Municipal solid waste management practices in inner cities of Osogbo, Osun State and its implications on health

Background: Indiscriminate waste disposal is a common practice in many cities of Sub-Saharan Africa and these unhealthy practices have made the region face severe environmental deterioration and health implications. The objective of this study is to assess the association between waste management practices and self-reported health outcomes among inner city dwellers in Osogbo.Method: The study is a cross sectional study carried out among 351 household heads using a semistructured interviewer administered questionnaire.Results: Majority (78.6%) of respondents had poor practice of waste management although, most showed concern on likely impacts of poor waste management. Most of them (81.8%) demonstrated positive attitude towards waste management and were willing to participate in organized waste management at low cost. Gender (X2 =7.217, P<0.05), income (X 2=12.140, P<0.05), occupation (X 2=29.034, P<0.05) and level of education were significantly associated with their poor waste management practices. Majority (74%) reported at least one ill health condition, practice and attitude were the major variables implicated in various ill health reported by the respondents.Conclusion: Poor waste management practices are strongly associated with ill health. Keywords: Solid Waste, Management, Self-reported health outcomes, Practices.

Detection of antibiotic resistance genes among multiple drug resistant Pseudomonas aeruginosa strains isolated from clinical sources in selected health institutions in Kwara State.

Introduction: Pseudomonas aeruginosa (P. aeruginosa) is a frequent nosocomial pathogen that causes severe diseases in many clinical and community settings. The objectives were to investigate the occurrence of multiple antibiotic resistant P. aeruginosa strains among clinical samples and to detect the presence of antibiotic resistance genes in the DNA molecules of the strains.Methods: Clinical specimens were collected aseptically from various human anatomical sites in five selected health institutions within Kwara State, Nigeria. Multiple drug resistance patterns of isolated micro-organisms to different antibiotics were determined using the Bauer Kirby disc diffusion technique. The DNA samples of the multiple resistant P. aeruginosa strains were extracted and subjected to Polymerase Chain Reaction (PCR) for resistance gene determination.Results: A total of 145 isolates were identified as P. aeruginosa from the clinical samples. Absolute resistance to ceftazidime, gentamicin and ceftriaxone was observed while low resistance to ciprofloxacin, piperacillin and imipenem was documented. The prevalence of bla VIM , ,bla CTX-M and blaTEM were 34.4 %, 46.7 % and 16.7 % respectively.Conclusion: This study has shown that there is a high occurrence of metallo â-lactamase- producing and antibiotic-resistant strains of P. aeruginosa in clinical specimens from the studied area. Keywords: Metallo â-lactamase enzyme, P. aeruginosa, clinical samples, antibiotic-resistance genes

Gastrointestinal motility and Intestinal structure following oral exposure to acrylamide in Wistar rats

Introduction: Acrylamide, a byproduct of the cooking process, has been reported to be a toxicant with likely carcinogenic properties. Its impairment of gastric function has been previously reported. In this study its effects on gastrointestinal motility and intestinal structure was investigated in male Wistar rats.Methods: Forty-five rats (120-180g) were divided into 3 equal groups (n=15) and treated p.o with either 0.2ml distilled-water, or acrylamide (7.5mg/kg and 15mg/kg respectively) for 28days. Thereafter, gastric emptying and intestinal motility was assessed. Intestinal structure (duodenum, jejunum and ileum), mucosal and intestinal cell counts were evaluated using histological techniques.Results: Gastric emptying and intestinal transit time increased (p<0.05) in the experimental (acrylamidetreated; 7.5mg/kg and 15mg/kg) groups compared to control. Mucosal cell counts (duodenum, jejunum and ileum) and ileum intestinal cell counts (p<0.05) were reduced in the experimental groups compared to control. Compared to control, duodenal samples of the experimental groups showed severe coagulative necrosis and sloughing off of the villi, luminal filling with necrotic debris, disruption and necrosis of the crypts of Lieberkühn, moderate polymorphonuclear cell infiltration and vascular congestion. These pathologies albeit with less severity were also observed in the jejunum and ileum of acrylamide treated groups.Conclusion: Increased oral exposure to acrylamide impairs gastric emptying, intestinal motility, mucus secretion and compromises digestive and absorptive functions of the small intestines, especially the duodenum. These observations may be ascribed to acrylamide-induced impaired neuronal signaling, autonomic neuropathy, oxidative stress, inflammation and cell necrosis. Keywords: Acrylamide, gastrointestinal tract, gastric emptying, intestinal motility, small intestines

Truth-telling and patients' diagnoses in optometric practice in Nigeria

Background: The doctor-patient relationship is crucial to health care services including eye care. Telling the truth is an important aspect of this relationship in ensuring safe and effective treatment and management of patients.Method: A qualitative study using one - on- one in- depth interviews (IDIs) and focus group discussions (FGDs). Forty four respondents comprising 10 eye care practitioners (ECPs) and 34 patients were recruited. The ECPs were between 32 to 51 years while the patients were between 18 and 50 years old.Results: Common lies told were mainly about age, onset or duration of condition, medications used prior to their visit to the doctor's and level of compliance to doctor's prescription. Others were about health status, history of self-medication and social habits like smoking and/or drinking. Reasons for telling some of these lies included fear of early retirement, fear of being judged or stigmatized, lack of privacy during clerking and embarrassment from being caught in a previous lie.Conclusion: Untruths and manipulation of information can damage the relationship between doctor and patient because it leads to distrust and this can compromise eye care. Keywords: Truth, doctor- patient, relationship, diagnoses

Relationship between resilience, depression, stress and anxiety among nurses in a tertiary health institution in Nigeria.

Background: This study determines the relationship between resilience, depression, stress and anxiety among professional nurses who are frontline workers.Methodology: The study was conducted among nurses working in Lagos State University Teaching Hospital (LASUTH) Ikeja, Lagos State. The Connor-Davidson Resilience scale and Depression, Anxiety and Stress questionnaire administered to 360 nurses. Simple frequency, mean, standard deviation and Pearson correlation were used for the analysis.Results: The majority (90%) of the respondents was female and about two thirds of them were married. Overall summarized scores for the level of anxiety, depression and stress were 46.6%, 38.5% and 37.7% respectively. Resilience had statistically significant positive correlation with years of experience (r=0.160, p=0.002); negatively significant with stress (r = -0.281, p< 0.001) and negatively significant with anxiety (r = -0.210, p < 0.001). Depression was negatively significant with years of experience (r = - 0.132, p = 0.013) while stress was positively significant with depression (r = 0.764, p< 0.001) and anxiety (r = 0.751, p < 0.001).Conclusion: There is a need to organize programmes that will improve the resilience of professional nurses should be organized to reduce the effects of stress, anxiety and depression among nurses. Keywords: Resilience, Nurses, depression, stress, anxiety

Pulmonary embolism in the COVID-19 pandemic era: Importance of bedside electrocardiography, echocardiography and use of Tenecteplase.

Pulmonary embolism is a blockage in one of the pulmonary arteries in the lungs. Globally, it is the third most frequent acute cardiovascular syndrome behind myocardial infarction and stroke. This is a 43-yearold Nigerian diabetic man who had liposuction three weeks before presenting with sudden onset breathlessness, productive cough, chest pain, fever, inability to complete a sentence and inability to carry out his normal daily activities during this coronavirus 2019 (COVID-19) pandemic. He was tachypneic, tachycardic, hypotensive with rapidly dropping oxygen saturation (84%-86%, 80%-84%). This presented a diagnostic challenge which was rapidly resolved with bedside electrocardiography and echocardiography. A diagnosis of pulmonary embolism was sustained. Subsequent SARS-COV-2 PCRbased test was negative. He was successfully managed with an antithrombotic agent, tenecteplase, without any adverse events. Keywords: COVID-19, pulmonary embolism, tenecteplase, electrocardiography, echocardiography

An appraisal of pattern and presentation of gynaecological malignancies in Bowen University Teaching Hospital, Southwest Nigeria

Background: Gynaecological malignancies are cancers that occur in or on a woman's reproductive organs and genitals which includes the vulva, vagina, cervix, uterus, fallopian tubes, and ovaries. The prevalence of gynaecological malignancies varies from one country to another. The factors responsible for the observed variance includes lifestyle, dietary pattern, level of education and the sophistication of health care system. This study aims to identify the pattern and clinical presentations of gynaecological malignancies at Bowen University Teaching Hospital, Ogbomoso over a five-year period.Methods: This was a retrospective study involving one hundred and twenty-three (123) patients with a histological diagnosis of gynecological malignancy.Results: Patients with gynaecological malignancies accounted for 3.6% of the patients seen in the period under review. Majority of these patients were multiparous and between the age range of 50 and 69 years. The commonest form of gynaecological malignancy seen was cervical cancer.Conclusion: Health care programs and policies that strengthen public awareness campaigns, health education and health promotion like human papilloma virus vaccination and follow up surveillance will help to reduce the morbidity and mortality associated with gynaecological malignancies. Keywords: appraisal, pattern, presentation, gynaecological malignancies

Sexually transmitted infections among young patients at two general outpatient clinics in Southwest, Nigeria: Assessment of knowledge and risk factors

Background: Sexually transmitted infections are one of the health outcomes of risky sexual behaviour and they constitute health burdens among young population. The study assessed the knowledge, prevalence and contributing factors for sexually transmitted infections among young patients seen at two general outpatient clinics.Method: The study adopted a cross-sectional design using a sample size of 370 unmarried young patients that were sexually active. Quantitative data was obtained using structured questionnaires and samples were taken to determine the causative organisms of sexually transmitted infections (STI). Analysis was done with SPSS, chi-square was used to test for association between STI and influencing factors and statistical level of significance was set at 5%. Results: General knowledge assessment showed 90.3% of the respondents knew STIs. Specific STI knowledge showed HIV/AIDS was known by 88.9% and chancroid by 14%. About 26% of the respondent presented with itch, 22.1% with vaginal discharge and 5.9% with swelling on the perineum. Organisms identified were Candida albicans (47%), Non-gonococcal urethritis (17.7%) and the least was Herpes 21.96%. Prevalence of STI was significantly associated with risky sexual behaviour (÷ = 8.437; p = 2 20.004), tertiary education (÷ = 5.330; p= 0.021) and poor family functioning (÷ = 5.507; p=0.005).Conclusion: Sexually transmitted infection was associated with risky sexual behaviour, education on behavioural change towards safe sexual practice is a tool that can help prevent the spread of the infection. French title: Infections sexuellement transmissibles chez les jeunes patients dans deux cliniques générales ambulatoires dans le sud-ouest du Nigéria : Évaluation des connaissances et des facteurs de risque Contexte général de l'étude : Les infections sexuellement transmissibles sont l'un des effets sur la santé des comportements sexuels à risque et elles constituent un fardeau pour la santé de la population jeune. L'étude a évalué les connaissances, la prévalence et les facteurs contributifs des infections sexuellement transmissibles chez les jeunes patients vus dans deux cliniques ambulatoires générales.Méthode de l'étude : L'étude a adopté une conception transversale en utilisant un échantillon de 370 jeunes patients célibataires qui étaient sexuellement actifs. Des données quantitatives ont été obtenues à l'aide d'un questionnaire structuré et des échantillons ont été prélevés pour déterminer les organismes responsables des infections sexuellement transmissibles (IST). L'analyse a été effectuée avec SPSS, le test du chi carré a été utilisé pour tester l'association entre les IST et les facteurs d'influence et le niveau de signification statistique a été fixé à 5 %.Résultat de l'étude: L'évaluation des connaissances générales a montré que 90,3 % des répondants connaissaient les IST. Les connaissances spécifiques sur les ISTont montré que le VIH/SIDAétait connu à 88,9 % et le chancre mou à 14 %. Environ 26 % des répondantes présentaient des démangeaisons, 22,1 % des pertes vaginales et 5,9 % un gonflement du périnée. Les organismes identifiés étaient le Candida albicans (47 %), l'urétrite non gonococcique (17,7 %) et le moins était l'herpès 1,96 %. La prévalence des IST était significativement associée aux comportements sexuels à risque (÷ 2 = 8,437 ; p = 0,004), à l'enseignement supérieur (÷ 2 = 5,330 ; p = 0,021) et au mauvais fonctionnement de la famille (÷2 = 5,507 ; p = 0,005).Conclusion : Les infections sexuellement transmissibles étaient associées à des comportements sexuels à risque, l'éducation sur le changement de comportement vers une pratique sexuelle sans risque est un outil qui peut aider à prévenir la propagation de l'infection.

Male participation in family planning: An untapped potential for increasing utilization of family planning services in Ondo, Southwestern Nigeria

Background: Men play crucial roles in the utilization of family planning services hence, ensuring their commitment to these services is essential for increasing family planning uptake. This study therefore, assessed the level of male participation in family planning services utilization and its associated factors in Ondo west LGA, Ondo State, Nigeria. Methods: The study utilized a community-based cross-sectional design. Multi-stage sampling technique was used to select 433 eligible respondents. Quantitative data were collected using semi-structured questionnaires and analyzed using IBM SPSS version 23; bivariate and multivariate analyses were done using Chi-square and binary logistic regression respectively at 5% level of significance.Results: 55% and 48.5% of the study participants, had poor knowledge and perception about family planning services respectively. At bivariate level, there were statistically significant associations between age (p = 0.046), number of children (p < 0.001), level of education (p = 0.023), and the utilization of FP services by the respondents. Conclusion: The knowledge of the respondents about FP services was poor and if unaddressed, could infringe upon the rights of their spouses to access such services. Increasing male participation may require targeting married men for educational interventions. French title: Participation des hommes à la planification familiale : un potentiel inexploité pour accroître l'utilisation des services de planification familiale à Ondo, dans le sud-ouest du Nigéria Contexte général de l'étude : Les hommes jouent un rôle important dans l'utilisation des services de planification familiale, par conséquent, obtenir leur engagement envers ces services est essentiel pour augmenter l'adoption de la planification familiale. Par conséquent, cette étude a évalué le niveau de participation des hommes dans l'utilisation des services de planification familiale et ses facteurs associés à Ondo West, Ondo State, Nigéria.Méthode de l'étude : Une étude transversale communautaire, les répondants étant des hommes mariés. Une technique d'échantillonnage à plusieurs degrés a été utilisée pour sélectionner 433 répondants admissibles. Les données ont été recueillies à l'aide de questionnaires semi-structurés. Les données ont été analysées à l'aide d'IBM SPSS version 23 ; des analyses bi variées et multi variées ont été effectuées en utilisant respectivement une régression logistique du chi carré et binaire à un niveau de signification de 5%.Résultat de l'étude : Environ 55 % et 48,5 % des participants à l'étude avaient respectivement une connaissance et une perception médiocres des services de planification familiale. Au niveau bi varié, il y avait des associations statistiquement significatives entre l'âge (p = 0,046), le nombre d'enfants (p < 0,001), le niveau d'éducation (p = 0,023) et l'utilisation des services de PF par les répondants.Conclusion : La connaissance des répondants sur les services de PF est faible et si elle n'est pas prise en compte, elle pourrait porter atteinte aux droits de leurs conjoints à de tels services. L'augmentation de la participation des hommes peut nécessiter de cibler les hommes mariés pour les interventions éducatives.

Medication interruptions and associated factors among nurses working in pediatric unit at a selected referral hospital in Rwanda

Introduction: Interruptions have been proven to cause medication administration errors in pediatric settings. Therefore, this study assessed the medication interruptions and associated factors among nurses in a pediatric unit at a selected referral hospital in Rwanda. Methods: A descriptive observational study was conducted among 59 nurses using a developed observational checklist. Data were entered into SPSS, version 26. Descriptive and inferential statistics were used to analyze the data. The IRB of the University of Rwanda approved the study. Results: Among the 414 medication administrations observed, 149 (36%) had interruptions. The main source of interruption was technical problem (14.5%) with interruption from direct care (12%) as the main reason. The factors associated with interruption occurrence were shift of the day, time of medication round, duration and phase of medication administration and nurse perception (p = 0.001), age (p=0.046), educational level (p = 0.044) and professional experience (p = 0.031). Conclusion: The existence of medication interruptions is evident with associated factors predominantly being demographics and technical. Therefore, the authors recommended that an in-service training program for nurses regarding medication administration errors. The hospital leadership should address the technical problems including availing the required materials for medication administration. French title: Interruptions médicamenteuses et facteurs associés chez les infirmières travaillant dans l'unité pédiatrique d'un hôpital de référence sélectionné au Rwanda Introduction : Il a été prouvé que les interruptions provoquent des erreurs d'administration de médicaments en milieu pédiatrique. Par conséquent, cette étude a évalué les interruptions de médication et les facteurs associés chez les infirmières d'une unité de pédiatrie d'un hôpital de référence sélectionné au Rwanda. Méthode de l'étude : Une étude observationnelle descriptive a été menée auprès de 59 infirmières à l'aide d'une liste de contrôle d'observation élaborée. Les données ont été saisies dans SPSS, 26. Des statistiques descriptives et inférentielles ont été utilisées pour analyser les données. L'IRB de l'Université du Rwanda a approuvé l'étude. Résultats de l'étude : Parmi les 414 administrations de médicaments observées, 149 (36 %) ont subi des interruptions. La principale source d'interruption était un problème technique (14,5 %) avec l'interruption des soins directs (12 %) comme principale raison. Les facteurs associés à l'occurrence d'interruption étaient décalage de la journée, heure de la tournée de médicaments, durée et phase d'administration des médicaments et perception de l'infirmière (p = 0,001), âge (p=0,046), niveau d'éducation (p = 0,044) et expérience professionnelle (p = 0,031). Conclusion : L'existence d'interruptions de médication est évidente avec des facteurs associés principalement démographiques et techniques. Par conséquent, les auteurs recommandent un programme de formation continue pour les infirmières concernant les erreurs d'administration de médicaments. La direction de l'hôpital devrait résoudre les problèmes techniques, notamment en mettant à disposition les matériaux requis pour l'administration des médicaments.