Adverse effects of exposure to petrol-generator exhaust fumes on the reproductive hormones, testis and spermatozoa in male dogs.

There is evidence that sperm count has progressively declined in men over the recent decades. Exposure to air pollutants including petrol and diesel exhaust have been reported to impair male reproduction although there is little experimental evidence. This study investigated the effects of petrol-generator exhaust fumes (PGEF) on semen, sperm, gonadal structure and hormonal status in the dog. Sixteen adult male Basenji dogs were randomly assigned four to each of 4 groups as follows: an unexposed (Control) group and three groups exposed to graded levels of PGEF for 1, 2 or 3 h per day (hpd), respectively, for 90 days. Serum concentrations of testosterone (T), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were measured on days 0 (baseline), 30, 60 and 90 of the study. At day 90, semen samples were collected for semen and sperm analysis. Testicular and epididymal tissues were subjected to gross, histopathological and histomorphometric evaluation. Graded exposure to PGEF resulted in increased serum concentration of T and decreased concentrations of FSH and LH, increased seminal plasma lipid peroxidation, seminiferous and epididymal tubular degeneration, germ cell depletion, lowered sperm concentration, decreased sperm motility and vitality, and increased sperm abnormal morphology. The close proximity between dogs and humans in exposed environments underscores the importance of these findings to human reproductive health and fertility. The findings suggest that with prolonged exposure, the impairment of reproductive functions will likely play significant roles in the decline in male fertility.

RESPONSE TO THE COVID-19 OUTBREAK: LESSONS FROM A TERTIARY HEALTHCARE FACILITY IN SOUTHWEST NIGERIA.

Background: Mitigating the risk of nosocomial infection is one of the core functions of healthcare managers in hospital environments. This study aimed to describe the COVID-19 outbreak response in a tertiary healthcare facility in Nigeria. Methods: A qualitative cross-sectional study was conducted among representatives of Heads of Infection Control Committees and units, the Accident and Emergency unit, Family Medicine unit, and Private Suites on the COVID-19 outbreak response at the University College Hospital, Ibadan, Nigeria. Data were analyzed using Colaizzi's phenomenological method. Results: Overall, seven (six physicians and one nurse) HCWs were interviewed; six (71.4%) males and two (28.6%) females. The average age of the key informants was 45 ± 4.73 years. Four themes were identified. Theme one "Essentials of screening protocol and screening area" described the development of screening protocol, and dedication of a triage area. Theme two "Infection prevention and control within consultation premises" detailed adequate spacing; hand hygiene, use of personal protective equipment; environmental sanitation; and waste management. Theme three "Mounting up surveillance in the response activity" specified communication with the Disease Surveillance Unit; and surveillance activities. Theme four "Training and psychosocial support for staff " described staff training, and provision of psychosocial care to infected staff. Conclusion: The COVID-19 outbreak measures implemented by the management of the University College Hospital, Ibadan were aimed at ensuring that the hospital does not get overwhelmed by the surge in COVID-19 cases. In order to improve outbreak response in hospital settings, it is important to undertake training, modify hospital practices, and evaluate implemented measures.

Effects of Controlled Generator Fume Emissions on the Levels of Troponin I, C-Reactive Protein and Oxidative Stress Markers in Dogs: Exploring Air Pollution-Induced Cardiovascular Disease in a Low-Resource Country.

Exhaust fumes from petrol/diesel-powered electric generators contribute significantly to air pollution in many developing countries, constituting health hazards to both humans and animals. This study evaluated the serum concentrations of Troponin I (TnI), C-reactive protein (CRP) and serum levels/activities of oxidative stress markers: catalase (CAT), reduced glutathione (GSH), malondialdehyde (MDA), nitric oxide (NO) and superoxide dismutase (SOD) in dogs experimentally exposed to graded levels of petrol generator exhaust fume (PGEF). Sixteen (16) healthy and adult male Basenji dogs were randomly assigned into four groups (A-D). Group A was the unexposed control while groups B, C and D were exposed to PGEF for 1, 2 and 3 h per day, respectively, for 90 days. Repeated analysis were performed at the baseline, and every thirty days, for a total of 90 days. There was a significant interaction (p < 0.05) between the effects of PGEF exposure level (in h/day) and duration of exposure (in months) on all the tested serum parameters. There was a significant main effect (p < 0.05) for PGEF exposure level on the serum parameters. As the level of PGEF exposure was increased, the serum concentrations of TnI, CRP, CAT, MDA and NO increased, GSH decreased, whereas SOD activity increased by day 30 but declined at the end. Moreover, there was a significant simple main effect (p < 0.05) for duration of PGEF exposure. All the parameters increased as the duration of PGEF exposure was increased to 90 days except GSH concentration which decreased, whereas SOD activity increased initially but declined at the end of the study. Thus, there was increased serum concentrations of TnI, CRP and increased oxidative stress in the PGEF-exposed dogs. These findings are instructive and could be grounds for further studies on air pollutants-induced cardiovascular disease given the widespread use of electricity generators in many low-resource countries.

Perception of Substance Use Disorder Training: a Survey of General Psychiatry Residents in Nigeria.

OBJECTIVE: Substance use disorder (SUD) is a global concern. Evidence from high-income countries suggests that SUD training for psychiatry residents is less than optimal but it is unknown whether the situation is different in low-/middle-income settings. This study assessed psychiatry residents' perception of their SUD training. METHODS: A cross-sectional survey was conducted among general psychiatry residents in Nigeria from November 2018 to May 2019. Data were collected through self-completion of an English-language questionnaire with multiple-choice and open-ended questions administered face-to-face and online. RESULTS: A total of 51 participants completed the questionnaire, mean age 33.6 years and 76.5% men. Most participants (70.6%) expressed interest in addiction psychiatry, and 47.1% perceived their SUD training as inadequate. When asked to rate satisfaction with the SUD training they have received so far, 52.9% were unsatisfied, and the absence of in-house SUD training (29.4%) was the leading cause of dissatisfaction. For those who were satisfied, the most common reasons were availability of SUD training and treatment-related factors (31.4%). The most frequent suggestions for making addiction psychiatry subspecialty attractive to psychiatry residents were provision of SUD treatment units, structured SUD training, and continuity of such training. Equipping existing SUD treatment units and creating more treatment units were the most common suggestions for improving current SUD training. CONCLUSION: This study demonstrated a high level of interest in addiction psychiatry, but satisfaction with SUD training was mixed. Addressing causes of dissatisfaction and areas suggested for improvement would be necessary to sustain interest.

Economic and feasibility comparison of the dRIT and DFA for decentralized rabies diagnosis in resource-limited settings: The use of Nigerian dog meat markets as a case study.

BACKGROUND: Rabies lyssavirus (RABV) is the aetiologic agent of rabies, a disease that is severely underreported in Nigeria as well as elsewhere in Africa and Asia. Despite the role that rabies diagnosis plays towards elucidating the true burden of the disease, Nigeria-a country of 180 million inhabitants-has a limited number of diagnostic facilities. In this study, we sought to investigate two of the World Organization for Animal Health (OIE)-recommended diagnostic assays for rabies-viz; the direct fluorescent antibody test (DFA) and the direct rapid immunohistochemical test (dRIT) in terms of their relative suitability in resource-limited settings. Our primary considerations were (1) the financial feasibility for implementation and (2) the diagnostic efficacy. As a case study, we used suspect rabies samples from dog meat markets in Nigeria. METHODS/PRINCIPAL FINDINGS: By developing a simple simulation framework, we suggested that the assay with the lowest cost to implement and routinely use was the dRIT assay. The costs associated with the dRIT were lower in all simulated scenarios, irrespective of the number of samples tested per year. In addition to the cost analysis, the diagnostic efficacies of the two assays were evaluated. To do this, a cohort of DFA-positive and -negative samples collected from dog meat markets in Nigeria were initially diagnosed using the DFA in Nigeria and subsequently sent to South Africa for diagnostic confirmation. In South Africa, all the specimens were re-tested with the DFA, the dRIT and a quantitative real-time polymerase chain reaction (qRT-PCR). In our investigation, discrepancies were observed between the three diagnostic assays; with the incongruent results being resolved by means of confirmatory testing using the heminested reverse transcription polymerase reaction and sequencing to confirm that they were not contamination. CONCLUSIONS/SIGNIFICANCE: The data obtained from this study suggested that the dRIT was not only an effective diagnostic assay that could be used to routinely diagnose rabies, but that the assay was also the most cost-effective option among all of the OIE recommended methods. In addition, the results of our investigation confirmed that some of the dogs slaughtered in dog markets were rabies-positive and that the markets posed a potential public health threat. Lastly, our data showed that the DFA, although regarded as the gold standard test for rabies, has some limitations-particularly at low antigen levels. Based on the results reported here and the current challenges faced in Nigeria, we believe that the dRIT assay would be the most suitable laboratory test for decentralized or confirmatory rabies diagnosis in Nigeria, given its relative speed, accuracy, cost and ease of use.

Health Insurance Knowledge, Attitude and the Uptake of Community-Based Health Insurance Scheme among Residents of a Suburb in Lagos, Nigeria.

BACKGROUND: Out of pocket payment for health services in the midst of financial hardship is a major contributor to poor access to healthcare in Nigeria with the resultant poor health indices. Towards the goal of Universal Health Coverage, Community Based Health Insurance (CBHI) was introduced in addition to the National Health Insurance Scheme but with minimal impact and utilization. OBJECTIVE: The objective of this study was to assess health insurance-related knowledge and attitudes and to examine the uptake of CBHI. METHODS: This was a descriptive cross-sectional study. A multi-stage sampling method was used to select 419 respondents from the Ajeromi-Ifelodun community. A semi-structured interviewer-administered questionnaire was used to collect data for the study. Data analysis was done using Microsoft Excel and Epi-Info 7.1. RESULTS: Most of the respondents (80.2%) had not heard of Community-Based Health Insurance and only about 9% of respondents had good knowledge about it. However, most (62.5%) of the respondents had a positive attitude towards health insurance generally. Only 4.5% of the respondents were enrolled in the CBHI scheme and had paid their premium up to date. There was a significant association between the respondents' knowledge and their uptake of the scheme (<0.001), and also between their attitudes and uptake (p = 0.002). CONCLUSION: This study suggests that for CBHI to be successful, certain strategies must be implemented towards increasing awareness and knowledge about CBHI. This will in turn increase the uptake of the scheme, a necessary requirement for achieving the goal of Universal Health Coverage.

The beneficial effect of dietary zinc supplementation on anaemia and immunosuppression in Trypanosoma brucei infected rats.

Zinc is an essential trace element crucial for normal development and function of cells mediating nonspecific immunity and protects bio-molecules from oxidative damage. This study was designed to assess the effects of dietary zinc supplementation on anaemia and immunity of trypanosome-infected rats. Thirty rats, divided into five groups (A-E) of 6 each, were used for the study. Parameters used to assess the effect of the supplementation are antibody response to Sheep RBC using direct haemagglutination test, parasitaemia using the rapid matching method, WBC count using the improved Neubauer haemocytometer method, haemoglobin concentration using the cynomethaemoglobin technique while PCV was determined using the microhaematocrit method. The pre-infection supplementation did not prolong the pre-patent period significantly (p > 0.05). However, it significantly (p < 0.05) increased the packed cell volume (PCV), haemoglobin (Hb) concentration, leucocyte count, and antibody titre by day 7 on the supplementation (OTS). Following infection on day 7 OTS, the PCV and Hb decreased but remained significantly (p < 0.05) higher than the infected not supplemented (INS) group, while on day 14 OTS, they maintained a significantly (p < 0.05) higher antibody titre as compared to other groups. On day 21 OTS, theweight of 8 ppm and not infected not supplemented (NINS) groups was significantly (p < 0.05) higher but the relative organ weight of their liver and spleen was significantly (p < 0.05) lower than 2 ppm, 4 ppm and INS groups. On day 21 OTS, the parasitaemia levels of INS group was significantly (p < 0.05) higher than the supplemented groups. From the results, dietary zinc supplementation can be useful in the management of anaemia and immunosupression caused by trypanosomes in rats.

SPUTUM SMEAR PATTERN AMONG PATIENTS DIAGNOSED WITH PULMONARY TUBERCULOSIS IN MAKURDI, NORTH CENTRAL NIGERIA.

BACKGROUND: Tuberculosis (TB) is endemic in Nigeria due mainly to the high burden of HIV/AIDS and especially in Benue state which has the highest prevalence of HIV in Nigeria. Sputum smear examination is of importance in the diagnosis of pulmonary TB and can be smear-positive or negative. In this study, we analyzed the sputum smear results of all patients diagnosed to have PTB during the time under review. METHODS: The study was a retrospective study done with records of patients diagnosed with PTB between July 2009 and July 2011. The sample size was 305. AIM: To determine the smear patterns in pulmonary tuberculosis and its relationship with HIV status. RESULTS: There was slight male preponderance among the study group. 37% were found to be smear positive, out of which 63.7% and 36.3% were males and females respectively. The highest frequency was between 21-40 years and in this age group there were more males than females.72.1% wereTB/HIV co-infected and 29.1% of the TB/HIV co-infected patients had smear-positiveTuberculosis. CONCLUSION: There is a high burden of TB/HIV co-infection affecting predominantly the youths. Sputum smear results in TB/HIV co-infection are largely negative. There is the need for provision of other diagnostic tests to improve the diagnosis of TB in our environment and targeted intervention among the youth to reduce the burden of TB/HIV.

Correlation of intraoperative cytological and final histological diagnoses: a retrospective 10-year study of neurosurgical cases from Ibadan, Nigeria.

OBJECTIVE: Intraoperative cytology is a cost-effective, rapid, and easy technique, and studies have shown good correlation between intraoperative cytology and histology. We undertook this study to compare the intraoperative cytology diagnoses of brain lesions made in our unit over a 10-year period with the definitive histological diagnoses. The aim was to determine the degree of accuracy of this procedure. STUDY DESIGN: This is a retrospective study of intraoperative neuropathology consultation cytology smears or imprints and histology of 69 cases obtained over a 10-year period. Cytology smears were stained using both Papanicolaou and Giemsa. Histology sections were prepared from routine formalin-fixed paraffin-embedded tissue and stained using H and E method. Each of the smears and histology samples were assessed by at least two pathologists. Cytological diagnosis was correlated with final histological diagnosis. The sensitivity and specificity of cytological diagnosis was evaluated using final histological diagnosis as gold standard. RESULTS: Correlation was strongest with inflammatory lesions followed by low-grade neoplasms. High-grade neoplasms also showed good concordance, but the degree of correlation was lower than in the other categories. Misdiagnosis was commonest with benign tumors. CONCLUSION: Intraoperative cytology is a relatively simple, reliable, and accurate diagnostic technique and should be more commonly used, particularly in low-resource settings.

Prevention of sexual assault in Nigeria.

Sexual assault occurs commonly worldwide and is particularly pervasive in the developing world. The background to sexual violence is important in the understanding of the ramifications of the problem. Some elements that offer the means to the prevention of sexual assault in the community are important highlights especially where the means - expertise and facilities - for managing cases of sexual assault is grossly inadequate. These concepts, though are applicable universally, are however discussed in the context of the developing world and with particular emphasis on the Nigerian situation. Their applicability in sexual assault prevention is derived from previous studies in different parts of the world that highlight the viability of these interventions. Therefore if one posits that sexual assault can be prevented, certain responsibilities are imperative; some challenges must be anticipated; and special needs/circumstances should be catered for.

Prevention of Sexual Assault in Nigeria

Sexual assault occurs commonly worldwide and is particularly pervasive in the developing world. The background to sexual violence is important in the understanding of the ramifications of the problem. Some elements that offer the means to the prevention of sexual assault in the community are important highlights especially where the means - expertise and facilities - for managing cases of sexual assault is grossly inadequate. These concepts; though are applicable universally; are however discussed in the context of the developing world and with particular emphasis on the Nigerian situation. Their applicability in sexual assault prevention is derived from previous studies in different parts of the world that highlight the viability of these interventions. Therefore if one posits that sexual assault can be prevented; certain responsibilities are imperative; some challenges must be anticipated; and special needs/circumstances should be catered for

The Prevalence and Antimicrobial Susceptibility Profile of Methicillin-Resistant Staphylococcus Aureus Isolates from Clinical Specimens in a Tertiary Hospital; South East Nigeria

Pathogenic microorganisms resistant to commonly used antibiotics are of worldwide concern. Methicillin-resistant Staphylococcus aureus (MRSA) has been reported worldwide and causes both hospital and community-associated infections in humans. Sixty-five (65) Staphylococcus aureus isolates from clinical samples were screened for methicillin resistance in order to evaluate the prevalence of methicillin-resistant strains at Ebonyi State University Teaching Hospital; Abakaliki and to determine the antimicrobial susceptibility profile of MRSA strains. Susceptibility testing of the isolates to oxacillin and to some other conventional antimicrobial sensitivity discs commonly used in the study area was done using Kirby-Bauer disc diffusion technique. Of the 65 Staphylococcus aureus isolates screened; 15 (23) were susceptible to methicillin while 50 (77) were resistant to methicillin. The Methicillin-resistant isolates showed 100resistance to ciprofloxacin; ceftriaxone; nitrofurantoin and erythromycin. The percentage resistance recorded for other antibiotics were ofloxacin (88); ampicillin (76); gentamicin (72); while the lowest resistance; (40) was recorded for vancomycin. It was noted that vancomycin is still the antibiotic of choice for the treatment of MRSA infections. It was concluded that the prevalence of MRSA is high in the study area; and this should necessitate caution in the prescription of antibiotics without proper indication

Pattern of homicide coroner's autopsies at University College Hospital, Ibadan, Nigeria: 1997-2006.

There is relatively little information regarding the pattern of homicides in developing countries such as Nigeria. This study is aimed at determining the pattern and demographic factors associated with homicide cases seen in a Nigerian Teaching Hospital. It is a descriptive autopsy study of homicide cases seen at the University College Hospital (UCH), Ibadan over a 10-year period from January 1997 to December 2006. All the coroner's autopsies for the period, of homicides or suspected homicides, were reviewed with emphasis on the following: gender, age, occupation, circumstances surrounding event, likely motive, type of weapon used, site(s) of injury and mechanism of death. Homicides accounted for 153 (3.1%) of the 4928 coroner's cases at the UCH within the study period. One hundred and thirty-seven of the 152 cases were men, and the overall age range was 4-83 years. The mechanism of death was haemorrhagic shock in 91 cases (59.9%); severe raised intracranial pressure in 58 cases (38.2%); septicaemic shock in two cases (1.3%); and asphyxia in one case (0.7%). Gunshot injuries accounted for 64.5% of the fatalities, sharp objects 21.1% and blunt force 14.5%. Most were victims of armed robbery attacks. The head, abdomen, chest and lower limbs were single sites of injuries in descending order of frequency and most of the cases sustained multiple injuries involving two or more of these sites. Gunshot deaths were the commonest form of homicides in the period under review. Young males and victims of armed robbery attacks were most susceptible.

The role of forensic dentist following mass disaster.

This review article focuses on mass disaster situations that may arise from natural or manmade circumstances and the significant role of forensic dental personnel in human identification following such occurrences. The various forensic dental modalities of identification that include matching techniques, postmortem profiling, genetic fingerprinting, dental fossil assessment and dental biometrics with digital subtraction were considered. The varying extent of use of forensic dental techniques and the resulting positive impact on human identification were considered. The importance of preparation by way of special training for forensic dental personnel, mock disaster rehearsal, and use of modern day technology was stressed. The need for international standardization of identification through the use of Interpol Disaster Victim Identification (DVI) for ms was further emphasized. Recommendations for improved human identification in Nigerian situation include reform of the National Emergency Management Association (NEMA), incorporation of dental care in primary health care to facilitate proper ante mortem database of the populace and commencement of identification at site of disaster.

The Role of Forensic Dentist Following Mass Disaster

This review article focuses on mass disaster situations that may arise from natural or manmade circumstances and the significant role of forensic dental personnel in human identification following such occurrences. The various forensic dental modalities of identification that include matching techniques; postmortem profiling; genetic fingerprinting; dental fossil assessment and dental biometrics with digital subtraction were considered. The varying extent of use of forensic dental techniques and the resulting positive impact on human identification were considered. The importance of preparation by way of special training for forensic dental personnel; mock disaster rehearsal; and use of modern day technology was stressed. The need for international standardization of identification through the use of Interpol Disaster Victim Identification (DVI) for ms was further emphasized. Recommendations for improved human identification in Nigerian situation include reform of the National Emergency Management Association (NEMA); incorporation of dental care in primary health care to facilitate proper ante mortem database of the populace and commencement of identification at site of disaster

The Correlation Between Ultrasound-Measured Fetal Heart Rate and Gestational Age in a Normal Pregnant Nigerian Population

A total of 400 apparently healthy pregnant women with singleton fetuses from Enugu; Southeast Nigeria were randomly selected for the study. The aims of the study are to establish : a normogram for fetal heart rate (FHR) and the relationship between fetal heart rate and gestational age (GA) by 2-D ultrasound. Crown rump length measurement was used for estimating GA in the first trimester while femur length and biparietal diameter measurements were used for estimating GA in the second and third trimesters. Result shows that the normal range of FHR was 120 to 162 beats per minute (BPM). There was a statistically significant negative correlation of FHR with GA in the first; second; third and combined trimesters as the coefficient of correlation; r = -0.652; -0.736; -0.8185 and -0883 respectively. The study shows that a unit increase in GA decreases the FHR by 32; 15; 12.6 and 13 in the first; second; third and combined trimesters respectively. Results suggest that FHR measurement should be done routinely as one of the essential parameters for the assessment of fetal well being by ultrasound