The evaluation of upper respiratory tract infection symptoms to show the significance of developing a quality-of-life evaluation instrument for upper respiratory tract infections to assess respiratory disorder-related disability

In a majority of clinical trials in upper respiratory tract infections (URTIs), it is now standard to include a measure of health-related quality of life (HRQOL) as a key outcome, and numerous clinicians are now adding QOL to routine clinical assessments. Because of this, the design of a disease-specific instrument for URTIs that has strong measurement properties and is more sensitive to minute changes is of great value in having an appropriate perception of what value patients put on their QOL and how changes in these values correlate with positive or negative progress in health. This is an attempt to show the significance and effects of URTIs on the affected patient and the potential genesis in the construction of a HRQOL evaluative tool named QOLAURTI, which, if eventually tested for interpretability with positive results, will measure fluctuations in a patient's QOL score that will correlate with minute but significant, moderate, or huge improvement or decline in a patient's QOL and also help in treating illness of URTI origin by classifying severity of illness. Relevant articles retrieved through PubMed and MEDLINE were cited to describe the impact of URTIs. Current published and available references outlining ways to construct an effective evaluative instrument that is based on the specific disease state and its impact on affected patients are employed to help construct a QOL questionnaire that could be effective in measuring the QOL of an affected patient. The construction of a potentially effective evaluative tool was achieved and is included here. However, since this tool was not tested due to inadequate numbers of test subjects and facilities required, its reliability, validity, and interpretability cannot be determined as of yet. Patients with URTIs are usually troubled by nasal symptoms and other symptoms including fatigue and headache. It can be inferred that suffering from these symptoms concomitantly can cause quite severe impairments of normal daily human protocol including physical, occupational, and social functioning and can also cause emotional distress. Because of the importance of the potential impact of these symptoms on affected individuals, a closer look into how these symptoms affect the HRQOL of an individual is important. The main goal in treating patients with URTIs is to make sure that all individual patient problems are recognized so that they can be treated properly. To achieve this, it is important to measure QOL. Research has shown that generic health-status questionnaires are able to compare burden of illness across different medical conditions but that they are not usually responsive enough to small but clinically essential changes in patients' QOL. Because of this, it is important to have a disease-specific instrument for URTIs that can measure the QOL of the affected individual. The main importance in measuring the QOL of the affected individual would be in assessing the potential effectiveness of drug therapies and treatment protocols used in treating URTIs.     

Glycosylated haemoglobin levels in children with protein-energy malnutrition.

Fasting blood glucose, serum protein and glycosylated haemoglobin level (HbA1c) were determined in 50 children (aged 1-5 years) suffering from protein-energy malnutrition and in 25 healthy and nutritionally normal children of the same age group. It was observed that HbA1c correlated well with the blood glucose values of the children. It was also observed that they had significantly higher values of HbA1c than the controls, indicating the existence in them of glucose intolerance. Long-term monitoring of the glycaemic status is therefore suggested as a means of assessing any relationship between glycosylated haemoglobin and impaired pancreatic function in such patients.     

Mefloquine chemoprophylaxis in Chinese railway workers on contract in Nigeria

BACKGROUND: Nonimmune Chinese nationals on a 2-year railway contract job were commenced on mefloquine (MQ) chemoprophylaxis 20 weeks after arrival in Nigeria. The objective of the study was to determine the usefulness of mefloquine (MQ) (despite the delay in starting) and its tolerability in this group. METHODS: Ninety-one workers (89 males, 2 females) were commenced on weekly MQ 250 mg doses for 17 weeks. Most of the subjects were followed up to 16 weeks after cessation of chemoprophylaxis. The morbidity pattern before, during, and after cessation of chemoprophylaxis was compared. RESULTS: Of the 91 workers included in the study, 89 were evaluable. Three (3.37%) of these developed clinical illness during the 17-week period of chemoprophylaxis. This protection was highly significant when compared to 23 of 91 people (25.27%) who developed clinical illness before chemoprophylaxis was commenced (RR 0.13, 95% CI 0.04-0.43, p <.001). The risk of developing acute malaria increased more than three times, among 84 members of the group who were followed up to 16 weeks after MQ was discontinued (RR 3.18, 95% CI 0.89-11.34). Two subjects withdrew after the second dose due to adverse reactions, however the remaining 89 subjects tolerated the drug for the 16-week period. CONCLUSIONS: Mefloquine significantly reduced malaria morbidity in the study group. Pretravel counseling and advice is important in preventing unnecessary deaths and morbidity in nonimmune travelers to malarious areas.     

Malignant melanoma in a black child: predisposing precursors and management

Malignant melanoma (MM) remains a pediatric rarity world-wide, but perhaps more so in black Africans. To the best of our knowledge, the current report of MM in a two-and-a-half-year-old Nigerian who had a pre-existing congenital giant hairy nevus is probably the first (in an accessible literature) in a black African child. Primary neoplastic transformation and metastatic spread were suggested by the appearance of multiple swellings over the "garment" precursor nevus at the posterior trunk, multiple ipsilateral axillary nodal enlargement, and fresh occipital swellings postadmission. Smaller-sized hyperpigmented lesions with irregular, nonlobulated, and frequently hairy surfaces were also discernible over the upper and lower extremities, but the face, anterior trunk, and mucosal surfaces were relatively spared. A diagnosis of MM was confirmed by the subsequent histopathologic findings from the fine-needle aspirate and biopsy specimens. Chemotherapy was initiated but was truncated shortly after by parent-pressured discharge. Despite the rarity of MM in a tropical African setting where management options are few, the current case underscores the need for a high clinical index of diagnostic suspicion, an early pursuit of investigative confirmation, and prophylactic excision in children with the predisposing skin lesions, like congenital giant hairy nevus. An expounded discourse of the possible precursors and management options of MM is provided. We emphasize the need for institutional cost subsidy for anticancer care in tropical children.     

Submental intubation in paediatric oral and maxillofacial surgery: Review of the literature and report of four cases

Several oral and maxillofacial surgery procedures require the simultaneous use of the oropharyngeal space by both the surgeons and the anaesthetists. This poses a lot of challenges especially in optimally securing the airway. Nasotracheal intubation or tracheostomy with their significant morbidity might even be contraindicated in these scenarios owing to several factors elucidated in the literature. Submental endotracheal intubation might be the last resort in adequately protecting the airway without interfering with the surgery. It also permits concurrent access to the dental occlusion and nasal pyramid without the risk associated with nasal intubation and morbidity of tracheostomy. Contraindications include patients who require long periods of assisted ventilation and a severe traumatic wound on the floor of the mouth. Complications include localised infection and sepsis, poor wound healing or scarring, and post-operative salivary fistula. The rationale for this study is to describe the indications, contraindications and the technique of submental endotracheal intubation as performed in our hospital.Key words: Intubation, submental endotracheal intubation, tracheostomy     

Effect of Co-Fermentation on Nutritional Composition,Anti-Nutritional Factors and Acceptability of Cookies from Fermented Sorghum (Sorghum bicolor) and Soybeans (Glycine max) Flour Blends

This study evaluated the effect of co-fermentation on nutritional composition, anti-nutritional factors, and acceptability of cookies from fermented sorghum (Sorghum bicolor) and soybean (Glycine max) flour blends. White sorghum and yellow soy-beans were soaked and fermented separately for 24 h, 48 h, and 72 h respectively at 27 ± 2°C with 0 h as control. Fermented sorghum and soy-beans were oven-dried at 60°C for 8 h, milled and sieved and then used for the production of cookies. Cookie samples produced from different flour blends were evaluated for nutritional (proximate and vitamins profile analyses), anti-nutritional (phytate, tannin and trypsin inhibitor activity) qualities, and sensory evaluation. Results showed that the moisture contents in percent of the cookies ranged from 9.65 ± 0.21–8.34 ± 0.16 for 0 h, 10.59 ± 0.22–10.21 ± 0.21 for 24 h, 10.46 ± 0.22–10.13 ± 0.21 for 48 h, and 10.28 ± 0.21–9.41 ± 0.19 for 72 h, respectively. The protein contents in % ranged from 10.98 ± 0.26–18.72 ± 0.32 for 0 h, 11.26 ± 0.26–20.42 ± 0.32 for 24 h, 12.01 ± 0.26–21.48 ± 0.32 for 48 h, and 12.41 ± 0.26–21.49 ± 0.32 for 72 h, respectively, while the fat contents in percent ranged from 9.73 ± 0.21–11.51 ± 0.24 for 0 h, 8.84 ± 0.16–11.42 ± 0.24 for 24 h, 8.69 ± 0.16–10.56 ± 0.22 for 48 h, and 8.31 ± 0.16–10.11 ± 0.22 for 72 h, respectively. In conclusion, fermentation of sorghum and soybeans through microbial activity led to the hydrolysis and the reduction of anti-nutritional factors, it also improves the nutritional composition of cookies from fermented sorghum and soybean flour blends, as there was an increase in protein and vitamin contents of cookies. Therefore, cookies from fermented sorghum and soybeans flour could be used as a remedy to solve the menace of protein-energy malnutrition in developing countries.     

Developing an mHealth Intervention to Reduce COVID-19–Associated Psychological Distress Among Health Care Workers in Nigeria: Protocol for a Design and Feasibility Study

BackgroundGlobally, COVID-19–related psychological distress is seriously eroding health care workers’ mental health and well-being, especially in low-income countries like Nigeria. The use of mobile health (mHealth) interventions is now increasingly recognized as an innovative approach that may improve mental health and well-being. This project aims to develop an mHealth psychological intervention (mPsyI) to reduce COVID-19–related psychological distress among health care workers in Nigeria.ObjectiveOur objective is to present a study protocol to determine the level of COVID-19–related psychological distress among health care workers in Nigeria; explore health care workers’ experience of COVID-19–related psychological distress; develop and pilot test mPsyI to reduce this distress; and assess the feasibility of this intervention (such as usability, engagement, and satisfaction).MethodsA mixed (quantitative and qualitative) methods approach is used in which health care workers will be recruited from 2 tertiary health care facilities in southwest Nigeria. The study is divided into 4 phases based on the study objectives. Phase 1 involves a quantitative survey to assess the type and levels of psychosocial distress. Phase 2 collects qualitative data on psychosocial distress among health care workers. Phase 3 involves development of the mHealth-based psychological intervention, and phase 4 is a mixed methods study to assess the feasibility and acceptability of the intervention.ResultsThis study was funded in November 2020 by the Global Effort on COVID-19 Health Research, and collection of preliminary baseline data started in July 2021.ConclusionsThis is the first study to report the development of an mHealth-based intervention to reduce COVID-19–related psychological distress among health care workers in Nigeria. Using a mixed methods design in this study can potentially facilitate the adaptation of an evidence-based treatment method that is culturally sensitive and cost-effective for the management of COVID-19–related psychological distress among health care workers in Nigeria.International Registered Report Identifier (IRRID)DERR1-10.2196/36174     

Neonatal burns in Lagos,South-Western Nigeria: Epidemiology and outcome of management

Background

Burns in the neonate are rare and result mostly from iatrogenic sources in developed countries. The socioeconomic settings of developing countries are different from those in the developed countries. A review of the epidemiology and management of burns in the neonates in Lagos, Nigeria is presented.

Methods

The case notes of burns in patients less than 29 days-old from 2004 to 2008 in 4 tertiary health institutions in Lagos were retrieved from the Medical Records Department; necessary data were extracted and analyzed.

Results

There were 21 neonates with burns within the study period. The incidence of neonatal burns ranged between 0.5 and 2.5%/year. The mean age was 16.38 ± 1.84 days and the mean BSA of 26.00 ± 5.53%. The etiology of burns was thermal in 19(90.5%) and chemical in 2(9.5%). Hypokalemia was common at early stages of their treatment. Burns were sustained at home in 90.5% of the cases. The mortality rate was 43.5%. Inhalation and thermal injuries were associated with most of the deaths.

Conclusion

Domestic incidents from flames are the commonest causes of neonatal burns in the study environment. These are associated with prolonged morbidity and high mortality rate. Health education, highlighting methods of prevention should be undertaken in the community. Well equipped burn centers should be established to treat burns in all age groups.