Search

Abstract Aims Fluoropyrimidine chemotherapy is important for treatment of many solid tumours but is associated with cardiotoxicity. The relationship of fluoropyrimidine‐associated cardiotoxicity (FAC) with conventional cardiovascular (CV) risk factors is poorly understood, and standard cardiovascular risk scores are not validated in this context. Methods and results Single‐centre retrospective study of patients treated with fluoropyrimidine chemotherapy using electronic health records for cardiovascular risk factors (and calculation of QRISK3 score), cancer treatment, and clinical outcomes. FAC was defined by cardiovascular events during or within 3 months of fluoropyrimidine treatment, and Cox regression was used to assess associations of CV risk and cancer treatment with FAC. One thousand eight hundred ninety‐eight patients were included (45% male; median age 64 years), with median follow up 24.5 (11.5–48.3 months); 52.7% of patients were at moderate or high baseline CV risk (QRISK3 score >10%) Cardiovascular events occurred in 3.1% (59/1898)—most commonly angina (64.4%, 38/59) and atrial fibrillation (13.6%, 8/59), with 39% events during cycle one of treatment. In univariable analysis, QRISK3 score >20% was significantly associated with incident FAC (HR 2.25, 95% CI 1.11–4.93, P = 0.03). On multivariable analysis, beta‐blocker use (HR 1.04, 95% CI 1.00–1.08, P = 0.04) and higher BMI (HR 2.33, 95% CI 1.04–5.19, P = 0.04) were independently associated with incident CV events. Thirty‐two of the 59 patients with FAC were subsequently rechallenged with fluoropyrimidine chemotherapy, with repeat CV events in 6% (2/32). Incident FAC did not affect overall survival (P = 0.50). Conclusions High BMI and use of beta‐blockers are associated with risk of CV events during fluoropyrimidine chemotherapy. QRISK3 score may also play a role in identifying patients at high risk of CV events during fluoropyrimidine chemotherapy. Re‐challenge with further fluoropyrimidine chemotherapy can be considered in patients following CV events during prior treatment.

Abstract Background This study investigated Bacillus cereus and Bacillus subtilis from food vendors in Ondo State, Nigeria. Methods A comprehensive whole-genome sequencing (WGS) analysis of Bacillus genomes, including genome assembly, plasmid prediction, species identification, antimicrobial resistance (AMR) gene identification, virulence gene identification, and multilocus sequencing typing, was conducted. Results The genome assembly revealed a B. cereus genome with 87 contigs, a length of 5,798,917 base pairs, and a GC content of 34.79%, whereas B. subtilis had a genome length of 4,238,143 bp and was composed of 253 contigs with a contig L50 of 24, a contig N50 of 55,053, and a GC content of 43.14904%. Plasmid prediction revealed the absence of prominent plasmids in the assembled B. cereus genome, whereas the repUS12 plasmid was recognized with an identity of less than 95.63% for the B. subtilis genome. Species identification via the average nucleotide identity (ANI) calculation confirmed that Bacillus cereus had a 98.97% ANI value, whereas a 98.39% ANI value was confirmed for B. subtilis WAUSV36. AMR genes were identified, with virulence genes such as the alo, cytK, and hbl genes also detected in B. cereus, whereas clpX, codY, purA, and purB genes were detected in B. subtilis. Multiple-locus sequence typing (MLST) revealed that B. cereus belongs to sequence type 73 with 100% identity, identifying housekeeping gene alleles, including glp_13, gmk_8, and ilv_9, whereas B. subtilis belongs to sequence type 130, with the ilvD gene showing a perfect match and the highest allele length of 471 for the housekeeping genes identified. Conclusions This detailed WGS analysis provides valuable insights into the genetic composition, potential virulence factors, and resistance profiles of B. cereus and B. subtilis, enhancing the understanding of their pathogenicity and epidemiology. The genomic analysis of B. cereus and B. subtilis revealed potential genomic applications in the context of food safety.

Abstract Background and objective The association of clinical factors of osteoarthritis (OA) with bone mineral density (BMD) is not well understood. We aimed to synthesize evidence regarding the associated clinical factors for low BMD in people with knee and/or hip osteoarthritis. Methods A systematic literature search limited to human studies was conducted from inception to September 12, 2022. CINAHL, Cochrane, Medline, PsycINFO, PubMed, Web of Science, and African Journal online databases were searched for all clinical factors associated with low BMD (either as osteopenia or osteoporosis). Gray literature or abstracts or protocols, studies with a mixed population of OA without a subgroup analysis for hip and or KOA and non-English were excluded. Following the title and abstract, full-text, screenings, and data extraction, data from eligible studies were synthesized based on the main objective of the study. The Joanna Brigg’s Institute (JBI) Critical Assessment tool was used for quality appraisal. Narrative synthesis and best evidence synthesis were used in the study. Result Five studies (2 case–control, 3 cross-sectional) were included after screening 3355 titles and abstracts. Clinical factors reported in the five studies included: body mass index (BMI); pain, function, and stiffness; symptom duration; presence of varus/valgus deformity; quality of life; and knee function. Whilst there was limited evidence to support the association between BMD measured at any site of the body and BMI, as well as conflicting evidence for the association of BMD with age and gender, there was insufficient evidence to support the association of BMD with other identified clinical factors of hip and or/ knee OA (p

The design thinking process is a human-centered, iterative methodology that designers use to solve problems and often results in an innovative approach to problem solving. Using a User Centered Design approach by applying the design thinking process, the researchers sought to know: 1. What national challenges were priority for Nigerians and 2. What solutions were best to tackle the problem that had the highest votes. To understand the need assessment, a survey form was designed and disseminated. A total of 406 participated in the poll, with over 70% votes for agriculture as the problem that requires urgent attention in Nigeria. Further research revealed post-harvest loss as a predominant problem in Nigeria’s agricultural sector. Key stakeholders in the sectors including farmers and agricultural experts were interviewed to further empathize, understand and redefine the problem. The design thinking process helped to refine the problem statement and identify other problems as well as potential solutions. From the survey, it was clear the majority of Nigerians who participated felt that agriculture and post-harvest loss were high priority needs that required urgent attention. Applying design thinking to prioritize agriculture in Nigeria reveals its power to address complex socio-economic issues effectively. By deeply understanding stakeholders' needs, clearly defining the problem, and iteratively developing and refining solutions, design thinking ensures that interventions in agriculture are not only relevant and impactful but also sustainable and scalable. This approach aligns perfectly with the urgent need for agricultural development in Nigeria to mitigate economic instability and enhance food security.

In this study, we explore the interconnected issues of food wastage, student hunger, and the potential of technology to facilitate food sharing. We begin by examining the general problem of food insecurity on university campuses and its impact on student well-being and academic performance. Through a mixed-methods approach involving 30 participants (13 Males (43%) and 17 Females (57%)), we gather both qualitative and quantitative data to understand attitudes towards surplus food and the challenges of accessing food when needed. Our quantitative findings reveal that while 69.6% of participants are willing to share surplus food, only 39.1% have access to a viable network for food distribution. Qualitative insights further uncover the profound effects of food insecurity on students, who advocate for technological solutions featuring financial tracking, transparent food distribution, and privacy measures to enhance the food-sharing experience. Building on these findings, we conduct a heuristic evaluation of a low-fidelity prototype designed to address the identified challenges. The results underscore the need for a user-friendly interface that aligns with students' preferences, with key areas for refinement highlighted for future development. Following this, we refine the application and evaluate it using the System Usability Scale, which provides valuable insights into user experiences with the FeedLine prototype. While the overall impressions are positive, the feedback also highlights the need for improved onboarding support and clearer communication of the app's capabilities. This research contributes to the development of a technology-driven solution aimed at alleviating food-related challenges among students.

This paper presents a formative assessment for the implementation of mobile portable chest X-ray (PDX) machines for tuberculosis (TB) contact tracing in the Oyo and Osun states, Nigeria. This descriptive qualitative study was carried out in eight local government areas, and 24 focus group discussions and 30 key informant interviews were conducted using a four-stage sampling technique to select participants. Validated transcribed notes were entered and analyzed using Nvivo. The respondents’ ages ranged from 17 to 85 years, with a mean age of 42.08 ± 14.9 years, and 4.0% had a postgraduate degree. The majority of government officials stated that deploying the PDX machine for screening at the community level is the best means for implementation because it will offer a level of proximity convenience to the TB contacts and assuage concerns about the cost of transportation to the health facility. In addition, it was suggested that TB community screening should be carried out with screening for other health conditions such as high blood pressure and diabetes. This portable X-ray machine intervention, therefore, should be implemented at the community level for contact tracing to allow more TB contacts living with the index patient to be screened without proximity and transportation constraints.

ackground: Respiratory distress syndrome causes significant morbidity and death especially among very low birth weight babies. Though the use of CPAP and surfactant have been shown to improve survival, these interventions were scarcely available in the past. This study aimed at comparing the clinical outcomes of preterm babies with RDS delivered at the Ife Hospital Unit of the Obafemi Awolowo University Teaching Hospitals Complex at two different periods. Objective: To compare the birth weight specific mortality rates and overall mortality rates of preterm babies with RDS between two periods in the neonatal ward of the Ife Hospital Unit of OAUTHC. Methods: A retrospective study comparing outcomes of 92 babies with RDS at GA 26 to 33+6 weeks between January 2015 and May 2016 and managed with intranasal oxygen alone to 104 babies of same gestational age characteristics between January 2019 and May 2020 who were managed with CPAP/surfactant. Results: The mean weight and gestational age of the babies respectively were 1.36 (±0.37) kg and 31.14 (±2.3) weeks in 2015/2016 and 1.35 (±0.322) kg and 30.95 (±2.24) weeks in 2019/2020. The overall case fatality rate and birth-weight specific mortality rates for ELBW, VLBWand LBW were 33.7%, 62.5%, 35.2% and 9.1% in 2015/2016 and 18.3%, 58.3%, 15.5% and 9.7% respectively in 2019/2020. Conclusion: While the use of CPAP and the administration of surfactant clearly show improved survival among very low birth weight babies who are at increased risk of death from RDS, this was not the case for extreme low birth weight babies.

Background/Aim: Preterm birth is a major pregnancy complication that imposes tremendous long-term medical and financial burdens on affected children, families, and the healthcare system. The aim of this study was to find out the prevalence, risk factors, and outcome of preterm babies admitted to Bingham University Teaching Hospital's inborn Special Care Baby Unit. Methods: It was a retrospective study of the medical records of all preterm babies delivered in the hospital from January 2021 to June 2022. Results: A total of 1,160 live births occurred in the hospital during the study period out of which 196 (16.9%) were admitted. Of these, 100 (51.0%) were preterm's with gestational ages ranging from 24 to 36 weeks with a mean gestational age of 31.24 weeks (±2.78).Birth weight ranged from 650g to 2450g CC –BY 4.0 with a mean of 1530.22g (±414.11). There were 47 males and 53 females (M: F 0.89:1) and 63 (63.0%) were delivered via caesarean section. The duration of hospital stay ranged from 1 to 182days with a median of 9and IQRof 11 days. Preterm premature membrane rupture and preeclampsia were the two most frequent risk factors for prematurity. Jaundice was the most prevalent morbidity seen, closely followed by anaemia. The overall mortality rate was 20%. Conclusion: Prematurity continues to be a major contributor to infant morbidity and mortality in our hospital, thus there is a need to improve the quality of health care delivery in order to improve survival rate of these newborns.

Abstract Background Learning environment (LE) research has been given priority in higher education institutions globally because of its influence on learning processes and outcomes. Although studies reporting the perceptions of health science students about LE in Nigeria are available, none have compared the perceptions of students from different health professions. Therefore, this study aimed to assess final-year clinical students’ perceptions of their LE from four programs (dentistry, medicine, nursing, and physiotherapy) and compared their LE perceptions. Methods This study adopted a cross-sectional study design using a mixed method approach. The quantitative survey involved all the final-year clinical students at the University of Ibadan, and they completed the Dundee Ready Education Environment Measure (DREEM) questionnaire. The qualitative aspect involved 24 consenting students in four focus group discussions. Results A total of 214 out of 223 copies of the DREEM questionnaire were duly completed and returned, yielding 96.0% response rate. The participants’ mean age was 24 ± 2.3 years (ranged between 22 and 25 years, p = 0.001). The mean DREEM scores of the students from the four programs ranged between 119.68 ± 18.02 and 147.65 ± 15.89 out of a maximum of 200, interpreted as more positive than negative perceptions of LE. Physiotherapy students’ DREEM score was significantly higher than those of medical, dental, and nursing students (p 0.05). Dental and medical students had similar positive perceptions. The qualitative aspect revealed that the students had positive perceptions of their teachers’ knowledge base and self-acquisition of knowledge but negative perceptions of their teachers’ communication skills, infrastructural facilities, lecturer-student relationships, and hostel accommodations. Conclusion Although the survey indicated that these clinical students had more positive than negative perceptions of their learning environment, the qualitative aspect of the study revealed many challenges that the students were confronted with. The clinical students’ perception of their learning environment could be improved if the university authorities would address these challenges.

Introduction The aims were to study the sociodemographic characteristics of patients presenting to the clinic and to study the clinical and serological pattern of systemic lupus erythematosus (SLE) in a new rheumatology clinic of a predominantly Yoruba population. Material and methods This was a retrospective, cross-sectional study conducted over 7 years (January 2017 – December 2023). Patients who satisfied the 1997 American College of Rheumatology (ACR) and/or the 2012 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria were enrolled using their medical records. Patients with overlap syndromes and other inflammatory or noninflammatory rheumatic diseases were excluded from the study. Their sociodemographic, clinical, laboratory, and treatment data were retrieved from their medical records and analysed using IBM SPSS version 23.0 software. Results A total of 65 patients were diagnosed with SLE with a frequency of 15.8%. The mean age ±SD of the patients at presentation was 33.85 years ±11.01 and the female to male ratio was 9.8 : 1. The median (IQR) duration of symptoms at presentation was 7.0 months (3–24). The common clinical presentations included synovitis (86.2%), acute cutaneous rash (53.8%), oral ulcers (52.3%), nonscarring alopecia (50.8%), and serositis (47.7%). Proteinuria was seen in 37.7% of the patients and the predominant renal histopathological feature was Class IV. Antinuclear antibody was 100% positive with 50.94% of the patients having a titre of 1 : 5,120 and above. Anti- double-stranded deoxyribonucleic acid and anti-Smith antibodies each had 50% prevalence. Dyslipidaemia was found in 76.7% of the patients. Conclusions The study’s findings are largely consistent with similar studies done in Africa. Further prospective multi-centred studies are needed to further determine the epidemiological characteristics of the disease in Nigeria with a multi-ethnic population.

Low-cost GNSS receivers have recently been gaining reliability as good candidates for ionospheric studies. In line with these gains are genuine concerns about improving the performance of these receivers. In this work, we present a comprehensive investigation of the performances of two antennas (the u-blox ANN-MB and the TOPGNSS TOP-106) used on a low-cost GNSS receiver known as the u-blox ZED-F9P. The two antennas were installed on two identical and co-located u-blox receivers. Data used from both receivers cover the period from January to June 2022. Results from the study indicate that the signal strengths are dominantly greater for the receiver with the TOPGNSS antenna than for the receiver with the ANN-MB antenna, implying that the TOPGNSS antenna is better than the ANN-MB antenna in terms of providing greater signal strengths. Summarily, the TOPGNSS antenna also performed better in minimizing the occurrence of cycle slips on phase TEC measurements. There are no conspicuous differences between the variances (computed as 5-min standard deviations) of phase TEC measurements for the two antennas, except for a period around May–June when the TOPGNSS gave a better performance in terms of minimizing the variances in phase TEC. Remarkably, the ANN-MB antenna gave a better performance than the TOPGNSS antenna in terms of minimizing the variances in pseudorange TEC for some satellite observations. For precise horizontal (North and East) positioning, the receiver with the TOPGNSS antenna gave better results, while the receiver with the ANN-MB antenna gave better vertical (Up) positioning. The errors for the receivers of both antennas are typically within about 5 m (the monthly mean was usually smaller than 1 m) in the horizontal direction and within about 10 m (the monthly mean was usually smaller than 4 m) in the vertical direction.

Background: The impact of antimicrobial resistance on children living in resource-limited countries has been underreported, despite its established global threat. Objective: This retrospective study aimed to describe the trend of antibiotic susceptibility in the paediatric age group. Methods: Sensitivity test report data consisting of 300 paediatric patients aged 18 hours to 192 months were retrieved from the microbiology laboratory records at a state-owned children’s hospital in Nigeria over a period of 4 months starting from December 2021 to March 2022. Five genera (Escherichia coli, Klebsiella spp., Pseudomonas spp., Staphylococcus aureus and Streptococcus spp.) were cultured as recommended by the Clinical Laboratory Standard Institute, using the Kirby Bauer disc diffusion method. Antimicrobial susceptibility testing was carried out on isolates using 15 different antibiotics. Results: Staphylococcus aureus was the most frequent pathogen isolated 32.1% (50/156) and Pseudomonas spp. was the least frequent pathogen isolated 7.1% (11/156) in all samples. The isolates with the highest rate of resistance to the tested antibiotics were S. aureus 32.1% (50/156), E. coli 28.2% (44/156) and Klebsiella spp. 20.5% (32/156). Isolates in all age groups were more resistant to ampicillin, amoxicillin + clavulanic acid, cefuroxime and cefepime. Conclusion: Antibiotic resistance is high, especially the younger Nigerian children. Strict antibiotic protocols should be adhered to especially in the use of empirical antibiotic therapy in hospitals. What this study adds: Our study reveals a higher trend of antibiotic resistance, especially in younger children. It further shows that the pathogens are most resistant to the most available empirical antibiotics in Nigeria.

# Background Cardiopulmonary resuscitation is a fundamental intervention for treating cardiac arrest, particularly when executed promptly and accurately. Paediatric Advanced Life Support (PALS), developed by the American Heart Association (AHA), is a specialized training designed for the emergency care of infants and children. Nigeria's National Surgical Obstetric Anaesthesia and Nursing Plan (NSOANP) has prioritized emergency preparedness and, in collaboration with a cleft-focused organization (Smile Train Incorporated, New York), deployed PALS training across the country. This report evaluates the scope and short-term outcomes of this training initiative, highlighting its potential role in enhancing paediatric surgical safety and outcomes in resource-limited settings. # Methods A retrospective review of 106 participants and 2 instructors trained in PALS over a period of 3 years. # Results A total of 106 participants, including 67 (70.7%) males and 39 (38.6%) females, from diverse specialties, were trained across the six geopolitical zones of the country. Participants included 75 (70.8%) consultants and 31 (29.2%) junior doctors. All participants passed the post-test and received AHA certification. The median pre-test score was 81% compared to the median post-test score of 92% (*p 0.05).* Feedback indicated 100% improvement in skills, confidence in handling paediatric emergencies, and satisfaction with the training quality. Participants expressed willingness to disseminate their newly acquired skills to colleagues. In addition, 2 instructors trained during the period have been involved in training participants for basic life support as well as PALS. # Conclusions The implementation of PALS training under NSOANP improved the knowledge and skills of healthcare providers in managing paediatric emergencies. This initiative demonstrates the potential impact of structured life support training in strengthening paediatric surgical safety and outcomes in low-resource settings.

Objective Fluoropyrimidine chemotherapy is a first-line treatment for many gastrointestinal (GI) cancers, however, cardiotoxicity concerns may limit administration in patients with pre-existing cardiovascular disease (CVD). This study investigated the association of pre-existing CVD with use of fluoropyrimidine chemotherapy in tumour-eligible GI cancer patients.Methods and analysis National cancer registry data from the Virtual Cardio-Oncology Research Initiative from England between 2014 and 2018 was used to identify GI cancer patients eligible to receive fluoropyrimidine chemotherapy. Linkage to Hospital Episode Statistics and CVD registry data were used to ascertain prior CVD and outcomes. Primary outcome was first administration of fluoropyrimidine chemotherapy following cancer diagnosis. Cox proportional hazard models determined HR and 95% CIs for the association between initiation of fluoropyrimidine treatment and prior CVD.Results 112 726 eligible patients were identified (median age 71 years (IQR 62–80), 39.7% female). 33 026 (29.3%) had pre-existing CVD. 73 392 (65.1%) patients had a diagnosis of colorectal, 23 208 (20.6%) oesophageal, 14 788 (13.1%) gastric and 1338 (1.2%) small bowel cancer. Individuals with pre-existing CVD had a 27% reduced rate of receiving fluoropyrimidine chemotherapy (HR, 0.73; 95% CI 0.70 to 0.75) on multivariable analysis. Significantly reduced rates of fluoropyrimidine administration were found across all subtypes of pre-existing CVD.Conclusions GI cancer patients with all types of pre-existing CVD are less likely to receive fluoropyrimidine chemotherapy despite eligibility. This suggests widespread caution regarding administration of fluoropyrimidines across this population; further research is needed to assess whether such conservatism is justified.

Human capital is critical in directing all resources to serve people and influencing the productivity of an economy. Human capital can be increased through good health and education. This research examined the effects of human capital development on economic growth and longevity in West Africa. This study was concentrated on four West African countries: Nigeria, Ghana, Burkina Faso, and the Benin Republic. We used panel ordinary least squares (POLS), fully modified ordinary least squares (FM-OLS), and dynamic ordinary least squares (DOLS) for robust analysis to look at how human capital development affects economic growth and longevity over the long term. Life expectancy at birth was employed to evaluate longevity. Before the estimate, correlation, unit root, and cointegration tests were run. According to the findings of this study, human capital development has a 347.5% favorable and significant long-term effect on economic growth. This indicates that enhancing human capital can stimulate economic growth. According to the data, human capital development has a 26.8 percent positive and significant long-term effect on life expectancy at birth. Based on the findings, this study concluded that human capital development has a favorable impact on economic growth and life expectancy at birth in West Africa, demonstrating that developing human capital is advantageous to both growth and life expectancy. As a result, West African governments must increase health and education budgetary expenditures to strengthen human capital.

Abstract Background Fruits of Hunteria umbellata (HU) have been utilized in folk medicine as potent against Staphylococcus aureus (SA) infections, particularly skin and nasal related conditions. However, there is scarcity of literature concerning toxicological evaluation of graded doses of HU fruit, especially at molecular level, specifically targeting the accessory gene regulator (AGR) system to prevent abuse of doses in the treatment of bacterial infections. This research evaluated molecular toxicological property of SA exposed to varied concentrations of aqueous HU fruit extract ranging from 500 to 3.90625 µg/µL using broth microdilution method and quantification of AGR I and II genes’ expression employing two-step reverse transcriptase quantitative polymerase chain reaction (RT-qPCR). We first identified quality and quantity of chemical compounds in aqueous fruit of HU using phytochemistry and hybrid gas chromatograph–mass spectrometer (GC–MS) technique. Additionally, preliminary bactericidal potential of HU was assessed before molecular toxicology. Results Results revealed six phytochemicals and twenty analytical grade compounds from a standard library were identified from chromatograms of HU fruit extract. Some main compounds detected are n-Hexadecanoic acid (25.24%), 2-Pentadecanone, 6,10,14-trimethyl (16.08%), Cuparene (16.63%), Tetradecanoic acid (6.21%) and 9-Octadecenoic acid, (E)- (5.70%). Bactericidal activity shows significant (p

Abstract Snack products are evolving as new carriers of functional ingredients with nutritional and health-promoting benefits. A blend of whole grains is increasingly being utilized to harness the functional potential of the grain mix. Amaranth, acha, and pearl millet grains flours were optimized using response surface methodology (RSM), to obtain optimum blends (90:5:5 and 47.98:26.68:25.34) with high protein content and low glycemic index. Snack bar products from the blends were labelled MBY and MBZ. A total of 40 diabetic and 10 non-diabetic subjects were recruited. Of the diabetic, about 42% were overweight while 40% were obese, the non-diabetic had normal weights. Each was allowed to consume snacks containing the equivalent of 50 g of carbohydrates. Finger prick was employed to evaluate the postprandial glucose response of snack products while venous blood was evaluated for antioxidant enzymes, carbohydrate-hydrolyzing activities, and insulin using standard methods. Consumption of the multigrain snacks elicited a stable postprandial response (133–141 mg/dL) with 16 and 24% postprandial decline. In addition, snacks had low to intermediate glycemic index (52 and 56) in diabetic and low glycemic index (43 and 45) in non-diabetics; likewise reduced α-amylase/α-glucosidase activities compared to control snacks. Similarly, glutathione level, glutathione peroxidase, superoxide dismutase, and catalase activities in serum from subjects that consumed multigrain snacks were upregulated compared to control and market sample groups. Moreso, snack products promoted a reduction in serum insulin levels in diabetic subjects (45 and 17% for MBY and MBZ respectively). Following the nutraceutical properties displayed by the formulated snack especially MBY, it can be promoted as a functional snack for the management of diabetes while solving the limited snack product choice of diabetes sufferers. Graphical Abstract

Despite the reported improvement in the nutrient status of fermented cereal-based diets in Sub-Saharan Africa, the nutrient needs of infants are still not being met. Hence, this study evaluated the nutritional compositions of fermented protein-fortified cereals. The proteins used in fortifying maize and millet were crayfish (30%), soybeans (30%) and a combination of both protein sources in a ratio of 70:15:15 for cereals, crayfish and soybeans, respectively. Fermentation of protein-fortified cereals was carried out using submerged fermentation for 5 days. Results revealed that fortifying maize and millet with crayfish and soybeans increased the protein content (11.1 to 19.1%). The fortification led to a reduction in crude fiber and carbohydrate contents of raw maize and millet. Fermentation also significantly reduced the carbohydrate content, with the lowest carbohydrate value observed on the last day of fermentation. Fortification with crayfish and fermentation increased all the minerals (potassium, magnesium and calcium) of raw maize and millet, but no significant effect at p < 0.05 on the iron content. All the samples that were fortified had better sensory acceptability than those that were not fortified. This study revealed that fermentation and fortification of maize and millet meal (cereal) with soybeans and crayfish can alleviate protein energy malnutrition (PEM) problems.

This study explored the potency of CTCA in reducing math anxiety and promoting meaningful learning of mathematics among secondary school students. The study adopted a mixed-method (explanatory sequential) design involving a quasi-experimental design and individual in-depth interviews. Participants were drawn from two schools, purposively selected within Lagos state educational district V. Three instruments: Set Theory Achievement Test, Math Anxiety Scale and Students' Perception about CTCA Interview Guide were used to collect the quantitative and qualitative data subsequently. The experimental group (102 students) was taught using the culturo-techno-contextual approach while the control group (106 students) was taught with the traditional lecture method. Treatment lasted six weeks after which posttest and retention test (four weeks after posttest) were conducted. MANCOVA was used to analyze the quantitative data. The results obtained suggest that CTCA reduces math anxiety and enhanced learning achievement [Pillai's Trace = 0.34 (F = 53.09; p<0.01)] more effectively than the traditional teaching method. No significant gender difference was also found in the achievement of the experimental group. Students' perception about the use of CTCA was generally positive. Within the scope and limitations of the study, it was recommended that CTCA should be adopted by secondary school teachers in teaching mathematics concepts.

The United Nations' Agenda 2030 for sustainable development calls, amongst others, for universal action toward ending malnutrition and ensuring healthy living and well-being for all. So, efforts have intensified to attain the sustainable development goal-2 targets on stunting and wasting in children. Reported herein, therefore, is the quantification of metals in biscuits. Biscuits are commonly consumed snacks world-over and have become sources of nourishment for children and adults due to growing sedentary lifestyles and hectic school/work schedules. Nine metals (Pb, Ni, Cu, Co, Zn, Fe, Na, Mg and Ca) were assayed in six biscuit types (crackers, cookies, shortcakes, digestives, cabins and wafers) via wet digestion and flame atomic absorption spectrophotometry, and the ensuing data subjected to multivariate analyses (analysis of variance, Tukey's test, Pearson correlation, and principal component and hierarchical cluster analyses). The highest concentrations of macrominerals were found in the wafers (Ca), crackers (Na) and cabins (Mg) whereas the micronutrients peaked in the cookies (Fe, Zn), crackers (Cu), shortcake (Co) and wafers (Ni), respectively. The metal levels in the sampled biscuits were all safe for consumption, except for Pb at 0.83 ± 0.76–2.3 ± 1.3 mg/kg. Similarly, the health risk assessments of ingesting metals from the biscuits exposed Pb as potentially liable to cause adverse non-carcinogenic and carcinogenic health effects in children (aged 4–20 years) but Co and Ni exhibited borderline non-carcinogenic and carcinogenic health risks, respectively, in children. Gratifyingly, the ecological risk assessments to evaluate the likelihood of wastes, from expired and/or egested potentially toxic metals-contaminated biscuits, to cause damage to ecology were categorized as low. Nonetheless, constant evaluation and monitoring remain germane.

Globally, studies have identified different ideologies in explaining the risk factors for divorce. However, few studies have examined health-related factors in the termination of marital union. This study explored how health-related factors- of Sexual Transmitted Diseases (STDs), lack of sexual desires, genotype and domestic violence influence divorce in Lagos, Nigeria. The study was conducted in Lagos Island, Lagos. Data were collected from 30 consenting divorcees comprising males and females through in-depth interviews. Participants’ selection was achieved through a purposive sampling technique. Findings revealed that domestic violence, infertility and other health related factors, such as incompatible genotype, sexually transmitted diseases (STDs) and lack of sexual desires, are potential causes of divorce. Therefore, intending couples need to ascertain the compatibility of their genotype with their spouses through medical screening. Couples battling with any health challenge in their marital union should seek help from licensed health professionals to help mitigate the potential impact the challenge may have on their marital union as well as engage the services of social workers in finding solution to the problem of domestic violence.

IntroductionThe primary health care system provides an ideal setting for the integration of oral health into general health care as well as equitable access to oral health care. However, the limited oral health knowledge of primary health care workers necessitates appropriate training before they can participate in health promotion efforts. This pilot training was designed to examine the impact of the Oral Health Education module for Nurses and Community Health Care Workers on their oral health awareness and referral practices.MethodsThis study will utilize a quasi-experimental design (pre-and post with a non-equivalent control group) to assess the impact of a five-day pilot oral health education program on the knowledge and referral practices of Nurses and Community Health Workers in primary health care centers in three states in Nigeria-(Lagos, Oyo, and Kano). The training modules were developed based on the six iterative steps described in the intervention mapping framework – needs assessment, highlighting program objectives and outcomes, selection of theory and mode of intervention, designing program based on theory, designing implementation plans, and developing an evaluation plan. Only the intervention group will participate in the full educational training sessions but both groups will complete the pre-and post-intervention questionnaires.DiscussionThis pilot training combined the standardized training modules from the recently launched “Oral Health Training Course for Community Health Workers in Africa” and a newly developed maternal and child oral health module by our group using an evidence-based approach. To the best of our knowledge, this is the first program to examine the impact of the standardized OpenWHO modules. The success of this training will lay the foundation for developing a sustained channel for providing oral health education at the primary health care level in Nigeria, West Africa, and Africa.

Introduction: Efforts to reduce the global burden of communicable and non-communicable diseases can significantly benefit from comprehensive immunisation programmes. Organisations such as the World Health Organization (WHO), regional partners, and national governments are deeply committed to this cause. Given that Africa has the world's second-largest population, approximately 1.3 billion people, the continent's health challenges underscore the critical need for such immunisation strategies. However, the continent recorded the lowest vaccination rate, less than 30 %, during the recent coronavirus disease 2019 pandemic, whereas global coverage was close to 70 %. The most commonly encountered vaccine-preventable diseases in Africa are chickenpox, diphtheria, hepatitis A, hepatitis B, human papillomavirus, measles, and mumps. Others include polio, pneumococcal diseases, tetanus, rubella, and Haemophilus influenzae type B. Objectives: To understand the general vaccination portfolio of the African continent, discuss awareness and concerns about the acceptability of vaccines in Africa, and analyse the effects of common vaccine-preventable diseases and vaccine communication. The overall objective was to evaluate vaccination and the status of vaccine-preventable diseases in Africa. Methodology: The authors relied on information from published academic resources and articles in PubMed, the National Center for Biotechnological Information, Google Scholar, the WHO, and the United States Centers for Disease Control databases, among others. Discussion: This review summarises the awareness and acceptability of vaccines in Africa, the level of understanding of vaccines, and offers solutions for how vaccines can reach every member of the African population. Conclusion: The most recent pandemic identified the need for national governments to increase investment in vaccine manufacturing. Hence, the new commitments of African leaders and relevant stakeholders to raise awareness of vaccine use, invest in vaccine manufacturing, training, and other strategies aimed at reducing vaccine-preventable diseases will make the African population healthier and wealthier.

Background: Doxorubicin (DOX) is an anthracycline antibiotic primarily utilized in the treatment of various solid tumors, including those affecting the cervix, ovaries, breasts, uterus, lungs, as well as certain blood cancers. However, the nephrotoxicity connected to DOX therapy restricts its clinical use. In an Ancient Chinese Medicine used Lime (Citrus. aurantifolia) Peel was employed to address cramps, colic pain, cold, and as an appetite stimulant. Lime is known as ''Zhi qiao'' in Traditional Chinese Medicine (TCM), in addition to its nephroprotective, antioxidant and immunostimulatory properties the peel had been noted for its effectiveness in regulating vital energy, used to treat cough, abdominal distention and constipation. Objective: The purpose of this research is to evaluate the potential protective effect of Citrus aurantifolia peel extract (CAPE) in alleviating the nephrotoxicity generated by doxorubicin (DOX) injection in rats. Methods: Thirty Wister albino rats were randomly and equally separated into six groups (n = 5), and they were treated as follows: group I received distilled water only (baseline), toxicant groups administered with 15 mg/kg, i.p. DOX, 24 h after, groups II, III IV, V and VI were treated with distilled water (negative control), Alpha lipoic acid, 150 mg/kg (positive control) and 100, 200 and 400 mg/kg of CAPE respectively, orally for seven days. Results: DOX caused kidney injury after a single intraperitoneal injection, as shown by substantial changes in kidney biomarkers, histological irregularities, and the reduction of antioxidant defense mechanisms (reduced glutathione, superoxide dismutase and catalase). CAPE treatment resulted in significant improvements in the amended renal biomarkers (urea, creatinine, albumin and uric acid), haematological parameters, antioxidative markers, and malondialdehyde. The present findings indicated that CAPE could reduce lipid peroxidation (LPO) and reactive oxygen species production, and observable histological improvements supported this result. Conclusion: Our results point out that CAPE is a potential therapeutic alternative for the prevention of DOX-related nephrotoxicity.

Ciprofloxacin is a second-generation broad-spectrum antibiotic of the fluoroquinolone class, highly effective against many bacteria. Several brands of this drug class are marketed for public consumption; hence, it has placed the public in a confused state about the best brands with suitable physical characteristics and safe oral consumption. Additionally, the adverse effects of heavy metal accumulation in drugs for oral use have made it essential to quantify the amount of such heavy metals present. Evaluating the physical quality, elemental analysis identity, and concentration of cadmium and lead in twenty-five brands of ciprofloxacin tablets marketed in Lagos, Nigeria, is the aim of this study. The physical assessment of the tablets was then methodologically evaluated for these parameters; Uniformity of weight, Hardness, Friability, and Disintegration tests. Determining the amount of Cadmium and Lead with the Atomic Absorption Spectrophotometer (AAS) and evaluating using the Permitted Daily Exposure (PDE). Among all the brands of Ciprofloxacin tablets analyzed, 96 % passed the Uniformity of weight test, 52 % passed the Hardness test, 96 % passed the Friability test, and 96 % passed the disintegration test while 2 % passed the test according to the Permitted Daily Exposure (PDE) to Cadmium. 72 % passed the test according to the Permitted Daily Exposure (PDE) to Lead. The brands that passed the physical tests have good quality and correct physical characteristics. Cadmium and lead are of no benefit to humanity in the body and because they are not easily eliminated from the body, their buildup can put people at risk for mental retardation in children, dementia, kidney damage, nerve damage, infertility, high blood pressure, and cancer at high exposure levels.

Despite the detrimental impact of apathy on the cognition, functional abilities, and quality of life of older people, it is often under-rated and under-managed. This integrative review provides a comprehensive overview of the barriers as well as potential facilitators to optimal care for older adults with apathy. A systematic search for relevant literature using Whittemore and Knafl’s framework was conducted to identify factors that inhibit or facilitate optimal detection and intervention for apathy in older people with and without dementia. Four key barriers were identified including lack of standardized definition of apathy, lack of awareness, overlap with other disorders, and methodological limitations of clinical trials. Key facilitators included involvement of the dyad (persons with apathy and their families/formal caregivers), education, training and experience, and adoption of new and innovative method of screening and intervention. To provide optimal care for older people with apathy, there is need to adopt a multifaceted approach, including the development of precise definition of apathy, consideration of person-centered approach, caregiver training, and best practice guidelines for management of apathy. Future research and practice into effective interventions for management of apathy in older adults, and enhanced education and training for healthcare professionals, are needed to ensure quality of care for older adults with apathy.

Background: This was a cross-sectional community-based survey to study the prevalence of serum antibodies against the severe acute respiratory syndrome coronavirus 1 (SARS-COV-1) and determine possible source of antibodies as to whether from vaccination or from natural infection as well as attempt to compare antibody levels in response to the different four types of vaccines administered in Nigeria. Methods: A cross-sectional community-based study of the prevalence of serum antibodies against all four vaccine types used in Nigeria amongst a representative sample of people aged 18 years and above in the six geopolitical zones of the country using a multistage sampling technique covering 12 states of the country with two states being randomly selected from each geopolitical zone. High-throughput Roche electrochemiluminescence immunoassay system (Elecsys Anti-SARS-COV-1 Cobas) was used for qualitative and quantitative detection of antibodies to SARS-COV-1 in human plasma. Results: There was no statistically significant difference between the proportions with seropositivity for both the vaccinated and the unvaccinated (P = 0.95). The nucleocapsid antibody (anti-Nc) titres were similar in both the vaccinated and the unvaccinated, whereas the Spike protein antibody (anti-S) titres were significantly higher amongst the vaccinated than amongst the unvaccinated. Antibody levels in subjects who received different vaccines were compared to provide information for policy. Conclusion: While only 45.9% of the subjects were reported to have been vaccinated, 98.7% of the subjects had had contact with the SARS-COV-1 as evidenced by the presence of nucleocapsid (NC) antibodies in their plasma. The 1.3% who had not been exposed to the virus, had spike protein antibodies which most likely resulted from vaccination in the absence of NC antibodies. Successive vaccination and booster doses either through heterogeneous or homologous vaccines increased antibody titres, and this stimulation of immune memory may offer greater protection against coronavirus disease 2019.

Background: Improvements in sickle cell disease (SCD) care have resulted in the survival of many patients into adulthood, although this is accompanied by the increased incidence of end-organ damage, including chronic kidney disease (CKD). Objectives: This study assessed the prevalence, pattern and predictors of renal dysfunction in SCD patients and investigated the associated renal histopathologic changes. Methods: We evaluated 105 patients with SCD, for proteinuria, estimated glomerular filtration rate (eGFR), and tubular dysfunction. Renal biopsy was conducted on 22 patients who qualified. Data were analysed using SPSS package version 23. Results: Thirty-seven (35.2%) of the 105 patients had CKD, as defined by an eGFR of 60 ml/min/1.73 m2 and/or proteinuria. The fractional excretion of potassium (FEK) was elevated in all patients, whereas the fractional excretion of sodium (FENa) was elevated in 98.1%. Glomerular filtration rate was negatively correlated with irreversible percentage sickle cell count (r = −0.616, P = 0.0001), FEK (r = −0.448, P = 0.0001) and FENa (r = −0.336, P = 0.004). Age, irreversible percentage sickle cell count, haemoglobin levels and FENa were the major predictors of CKD. The histological pattern in the 22 patients who had biopsies was consistent with mesangioproliferative glomerulonephritis 11 (50%), minimal change disease 6 (27.3%), focal segmental glomerulosclerosis 3 (13.6%) and interstitial nephritis 2 (9.1%). Conclusions: CKD was prevalent in SCD patients, and it was characterised by tubular dysfunction and mesangioproliferative glomerulonephritis. The main predictors of CKD were increased age, severity of vaso-occlusive crisis, worsening anaemia and tubular dysfunction.