bluuebunny/crossref_metadata_2025 huggingface dataset:
Processing and Nutritional Quality of Sea Snail (Rapana venosa Valenciennes, 1846) Meat
Authors: Korkmaz Koray , Tokur Bahar
Published: December 2023

Sea snail, which is considered an invasive species in the Black Sea, has been caught by fishermen who earn their living in this area since the second half of the 1980s, as an alternative to other products, processed in factories and exported to countries with demand abroad. The fishing of sea snails, a highly sought-after delicacy in the Far East, has been limited due to declining stocks in the Sea of Japan caused by overfishing. Consequently, this has created export opportunities for several countries, including Turkey, and its significance has been steadily growing with the increasing export volumes. Due to their low cholesterol and fat content, and significant levels of protein and minerals, snails are among the healthiest foods consumed by humans. The fact that shellfish are sensitive and perishable products increases the sensitivity of the issue on issues such as the processing method, duration, and cold storage of these products. Therefore, ensuring that the quality reaches consumers without deterioration and monitoring it is of great importance in the export of shellfish. It will be possible for countries to reach a higher potential in snail exports and increase their market share in snail trade by obtaining products of appropriate quality. For this, it is necessary to improve the collection conditions in snail hunting, to monitor its transportation under appropriate conditions and to improve the processing stages. The purpose of the article was to provide an overview of the processing and quality of sea snail (Rapana venosa) meat.
Foundation of Revolutionary Topologies: An Overview, Examples, Trend Analysis, Research Issues, Challenges, and Future Directions
Authors: Smarandache Florentin
Published: December 2023

We now found nine new topologies, such as: NonStandard Topology, Largest Extended NonStandard Real Topology, Neutrosophic Triplet Weak/Strong Topologies, Neutrosophic Extended Triplet Weak/Strong Topologies, Neutrosophic Duplet Topology, Neutrosophic Extended Duplet Topology, Neutrosophic MultiSet Topology, and recall and improve the seven previously founded topologies in the years (2019-2023), namely: NonStandard Neutrosophic Topology, NeutroTopology, AntiTopology, Refined Neutrosophic Topology, Refined Neutrosophic Crisp Topology, SuperHyperTopology, and Neutrosophic SuperHyperTopology. They are called avantgarde topologies because of their innovative forms.
ETHICAL REGULATION OF FOOD PRODUCTION AND MARKETING AS ONE OF THE CHALLENGES FOR THE EDUCATION OF AGRICULTURAL AND AGRI-FOOD EXPERTS
Authors: Pechočiaková Svitačová Eva
Published: December 2023

The quality and quantity of food to ensure the quality of life of the population is primarily the responsibility of entrepreneurs engaged in agriculture, agri-food and business. In their activities, entrepreneurs should also employ ethics, which, as one of the regulatory mechanisms, should regulate the production and sale of food to improve the quality of life of the population while respecting the requirement of sustainability. First, an argument is made for the need for ethical regulation of agricultural business and agri-food industry in Slovakia based on a qualitative analysis of theoretical sources in the field of ethics, applied ethics, sociology and other social sciences and humanities, and using knowledge from the field of economics and management of agriculture and food industry,. Given the lack of ethics programmes in these areas of the economy to fulfil this role, the need to implement ethics and applied ethics in the education of professionals for these areas of the economy is explained, with the aim to provide safe and quality food to the population and thus a better quality of life.
DODRŽOVÁNÍ PÉČE ŘÁDNÉHO HOSPODÁŘE, ZEJMÉNA LOAJALITY A DALŠÍ PRAVIDLA CHRÁNÍCÍ OBCHODNÍ SPOLEČNOSTI PŘED PROTIPRÁVNÍMI A NEETICKÝMI JEDNÁNÍMI
Authors: Ondřej Jan
Published: December 2023

Článek je věnován problematice předcházení protiprávním a dalším neetickým činům v rámci příslušné obchodní společnosti ze strany volených orgánů společnosti, zejména orgánů statutárních. Taková jednání mohou ohrozit prosperitu, případně i existenci dané obchodní společnosti. Členové volených orgánů obchodních společností mají řadu povinností, které pokud budou dodržovány, snižují či eliminují riziko protiprávních jednání, které mohou poškozovat zájmy dané obchodní společnosti. Mezi povinnosti statutárních a jiných volených orgánů patří zejména povinnost vykonávat funkci člena orgánu s péčí řádného hospodáře, její součástí je také nezbytná loajalita. Z požadavku loajality vyplývá povinnost člena voleného orgánu upřednostňovat zájmy obchodní společnosti před zájmy svými vlastními. Nezbytná loajalita je významná pro posouzení toho, zda člen voleného orgánu nejedná v rozporu se zájmy dané společnosti. V případě porušení povinnosti péče řádného hospodáře vzniká dané osobě povinnost hradit újmu vzniklou v důsledku porušení. Pro předcházení porušování povinností osob v postavení příslušných volených orgánů je významná kontrola ze strany společníků (akcionářů) a také provádění kontroly ze strany kontrolních orgánů, pokud jsou zřízeny.
Outcome of unbooked pregnancies at the Federal Medical Centre, Owerri, Nigeria
Authors: Onwube OC  , Nzeribe EA
Published: December 2023

Background: Booking in pregnancy has been found to significantly influence the maternal and perinatal outcome of pregnancy. Unbooked pregnancies contribute to adverse maternal and perinatal outcomes. Some paturients in Owerri, South eastern Nigeria and environs have the erroneous idea that booking was not important for safe motherhood.

Objectives: The study was to determine the maternal and perinatal outcomes of unbooked versus booked  pregnancies.The maternal outcomes examined included normal deliveries, instrumental vaginal deliveries, caesarean sections and maternal mortality. The perinatal outcomes included an evaluation of Apgar scores and perinatal mortality.Design: It was a retrospective comparative studySetting: The study was carried out at the Federal Medical Center,Owerri South-eastern Nigeria between January, 2010 and December, 2011.

Methodology: The labour ward records of all deliveries in the Centre between January 2010 and December 2011were examined and data collected from the theatre and Special care baby unit to determine the maternal and perinatal outcomes. Paturients who registered their pregnancies and received antenatal care in the Centre were termed booked, while those seen in labour for the first time irrespective of whether they registered elsewhere or not, were termed unbooked. Data was analysed using standard electronic calculators.

Results: There were a total of Six thousand, six hundred and seventy five (6675) deliveries within the period under review with a total of 680 unbooked pregnancies giving an overall incidence of 10.2%. The incidence was10.12% for 2010 and 10.24% for 2011respectively. In all the indices used to assess maternal and perinatal outcome, there was a more favourable outcome in the booked parturients compared to those who were unbooked.

Conclusion: The study goes on to re- emphasize the contribution of the unbooked mother to bad obstetric indices. The unbooked mother increases the risk of operative deliveries, maternal mortality, birth asphyxia and perinatal mortality.
Five year review of intrauterine contraceptive device use in Federal Medical Centre Owerri, Nigeria
Authors: Onyegbule OA  , Idih EE  , Ododo NA  , Nzeribe AE
Published: December 2023

Background: Unplanned pregnancy poses a major public health challenge in women of reproductive age, especially in developing countries. The intrauterine device contraceptive (IUCD) is a widely used method of contraception.

Objective: This study aimed to determine the contraceptive prevalence at this centre, the socio-demographic characteristics and other parameters among clients that accepted intrauterine contraceptive device insertion.

Materials/Methods:  This was a five year retrospective study of the period January 2010-December 2014. The family planning register of the department of Obstetrics and Gynaecology, Federal Medical Center (FMC) Owerri was used to trace the case records of the clients who had accepted intrauterine contraceptive devices over the 5-year period.  Statistical package for Social Sciences version 17 for Windows was used to analyze the data. Chi-squared tests were used and differences were considered significant if P < 0.05

Results: During the period under review 900 clients out of 2511 acceptors of family planning method in FMC had IUCD insertion giving an  a prevalence of 35.8%. About 65.3% were para > 5.  The total percentage of clients that had at least primary education was 90.49% while 92.7% of the women were married in a stable relationship. The main indication for IUCD use in FMC was completion of family size in 82.9%.  Over the five year period, the uptake of emergency IUCD insertion was however low (0.67%). There was no statistically significant difference in the uptake of IUCD (p=0.16)

Conclusion: Utilization of IUCD in our centre is high; therefore there is a need for continuous reinforced counselling of clients, training of personnel in insertion and its use in other situations like emergency contraception.
Babesia microti a rare infective cause of transfusion dependent anaemia and proteinuria, eight cases series report seen over nine years from a Benin City University Teaching Hospital
Authors: Lofor PVO  , Lofor AE
Published: December 2023

Babesiosis (piroplasmosis) is transmitted to humans by the bite of ticks commonly found on the body of dogs and deers infected with Babesia microti (a protozoa). From the literature only about three hundred human cases had being reported, with all in adults.A nine-year (2006 to 2015) report of eight cases (including a child) of Babesia microti infection presenting as transfusion dependent anaemia and proteinuria amidst other varied clinical presentation is presented to appraise laboratory and clinical physicians of such uncommonly reported condition in humans.Combination of clindamycin and quinine aborted the transfusion dependent anaemia and proteinuria amidst other varied clinical presentation in less than twenty- four hours of therapy for all eight cases of Babesiosis.In the absence of gametocytes, schizonts and brown – black malaria pigments and sometimes presence of characteristic 'maltese cross' in a thin blood film stained with Giemsa stain from patients with classical clinical presentation of Babesiosis resembling malaria; Babesiosis should be first on the list of differential diagnosis especially when there is a history of contact with animals like dogs which habour the ticks which carry Babesia microti which in these cases they all had contact with dogs as pets at home.
Lassa fever and infection control: Knowledge, attitudes and practice in a University Teaching Hospital in Uyo, Nigeria
Authors: Ekuma AE  , Akpan IS
Published: December 2023

Context: Lassa fever is a deadly viral hemorrhagic disease that is endemic in Nigeria with recurrent outbreaks that often affect healthcare workers. Hospital infection control can potentially limit the impact of outbreaks of this disease in healthcare settingsObjective: To determine the knowledge attitudes and practices toward Lassa fever and infection control among medical doctors and students in Uyo, Nigeria.Methods: This was a cross sectional survey of knowledge attitude and practice among medical students, house officers and resident doctors undergoing training in the University of Uyo Teaching Hospital using a 23-point structured self-administered questionnaire.Results: 89.5% of participants correctly identified the causative agent for Lassa fever to be a virus. 141 participants correctly identified rats as the reservoir for Lassa fever. The state chosen by most participants to have the highest prevalence of Lassa fever was Edo State (44.8%), followed by Adamawa State (20.4%). 79.7% of participants correctly identified the drug treatment of Lassa fever. Most participants agreed that there is a possibility of contracting Lassa fever in the course of their duties and that facilities in the hospital are not sufficient to protect them from contracting the infection.Conclusion and recommendations: There is good knowledge of Lassa fever among medical trainees but with significant gaps. There is need to place more emphasis on Lassa fever and infection control in training curricula.
Femoral shaft fractures: mechanisms, patterns and associated injuries in Makurdi, Nigeria
Authors: Yongu WT  , Itodo EC  , Daniel MD  , Joseph KN  , Stephen A
Published: December 2023

Context: The femur is the strongest and longest bone in the body but is frequently fractured in high energy trauma. Femoral shaft fractures are commonly associated with multiple system injury which may be missed during initial assessment.

Methods: A four year retrospective   study was conducted at Benue State University Teaching Hospital. The data was ob¬tained from records of all the patients with femoral shaft fractures that were admitted and treated in the hospital. These included demographic characteristics, mechanism of fracture, associated injuries, radiological findings. and treatment options. Descriptive statistics done using the Statistical Package for Social Sciences version 16.0  (SPSS Inc. Chicago, IL).Results: There were 83 patients with femoral shaft fractures with  mean age of 32.75±1.5 years. The age range was 3 -80 years. There were 52 males and 21 females giving a  male to female ratio of  1.7:1 .Thirty of them (36.1%) presented  within 1 hour (Golden hour). There were 62(72.7%) closed fractures while open fractures accounted for 21(27.3%). The most common cause of femoral shaft  fracture was motor vehicular/motorcycle collision 28(33.7%).The most frequent fracture pattern observed was comminuted fracture accounting for 21(32.5%).There were 26 associated injuries occurring a total of 81 times in 52 patients.. Head injury accounted for 27(33.7%) of the associated injuries. Plate and screws, interlocking nail  and external fixation were used for treatment.

Conclusion: Femoral shaft fractures are common and mostly result from  motor vehicular/motorcycle crashes among young people in Makurdi. These fractures are often associated with multiple system injuries including the head and limbs.
Outcome of pregnancies complicated by abruptio placentae in Kano, Nigeria: A 5 year review
Authors: Attah RA  , Muhammad Z  , Aisha A
Published: December 2023

Background: Abruptio Placentae is the commonest cause of bleeding per vaginam in the third trimester of pregnancy. It remains a major cause of perinatal morbidity and mortality globally, though of most serious concern in the developing world. As most known causes of abruptio placentae are either preventable or treatable, an increased frequency of the condition remains a source of concern to obstetricians in the developing world.Objectives: To determine the incidence and the feto-maternal outcome of pregnancies complicated by abruptio placentae in Aminu Kano Teaching Hospital, Kano.Study design: Retrospective study of pregnancies complicated by abruptio placentae at Aminu Kano Teaching Hospital, Kano, Nigeria between 1st January 2010 and 31st December 2014.Results: A total of 152 cases of abruptio placentae were recorded out of 18,220 cases admitted for delivery during the study period, giving a rate 0.83%. Major complications were intra uterine fetal deaths in 52.0%, fetal distress in 36.5%, postpartum haemorrhage in 24.3% of cases, and anaemia necessitating blood transfusion in 61.5%. No maternal mortality occurred due to abruptio placentae during the study period.Conclusion: There is a high incidence of abruptio placentae in our setting. The most frequent foetal outcome was intrauterine foetal death, while postpartum haemorrhage, increased blood transfusion  due to severe anaemia and disseminated intravascular coagulopathy, were the major maternal complications.
Perception of and attitude towards mental illness among residents of a community in south- south Nigeria
Authors: Johnson OE  , Benson BM
Published: December 2023

Context: The burden of mental illness is increasing steadily and cuts across every community.Objectives: This study was carried out to determine the perception and attitude towards mental illness among residents of a community in Nigeria.Study Design: A cross sectional descriptive study was conducted among residents of Obio Offot community in southern Nigeria in June 2016. Participants were selected using cluster sampling method and data collected with semi-structured, interviewer administered questionnaires and analyzed using Statistical Package for the Social Sciences (SPSS) version 20. Level of significance was set at 5%.Results: A total of 272 respondents participated in the study. The average age of respondent was 29.3 ± 10.14 years, consisting of 52.6% males and 47.4% females. Majority, 72.1% had tertiary education. Almost half of the respondents, 46.0% felt mental illness could not be cured. Various attitudes of the respondents towards the treated mentally ill included shame, 81.3%, unwillingness to share rooms,64.7%, and avoiding all contacts, 41.9%. Majority, 76.5% and 73.5% respectively, considered them as public nuisances and mentally retarded. Identified options of care included psychiatric hospital, 89.3% and church, 72.8%. Unwillingness to share room and perceiving the treated mentally ill as dangerous increased with literacy (p<0.05) The commonest perceived causes of mental illness were substance abuse, 92.3%, brain disease 86.4%  and traumatic events  59.2%.Conclusion: Despite the high level of literacy among the respondents, there were many stigmatizing attitudes towards the treated mentally ill.  A multi dimensional approach is needed towards ensuring social acceptance of the treated mentally ill.
Pattern of ear, nose and throat foreign bodies seen in Uyo Nigeria
Authors: Ette VF
Published: December 2023

SUMMARY:Insertion, inhalation and ingestion of diverse kinds of foreign bodies have always been encountered anywhere otorhinoloarnology is practiced. This is a 5 year retrospective study (August 1998-2003) to determine the etiological pattern of foreign bodies reported in this part of Nigeria. A total of 1.797 patients were seen over the period of which 113 presented with foreign bodies. These were 46 (40.7%) males and 67 (59.3%) females with a M;F ratio of 1:1;5. Their ages ranged from 6 months to 71 years. The anatomic site distribution of foreign bodies showed that 77 (68%) occurred in the ear, 21 (18.6%) occurred in the nose while 15 (13.3%) occurred in the composite region generally called the throat. The pharynx and oesophagus were the commonest sites of foreign body lodgment in the throat followed by the larynx. The study revealed that children are still the most vulnerable group endangered by foreign bodies. Continuous caution both in prevention and appropriate management of cases must be exercised especially by the primary care providers who make up the first contacts with the patients. Early presentation and prompt referral to expert centres will avert some calamities that result from management of some foreign bodies.
Making motherhood safer in eclamptic patients
Authors: Orji EO  , Olabode TO  , Orji VO
Published: December 2023

ABSTRACTContext: Eclampsia remains an important cause of maternal and perinatal morbidity and mortality throughout the world, particularly developing countries.Objective: To determine the prevalence, socio-demographic predisposing factors, management modalities and outcomes of eclampsia with the aim of making motherhood safer in eclamptic patients..Study setting: Retrospective analysis of case notes of patients managed for eclampsia at the Wesley Guild Hospital, Ilesa.Method: Case notes of patient managed for eclampsia at Wesley Guild Hospital, Ilesa over a 10 year period from January 1, 1996 to December 2005 were analysed.Main outcome Measure: Prevalence of eclampsia, sociodemographic predisposing factors, mode of delivery, drug therapy, maternal and perinatal outcome.Result: The analysis showed that the incidence of eclampsia was 0.9% and unbooked patients accounted for 93.3%. 65.8% of them were primigraidae and 78.5% of them were below 30 years with a mean age of 23.4years. Intrapartum eclampsia was the commonest type of eclampsia, occurring in 46.7% of the patients. Convulsion was controlled with diazepam in 91.0% of cases. Vaginal delivery was the mode of delivery in 59.8% of cases. Maternal and perinatal mortality were 3.3% and 16.7% respectively.Conclusions: Eclampsia is associated with significant maternal and perinatal morbidity and mortality especially among unbooked patients. Public awareness on the need for early antenatal booking and adequate training of health care providers on how to recognize high risk patients and early referrals will go a long way in reducing the incidence of eclampsia and making motherhood safer among patients.
Breech presentation – An overview
Authors: Umoh AV  , Abah MG  , Umoiyoho AJ
Published: December 2023

IntroductionBreech presentation is a form of mal-presentation in which the fetal buttocks or lower extremities occupy or is in direct relationship with the maternal pelvic inlet. It is the commonest form of mal-presentation of the fetus. Its incidence decreases with advancing age from 25% at 28 Weeks, through 15% at 32 Weeks to 2-4% at term[1-3].

It accounts for 3-4% of infants born at term or at least 20,000 babies per year in the United Kingdom[3-5].  It is commoner in preterm babies and may be associated with both fetal and maternal anomalies. There has been intense debate about the safest mode of delivery for breech babies[5,6].Depending on the attitude of the fetus, breech presentation has been classified as:(a) Frank or Extended breech presentation when the fetal hips are flexed and the knees extended. It is also called 'pike'. This accounts for 50-70% of breech presentations and is commoner in Primigravidae;(b) Complete or Flexed breech presentation when both the hips and the knees are flexed. It is also described as 'cannon ball' and accounts for 5-10% of breech presentations. It is commoner in Multiparous women.(c) Footling or Incomplete breech presentation when one or both hips are extended. Here the foot (or feet) lies below the fetal buttock and either it or the knee(s) may be presenting[3,5,7].
Near miss maternal mortality in Jos University Teaching Hospital (JUTH), Jos, Plateau State Nigeria
Authors: Daru PH  , Musa J  , Achara P  , Pam IC
Published: December 2023

Background: Near misses are incidents which might have resulted in a maternal death, but for prompt and effective treatment. Characterizing near-miss mortality is valuable for monitoring the quality of hospital based obstetric care, and for assessing the incidence of life threatening complications. It is the major indicator used to monitor maternal health in the developed world, and it is also being increasingly used in Africa. For every woman who dies; many suffer serious life threatening complications of pregnancy. The near miss case definition was based on five diagnostic categories: Hypertensive disorder in pregnancy, haemorrhage, infections, labour dystocia, and severe anaemiaAim- To determine the incidence of near-miss obstetric mortality in Jos University Teaching Hospital (JUTH) over a 12 month period

Method: Retrospective analysis of near-miss maternal morbidity from 1st January 2006 to 31st December 2006 was carried out. Data on maternal age, parity, diagnosis, booking status, duration of admission and treatment were collected. Analysis was done with EPI-Info, version 6 statistical software packages.

Result: There were 2,972 deliveries, and 73 near-miss cases. The incidence of near misses in the year under review was 2.5%, or 2,500 per 100,000 deliveries. Forty of the 73 case files were retrieved .Hypertensive disorders constituted 32.5%, and were the leading event. It was followed by haemorrhage (27.5%), infections (22.5%), dystocia (15%), and severe anaemia (2.5%). Majority (60%) of the cases were unbooked, many (27.5%) booked elsewhere, and only a small minority (12.5%) booked in this center.

Conclusion: Hypertensive disorders, haemorrhage, and infections were the leading near miss events in this center, and efforts should be made to further allocate more resources for managing these cases, especially in unbooked patients.
Maternal blood loss by mode of uterine incision at caesarean section: A comparison between sharp and blunt techniques
Authors: Orji EO  , Olaleye OA
Published: December 2023

Objective: To evaluate the effect of two techniques of uterine incision expansion at caesarean section on the maternal blood loss, inadvertent extension of incisions and the feto-maternal outcome .Methods: A quasi-experimental study with convenient sampling involving two groups of women who underwent lower segment transverse caesarean section. Both groups were studied for their demographic characteristics and clinical data. Standard surgical techniques were used in both groups except the technique of uterine incision either by blunt or sharp method. Finally a comparison of the two groups was made regarding blood loss, changes in haemotocrit, blood transfusion and uterine tears. The study was conducted at the obstetric unit of Obafemi Awolowo University teaching Hospital Ile-Ife, Nigeria from January to December 2006.Result: Seventy-two women were studied (36 into either method). Blunt method of uterine expansion was significantly associated with in creased risk for blood loss, fall in haematocrit (P=0.001), need for blood transfusion (P<0.05) and uterine, vaginal and cervical tears due to  inadvertent extension compared to sharp expansion group.Conclusion: The sharp expansion method is recommended because it is associated with reduced maternal morbidity in term of blood loss and uterine tears
Acquired gynaetresia with cryptomenorrhoea secondary to induced abortion – A case report
Authors: Omale AE  , Ibrahim SA  , Anor F
Published: December 2023

Gynaetresia is the occlusion of some part of the female genital tract especially occlusion of the vagina. It may be congenital or acquired. Acquired gynaetresia with cryptomenorrhoea usually presents with cyclical monthly pelvic or rectal pain but no bleeding per vagina. It may occur as a result of trauma to the female genital tract with secondary infection and adhesions.  We present a case of acquired gynaetresia with secondary amenorrhoea in a twenty year old student of a secondary school in an urban centre, who presented at the gynaecological unit of Armed Forces' Specialist hospital with history of termination of eight weeks pregnancy at a chemist five months prior to time of presentation. Since then she has been having cyclical monthly lower abdominal pain but remained amenorrhoeic. The pain became severe that day hence she presented at the hospital. Findings at the surgery were dense adhesions in the vagina with complete obliteration of the cervix. She had adhesiolysis and cruciate incision and evacuation of about 600 ml of dark brown insipitated blood.
Vaginal birth after a previous caesarean section functional vs static marker
Authors: Omole-ohonsi A
Published: December 2023

Background: Primary caesarean section increases the chances of repeat caesarean section. In our society, there is a high prevalence of teenage pregnancy which is a high risk factor for primary caesarean section due to cephalopelvic disproportion. Continuing growth of these adolescents and their pelvic bones, makes their pelves bigger in the next pregnancy with a favourable prospect of vaginal delivery. A reliable method of assessment of these patients to identify those who are suitable for trial of labour is invaluable.Aims: This study was aimed at assessing the reliability of the Head Fitting Test (HFT) compared with Antepartum X-ray Pelvimetry (AXRP) in selecting patients for trial of labour after primary caesarean section.Methods: This was a comparative prospective study of 300 women with a previous lower uterine segment caesarean section who were delivered at Aminu Kano Teaching Hospital, Kano, Nigeria, over a six year period (1998-2003).  Result: The sensitivity of HFT was 97.0%, specificity was 96.1%, positive predictive value was 98.0% and negative predictive value 94.2%. The sensitivity of AXRP was 34.7%, specificity 24.0%, positive predictive value 31.3% and negative predictive value 26.9%. The sensitivity of PXRP was 49.3%, specificity 18.7%, positive predictive value 37.8% and negative predictive value 26.9%.Conclusion: HFT was found to be a better method than AXRP in selecting the women with a previous caesarean section, who were suitable for trial of labour and vaginal delivery.
Extensive interstitial emphysema complicating blunt chest injury
Authors: Ekpe EE  , Ikpe MC
Published: December 2023

We report the case of a 50-year old farmer who sustained multiple injuries during involvement in a road traffic accident. He sustained blunt chest injury with left lower rib fractures, partial pneumothorax in an area of pleural symphysis, extensive interstitial emphysema, and closed fracture of left femoral shaft.Initial presentation was to a general hospital and then a private hospital  where he was managed during the first five days of the injuries. Since no specific treatment was given to either the pneumothorax or the interstitial emphysema, the latter continued to progress to a frightening and life-threatening proportion thereby necessitating referral to our centre on the sixth post-injury day.Examination showed a middle aged man that was 'ballooned' from face to legs, in respiratory distress, breathing through an opened mouth, complete and bilateral ptosis due to swollen / ballooned eyelids, and talked with 'nasal voice'. There were extensive subcutaneous crepitus from the face to the legs, positive chest compression tenderness over left lower aspect, hyper resonant percussion note, and diminished intensity breath sound worse over left lower lung zone, and widespread crepitations. The trachea was centrally located. Examination of the left lower limb revealed simple fracture of left femoral shaft.The clinical diagnoses of blunt chest injury with left lower rib fractures and partial left pneumothorax and extensive interstitial emphysema, and closed left femoral fracture were confirmed radiologically. The patient was successfully treated with left closed tube thoracostomy drainage, supplemental oxygen therapy, analgesic and supplementary parenteral nutrition, with complete resolution of interstitial emphysema by the eighth post-intubation day.
Determination of the semen quality in male partners of infertile couples in Aminu Kano Teaching Hospital, Kano: A three year review
Authors: Ibrahim SA  , Muhammad Z
Published: December 2023

ContextMale infertility contributes a lot to the causes of infertility among couples attending Gynaecology clinics in our environment.

Objectives:To determine semen quality in male partners of infertile couples attending Gynaecology Clinic in Aminu Kano Teaching Hospital, and to describe the pattern of abnormality found among the semen samples.

Methodology:Reports of semen samples submitted to the andrology laboratory of AKTH Kano, over a period of three years, were analysed

Results:A total of 558 semen samples were analysed for semen quality  out of 562 samples over the three-year period.Two hundred and eleven (37.8%) had normal semen quality or parameters, while 347 (62.2%) had abnormal semen quality or parameters. The abnormal semen parameters consisted of low sperm volume (25.8%), prolonged liquefaction time (27.2%), azoospermia (14.2%), oligozoospermia (39.4%), teratozoospermia (23.7%), asthenozoospermia (61.6%) and the combineddefect of Oligo-Asthenozoospermia (12.8%),Oligo-teratozoospermia (6.0%), Asthenozo-teratozoospermia (5.2%), oligo-astheno-teratozoospermia (11.6%).

Conclusion:The study showed that abnormal semen parameters are a major contributor of male factor infertility in our environment. Efforts geared towards preventing the contributory factors will go a long way in alleviating theagony of infertile couples due to male factors.
Commentary on the burden of chronic kidney disease
Authors: Unadike B
Published: December 2023

The kidneys are two bean shaped organs situated in the abdomen that is responsible for the excretion of metabolic waste, production of hormones, and metabolism and excretion of drugs and toxins amongst others. Chronic renal failure is said to occur when there isan irreversible deterioration of kidney function, which develops over a period of years.  This ultimately leads to end-stage renal failure at  which  stage kidney  function  must be  replaced artificially  by either  renal dialysis or renal  transplantation in order to avert death.

The incidence and prevalence of kidney failure has been on the increase in recent times. The prevalence increased from 10% in 1988-1994 to 13.1% in 1999-2004. Kidney failure is also the ninth leading cause of death in the United States. In Nigeria, the data from various centres indicate an increasing incidence of kidney diseases in the population. The increase in kidney failure is partly explained by the rising incidence and prevalence of Diabetes and hypertension, the two leading causes of kidney failure. Other causes of kidney failure include glomerular disease, analgesic nephropathy, obstructive uropathy, chronic pyelonephritis, sickle cell disease amongst others.
Quality of life of women awaiting vesicovaginal fistula repair in Uyo, Akwa Ibom State, Nigeria
Authors: Inyang-Etoh EC  , Umoiyoho AJ
Published: December 2023

Background: Vesicovaginal fistula has devastating effects on the health of afflicted women leading to alteration in their quality of life.Aim: This study set out to assess the quality of life of women with vesicovaginal fistula who presented for repair.Methods: The World Health Organization quality of life- BREF questionnaire was used to evaluate the women's quality of life. Results: Only 20% of the women adjudged their general state of health and quality of life to be satisfactory. A vast majority (73.4%) of the women were assessed to have good quality of life in the physical health domain. Most (78%) of the women were evaluated to have poor quality of life in the mental health domain. The majority (63%) of the women were evaluated to have poor quality of life in the social health domain. Fifty percent of the women were assessed to have good quality of life in the area of the environment. Conclusion: Vesicovaginal fistula was associated with significant impairment of the mental and social health of afflicted women.
Why do orthopaedic trauma patients leave hospital against medical advice?
Authors: Ngim NE  , Nottidge TE  , Akpan AF
Published: December 2023

Background: Discharge against medical advice (DAMA) has emerged as a pervasive problem in hospitals. Since the incidence and reasons for DAMA varies from one society to another and among clinical conditions, this study was undertaken to evaluate the occurrence of DAMA among Orthopaedic trauma patients in a teaching hospital with a view to identifying appropriate preventive strategies.Methodology: A prospective cohort study of Orthopaedic trauma patients who presented at a teaching hospital over a six-month period and indicated their desire to leave the hospital against medical advice. The patients were interviewed after obtaining informed consent; information obtained included sociodemographics and reasons for discharge against medical advice which were entered into a proforma. For those who indicated intention to go to the traditional bone setters for further treatment, the reasons for such a decision were obtained. Data was analysed using SPSS version 16.Results: A total of 488 orthopaedic trauma patients presented at the Accident and Emergency unit of the hospital during the study period. Twenty nine (5.9%) of the patients, discharged themselves against medical advice. Male to female ratio was 3.8:1.0 with median age of 30 years. Main reasons for DAMA were: going to the traditional bone setter – 11 (37.9%); not satisfied with planned treatment – 10 (34.5%); no one to take care of me/children while on admission – 6 (20.7%), financial constraints – 2 (6.9%). Of the 11 patients who left hospital to go to the traditional bone setter (TBS), 7 (63.6%) indicated that they had more faith in the TBS method of treating injuries.Conclusion: Discharge against medical advice is common among orthopaedic trauma patients in our hospital. Intensification of the campaign to purge the society of misplaced belief in the supernatural prowess of the TBS in treatment of orthopaedic trauma injuries and improvement of patient-doctor communication are advocated as preventive strategies.
Prevalence of diabetic retinopathy in diabetes mellitus patients attending a tertiary eye clinic in Uyo south- south Nigeria
Authors: Abraham EG  , Umoh VA
Published: December 2023

Diabetes retinopathy is the most serious eye complication of diabetes mellitus. Ocular complications from diabetes mellitus could result from microangiopathy and changes in the lens largely from poor gylcaemic control. Ocular complications also depend on duration of diabetes and presence or absence of other co-morbid conditions like hypertension. Since onset of diabetic retinopathy is without symptoms and may even occur several years prior to first diagnosis of diabetes mellitus, there is the need for improved level of awareness in the community about this potentially blinding condition. This can only occur from the background of knowledge, hence this study.Interviewer administered questionnaire was administered to 218 consenting diabetic patients who were previously diagnosed or diagnosed in the eye clinic between January 2009 and December 2010. Ocular examination was carried out by the investigator. Result so obtained was analysed using SPSS17.0 statistical package. Result obtained presented as simple frequency tables of the 218 diabetic patients examined 115 (52.7%) had diabetic retinopathy and commonest wasnon-proliferative diabetic retinopathy (63.3%)while proliferative diabetic retinopathy accounted for only1.7% and 2.6% had DR coexisting with other retinopathies.
Reasons for delay to perform emergency caesarean section among parturients in a tertiary health care facility in south-south Nigeria
Authors: Inyang-Etoh EC  , Umoiyoho AJ  , Abasiattai AM
Published: December 2023

The low-resource setting prevalent in developing countries is associated with a lower quality of health care delivery to the populace largely due to lack of facilities. Aim: This study set out to determine the reasons for delay to perform emergency caesarean section in the centre studied. Methods: This was a review of the case notes of women who had emergency caesarean section during the period of the study. Results: The prevalence of caesarean section during the study period was 23% with emergency caesarean section rate of 66.4%. The modal (43.3%) age group was 26-30 years among parturients in the study population with half of the women being multiparous. A vast majority (79.3%) of the women had booked and obtained antenatal care in the centre. Failure to progress in labour was responsible for the majority (60.0%) of the caesarean section among the women followed by fetal distress, which accounted for 28.7%. A large number (43.3%) of the parturients were delayed for 1.1 to 3.0 hours and only 6 (4.1%) of the parturients had a minimal delay of half an hour or less. In 55.3% of the parturients, the reasons for delay were not stated in their case notes; although, 20.7% of the parturients were delayed because the theatre was engaged.CONCLUSION: Lack of essential health care facilities led to undue delay to perform emergency caesarean section in the centre studied.
Attitude and knowledge of pregnant women attending antenatal clinic at St. Luke's Hospital, Anua in Uyo, Nigeria towards congenital anomalies
Authors: Peter AI  , Ekong MB  , Ekanem TB  , Umoh IU  , Edagha IA  , Davies KG  , Mbadugha CC
Published: December 2023

Context: The birth of a congenitally abnormal child is an event that affects all the family members, and both their internal and external relationships.Objective: To know the attitude and knowledge of women visiting an antenatal clinic in Uyo, Nigeria on congenital anomaly.Study Design: This study was a descriptive cross-sectional study using structured questionnaire with a sample population consisting of 600 pregnant women attending antenatal clinic at St Luke's Hospital, Anua in Uyo, Nigeria.Results: The attitude of respondents towards children with birth defect was that of pity, 286 (47.7%); resentment, 28(4.7%); and wanting to help, 243 (40.5%). The attitude of respondents in helping their children with birth defect was mostly to seek medical help, 505 (86.6%); 76 (13.0%) would seek spiritual help, while 2 (0.4%) would abandon the child. In addition to this 513 (87.7%) will feel bad if they had a child with birth defect. Their knowledge of the causes of congenital anomally was good: maternal intake of non prescribed drugs, maternal intake of herbal medication, maternal infection during pregnancy, failed attempted abortion (ranging from 59.2% to 81.2%); except for that of environmental pollution/radiation (48.8%), which was poor and spiritual attack (56.7%), which was wrong. Most respondents, 531 (88.5%) believed that congenital anomally is a big burden to parentsConclusion: More public enlightenment was advocated to help parents prevent/cope better with the consequences of having children with congenital anomalies, as proper understanding of parent's attitude is necessary for the success of treatment and proper rehabilitation.
Successful voluntary blood donor recruitment among previously skeptical (naïve) donor population
Authors: Ino-Ekanem M  , Ekwere TA
Published: December 2023

AIM: To assess the responses of previously unexposed communities in Akwa Ibom State (AKS) to direct appeals for voluntary non-remunerated blood donationsMETHODS: A transfusion Medicine training workshop which drew participants from different parts of the country was organised in UUTH, Uyo from July 4th to 15th, 2011. The academic programme with unique but relevant local features designed by Professors Watson-Williams, Christopher Gresens, Etim Essien and Mr Tom Schallet was arranged and executed simultaneously in three parallel components- Clinical, Laboratory and Blood Donor Recruitment Tracts.The Blood Donor Recruitment component conducted blood drives to different communities. The records of blood donors obtained after the training workshop were compared to those obtained prior to the training workshop.RESULTS: Within the year after the exercise, the contribution of Voluntary Non-remunerated Donors to UUTH blood supply increased substantially from 1.2% to 20.9%.CONCLUSIONS: These results show that when communities are properly sensitized and enlightened on the health benefits and safety of blood donations, they are willing to become voluntary non-remunerated blood donors.
Pattern of paediatric neurological emergencies in University of Uyo Teaching Hospital, Uyo, Akwa-Ibom State of Nigeria
Authors: Akpan MU  , Utuk EE
Published: December 2023

Background: Neurological problems are responsible for a significant number of emergencies in children. Knowledge of its pattern is important for effective preventive strategies, healthcare planning and delivery.Aim: To determine the pattern of paediatric neurological emergencies seen in University of Uyo Teaching Hospital, Uyo.Method:  Health information records of children with paediatric neurological problems who presented in the Children's Emergency Unit (CHEU) of University of Uyo Teaching Hospital (UUTH) over a two year period between January 2007 and December 2008 were retrieved. Data obtained were age, gender, diagnosis made, duration of hospitalisation and outcome.Results: Of the one thousand eight hundred and thirty three (1833) patients seen during the study period, one hundred and ninety six (196) had neurological problems giving a prevalence rate of 10.7%. Majority (78.6%) of the patients were under the age of five years. Males were more affected with a male to female ratio of 1:0.75. The three commonest neurological emergencies encountered were febrile convulsion (42.3%), bacterial meningitis (21.9%) and cerebral malaria (17.9%). Duration of hospitalization ranged from one to thirty days with a mean of 4.5days. Mortality rate of 6.1% was recorded with cerebral malaria and bacterial meningitis responsible for 83.3% of the deaths.Conclusion: Febrile convulsion is the commonest neurological emergency recorded in this study. Since malaria is the commonest cause of febrile convulsion in Nigerian children, its prevention and control could be achieved by provision and proper utilisation of insecticide treated nets as well as early diagnosis and treatment.
Myths and misconceptions as barriers to uptake of immunization services in Calabar, Cross River State of Nigeria
Authors: Etokidem AJ  , Ndifon W  , Ogaji D  , Ebenso B  , Nsan E  , Ikpeme B
Published: December 2023

Context: Nigeria is presently one of only three countries in the world that are polio endemic.   The immunization program in Nigeria has been marred by several factors including myths and misconceptions.  Objective: The objective of this study was to identify myths and misconceptions that affect utilization of childhood immunization services in Calabar, Nigeria.Materials and Methods: Focus group discussion sessions were held among caregivers in Calabar, Nigeria. Each group consisted of 12 women of reproductive age. Data obtained from each session were transcribed and analyzed using the content analysis approach.Results: Participants had poor knowledge of vaccine preventable diseases (VPDs). Some mentioned non-VPDs as if they were VPDs. Some believed that “so called” VPDs are caused by mermaid spirits, witches and wizards. The solution to VPDs proffered by participants was sacrificing in the river by midnight. Some caregivers felt that multiple doses of vaccines could harm the children. With regard to polio, one caregiver said that “Polio is due to mammy water (water mermaid). The solution is not immunization. The solution is to sacrifice to the mermaid by 12 midnight in any river close to where the child was born, on the night of the child's birth. Once this is done, the child can never never have polio.”Conclusion: Myths and misconceptions regarding immunization are rife in most Nigerian communities. There is need to debunk them through health education in order to ensure success of the country's immunization program.