the use of pre-tested questionnaire administered to 35 pharmacists and a stratified sample of 130 nurses over a period of 2 weeks. The questionnaires were sorted and analysed. Results: The pharmacists that responded (80) cited incorrect drug; incorrect strength of drug (70) and wrong dose of drug (60) as the most common dispensing errors. Fifty percent of pharmacists put the estimated frequency of occurrence of these dispensing errors at 1 per 100 prescriptions dispensed. Most of the nurses (65) identified administration of wrong drug; administration of wrong dose (63) and wrong time of drug administration (57) as the most frequently occurring medication administration errors in the teaching hospital. All the pharmacists and 78of nurses identified excess workload as the most important factor contributing to errors in medication dispensing and administration respectively. Conclusion: The fundamental factor perceived to be contributing to errors in medication dispensing and administration was excess workload resulting from insufficient members of staff.) cited incorrect drug; incorrect strength of drug (70) and wrong dose of drug (60) as the most common dispensing errors. Fifty percent of pharmacists put the estimated frequency of occurrence of these dispensing errors at 1 per 100 prescriptions dispensed. Most of the nurses (65) identified administration of wrong drug; administration of wrong dose (63) and wrong time of drug administration (57) as the most frequently occurring medication administration errors in the teaching hospital. All the pharmacists and 78of nurses identified excess workload as the most important factor contributing to errors in medication dispensing and administration respectively. Conclusion: The fundamen- tal factor perceived to be contributing to errors in medication dispensing and administration was excess workload resulting from insufficient members of staff

Lead levels in some biological samples of auto-mechanics in Abeokuta, Nigeria.

Lead levels were determined in the blood, scalp hair and fingernails of 38, all male auto-mechanics (aged 18-45 years) from Abeokuta, South-western Nigeria. The subjects were classified into four sub-groups based on the period of exposure namely: 1-5, 6-10, 11-15, and >16 years. Thirty-two occupationally unexposed subjects (mainly office workers) served as the control. The weight, height and body mass indexes of all subjects were noted, in addition to other information obtained through structured questionnaire. The mean values of blood lead (BPb), hair lead (HPb) and fingernail lead (NPb) of the occupationally exposed subjects (n=38) were 48.50 +/- 9.08 microg/dL, 17.75 +/- 5.16 microg/g, and 5.92 +/- 3.30 microg/g respectively, while the corresponding mean values for these parameters in the control subjects (n = 32) were 33.(,5 +/- 10.09 microg/dL, 14.30 +/- 5.90 microg/g and 5.31 +/- 2.77 microg/g respectively. The differences in BPb and HPb levels of the two groups were statistically significant (P <0.05 and P <0.01 respectively), while that of NPb was not significant. The levels of lead in the biological samples appeared to have no relationship with the number of years on the job. From these results, it was obvious that the higher levels of lead in the biological samples of test subjects, compared with those of the controls were from environmental sources.

Trachoma: an Ancient and Contemporary Scourge

Trachoma is an ancient yet contemporary scourge. It is a specific kerato-conjunctivitis caused by certain serovars of Chlamydia trachomatis. It affects an estimated 84 million people and remains the commonest communicable cause of blindness in 6 million people. WHO has introduced the SAFE strategy which needs to be implemented with more determination in Nigeria if the level of trachoma blindness is to be positively impacted. This is particularly in the area of identification of communities in need of intervention through more widespread application of Rapid assessment methods. The challenges in trachoma research remain to improve the accurate diagnosis of active disease; to monitor emergence of antibiotic resistance and to improve the understanding of transmission and reservoirs of the infectious agent

Psychosocial dynamics of psychoactive substance misuse among Nigerian Adolescents

Background: Psychoactive substance misuse has for many years been an issue of increasing health and social importance in Nigeria. This is especially so for the critical adolescent period marked by several changes including the psychological phenomenon of experimentation. Studies carried out in the last two decades in Nigeria have identified adolescents as a major group involved in the use of psychoactive substances. However, most studies employed quantitative methods to gather information on drug misuse. In developing programmes for prevention and control of drug misuse it is important to complement quantitative information with qualitative data. This article reviews the available data on drug use in Nigerian adolescents and utilises a qualitative method to explore the psychosocial dynamics of drug use among adolescents. Methods: Review of current literature on drug use among adolescents in Nigeria and in-depth interviews of two adolescents with poly-drug misuse to identify psychosocial dynamics surrounding their use of psychoactive substances. Results: Surveys suggest that in both in-and out-of-school adolescents, the socially acceptable drugs like alcohol and cigarettes are commonly used. The patients interviewed illustrate the important 'gateway' theory of drug progression. Psychological dynamics identified include peer pressure, experimentation and conduct problems while social factors include poverty, family problems, and social acceptability of local alcoholic drinks like palm-wine. Conclusion: These identified factors must be utilised in developing drug prevention programmes. The public health implications of the social acceptability of palm wine, especially its consumption by children, needs to be further explored

The Persistence of chlamydial inclusions in clinically quiescent trachoma

Most of the trachoma patients seen at the Guinness Eye Clinic in Kaduna; Northern Nigeria today are in the healed or quiescent stages of evolution and disease intensity is largely trivial. A significant proportion however; seem to have recrudescence of the active stages; a phenomenon that is usually attributed to reinfection