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Global food shortage and poverty scourge are challenges requiring urgent attention across the globe.Food insecurity of the lower income groups is mainly due to poverty and most food unsecured people lives in the rural areas.The research focuses on the food crisis and population growth in Nigeria. The analysis provides information on food crops production and population growth. The result through multiregression analysis shows a strong inverse relationship between the growth in population and each of the identified food crops. The correlation in each case with population growth indicated food output does not cope with population growth. Government must assist through necessary adequate assistance. Policies must be evolved leading to sustainable agricultural growth in the countries where agricultural sector accounts for large share of the economy. [ABSTRACT FROM AUTHOR]

Background: The outlook of chronic kidney disease (CKD) in low-and-medium-income-countries is poor. Modern farming practices in Nigeria are becoming increasingly associated with the use of herbicides and pesticides., Aim: The study aimed to evaluate agrochemical use in farming practices and risk factors for kidney disease among dwellers of rural farming communities in South-West Nigeria., Methods: This was a cross-sectional survey of adult dwellers of an agrarian rural farming community in South-West Nigeria. Participants provided information on demographics, lifestyles, knowledge, and awareness of risk factors for kidney disease, and the use of agrochemicals in farming practice. Anthropometric measurements and blood pressure values were obtained while blood and spot urine were collected for random blood glucose, serum creatinine, urinalysis, and albumin-creatinine ratio., Results: A total of 572 rural dwellers were enrolled in the study, with a mean age of 49.9 ± 17.5 years while 39.3% were male and 88.9% engaged in active farming. The prevalence of traditional risk factors for kidney disease was hypertension (24.3%), Diabetes mellitus (2.8%), cigarette smoking (7.5%), alcohol intake (20.8%) and herbal consumption (57.1%). The use of pesticides/herbicides was reported in 69.9%, while 25.3% did not use protective gear during its use. Proteinuria, hematuria, and reduced eGFR were observed in 29.8%, 6.1%, and 33.9% of participants, respectively., Conclusion: This study showed a high prevalence of herbicides and pesticide use and traditional risk factors for kidney disease, in addition to the high prevalence of markers of kidney damage among the dwellers of rural farming settlements in South-West Nigeria., (Copyright © 2024 Copyright: © 2024 Nigerian Journal of Clinical Practice.)

The paper chronicles the life and times of Professor Alexander Brown, the Foundation Professor and Head of the Department of Medicine at the University of Ibadan. The official opening of the University College Ibadan, Nigeria on 20 November 1957 as well as the graduation of the first set of clinical students in 1960 were glorious moments for Alexander Brown who laboured for 12years to witness these. He was also instrumental to the creation of the Department of Paediatrics (1962), Department of Radiology (1963) and the Medical Illustration unit of the hospital. Paediatrics and Radiology were initially units in the Department of Medicine. He played significant role in the development of postgraduate programmes in Cardiology, neuropsychiatry and nephrology units of the hospital and substantial role in the development of nursing education in the hospital. He was the brain behind the famous Ibarapa Community Health Project., (© Association of Resident Doctors, UCH, Ibadan.)

COVID-19 infection predominantly affects the respiratory system; however, other systems and organs are also affected. The kidneys are among the organs commonly affected by SARS-CoV-2 and this has been reported to be a predictor of increased severity, need for intensive care (ICU), admission, and death. We presented two cases of COVID-19 that were associated with co-morbidities that include diabetes mellitus, systemic hypertension and impaired kidney function. The relationship of the multiple co-morbidities particularly the impaired kidney function with the outcomes of COVID-19 infection and the challenges of offering dialysis for patients with COVID-19 infection with kidney failure were discussed. The two cases presented also highlighted the state of preparedness for the management of COVID-19 and its various complications and co-morbidities, particularly kidney failure in a tertiary hospital in Nigeria at onset of the COVID-19 outbreak., Competing Interests: The Authors declare that no competing interest exists

Background: Chronic kidney disease of unknown origin (CKDu) is assuming an epidemic proportion, especially in farming communities worldwide. We explored the relationship between CKD markers and agrochemical exposure among rural farmers in South Western Nigeria., Methods: We studied selected farming communities in Southwestern Nigeria where the use of agrochemicals was widespread. A pre-tested questionnaire was administered to participants. Anthropometric data, information on use of agro-chemicals; urine and blood samples were obtained. Informed consent was obtained from participants. The study was approved by the Institutional Ethics committee and complied with 1975 Helsinki declaration, as revised in 2000., Results: A total of 438 farmers made up of 202 males (46.1%) and 236 females (53.9%) were studied. The mean microalbuminuria was 30.2 ±11.7 mg/dl. Majority of the farmers had CKD stage 2(42.0%) and CKD stage 3 (37.7%). The type of farming engaged in had a positive, but not significant, correlation with eGFR (r=0.012, p=0.832). There was positive correlation between type of farming and GFR category (r=0.24, p=0.000). Frequency of use of hexachlorocyclohexane had a positive and significant correlation with eGFR (r=0.111, p=0.045). Annual crop farming had a correlation with UACR (r=0.149, p=0.024)., Conclusion: Annual crop farming had a positive correlation with UACR, eGFR and GFR category. The prolonged use of agrochemicals on an annual basis can cause kidney damage.

Forensic mental health services are fledgling in most African countries including Nigeria. The current formulation of such services in Nigeria is correctional psychiatry in addition to some hospital-based services. The COVID-19 pandemic presents significant challenges to the already fragile state of forensic mental health services within the country. Its impact includes limitation of access to and continuity of mental healthcare in prison as well as reduction in referrals from other services within the criminal justice system such as the police and the courts. Further tapering of previously less prominent aspects of forensic mental health service in the country such as the preparation of psychiatric court reports has also been observed. Forensic psychiatry training and research have equally been hampered by the pandemic. The lessons learnt from these challenges should offer practitioners and policy makers insight into strategic developmental objectives for the post-COVID era within services and training programmes., Competing Interests: The authors have no competing interests to declare., (© 2020 The Authors.)

Background: Sleep disordered breathing has been closely linked to pathogenesis, poor control of hypertension, and progression of chronic kidney disease (CKD). Though hypertension and CKD are highly prevalent in Nigeria, the effects of sleep disorders on CKD and hypertension phenotypes have not been widely studied. This study investigated the relationship between self-reported sleep disorders, and ambulatory blood pressure phenotypes in patients with hypertension and those with or without CKD., Methods: Participants aged 18 years and above who consented were recruited into the study. Anthropometric measurements including height, weight, and waist and hip circumferences were obtained, Office/clinic hypertension was defined as SBP =140mmHg and/or DBP =90mmHg or being on pharmacological treatment for hypertension. 24-hour ambulatory blood pressure monitoring were done. Obstructive sleep apnea was assessed using Stop Bang questionnaire. Estimated GFR was calculated using CKD-EPI Creatinine 2Equation and CKD was defined as eGFR<60ml/min/1.73m ., Results: A total of three hundred and forty-nine (349) patients were enrolled for the study: 175 males and 174 females. Moderate to severe risk for obstructive sleep apnea (OSA) was observed in 51.4% of patients with CKD, 58.5% of hypertensive and 17.3% of apparently healthy participants. Male participants were more likely than female patients to have moderate and high OSA risk (41.7% vs 32.8%) and (10.3% vs 4.6%) respectively. Compared with other groups, CKD patients had the highest office and ambulatory blood pressure parameters; p<0.0001., Conclusion: This study has demonstrated that obstructive sleep apnoea is prevalent among patients with chronic kidney disease and hypertension. Furthermore, the phenotypes of hypertension are accentuated in CKD and therefore, OSA may well be an important risk factor for CKD.

Background: Early diagnosis of cancer allows an opportunity for timely treatment while disease burden is in its earliest stages. Unfortunately, late presentation and delayed diagnosis of childhood cancers remains a problem in developing countries., Objectives: To describe the pre-diagnostic symptomatic intervals and the factors influencing these time intervals in childhood cancer at the University College Hospital, Ibadan, Nigeria., Methods: Information was obtained from the case notes of children seen between March 2006 and August 2008. Information included socio-demographic variables, stage of the cancer, duration of illness at diagnosis and other health seeking activities., Results: Sixty-four children (40 males, 24 females) were studied. Median overall lag time was 13.1 weeks; median parent delay was 2 weeks and median health system delay was 8.8 weeks. Median lag times were shortest in acute leukaemia (8.1 weeks) and Wilms. tumour (8.7 weeks) and longest in Hodgkin lymphoma (101.7 weeks)., Conclusion: Lag times were longer than those in developed countries. Factors contributing to delayed diagnosis included delayed referral by doctors, seeking health care from alternate sources and financial constraints. Education of parents and physicians on early presentation and early referral for early diagnosis is recommended.

Aim: Despite heart failure having been identified in subjects in sub-Saharan Africa over the last 60 years, there is still a dearth of data, especially echocardiographic data on heart failure. We therefore set out to analyse the clinical and echocardiographic features of all consecutive subjects presenting with heart failure in a tertiary institution in Nigeria., Methods: Three hundred and forty subjects with heart failure, according to the guidelines of the European Society of Cardiology, were studied. Each patient had two-dimensional guided transthoracic echocardiography., Results: The mean age of the patients was 50.60 +/- 15.29 years, and 50.9% of the study population were males while 49.1% were females. The commonest cause of heart failure identified was hypertension in 61.5% of the patients; 75.5% had systolic heart failure, whereas 23.5% had heart failure with preserved ejection fraction., Conclusions: Untreated hypertension has been identified as the leading cause of heart failure in Abuja, Nigeria, which is similar to that in many other parts of sub-Saharan Africa. Coronary artery disease is a rare cause of heart failure in this population group.

Variabilities exist in the relationship between serum creatinine (Se-C) and creatinine clearance (CCr) due to the influences of age, muscle mass and gender on creatinine production. We studied this variability in a group of hypertensives (n = 62, 30 male, age 44 +/- 7 years) and normotensives (n = 90, 47 male, age 42 +/- 10 years) with normal renal function (Se-C < 1.5 mg/dL). There was a wide scatter of CCr about each Se-C value. Se-C was higher in males than females and in hypertensives than normotensives, but the differences were not statistically significant. Mean Se-C for the whole group was 0.91 +/- 0.23 mg/dL and corresponded to CCr of 93 +/- 23 mL/min and 93 +/- 21 mL/min before and after adjustment to a body surface area (BSA) of 1.73 m2. Adjusted CCr was significantly lower in hypertensives than normotensives in males (86 +/- 20 mL/min Vs 99 +/- 21 mL/min, P < 0.01) and females (84 +/- 19 mL/min Vs 96 +/- 19 mL/min, P < 0.01). Crude CCr was significantly higher in men than women (P < 0.05) in the whole group but not significantly in the normotensive or hypertensive subgroups. After adjustment, the differences diminished and became insignificant in the whole group. Some subgroups had identical mean Se-C values but different adjusted CCr. A particular Se-C value did not always indicate a particular CCr. Adjustment of CCr to 1.73 m2 BSA reduced the variability between Se-C and CCr and the difference between the genders. CCr showed significant difference in renal function between subgroups where Se-C did not.

Several attempts have been made to improve primary prevention of essential hypertension and many of these have been directed at avoiding the well known risk factors. Both asthma and hypertension are spastic disorders of smooth muscle, also asthmatics and hypertensives have been found to be salt sensitive. There is a suspicion that the similarities between these two diseases may predispose the individuals with one disease to the other, as pulmonary hypertension has been described during exercise-induced bronchoconstriction. We therefore, studied the blood pressure pattern during and after acute severe asthma (ASA) along with the frequency of hypertension in stable asthmatic patients. Two groups of patients were studied. Group 1 consisted of 12 patients with ASA (2 males, 10 females) with a mean age of 30 +/- 9.9 years. The mean blood pressure during attack of ASA (147 +/- 16.9/100 +/- 8.2 mmHg) was higher than the mean BP (132 +/- 8.3/82 +/- 7 mmHg) 2 weeks after discharge from hospital without treatment in all patients (P < 0.05). Group 2 included 134 asthmatic subjects in stable state (54 males, 80 females) with a mean age of 45 +/- 15 years and a range of 15-90 years. The overall frequency of hypertension was 37% with a proportion of 39% in males and 35% in females. Hypertension was defined as systolic blood pressure of > or = 140 mmHg and or diastolic blood pressure of > or = 90 mmHg. There was no difference between the frequency of attack of ASA in hypertensives (5.7 +/- 5.6 per year) and nonhypertensives (5.5 +/- 3.8 per year), P < 0.05. We concluded that transient elevation of blood pressure may occur during ASA. The frequency of hypertension among asthmatics is quite high and concurrent family history of hypertension and frequency of attack of ASA did not seem to determine the status of blood pressure. Patients with asthma should have regular blood pressure check during follow-up visits.

Objective: To investigate whether quinolones produce in vivo responses comparable to reported in vitro activity against the spectrum of organisms in uncomplicated urinary tract infection (UTI) in Nigeria., Design: Equal numbers of patients with urine culture positive UTI were randomized to oral quinolone, perfloxacin 400 mg bd twice a day and ofloxacin 200 mg bd twice a day for five days., Setting: Out-patient clinics and wards at the University College Hospital, Ibadan., Subjects: Sixty patients aged sixteen years and above with uncomplicated UTI., Main Outcome Measures: Number of isolates, number of patients with clinical and bacteriological cure one week after commencing therapy. Relative effectiveness and side effects of the drugs., Results: Sixty- four bacterial isolates were obtained with the enterobacteriaceae comprising 86%. Sixty-two (97%) were sensitive to both drugs in vitro. Clinical cure occurred in 57 patients (95%), being 28 (93%) in those taking perfloxacin and 29 (97%) in those taking ofloxacin. Bacteriological cure occurred in 55 patients (92%), being 27 (90%) in those taking perfloxacin and 28 (93%) in those taking ofloxacin. Fifty-nine of the 64 isolates (92%) were eliminated in one week, 30 of 33 (91%) in those taking perfloxacin, and 29 of 31 (94%) in those taking ofloxacin; the difference was insignificant (p = 1.16). The enterobacteriaceae were generally susceptible to both drugs. Side effects were minor and infrequent., Conclusion: Quinolones were highly active against the common urinary pathogens in these Nigerian patients and can be reliably employed in treatment when culture results are unavailable.