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This study assessed health insurance uptake, and payment preferences for health insurance enrollment, and identified barriers and facilitators of the utilization of health insurance amongst residents in Lagos State.

Abstract Introduction: Human immunodeficiency virus (HIV) the causative agent of Acquired immunodeficiency syndrome (AIDS) is an important cause of renal diseases in sub-Saharan Africa. There is paucity of studies on the burden of chronic kidney disease (CKD) among patients with HIV/AIDS in the North-Central zone of Nigeria. Methods: This is a cross-sectional study of 227 newly-diagnosed, antiretroviral naïve patients with HIV/AIDS seen at the HIV clinic of the Medical Out-patient Department (MOPD) of University of Ilorin Teaching Hospital (UITH). They were matched with 108 control group. Laboratory investigations were performed for the participants. CKD was defined as estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73 m2 and/or albumin creatinine ratio (ACR) > 30 mg/g. Results: There were 100 (44%) males among the patients and 47 (43.5%) among the control group. The mean ages of the patients and controls were 40.3 ± 10.3 years and 41.8 ± 9.5 years respectively. CKD was observed in 108 (47.6%) among the patients and 18 (16.7%) of the controls (p = 0.01). The median CD4 T-cell count was significantly lower in patients with CKD. Ninety-three (41.0%) of the patients had dipstick proteinuria of > 2 +. The median albumin creatinine ratio (ACR) was significantly higher among the HIV-positive patients (272.3 mg/g) compared with the HIV-negative controls (27.22 mg/g) p = 0.01. The CD4 T-cell count correlates positively with eGFR (r = 0.463, p = 0.001) and negatively with ACR (r = -0.806, p = 0.001). Conclusions: CKD is very common among patients with HIV/AIDS in Ilorin. Screening and early intervention for CKD should be part of the protocols in the management of these patients.

Cystic kidney disease is an important cause of chronic renal failure. Since the utili-zation of imaging techniques in the diagnosis of diseases has become widespread, cystic kidney disease is now being increasingly diagnosed. This study is designed to determine the prevalence and pattern of cystic kidney disease at the Nephrology Unit of University of Ilorin Teaching Hospital (UITH), Ilorin. All consecutive adult patients seen in the Nephrology Unit of UITH during a ten-year period (January 1999-December 2008) were studied for the presence of cystic kidney disease. The results were analyzed with specific reference to age, gender, annual inci-dence, type of cystic disease, location of cyst, mode of presentation, complications and prognosis. A total of 67 out of 436 renal patients (15.4%) studied had cystic kidney disease. A progressive annual increase in the number of cases was noticed. The age-range was 20-83 years with a mean of 47.4 +/- 16.2 years and the peak incidence was in the third and sixth decades with male to female ratio of 1.3:1. The types of cystic kidney disease identified in the study were: 26 simple cysts (38.8%), 35 polycystic kidney disease (53.3%) and six multicystic kidney disease (8.9%). The most common mode of presentation was abdominal pain followed by hypertension, urinary tract infection, chronic renal failure and palpable abdominal mass, in decreasing order. Our study indicates that cystic kidney disease is not an uncommon problem among our renal patients and the incidence is on the increase. Although, routine screening of family members with cystic kidney disease still remains a contentious issue because the knowledge may evoke anxiety in terms of employment and insurance, screening of symptomatic cases or those that develop hypertension, hematuria and proteinuria is strongly recommended.

Abstract Introduction Necrotizing fasciitis is a rare and life-threatening rapidly progressive soft tissue infection. A fulminant case could involve muscle and bone. Necrotizing fasciitis after corticosteroid therapy and intramuscular injection of non-steroidal anti-inflammatory drugs has been reported. We present a case of fulminant necrotizing fasciitis occurring in a patient who used a herbal concoction to treat a chronic leg ulcer. Case presentation A 20-year-old Ibo woman from Nigeria presented with a three-year history of recurrent chronic ulcer of the right leg. She started applying a herbal concoction to dress the wound two weeks prior to presentation. This resulted in rapidly progressive soft tissue necrosis that spread from the soft tissue to the bone, despite aggressive emergency debridement. As a result she underwent above-knee amputation. Conclusion The herbal concoction used is toxic, and can initiate and exacerbate necrotizing fasciitis. Its use for wound dressing should be discouraged.

Abstract Introduction Scrotal lymphedema is common in the tropics and subtropics. The giant variants can cause a lot of physical disability and psychological disturbances. Case presentation We present a 25-year-old Nigerian male with giant scrotal lymphedema with severe debilitating symptoms, immobility and emotional disturbance. He benefited from a modified Charles' procedure and reconstruction of the penile shaft using a split-thickness skin graft. Conclusion Giant scrotal lymphedema related to poverty, ignorance and neglect, is amenable to surgery. Surgery provides a cosmetically acceptable and functionally satisfying outcome.

Monitoring lithium ions (Li + ) in lithium-rich brine (LrB) is critical for metal recovery, yet challenges such as high ionic strength and gypsum-induced surface deterioration hinder the performance of potentiometric ion-selective electrode (ISE) sensors. This study advances the functionality of Li + ISE sensors and enables continuous monitoring of Li + concentration in LrB by introducing apolyelectrolyte multilayer (PEM) of poly(allylamine hydrochloride)/poly(sodium 4-styrenesulfonate) (PAH/PSS) that serves as an antigypsum scaling material to minimize nucleation on the sensor surface. With 5.5 bilayers of PAH/PSS coating, the Li + ISE sensors possess a high Nernst slope (59.14 mV/dec), rapid response (<10 s), and superior selectivity against competitive ions (Na + , log K s = -2.35; K + , log K s = -2.47; Ca 2+ , log K s = -4.05; Mg 2+ , log K s = -4.18). The impedance (85.1 kΩ) of (PAH/PSS) 5.5 -coated sensors is 1 order of magnitude lower than that of electrospray ion-selective membrane (E-ISM) Li + sensors (830 kΩ), attributed to the ultrathin (45.3 nm) and highly dielectric PAH/PSS bilayers. During a 15-day continuous monitoring test in LrB, the (PAH/PSS) 5.5 -coated Li + ISE sensors with their superhydrophilic and smooth surface diminish nucleation sites for scaling agents (e.g., Ca 2+ and SO 4 2- ) and consequently mitigate gypsum scaling. Moreover, a brine-tailored denoising data processing algorithm (bt-DDPA), coupled with the salinity-adjusted mathematical model with Lagrange interpolation, effectively captures Li + fluctuation by filtering out anomalies and reducing sensor drift in brine. Bt-DDPA alleviates the discrepancy between the sensor readings and the lab-based validation results by 46.06%. This study demonstrates that the integration of material advancement (PAH/PSS coating) with sensor data processing (bt-DDPA) bolsters continuous and accurate Li + monitoring in LrB, crucial for brine water treatment and resource recovery.

A multidisciplinary approach to research affords the opportunity of objectivity, creation of new knowledge and potentially a more generally acceptable solution to problems that informed the research in the first place. It increasingly features in national programmes supporting basic and applied research, but for over 40 years, has been the arena for many research teams in environmental geochemistry and health. This study explores the nature of multidisciplinary research in the earth and health sciences using a sample selected from co-authored articles reporting research on arsenic (As) in drinking water from 1979 to 2013. A total of 889 relevant articles were sourced using the online version of the science citation index-expanded (SCI-expanded). The articles were classified according to author affiliation and later by author discipline/research interests using the Revised Field of Science and Technology Frascati manual DSTI/EAS/STP/NESTI (2006) 19/FINAL and a decision algorithm. Few articles were published on the topic until 2000. More articles were published across all affiliations in the last 10 years of the review period (2004-2013) than in the first 10 years (1979-1988). Only 84 (~9%) articles fell within the "earth and health" only and "earth, health and other" categories when classification was undertaken by author affiliation alone. This suggests that level of collaboration between earth and health scientists in arsenic in drinking water research may be very low. By refining the classification further using author discipline/research interests, only 28 of the 84 articles appear to be co-authored by earth and health scientists alongside professionals in other fields. More than half of these 28 articles involved descriptive non-experimental, observational study designs, limited in direct causal hypotheses and mechanistic investigation. If collaborative research is to lead to the increased multidisciplinary research, early interaction should be encouraged between students from different disciplines. In order to achieve multidisciplinarity in practise, it is imperative that scientific communities and research agencies do more to encourage interaction and integration between researchers from different disciplines. This must develop from educational institutions seeing opportunities to improve graduate skills in an increasingly diverse research landscape.