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The new severe acute respiratory syndrome coronavirus‑2 (SARS‑CoV‑2) brings about the coronavirus disease 2019 (COVID‑19) pandemic. It is a pathogen that causes extreme respiratory tract infection, especially as the world’s populations had no previous immunity and there were little or no uniformly acceptable treatment options. The virus may persist to bring about considerable morbidity and mortality except an efficient vaccine is produced. Following erstwhile evidence and experience with SARS and Middle East respiratory syndrome, the major focus to vaccine development was the spike glycoprotein, regarded as the most important target for SARS‑CoV‑2 immunotherapies. Collaborative efforts were undertaken to ensure that manufacturing occurred as quickly as possible to salvage the situation. Three vaccine candidates were respectively made of one protein‑based vaccine, a simian‑derived adenovirus vector, and one messenger RNA vaccine. Two of them published their short‑term analyses and effective results after their third trial phase. The messenger RNA vaccine was first confirmed in the USA andthe adenovirus‑derived vaccine in the UK. This paper gives a narrative review of the literature on the present knowledge about this new virus as it concerns the drawn‑up plans of COVID‑19 vaccines that are not only effective but safe following the new and established approaches to vaccine development.

Background: The COVID-19 pandemic greatly affected eye care globally in terms of service provision and training. It is important to recognize the challenges faced and the adaptations instituted to overcome them. Aim: The aim of this study was to determine the impact of the COVID-19 pandemic on eye care services and training in eye institutions in Nigeria. MaterialsandMethods: This was a cross- sectional survey involving ophthalmologists and senior ophthalmology trainees selected purposively to ensure a varied representation in terms of location and type of practice. Data collection was done through a web-based questionnaire (Google Forms). The main outcome of interest was the impact of the pandemic on four major aspects of practice: outpatient care, surgical care, inpatient care, and residency training. Data on respondents' sociodemographic features and practice details were descriptively summarized with means and standard deviations (SDs) for the continuous variables and proportions for the categorical variables. Practice patterns before and at the height of the pandemic were compared for the four aspects of practice, andP< 0.05 was considered statistically significant.Results:A total of 59 responses were received from eye institutions in 28 states in Nigeria. The mean age of respondents was 38.1 years (SD 6) and 36 (61%) were female. Forty-seven (81.4%) responses were from participants working in public institutions and 40 (67.8%) responses were from respondents whose institutions run ophthalmology residency training programs. Glaucoma was the most affected subspecialty during the pandemic (24, 40.7%). Respondents reported complete closures of clinics (21, 35.6%), theaters (40, 67.8%), and wards (18, 30.5%) at the height of the pandemic. Training activities requiring physical contact were negatively affected, while reports on the use of virtual seminars increased to 75% (n= 30) at the peak of the pandemic from 5% (n= 2) before the pandemic. Overall, all respondents affirmed that the pandemic negatively affected their practice, and 51 (86%) reported an extent of more than 25%.Conclusion: The COVID-19 pandemic has disrupted most aspects of ophthalmology practice. Adaptations are required to ensure the optimization of patient care and training experiences in the post-COVID era.&nbsp

Subconjunctival worm is a manifestation of ocular filariasis, one of the Neglected Tropical Diseases (NTDs) which constitute an important public health problem in Nigeria.The most commonly reported subconjunctival worm is loaloa which in some occasions is associated with the so called 'Calabar swelling'. However there exist few reports of ocular filariasis caused by Wuchereriabancrofti involving the eyelids, conjunctiva, cornea, anterior chamber, and uvea with variable presentations. We report a case of a 31-year-old female, constitutionally asymptomatic patient who presented with Wuchereriabancrofti filarial worm encysted in the subconjunctival space.

Background: Street sweeping is an increasing popular outdoor occupation in major cities of Nigeria. These workers are chronically exposed to diverse occupational and environmental sources of ocular hazards, that they may not be aware of. This may impair their adoption and compliance with the requisite safety practices. This study was aimed at assessing levels of awareness, knowledge, and practice of ocular safety among street sweepers in Calabar, Southern Nigeria.Materials and Methods: The study was a cross sectional study among one hundred and fifteen (115) street sweepers in Calabar Urban Development Authority, Nigeria over a period of three months. A systematic random sampling method was used to select respondents eligible for the study and a pretested semi-structured interviewer administered questionnaire was used to obtain data. Data obtained was analysed using statistical package for social sciences version 20 (Armonk, NY: IBM Corp.).Results: One hundred and fifteen (115) subjects were studied, with mean age of 41.8 ± 10.4 years, and female to male ratio of 1:0.03. Seventy percent had good knowledge of ocular health safety; while 68% were aware of the occupational hazards associated with the job. Less than a quarter (19%) of workers used personal protective devices (PPD). Only 1% of the total who used PPD wore protective goggles while at work.Conclusion: Good knowledge and a high level of awareness on ocular health safety was seen among street sweepers. However, there was poor utilization of personal protective devices especially protective goggles among the workers which will increase their risk to occupational hazards.Keywords: Ocular health safety, street sweepers, Calabar

Objectives: To determine the anthropometric indices, lipopolysaccharide-binding proteins (LBP), and lipid profile in patients with metabolic endotoxemia. Methods: The study comprised of 47 patients with metabolic endotoxemia (the metabolic endotoxemia group) and 43 controls (the control group). Patients in the metabolic endotoxemia group were categorized further into three subgroups including the normal weight group (n=8), the overweight group (n=12) and the obese group (n=27). Height, weight, waist, and hip circumference were measured, and waist-hip ratio (WHR) and body mass index (BMI) were calculated. LBP was determined by ELISA and total cholesterol, triglycerides, high density lipoprotein by the respective enzymatic colorimetric methods. In addition, low density lipoprotein and very low density lipoprotein were determined by Friedewald’s formula. Results: The mean waist circumference (WC), hip circumference (HC), BMI, total cholesterol, low density lipoprotein, and LBP of the metabolic endotoxemia group were significantly higher (P< 0.05) than those of the control group. WHR, TG, high density lipoprotein and very low density lipoprotein of the metabolic endotoxemia group were not significantly different (P>0.05) from those of the control group. The mean WC, HC, WHR, and BMI of the obese group with metabolic endotoxemia were significantly higher (P< 0.05) than those of the overweight group and the normal weight group with metabolic endotoxemia. Significant positive correlations were obtained between BMI and LBP (r=0.610, P=0.001), total cholesterol and LBP (r=0.385, P=0.007), TG and LBP (r=0.356, P=0.014) in patients with metabolic endotoxemia. Conclusions: Metabolic endotoxemia arising from increased circulating level of bacterial derive particles consequent to perturbation in the gut microbial community and the elevated serum level of LBP may precede the development of obesity, characterized by dyslipidemia, dysregulation of gut energy harvest, and metabolic energy imbalance.

BACKGROUND: Vascular trauma is a significant cause of morbidity and mortality following trauma. Injury to a major blood vessel may worsen the prognosis of trauma. Avoidable mortality may result from massive haemorrhage. Available data in Nigeria is scanty. AIM: This retrospective study was carried out to review the pattern and outcome of vascular trauma patients in the University of Calabar Teaching Hospital. METHODOLOGY: The Hospital records of all patients managed in the facility for vascular injuries during the study period were retrieved and data collected retrospectively. RESULTS: Forty – two patients, with a male: female ratio of 5:1 and a mean age of 31.15 years were studied. The age range 21 – 30 years were most affected. Mean interval between injury and presentation at the hospital was 7.05 hours. The mean duration between presentation to the hospital and surgical intervention for the rest of the patients was 13.32 hours. The most commonly injured vessel was the brachial artery. Prompt presentation and intervention are critical to successful outcome. CONCLUSION: Most vascular trauma in Calabar occur predominantly in young males who lead an active life.

Background: Sleep disorders are a common and often undiagnosed chronic health problem associated with an increased incidence of metabolic syndrome and pregnancy complications. Aim: The purpose of this study was to find out how common sleep disturbances are among pregnant women in Calabar, as well as their patterns and risk factors. Materials and Methods: A cross-sectional study was conducted among 360 antenatal attendees in the three major public health facilities in Calabar and 338 completed questionnaires were included in the analysis. Socio-demographic, medical, and obstetrics information were obtained using interviewer-administered questionnaires. Major international sleep classification tools were used to identify the patterns of sleep disturbance. Their weights and heights as well as their blood pressures (BPs) were measured. Data were analyzed using SPSS version 23. The predicting factors were extracted using a logistic regression model. Results: The prevalence of sleep disorder was 44.1%. The most common pattern of sleep disorder was insomnia (34.6%). Nineteen (5.6%) of them reported mixed disorders. On logistic analysis, pregnant women with normal BP (odds ratio [OR]: 0.440, 95% confidence interval [CI]: 0.230–0.843, P = 0.013), normal body mass index (OR: 0.365, 95% CI: 0.133–1.001, P = 0.050) and maternal age 20–30 years, (OR: 0.169, 95% CI: 0.30–0.969, P = 0.046) were significantly less likely to suffer from sleep disorders. Residing in a single a room apartment with family members was an independent social determinant of sleep deprivation (OR: 2.009, 95% CI: 1.003–4.025, P = 0.049). Conclusion: The study suggested that the prevalence of sleep disturbance is high among pregnant women. Counseling on good quality sleep during pregnancy may improve pregnancy outcome by ensuring appropriate weight gain and good BP control.

The delivery locations of pregnant women contribute greatly to their birth outcome. The objectives of this study were to determine the choices and determinants of delivery locations among mothers attending a primary health centre (PHC) in southern Nigeria.This was a descriptive cross-sectional study among mothers attending PHC, West Itam, Itu, Nigeria. Data were collected using interviewer-administered questionnaire and analysed with STATA version 12.0. Level of significance was set at 0.05.A total of 185 mothers participated in the study. The mean age of respondents was 27.6 ± 5.2 years. The delivery locations of last pregnancy were health facility (64.9%), traditional birth attendant's place (23.3%), respondent's residence (6.3%) and church (5.4%). The top five reasons that influenced the choice of delivery locations were distance (45.4%), cost (34.6%), skills of healthcare workers (30.3%), drug availability (27.6%) and attitude of healthcare workers (26.5%). Utilisation of healthcare facilities for delivery increased significantly with level of education and income of respondents and spouses (P0.05).Different non-institutionalised delivery locations were utilised by some of the respondents. Factors influencing women's choices of delivery locations included distance, cost and attitude of health workers. It is recommended that pregnant women be offered free or highly subsidised healthcare services to encourage their delivery at health facilities. Healthcare providers should endeavour to develop better relationship with clients who patronise their services. Female education should also be encouraged as this would empower them to make better choices about their health services options.

Mammography is a major tool for the screening and diagnosis of breast cancer globally. Poor funding and lack of good public health education for mammography in resource-limited countries limit access to mammographic services. In these settings, patients bear the cost of breast cancer screening from out-of-pocket expenses. The aim of this study was to interrogate the pattern of utilization of mammography by women of childbearing age, who attended Asokoro District Hospital (ADH) for Healthcare, with the view to increase uptake.This was a 4-year retrospective, cross-sectional study of 534 women who attended ADH from July 2015 to June 2019 for screening or diagnostic mammography. Data were extracted from completed questionnaire by women who had mammography during the period under review. The data were entered into Statistical Package for the Social Sciences version 27 by IBM for analysis.The mean age of the women was 47.8 years ± 7.7 with a range of 30-82 years. Most of the women, 525 (94.9%), were referred for mammography by health workers; only nine (5.1%) had mammography on self-referral. In all, 71% of the women paid for their mammography from their pockets, whereas 28.1% made payments through the National Health Insurance Scheme (NHIS). A total of 100% of women who reported for mammography on self-referral paid for the services from their pockets. The association between the funding options and mode of referral was statistically significant,This study showed that referral for mammography by health workers was responsible for not only most of the mammograms conducted but also all the women who utilized NHIS to pay for this service. Resources should therefore be directed towards creating awareness among health workers, especially with the present level of NHIS coverage in the population, in order to increase the uptake of screening mammography in the population.

Objectives: This study aimed to evaluate the efficacy and efficiency of optical services provided in a tertiary hospital in South- South, Nigeria. Materials and Methods: This was a cross-sectional descriptive study. Six hundred and fifty consecutive patients with errors of refraction who attended the outpatient’s eye clinics of the University of Calabar Teaching Hospital were interviewed using interviewer-administered questionnaires. They were questioned regarding time to acquisition of spectacles, source of prescription glasses and reasons influencing their choices. Data wereanalyzed using Statistical Package for Social Sciences (SPSS) for IBM (version 20, SPSS Inc, Chicago, IL, USA) and the results presented in tables and figures. Results: Majority of participants (88.3%) had their lenses fitted in the hospital, and the remaining got their glasses from peripheral clinics. Importantly, only 56% of respondents bought their spectacle frames in the teaching hospital. The major reasons were cost (43%) and poor quality of frames (32%). Ninety percent acquired their pair of fitted glasses within two weeks of submission of their prescriptions to the optical service and 10% beyond this time frame. Conclusion: The optical service of the hospital at present is effective, but its efficiency could be improved by adding some readymade spectacles and provision of good quality and cosmetically acceptable frames.