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Intensive care unit deaths among neurosurgery patients in a tertiary hospital in South Western Nigeria
Get PDFBackground: Neurosurgical patients are the most critical ICU admissions. While advancements in neurosurgical ICUs (NICU) have improved outcomes of care globally, ICU mortality remains a major clinical issue in developing nations. This study evaluates ICU mortalities of neurosurgical patients in a general ICU setting at the UNIOSUN Teaching Hospital, Osogbo, Nigeria.
Method: Case records of neurosurgery patients who died in the ICU of UNIOSUN Teaching Hospital, Osogbo, South-Western, Nigeria from June 2012 to May 2022 were reviewed. Simple descriptive statistics of data on demographics, clinical diagnoses, management and outcome were done.
Results: Mortality rate was 38.9% (84 of 216 admissions). Males were 67(79.8%) and the mean age was 41.5years (Range: 2-85years). The average duration of ICU stay was 3.5days (Range: 30minutes-20days). Most patients had severe traumatic brain injury (TBI) (62, 73.8%). This was followed by cerebrovascular diseases (12, 14.3%) and brain tumours (6, 7.1%). Two had brain abscess. One patient each had mixed subacute/chronic subdural haematoma and severe cervical spondylotic myelopathy. Of the 69 whose case files were found, 7(10.1%) had a diagnosis of brainstem death before eventual 'final' death after an average of 13.5 additional hours on mechanical life support. The identified secondary causes of death included raised ICP, sepsis, primary surgical haemorrhage, seizures, acute kidney injury, malignant hypertension, poor glycaemic control and aggressive blood pressure lowering. Only 1 patient had autopsy.
Conclusion: Most ICU mortalities among neurosurgical patients were from severe TBI. The establishment of NICU is necessary to improve outcome of care of neurosurgical patients.  
Factors Associated with Viral Load Suppression among Human Immunodeficiency Virus (HIV) Positive Adolescents and Young Adults in Ngororero District, Rwanda
Get PDFBackgroundOptimal viral load suppression results from good adherence to treatment. The viral load suppression advantages include the reduction of virus transmission. In Rwanda, however, viral load suppression among adolescents and young adults has been proven relatively low than in other age groups.ObjectivesTo assess the factors associated with viral load suppression among adolescent and young adults in Ngororero district, Rwanda.MethodsA cross sectional study that included 151 adolescents and young adults aged from 15 to 24 years was conducted in Ngororero district. Data were entered in Epi-Info version 7 software and analyzed using STATA15.ResultsFemales and males were 68% and 32% respectively. Sixty percent of the participants were aged 20-24 years. Multivariable analysis revealed the factors associated with viral load suppression: Ubudehe category 2, P= 0.016, AOR = 6.6, CI [1.4, 31.1]; ubudehe category 3, P= 0.004, AOR = 8.9, CI [2.01,39.8]; spending between 5 to 9 years on ART, P= 0.022, AOR = 0.16 [CI0.03, 0.89;) and often forget to take medication, P= 0.011, AOR = 0.35, CI [0.13, 0.97.]ConclusionViral load suppression among adolescents and young adults was low. Improving socio-economic conditions of adolescents and young adults, as well as provision of continuous counselling to them during their whole treatment life can improve significantly their adherence.Rwanda J Med Health Sci 2023;6(1):43-5
Screening for neurocognitive deficits in adult populations reliant on toxic cassava as the main source of food: Dépistage des déficits neurocognitifs dans les populations adultes dépendant du manioc toxique comme principale source de denrées alimentaires
Get PDFContexte & objectif. La dépendance alimentaire chronique au manioc cyanogène mal détoxifié est largement répandue en Afrique subsaharienne. L’objectif de la présente étude était de dépister les troubles neurocognitifs et le fonctionnement de la vie quotidienne chez les adultes avec dépendance alimentaire au manioc cyanogène comme principale source de nourriture. Méthodes. C’était une étudebtransversale analytique incluant les chefs de ménage vivant dans le district rural de Kahemba, en République démocratique du Congo. Les participants ont été dépistés pour les troubles neurocognitifs à l'aide de Community Screening Interview for Dementia (CSID). L’exposition au manioc cyanogène a été déterminée par les concentrations urinaires de thiocyanate (SCN). Des modèles de régression ont été utilisés pour identifier les prédicteurs de mauvaises performances au CSID. Résultats. Quatre cent et six chefs de ménage (203 couples, âge moyen 38,4 ± 11, 4 ans) ont été enrôlés. Cent trente-six (33,5 %) [69 femmes et 67 hommes, âge moyen 39 ± 14,4, ans et 13 (3,2 %) [7 femmes et 6 hommes, âge moyen 32 ± 2,6 ans,) remplissaient respectivement les critères de trouble neurocognitif léger (TNL) et de trouble neurocognitif majeur (TNCM). La concentration urinaire Moyenne globale de SCN était de 949,5 ± 518,3 μmol/L. Après ajustement pour l'âge, le sexe, l'état nutritionnel et les antécédents de konzo, les déficits spécifiques aux différents domaines de la neuro-cognition étaient significativement associés de manière indépendante à l'hypertension ou à l'USCN (350 μmols/L, augmentation incrémentale de l'excrétion). Les déficiences fonctionnelles dans les activités de la vie quotidienne ont été directement proportionnelles à la mauvaise performance au CSID (Spearman r = - 0, 2, p <0,01). Conclusion. Les déficits neurocognitifs sont courants chez les adultes congolais qui dépendent du manioc cyanogène comme principale source de nourriture. Ce qui justifie la réalisation d'études ultérieures pour élucider l’impact cérébral / comportemental global ainsi que les mécanismes de la toxicité du manioc chez les adultes ayant une dépendance alimentaire au manioc cyanogène.
Context and objective. Chronic dietary reliance on improperly processed cyanogenic toxic cassava is widespread in sub-Saharan Africa. The objective of the present study was to screen for neurocognition impairments and daily-life functioning in adults with dietary dependency on cyanogenic cassava as the main source of food. Methods. A cross-sectional design enrolled heads of households (in couples) in the rural district of Kahemba, Democratic Republic of Congo. Participants were screened for neurocognitive impairments using the Community Screening Interview for Dementia (CSID). Detailed neuropsychiatric evaluations were performed and disease entities classified according to the Diagnostic and Statistical Manual of Mental Disorders (DSMIV) criteria when applicable. Cassava cyanogenic exposure was ascertained by urinary concentrations of thiocyanate (SCN). Regression models were used to identify predictors of CSID performance at the 0.05 significance level. Results. For hundred and six households (203 couples, mean age 38.4 ± 11. 4 years) were involved. One hundred thirty-six subjects (33.5 %) [69 women and 67 men, mean age 39 ± 14.4 years)] and 13 (3.2 %) [7 women and 6 men, mean age: 32 ± 2.6 years] fulfilled the criteria for mild cognitive impairment (MCI) and Major Neurocognitive disorder (MNCD), respectively. The overall mean urinary concentration of SCN was ting for age, gender, nutritional status, and history of konzo, neurocognition domain-specific deficits were independently associated with either hypertension or excretion). Functional impairments in daily-life activities increased as subjects poorly performed at the CSID screening (Spearman r = - .2, p < 0.01). Conclusion. Neurocognitive deficits in adults are common in Congolese adults relying on cyanogenic cassava as the main source of food. Our study findings warrant further studies to elucidate the overall lifespan brain/behavioral burden and mechanisms of cassava toxicity among adults with dietary dependency on cyanogenic cassava as the main source of food
Performance des explorations cliniques et de l’échographie mammaire dans le diagnostic des tumeurs bénignes du sein en milieu peu équipé d’Afrique subsaharienne: Performance of clinical investigations and breast ultrasound in the diagnosis of benign breast tumors in low-resource settings in sub-Saharan Africa
Get PDFContext and objective. Despite the high frequency of Benign Breast Tumors (BBT) in sub-Saharan Africa, very few studies have been conducted on these tumors. The objective of the present study was to evaluate the diagnostic value of clinical and ultrasound breast examinations for BBT in poorly equipped settings. Methods. This was a retrospective analysis of BBT cases followed at the Kinshasa University Hospital, between January 2016 and December 2021. The diagnostic value of clinical and ultrasound explorations of BBT (sensitivity, specificity, negative predictive value NPV, PPV, Kappa coefficient) was calculated taking as reference the anatomopathological finding of biopsy parts. Results. A total of 81 cases of BBT were collected. Fibroadenoma 58 (71.6%), Fibrocystic disease (MFK) 15 (18.5%), Tubular adenoma 6 (7.4%), Phyllodes tumor (PT) 1 (1.2%) and cyst 1 (1.2%) were diagnosed on the basis of pathological analyses after lumpectomy. On clinical examination, the ability to diagnose BBT other than Fibroadenoma was zero. The specificity, NPV and kappa coefficient were 60.0%, 39.1% and 32.2%, respectively for the diagnosis of Fibroadenoma. Breast ultrasound was performed in 98.6% while mammography in only 11.1% of cases. The majority of tumors were classified as Breast Imaging reporting and Data system (BIRADS) 2 (70.0%). Specificity, NPV and kappa were 80.6%, 40.9% and 39.0% for Fibroadenoma, respectively, and 84.4%, 66.7% and 1.9% for MFK. PT was classified as BIRADS3. Conclusion. Breast ultrasonography performs well in the BIRADS classification of BBT; clinicians practicing in low-equipped settings can therefore unequivocally follow the recommendations on the management of tumors classified as BIRADS2 and BIRADS3 on ultrasonography, although the performance with respect to the differential diagnosis of these tumors is debatable.
Contexte et objectif. Malgré leur fréquence élevée, très peu d’études ont été menées sur les tumeurs bénignes du sein (TBS) en Afrique subsaharienne. L’objectif de la présente étude a été d’évaluer la valeur diagnostique des explorations clinique et échographique mammaire des TBS en milieu peu équipé. Méthodes. Il s’agissait d’une étude documentaire, sur les TBS suivies aux Cliniques Universitaires de Kinshasa, entre janvier 2016 et décembre 2021. La valeur diagnostique des explorations clinique et échographique mammaire des TBS (sensibilité, spécificité, valeur prédictive négative VPN, VPP, coefficient Kappa) a été calculée en prenant pour référence la découverte anatomopathologique des pièces biopsiques. Résultats. Au total, 81 dossiers de TBS ont été colligés. Le Fibroadénome 58 (71,6 %), la Maladie fibrokystique (MFK) 15 (18,5 %), l’Adénome tubuleux 6(7,4 %), la Tumeur Phyllode (TP) 1(1,2 %) et le kyste 1(1,2 %) étaient les tumeurs diagnostiquées à l’anatomopathologie, après tumorectomies. A l’examen clinique, la capacité diagnostique des TBS autres que le Fibroadénome était nulle. La spécificité, la VPN et le coefficient kappa étaient respectivement, de 60,0 %, 39,1 % et 32,2 % pour le diagnostic du Fibroadénome. L’échographie mammaire était faite dans 98,6 % tandis que la mammographie seulement dans 11,1 % des cas. La majorité des tumeurs étaient classées Breast Imaging reporting and Data system (BIRADS) 2 (70,0 %). La spécificité, la VPN et le coefficient kappa étaient respectivement, de 80,6 %, 40,9 % et 39,0 % pour le Fibroadénome, et de 84,4 %, 66,7 % et 1,9 % pour la MFK. La TP était classée BIRADS3. Conclusion. L’échographie mammaire très réalisée, est très performante dans la classification BIRADS des TBS; les cliniciens exerçant en milieu peu équipé peuvent donc sans équivoque suivre les recommandations sur la prise encharge des tumeurs classées BIRADS2 et BIRADS3 à l’échographie, bien que sa performance en ce qui concerne le diagnostic différentiel de ces tumeurs soit moindre
Comparative Evaluation of the Proximate, Mineral and Phytochemical Compositions of the Aqueous and Ethanol Extracts of Albizia zygia Leaves
Get PDFThis study was carried out to comparatively examine the proximate, phytochemical and mineral compositions of Albizia zygia leaf extracts (ethanol and aqueous). The determinations were made by standard methods. Results of proximate analysis indicated the existence of significantly (p < 0.05) higher moisture (11.37±0.14%), and crude fibre (31.70±0.30 %) contents in the aqueous extract (AE) relative to the ethanol extract (EE). Also, higher (p < 0.05) protein (4.85±0.04 %), ash (16.41±0.09 %) and carbohydrate (35.29±0.28 %) contents were obtained in the EE when compared with the AE. While phytochemical assessment of AE and EE revealed the presence of tannins, alkaloids, flavonoids, terpenoids, saponins, glycoside, steroids, anthraquinones and anthocyanins, with significantly (p < 0.05) higher alkaloids (0.92±0.09), flavonoids (2.89±0.16), tannins (0.94±0.05), anthraquinones (0.90±0.04) and terpenoid (1.13±0.04) in the AE compared with the EE, and significantly (p < 0.05) higher saponins (3.14±0.46 %) and glycoside (3.28±0.79) in the EE. Similarly, significantly (p < 0.05) higher iron (189.69±0.51) content was recorded in the AE relative to the EE. Also, higher (p < 0.05) content of phosphorus (222.61±0.69 mg/kg), sodium (122.77±1.29 mg/kg), potassium (274.18±1.98 mg/kg), calcium (432.50±1.54 mg/kg), magnesium (231.99±1.60 mg/kg), zinc (8.34±0.06 mg/kg), manganese (4.10±0.06 mg/kg), lead (1.39±0.02 mg/kg), copper (36.64±0.36 mg/kg) and cadmium (0.51±0.01 mg/kg) was obtained in the EE relative to the AE. Thus, higher concentration of nutrients were obtained from EE relative to AE. It can be concluded that the presence of phytochemicals and nutrients in the EE and AE of A. zygia documented in this study enables its various biological functions and as precursors of valuable drugs in pharmaceutical industries
Efficiency of chemically modified activated carbon derived from banana peel for removal of Pb2+ and Zn2+ from aqueous Solution
Get PDFNatural and anthropogenic activities generally result to large production of heavy metals. These heavy metals produced are indiscriminately discharged into rivers and other water bodies. Wastewater treatment of industrial effluents become very necessary due to toxic effect of heavy metal pollutants and its indirect effect pose to human health. Banana peel, an agricultural waste biomass can be used to produce bio-sorbent for adsorption of heavy metals from industrial wastewater. This study focused on the production of chemically modified activated carbon using various concentrations of phosphoric acid for removal of lead and zinc metals from aqueous solution. Activated carbon was produced from waste banana peel through thermal pretreatment at temperature of 450℃ preceding chemical modification with different concentrations of phosphoric acid of 0.5 M, 1.0 M and 1.5 M. The three different concentrations of the phosphoric acids represent sample X, Y and Z respectively. To study the adsorption efficiency of chemically modified activated carbon using different concentrations of phosphoric acid, batch experiments were conducted on chemically modified samples to assess the adsorption of lead (II) and zinc metals from aqueous solution. The three adsorbents were interacted with varying parameters such as effect of initial concentration of lead and zinc metal of concentration of 10 mg/L and 2 mg/L respectively. Based on batch experiments conducted, results indicated that adsorbent dose, pH, initial concentration as well as contact time are important factors influencing lead (II) and Zinc metals adsorption from aqueous solutions. Percentage adsorption of lead (II) and zinc metals was above 80 % for all three chemically modified adsorbents investigated. The adsorption capacities of the adsorbents under study showed high adsorption capacity for both zinc and lead metals. This implies that sample X, Y and Z are good adsorbents for adsorption of both zinc and lead metals in an aqueous solution
Potentials of Information and Communication Technology (ICT) adoption by health workers in Nigeria: A case study of Abdullahi Wase Specialist Hospital Kano
Get PDFInformation and Communication Technology (ICT) has been identified as a vehicle with the potential to improve the quality of health care systems as well as the efficiency of the health workers both in the developed and developing countries. Non-governmental organizations initiatives often fail in making use of ICT technology possibly due to lack of ICT knowledgeable and skilled personnel in the health sector. This study investigates the potentials of information and communication technology (ICT) adoption by health workers in Nigeria. Quantitative survey was used to collect data from randomly chosen health workers at Abdullahi Wase Specialist Hospital Kano in Nigeria. A total of 150 on-paper questionnaires were distributed among clinical and non-clinical staff and 140 (93.3%) questionnaires were collected and analysed using a modified technology acceptance model (TAM). The results showed that there is significant correlation between the knowledge (dependent variable) and perceive usefulness and perceive ease of use (independent variables) both at significant level of 0.05. This indicates that presence of prior computer knowledge and exposure has significant influence on health workers perceptions (perceive usefulness and perceive ease of use), overall attitude toward adoption and eventually usage of information and communication technologies. This indicates that knowledge and attitude scores of health workers in this study reflect progress despite the lack of institutional training
Phytochemical Contents and Antioxidant potentials of Eggplants from Kano State, Nigeria: A Review
Get PDFFruits and vegetables are considered as good source of functional foods due to their health benefits and nutritional content. Dietary constituents of fruits and vegetable are commonly available and has significant application in management of chronic diseases such as; coronary heart disease, stroke, cancer and diabetes, many medicinal purposes, control of excess weight and obesity due to high fiber content present. Many phenolic compounds had been identified in garden eggplant such as; catechin, rutin, naringin, naringenin, syringic acid, chlorogenic acid, caffeic acid, p-coumaric acid, sinapic acid and anthocyanin. Health-conscious consumers generally focus on the antioxidant capacity, and the phenolic content, vitamins, carotenoids and phytochemicals. All varieties of garden egg vary in polyphenol endowed with antioxidant activity. Polyphenolic compounds and antioxidant activity in eggplants which depend on the cultivar, maturity stage and parts of the fruit. Growing conditions are also reported to significantly affect the phenolic contents. This review discussed the polyphenolic contents and antioxidant activities of different eggplant cultivars. Priority was given to green, white and dark-purple cultivars which are commonly grown in Nigeria. White and green eggplants possess higher phenolic contents when compared with dark purple eggplant which possesses higher antioxidant capacity. They contain about 92% water, 5% protein, copper (0.62mg/100g), magnesium (81.69mg/100g), potassium (87.22mg/100g), sodium (32.51mg/100g), irons (31.41mg/100g), zinc (1.41mg/100g), carbohydrate (7.2 g/100g), fibers (2.0g/100g), calcium (28 mg/100g), iron (1.5 mg/100g) and considerable amount of beta carotene (0.35 mg/100g), ascorbic acid (8 mg/100g), riboflavin (0.06 mg/100g) and thiamin (0.07 mg/100g). The species of African eggplant have nutritional and therapeutic values and can be used in the development of functional foods and these bioactive compounds are responsible for high functions of eggplants and provide antibacterial, anti-inflammatory, anti-allergic, hepatoprotective, antithrombotic, antiviral, anti-carcinogenic and vasodilatory properties in humans
Assessment of Heavy Metal Concentration in Drinking Water Sources from some Selected Districts of Michika, Adamawa State, Nigeria
Get PDFSafe discharge of untreated wastewater and scarcity of water is still a burning issue facing mankind today. The current study was carried out to analyze the concentration of heavy metals in drinking water sources from some selected districts of Michika, Nigeria. Atomic Absorption Spectrophotometer (AAS) was used in the analysis of the water samples from boreholes and wells. The respective mean concentration of heavy metals for borehole and well water is 0.0286 and 0.0209 for Nickel, 0.2051 and 0.3979 for Manganese, 0.0015 and 0.0021 for Copper, 0.5472 and 0.8314 for Magnesium, 0.1457 and 0.1420 for Chromium, 0.0011 and 0.001 for Cadmium, 0.1056 and 6.9317 for Lead, 0.5552 and 0.2183 for Cobalt and 0.9924 and 0.5747 for Iron. The results reveal that the first four element (Ni, Mn, Cu and Mg) have values below the maximum recommended value by WHO and USEPA. However, the concentrations of the remaining elements (Cr, Cd, Pb, Co and Fe) exceed the accepted value set by USEPA, WHO and NSDWQ. The water is thus not completely safe for drinking and domestic use. It is therefore recommended that the water needs proper treatment
Application of structural equation modeling in petroleum science and technology research
Get PDFThis work intends to optimize research and development performance processes in the field of oil and gas academia/industry derived from a case study, based on theoretical framework on the principles of structural equation modelling (SEM). We define the basis of the model by six different structural constructs derived from literature and the ir interdependence in the form of hypotheses. The constructs consist of one latent exogenous variable and five latent endogenous variables. Furthermore, five independent operational variables were established with respect to the latent exogenous variable while 20 dependent operational variables were also established with respect to the latent endogenous variables. The evidence of interdependence among the constructs and their respective operational variables were provided by five different hypotheses carried out on the path diagrams. As a result, the interaction between each construct and its variables defines its individual measurement model, which translates into some sets of linear equations. Having obtained the measurement for each construct, the interaction can then be applied to define other sets of linear equations that represent the behaviour of the organisation of the entire process which is expected to yield the proposed research and development programme. The developed model can easily be adopted by interested parties for application on similar projects