Search

Chlorpromazine (CPZ) is among the most famous drugs used for the treatment of psychosis such as delusions, hallucinations, schizophrenia, paranoia, or disordered thought in humans. In the present s...

The study investigated counsellors‟ role in ensuring quality education for national security in Enugu Education Zone. One research question and one null hypothesis were formulated to guide the study was tested at.05 level of significance. The study adopted a descriptive survey research design. The population for the study consisted of 59 school counsellors in the 31 public secondary schools in the area. The number is small and manageable; so no sampling was done. The instrument used for data collection was a 6-item questionnaire. The instrument was validated by three experts from Faculty of Education, Enugu State University of Science and Technology, Enugu. One each from Guidance and Counselling, Psychology and measurement and evaluation. Mean, with standard deviation and t-test statistic were used for data analysis. The study revealed, among others that counsellors ought to encourage the development of students' talents and strengths. Secondly, it was also found out that there is no significance difference between the mean ratings of male counsellors and female‟ school counsellors in their role towards ensuring quality education for national security in Enugu Education Zone of Enugu State, Nigeria. The study recommended, among others, that seminars and workshops should be organized regularly for school counsellors with a view to updating their knowledge on how to effectively curb insecurity while encouraging students in their talents and abilities.

Background: The HIV epidemic in Nigeria is concentrated in Key Populations (KP), people who inject drugs (PWID), men who have sex with men (MSM), female sex workers (FSW), and partners of people living with HIV. Due to stigma and discrimination, these groups have poor access to HIV testing services (HTS) and linkage to treatment is challenging. To address this gap, index case testing, targeting sexual contacts and injecting partners of KP index clients, was introduced in 2017.MethodsHTS was offered between October 1, 2018 and September 30, 2019 in nightclubs, hotels, or community-based ART clinics in Akwa Ibom, Cross River and Lagos states. Index testing was assisted by peer navigators. In-person and social network methods were used to mobilize partners of KP. We described the feasibility of implementing index testing, analyzed Partner Notification (PN) delivery models, and calculated HIV seropositivity among persons who underwent Index Testing. Findings: We found that a mixed approach to partner notification was effective. PN was predominantly done through provider referral 5,159 (68.3%) and passive referral 2,278 (30.1%). A total of 3,119 index partners; 1,322 FSW (42.4%), 1,255 MSM (40.2%) and 542 PWID (17.4%) identified 8,989 sexual and injecting partners (average of 2.9 per index client). Among the partners, 7,556 (84.1%) were first-time testers, and 79.4% (5,999) of male partners tested. Of the 3,753 (49.7%) partners tested HIV-positive, 3,492 (93.0%) were enrolled in HIV care. HIV seropositivity rate was 65.5% (1,021/1,557) among females and 45.5% (2,732/5,999) among males and was disproportionately higher among PWID injecting partners 99.1% (581/586), PWID sexual partners 98.9% (433/438) and MSM sexual partners 95.6% (605/633) in Cross river compared with 71.4% (575/805) in FSW sexual partners. Interpretations: Including index case testing as part of community led HTS is feasible and effective, particularly for reaching first-time testers, many male KP and persons not yet diagnosed with HIV. Scale-up of index case testing within community-led HTS for KP is essential for achieving the United Nations 90-90-90 goals. Funding: This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. OK was supported by a professorship grant from the Swiss National Science Foundation (grant no. 163878) and a Swiss National Science Foundation project grant (320030_192452). Declaration of Interest: None to declare. Ethical Approval: Ethical approval was obtained from the Federal Capital Territory, Health Research Ethics Committee, Nigeria (approval no: FHREC/2020/01/123/12-11-20). This study only analyzed anonymized and de-identified data.

Comminution of bio-fibers is necessary for their effective application in development of reinforced composite and feedstock; however, comminution is an energy intensive process and minimization of specific energy required in the size reduction of bio-fibers is an optimization task in design of various particulate based materials. The objective of this study was to model specific energy requirement in bio-fiber comminution process. The banana and coir bio-fibers used in the study were respectively extracted from post-harvest banana stem and outer shell of a coconut. Characterization of treated bio-fibers was done using Fourier Transform Infrared Spectroscopy and comminution process was carried out in a laboratory-scale knife mill. Electrical energy was recorded using a plug-in power energy meter while Kick’s, Rittinger’s and Bond’s energy laws provide insight into the relationship between particle size reduction and energy consumption during comminution process. The Rosin Rammler-Bennett (RRB) and Gaudin-Schuhmann (GS) models were fitted with MATLAB® R2014a. The Artificial Neural Networks (ANN) and Response Surface Method (RSM) was utilised in predicting specific energy requirements as controlled by fiber treatment conditions, milling speed, initial fiber length and drying temperature. The predictive accuracy of the RSM and ANN models were adjudged adequate in terms of the process independent variables. A global optimal condition was found at 2% NaOH concentration, 29 mm fiber length, 1981 rpm mill speed and 41 °C drying temperature. At these conditions, specific energy was 1.430 kJ/kg for banana fiber and 1.109 kJ/kg for coir fiber having desirability of unity.

IntroductionCoronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan1,2, China, and has subsequently spread worldwide. Knowledge of coronavirus-related risk factors can help countries build more systematic and successful responses to COVID-19 disease outbreak. Here we used Supervised Machine Learning and Empirical Bayesian Kriging (EBK) techniques to reveal correlates and patterns of COVID-19 Disease outbreak in sub-Saharan Africa (SSA).MethodsWe analyzed time series aggregate data compiled by Johns Hopkins University on the outbreak of COVID-19 disease across SSA. COVID-19 data was merged with additional data on socio-demographic and health indicator survey data for 39 of SSA’s 48 countries that reported confirmed cases and deaths from coronavirus between February 28, 2020 through March 26, 2020. We used supervised machine learning algorithm, Lasso for variable selection and statistical inference. EBK was used to also create a raster estimating the spatial distribution of COVID-19 disease outbreak.ResultsThe lasso Cross-fit partialing out predictive model ascertained seven variables significantly associated with the risk of coronavirus infection (i.e. new HIV infections among pediatric, adolescent, and middle-aged adult PLHIV, time (days), pneumococcal conjugate-based vaccine, incidence of malaria and diarrhea treatment). Our study indicates, the doubling time in new coronavirus cases was 3 days. The steady three-day decrease in coronavirus outbreak rate of change (ROC) from 37% on March 23, 2020 to 23% on March 26, 2020 indicates the positive impact of countries’ steps to stymie the outbreak. The interpolated maps show that coronavirus is rising every day and appears to be severely confined in South Africa. In the West African region (i.e. Burkina Faso, Ghana, Senegal, Cote d’Iviore, Cameroon, and Nigeria), we predict that new cases and deaths from the virus are most likely to increase.InterpretationIntegrated and efficiently delivered interventions to reduce HIV, pneumonia, malaria and diarrhea, are essential to accelerating global health efforts. Scaling up screening and increasing COVID-19 testing capacity across SSA countries can help provide better understanding on how the pandemic is progressing and possibly ensure a sustained decline in the ROC of coronavirus outbreak.FundingAuthors were wholly responsible for the costs of data collation and analysis.

Background Lifelong antiretroviral therapy (ART) improves optimal health outcomes for HIV‐positive individuals, but is threatened by fluctuations in sustained care, self efficacy and hence poor adherence. Retention of patients in the HIV care continuum is crucial for epidemic control. This study aimed to aggregate loss to follow-up (LTFU) behaviour in People Living with HIV (PLHIV) into clusters in order to examine and describe PLHIV clusters having similar characteristics and patterns according to their risk profile. Methods This was a retrospective, cross-sectional study that randomly reviewed 11,589 records of LTFU adult patients initiated on first-line ART from 313 USAID/PEPFAR-supported HIV clinics spread across 5 of Nigeria’s 6 geographical regions between July 1, 2008 and June 30, 2020. LTFU, was defined for PLHIV on ART as > 28 days without an encounter since the last scheduled ART refill appointment. Using the Minkowski method and ward.D2 clustering technique for unsupervised machine learning algorithm "agglomerative hierarchical clustering" in R, we identified 6 clusters associated with patients LTFU behaviour. Results Within the review period, 497,620 patients were ever enrolled on ART. 324,225 (65.2%) remained on treatment, 101,716 (20.4%) had an LTFU event captured, 36,021 (7.2%) were transferred out to other facilities, 25,633 (5.2%) died and 10,025 (2.0%) self-terminated treatment. Approximately 11% (11,589) of LTFU patients were included. Majority (66.7%) of the clusters consist of female LTFUs. LTFU doubled steadily by age among adolescents (15-19 years) and young people (15-29 years), but as age increased above 40-years the rate of LTFU decreased. High rate of LTFU was reflective of shorter-time on ART. Patients classified in clusters with shorter-time on ART [8-months (female) vs. 72.6-months (male)] indicated the highest rates of LTFU [31.0% (female) vs. 14.9% (male)]. LTFU rate varied by region, was highest among clusters confined in the North West (50%) followed by the South South (33%) and lowest in the North East (17%). Viral load test was low, with only half (50.0%) of the clusters having a documented viral load test result. Conclusion LTFU rates in HIV-positive patients receiving ART in our clinical sites have varied by the duration of ART, with rates declining in recent years. Our study demonstrates that aggregating LTFU behaviour among patients on ART offers great benefit for LTFU surveillance in the HIV care continuum. Our findings would inform targeted HIV program interventions for patient-centered care, reduce LTFU and promote optimal retention.

Author(s): Yotebieng, Marcel; Brazier, Ellen; Addison, Diane; Kimmel, April D; Cornell, Morna; Keiser, Olivia; Parcesepe, Angela M; Onovo, Amobi; Lancaster, Kathryn E; Castelnuovo, Barbara; Murnane, Pamela M; Cohen, Craig R; Vreeman, Rachel C; Davies, Mary-Ann; Duda, Stephany N; Yiannoutsos, Constantin T; Bono, Rose S; Agler, Robert; Bernard, Charlotte; Syvertsen, Jennifer L; Sinayobye, Jean d'Amour; Wikramanayake, Radhika; Sohn, Annette H; von Groote, Per M; Wandeler, Gilles; Leroy, Valeriane; Williams, Carolyn F; Wools-Kaloustian, Kara; Nash, Denis; IeDEA Treat All in sub-Saharan Africa Consensus Statement Working Group | Abstract: Introduction"Treat All" - the treatment of all people with HIV, irrespective of disease stage or CD4 cell count - represents a paradigm shift in HIV care that has the potential to end AIDS as a public health threat. With accelerating implementation of Treat All in sub-Saharan Africa (SSA), there is a need for a focused agenda and research to identify and inform strategies for promoting timely uptake of HIV treatment, retention in care, and sustained viral suppression and addressing bottlenecks impeding implementation.MethodsThe Delphi approach was used to develop consensus around research priorities for Treat All implementation in SSA. Through an iterative process (June 2017 to March 2018), a set of research priorities was collectively formulated and refined by a technical working group and shared for review, deliberation and prioritization by more than 200 researchers, implementation experts, policy/decision-makers, and HIV community representatives in East, Central, Southern and West Africa.Results and discussionThe process resulted in a list of nine research priorities for generating evidence to guide Treat All policies, implementation strategies and monitoring efforts. These priorities highlight the need for increased focus on adolescents, men, and those with mental health and substance use disorders - groups that remain underserved in SSA and for whom more effective testing, linkage and care strategies need to be identified. The priorities also reflect consensus on the need to: (1) generate accurate national and sub-national estimates of the size of key populations and describe those who remain underserved along the HIV-care continuum; (2) characterize the timeliness of HIV care and short- and long-term HIV care continuum outcomes, as well as factors influencing timely achievement of these outcomes; (3) estimate the incidence and prevalence of HIV-drug resistance and regimen switching; and (4) identify cost-effective and affordable service delivery models and strategies to optimize uptake and minimize gaps, disparities, and losses along the HIV-care continuum, particularly among underserved populations.ConclusionsReflecting consensus among a broad group of experts, researchers, policy- and decision-makers, PLWH, and other stakeholders, the resulting research priorities highlight important evidence gaps that are relevant for ministries of health, funders, normative bodies and research networks.

Coronavirus disease 2019 (COVID-19), a highly transmissible viral infection has spread worldwide causing exponential increase in morbidity and mortality. But so far, there is limited information available to describe the presenting characteristics, outcomes and treatment modalities of COVID-19 patients in Nigeria. This study aimed to describe the demographic and clinical characteristics, underlying comorbidities, treatment modalities and outcomes of patients isolated and treated in a repurposed COVID-19 isolation and treatment centre in Abuja, Nigeria.A retrospective study which reviewed the medical records of 300 confirmed COVID-19 patients isolated and treated according to the World Health Organisation and Nigeria Centre for Disease Control guidelines between 22Out of 300 patients studied, 61.0% were male. The mean age of the participants was 38.2 ± 14.7. Less than half of the patients (40.3%) had one or more underlying comorbidities with hypertension the most common co-morbidity. Majority (62%) of patients were mildly symptomatic, 33% were asymptomatic while only 2% were severely symptomatic. The most common presenting symptoms include cough 34.0%, fever 30.3%, anosmia 28.7% and dysgeusia 22.7%. Older age (P0.001), tertiary education and the presence of underlying comorbidity (P0.001) were significantly associated with symptomatic presentation of COVID-19. The median duration of time between positive laboratory testing and presentation for treatment was 5 days (0-29). All patients were treated with a combination of Ivermectin, Azithromycin, Zinc and Vitamin C with no recorded death. The median length of stay at facility was 9 days.Close attention should be given to patients with co-morbidities as an inefficient management of such co-morbidities could lead to mortalities which may not be directly attributable to COVID-19.

Background: In Sub-Saharan Africa, approximately 57% of Adults living with HIV are Women.HIV prevalence in Cross River State is 7.1%, compared to National of 4.1%. This study aims to ascertain the HIV prevalence rates among men and women assessing HIV Testing and Counseling (HTC) services in Nigeria's South-South region. Methods: Cross-Sectional quantitative study was conducted in November, 2011 among clients who received HTC services in 34 Primary Health centers across 5 LGAs of Cross River state. Relevant data of HIV Sero-Status of clients were collected from provider administered HTC client intake forms. Data was analyzed using Pearson Chi-Square. Results: 690 clients 316 (45.8%) male and 374 (54.2%) females were tested for HIV using Determine Abbott test kits. Age distribution of clients ranged from 18-41 years with mean age of 29.5 years. Prevalence of HIV among clients is 4.2% (29/690) with women contributing 7.0% (25/374) as compared with Men 1.2% (4/316). There was a significant association between HIV Sero-Status of Men and Women, (Pearson Chi-Square, P= 0.01). Conclusion: This result indicates that HIV Prevalence among women is disproportionately greater than that among men in Cross River state which appeared significant at the 95% confidence interval.

The aim of the study was to compare symptom-triggered and standard benzodiazepine regimens for the treatment of alcohol withdrawal syndrome in an emergency department clinical decision unit. The authors found that the symptom-triggered approach reduced cumulative benzodiazepine dose and length of stay.

The relationship between self-efficacy (self-confidence) and anxiety levels, and the use of Human Patient Simulations (HPS) as a teaching-learning strategy, has not been sufficiently studied in the area of clinical nursing education. The purpose of this chapter is to evaluate the self-efficacy/self-confidence and anxiety levels in clinical skills performance of undergraduate nursing students, pre-use and post-use of Human Patients Simulations (HPS), as a teaching and learning strategy in maternity nursing. The study used a quantitative, pre-experimental, one group study design with a pretest and posttest experiment in data collection. The findings concluded that HPS reduced anxiety and increased self-efficacy/self-confidence in clinical skills performance and decision-making of the participants. In addition, the study found that the participants had difficulties in tasks performance with the following action verbs associated with the cognitive domain of Bloom's taxonomy. The verbs were “identify,” “apply,” and “analyze.”

Benign fibrous histiocytoma (BFH) is a rare skeletal tumour. Its occurrence in the metacarpal bones is even rarer. The management in this location can be challenging, involving tumour resection and metacarpal reconstruction. The authors present a case of BFH involving the second metacarpal bone.

Methods A retrospective study was conducted in July, 2011 among male and female infants receiving PMTCT intervention for Early Infant Diagnosis in PHC’s at four different LGA’s of Cross River namely: Akamkpa, Calabar South, Odukpani and Biase respectively. Relevant data of the HIV infection status to male and female infants, whose samples were collected and diagnosed using PCR, was obtained from the National PMTCT-EID register. The data was analyzed using Cross-tabulation.

Background: Surgical options for treatment of extremity musculoskeletal tumours include excision [limb sparing] surgery or amputation [limb ablation]. Ablative surgery is for advanced extremity musculoskeletal tumours when limb salvage surgery is not feasible. Objective: To determine the indications for ablative surgery in extremity musculoskeletal tumours in our centre. Method: This is a 6 year prospective study of patients presenting with extremity musculoskeletal tumours at National Orthopaedic Hospital Lagos. Data such as age, gender, presenting complaints, anatomic location of the tumour, clinical stage, type of ablative surgery and adjuvant treatment offered, histologic type of tumour, and treatment outcome were documented. Results: Nineteen patients had ablative surgery as a mode of treatment. 11 were male while 8 were female with a M:F of 1.3:1. The age range was 3 – 69 years. Seven patients [ 6 males and 1 female] refused ablative surgery and voluntarily discontinued treatment. Most tumours were located in the lower limb and all patients that had ablative treatment presented with stage 3 or 4 disease. Osteogenic sarcoma was the most common diagnosis, accounting for 4 cases [21.1%]. Six patients [31.6%] with non-malignant tumours had ablative surgery due to either late presentation [4] or inaccurate preoperative diagnosis [2]. Trans-femoral amputation was the most common level of amputation and this was done in 9 patients [47.4%]. Adjuvant chemotherapy was prescribed for all patients. The recurrence and survival rates could not be determined for each tumour as the patients were lost to follow-up soon after surgery with average post operative follow up of 5.5 months. Conclusion: Late presentation with locally advanced disease remains the dominant indication for ablative surgery in extremity musculoskeletal tumours Keywords: Ablative surgery, extremity musculoskeletal tumours

Background The deceptive entity of Richter's hernia typically presents with complications that are usually associated with high morbidity and mortality. Objective The purpose of this case report is to highlight the association between Richter's groin hernia and Fournier's gangrene as demonstrated in a patient we managed recently. Methods A case report of the management of an elderly patient who presented with Fournier's gangrene to a Nigerian tertiary institution following a neglected Richter's hernia on the right groin. The scrotal gangrene was managed by aggressive debridement and secondary closure while the ruptured caecal Richter's hernia was treated by a limited right hemicolectomy with end-to-end ileocolonic anastomosis and repair of the internal ring. Report We describe a rare case of Fournier's gangrene complicating a neglected caecal Richter's inguinal hernia in a 75-year-old Nigerian; highlighting the pathogenesis and management options. Conclusion Caecal Richter's hernia can be associated with Fournier's gangrene.

Food is the most basic of human needs and adequate nutrition is universally recognized as a fundamental human right. However, despite the fact that the world's agricultural resources and the current sensational wave of biotechnological revolution are amply sufficient to assume a reasonable diet to everybody, a very significant proportion of the world's population is still suffering from serious under nutrition. There is the need to correct the assumption that the biotechnological revolution is not the eureka for the world's food problem. The objective of this paper is to challenge and possibly change the notion that biotechnology alone is the magic wand that brings solution to all of agriculture's pitfalls, by clarifying misconceptions concerning these underlying assumptions. The article reviews some of the highlights of modern plant biotechnology and discusses the potential applications and the limitations in the betterment of farming systems in this millennium and beyond. Despite the fact biotechnology will facilitate the farming of crops and rearing of livestock with multiple durable resistance to the vast array of pests and diseases particularly in the absence of pesticides and other non-degradable toxic chemicals, there is also enough evidence to prove that it will not ensure absolute food security, protect the environment and reduce the poverty level in the developing world. International Journal of Agriculture and Rural Development Vol. 7(2) 2006: 26-32

Background Serodiscordance exists when the known HIV result of one member of a couple pair is positive while that of his/her partner is negative. In sub-Saharan Africa, in stable long-term couple partnerships (married or cohabiting), serodiscordance is a growing source of HIV-transmissions. This study aimed to ascertain across Nigeria, serodiscordance prevalence, partner HIV status disclosure and explore associations between suspected determinants and serodiscordance among PMTCT enrolled HIV positive pregnant women and their partners. Methods A retrospective Quality of Care performance evaluation was conducted in July 2013 among 544 HIV positive pregnant enrolees of PMTCT services in 62 comprehensive facilities across 5 of Nigeria’s 6 geo-political zones. Data of client-partner pairs were abstracted from pre-existing medical records and analysed using chi-square statistics and logistic regression. Results A total of 544 (22 %) of 2499 clients with complete partner details were analysed. Clients’ age ranged from 15 to 50 years with a mean of 30 years. Serodiscordant prevalence was 52 % and chi-square test suggests no significant difference between serodiscordant and seroconcordant clients and their partners (p = 0.265). Serodiscordant rates were closely associated trend wise with national HIV sero-prevalence rates and the median CD4+ count was 425 ul/mm3 (IQR: 290–606 ul/mm3). Similar proportion of clients (99 %) received testing and agreed to disclose status to their partners. Yet, there was no association between clients agreement to disclose HIV status to their partners and these partners getting tested and receiving results (p = 0.919). Significantly, 87 % of clients in concordant HIV positive relationships appeared to be symptomatic (WHO clinical stage 3 or 4) compared to 13 % clients in HIV-discordant relationships (p