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Guidelines for the Management of Hypertension in Nigeria
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PREDISPOSING FACTORS TO EXTRAMARITAL SEXUAL BEHAVIOUR AMONG MARRIED MEN IN IBADAN NORTH LOCAL GOVERNMENT AREA, NIGERIA
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Community perceptions and home management of malaria in selected rural communities of Ogun state, Nigeria
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High Prevalence of Anti-HCV Antibodies Among Pregnant Women in Southwestern Nigeria
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Development of a coir fibre extracting machine
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Development of a visible spectrophotometric method for the assay of Methyldopa following oxidative coupling with N-(1-naphthyl) ethylenediamine dihydrochloride
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- Research on sexual violence is fraught with ethical and methodological challenges due to its sensitive nature. This paper describes the ethical and methodological challenges encountered in planning and conducting two exploratory studies on sexual violence that included in-depth interviews of eight female adolescent rape survivors in Ibadan and four married women in Lagos Nigeria who were raped, forced to perform sexual acts and sexually deprived. The first challenge encountered was an Institutional Review Board (IRB) requirement to obtain parental permission from adolescents, when such a requirement may place the adolescent at risk if a parent was a perpetrator of sexual violence. Using arguments emphasizing the Council for International Organization for Medical Sciences guidelines helped convince the IRB to provide a waiver of parental consent. Second, the privacy required to conduct in-depth interviews for rape survivors was difficult to achieve because five of the rape survivors were apprentices who work in public settings that which are typically used to conduct business In the informal sector. To overcome this challenge, interviews were conducted in safe locations, investigator's offices and homes of survivors. The culture of silence associated with sexual violence posed a challenge because it encourages perpetration of violence with impunity causing rape survivors to suffer in silence. None of the affected adolescents had sought judicial redress for rape despite availability of stringent punishment for this behaviour. Referral information was provided on where survivors could seek care. Interviews with the women could not be recorded on audio-tapes because of concerns that their partners might identify their voices from the tapes and punish them for this. Although research on sexual violence poses ethical and methodological challenges, it is not only desirable but also feasible to conduct such research in ways that ensure safety of participants. 2 results 2
- AMFm-ACTs 1 results 1
- Advertisement 1 results 1
- Antimalarial Drug Utilization 1 results 1
- Antimalarial Treatment Guidelines 1 results 1
- Artemisinin Combination Therapy 1 results 1
- Artemisinin-based combination therapy (ACT) 1 results 1
- Available literature has applied different theories to the language of advertisement. It has examined it through stylistic, pragmatic and speech act theories but not from the perspective of interactional sociolinguistics. Therefore, this study applied John Gumperz‟s theory of interactional sociolinguistics to the language of Insurance advertising in newspapers and on billboards within the Nigerian linguistic and sociocultural context, with the aim of analysing the persuasive strategies employed in it. The theoretical framework for the study was an adaptation of Gumperz‟s theory of interactional sociolinguistics and Halliday‟s Systemic Functional Grammar (SFG), which was used to analyse the lexico-syntactic aspect of the work. This is because Gumperz‟s theory of interactional sociolinguistics has the ability to account for the linguistic and socio-cultural variables that are employed in a communicative event while Halliday‟s SFG gives comprehensive information about grammatical description. The data, consisting of 100 published insurance advertisements, were collected from three purposively selected Nigerian national newspapers – The Guardian, The Punch and Daily Champion covering 2001-2009, complemented with billboard advertisements from all the southwestern states of Nigeria. The newspapers were selected because they have national coverage and a high density of insurance advertisements from different insurance companies in Nigeria. Several pragmatic strategies were used in both newspaper and billboard insurance advertisements to encourage potential customers to patronise the insurance companies. They included reliance on shared social and cultural rules, allusion to shared history and values, reliance on shared knowledge and presuppositions about the world. Speech-style switching was used to get the reader interested and conversationally involved with the texts. The lexical choice of the advertisers contained a dominant use of skill-indicative adjectives which portrayed the insurance companies as experts in their field and were used to evoke confidence in their expertise. Examples are „unfailing‟, „exceptional‟ and „skilled‟. There was also the use of morality indicative nouns, such as „integrity‟ strategically utilised to persuade potential customers about the trustworthiness of the company, and the use of riskindicative nouns for instance „disaster‟ to show that insuring was mandatory. Actionprovoking verbs such as „get‟ and „come‟ were used to encourage the reader to respond and act on what they had read. The syntactic option of the advertisers displayed a copious use of the simple sentence through which they declared their virtues and the benefits of patronising them. Pictorial rhetoric was designed to make participation in insurance appealing to the reader. Rhetorical devices such as symbolism, metaphor, hyperbole and personification were used to enhance their persuasive presentation. Creative and manipulative use of capital letters and typefaces of different sizes emphasised different aspects of the message. Insurance advertisers draw on linguistic, social, cultural, pictorial and aesthetic resources to build a strong persuasive discourse. The language of insurance advertisement revealed that insurance advertisers considered these media a powerful means of renewing the almost lost interest of the average Nigerian in participation in insurance 1 results 1
- Awareness and Access 1 results 1
- Background: A pilot programme of Cohort Event Monitoring (CEM) was conducted across the six geopolitical zones of Nigeria on patients treated for uncomplicated malaria with artemisinin-based combination therapy (ACT). The emergence and spread of malaria parasites resistant to commonly available antimalarial drugs necessitated a shift in policy for malaria treatment by the Federal Government from the use of chloroquine and sulphadoxine-pyrimethamine (SP) as first-line treatments to ACTs. Initial reports following deployment of ACTs in clinical settings raised safety concerns regarding their use. Although artemisinin and its derivatives are generally thought to be safe, there are currently few or no data on their safety among populations in Nigeria. Objectives: The main objectives of the CEM programme were to proactively determine the adverse event (AE) profile of artesunate/amodiaquine (AA) and artemether/ lumefantrine (AL) in real-life settings and to find out the factors predisposing to AEs. Methods: The CEM study was observational, longitudinal, prospective, and inceptional. Patients were observed in real-life situations. It was conducted in six public health facilities in Nigeria on patients with a clinical diagnosis of uncomplicated malaria treated with ACTs. Patients were prescribed one of the ACTs on an alternate basis as they enrolled into the programme. Follow-up reviews were undertaken on days 3 and 7 following commencement of ACT treatment. At follow-up, patients were evaluated for any clinical event that they might have experienced following the use of the ACTs. We report the result of this initial pilot in which 3,010 patients treated for uncomplicated malaria with AA or AL were enrolled. Results: The seven most common AEs seen were general body weakness 25.0/36.6 % (AL/AA); dizziness 11.9/17.2 % (AL/AA); vomiting 8.0/10.2 % (AL/AA); abdominal pain 8.5/7.2 % (AL/AA); insomnia 6.3/5.9 % (AL/AA); body pains 3.4/5.2 (AL/AA) %; anorexia 8.5/4.6 % (AL/AA). Most adverse events occurred from day 1 and peaked by day 2 and 3 of medication with the mean duration of events being 3 days. By the end of the followup visit on day 7, the AEs had resolved in the majority of patients. Adverse events were more common in the AA group than AL revealing a better safety profile for AL (p< 0.001). Both ACTs demonstrated good ability to resolve the clinical symptoms of uncomplicated malaria. Conclusion: In conclusion, this pilot CEM programme suggests that adverse events with ACTs were common. However, serious life-threatening events were not common. It appears that ACTs have a tolerable safety profile among Nigerians. 1 results 1
- Background: Hypertension, defined as blood pressure > 140/90 mmHg, has assumed greater public health importance in Nigeria in the last 2 decades. Many reports put the adult prevalence rates at 20-40%, with some major ones specifically reporting 27.8% and 28.9%. Low detection and reporting rates, inadequate investigation and treatment rates all combine to increase the burden. The guidelines provide updated information. Recommendations: The traditional risk factors, with the addition of high income and education status, are highlighted. Recommendations regarding the use of devices and the setting, including home and ambulatory, in the measurement of the blood pressure, are updated. The importance of total cardiovascular risk assessment and risk stratification, employed in initiating and guiding therapy, is emphasized. Lifestyle modifications are prescribed for all; they are described with estimates of BP responses and with a greater reference to local conditions. Attention is drawn to the early use of medicine therapy in those with high CV risk and multi-medicine therapy in those with BP > 160/100 mmHg. The use of single pill combinations, wherever feasible, is recommended, and the prediction is made of most patients eventually requiring multi-medicine therapy. Considerations of cost, availability, tolerance and patient-specific factors influence the choice of medicines, and although any of the several medicine classes could be used for initial therapy, thiazide and thiazide-like diuretics and calcium channel blockers are recommended for single or dual-medicine therapy. Alternatively, any of these and any of angiotensin converting enzyme inhibitor, angiotensin receptor blocker, centrally acting agent, beta-blocker or alphablocker could be used for combination therapy. Effective and recommended combinations and a list of the commonly available medicines in Nigeria are listed. Aspirin for secondary prevention and statin therapy should be used as required. The goal of treatment is commonly <140/90 mmHg, but could be lower in patients with diabetes, chronic kidney disease. Patient counselling, follow-up and treatment monitoring are emphasised. Outlines of treatment in special groups or situations including diabetes, chronic kidney disease, haemoglobinopathies, HIV-infection, paediatric patients, patients with sexual dysfunction, resistant hypertension, hypertension emergency, community control and prevention are provided. 1 results 1
- Background: In Nigeria ACT use at the community level has not been evaluated and the use of antimalarial drugs (commonly chloroquine (CQ)) at home has been shown to be largely incorrect. The treatment regimen of ACT is however more complicated than that of CQ. There is thus a need to determine the feasibility of using ACT at the home level and determine community perception on its use. Methods: A before and after qualitative study using key informant interviews (KII) and focus group discussions (FGDs) was conducted in selected villages in Ona-Ara local government area. At baseline, 14 FGDs and 14 KIIs were conducted. Thereafter, community medicine distributors (CMDs) were trained in each village to dispense artemeter-lumenfantrine (AL) to febrile children aged 6–59 months presumed to have uncomplicated malaria. After one year of drug distribution, nine KIIs and 10 FGDs were conducted. Participants and key informants were mothers and fathers with children under five years, traditional heads of communities, opinion leaders and health workers. Results: None of the participants have heard of AL prior to study. Participants were favourably disposed to introduction of AL into the community. Mothers/caregivers were said to have used AL in place of the orthodox drugs and herbs reported commonly used prior to study after commencement of AL distribution. The use of CMDs for drug distribution was acceptable to the participants and they were judged to be efficient as they were readily available, distributed correct dose of AL and mobilised the community effectively. AL was perceived to be very effective and no significant adverse event was reported. Major concerns to the sustainability of the program were the negative attitudes of health workers towards discharge of their duties, support to the CMDs and the need to provide CMDs incentives. In addition regular supply of drugs and adequate supervision of CMDs were advised. Conclusion: Our findings showed that the use of AL at home and community level is feasible with adequate training of community medicine distributors and caregivers. Community members perceived AL to be effective thus fostering acceptability. The negative attitudes of the health workers and issue of incentives to CMDs need to be addressed for successful scaling-up of ACT use at community level. 1 results 1
- Background: Methyldopa is a centrally acting hypertensive drug that remains one of the choice treatment options in the management of hypertension in pregnancy and during surgical anaesthesia. Although a number of methods of analysis are available, most employ sophisticated techniques and strict experimental conditions. Objective: To develop and validate a simple visible spectrophotometric analysis for the quantitative determination of methyldopa in bulk and dosage forms. Method: The method was based on the oxidative coupling reaction between methyldopa and N-(1-naphthyl) ethylenediamine (Bratton-Marshall’s reagent) to generate a blue chromogen. Reactions variables critical to optimal response were established. Various analytical and validation parameters including repeatability, reproducibility and selectivity were also determined. Results: The calibration graph was linear between 30 and 80 μg/ml at 580 nm with a correlation coefficient of 0.9996. The apparent molar absorptivity was 1.52 ×103 L mol−1 cm−1 while the limits of detection and quantification were 9.3 and 31 μg/ml respectively. The method was accurate and precise with recovery in the range of 99.26-101.30 % and intra- and inter-day precision (%RSD) at three different concentrations less than 1.0%. When applied to the analysis of dosage form, there was no statistical difference between the new method and the official method. There was no interference from commonly used excipients. Conclusion: The method is rapid, simple and cost-effective. It can serve as a reliable and affordable assay method for the routine analysis of methyldopa in bulk and dosage forms 1 results 1
- Background: Policymakers have recognized that proprietary patent medicine vendors (PPMVs) can provide an opportunity for efective scaling up of artemisinin-based combination therapy (ACT) since they constitute a major source of malaria treatment in Nigeria. This study was designed to determine the stocking pattern for anti-malarial medications, knowledge of the recommended anti-malarial medicine among PPMVs in Akinyele Local Govern ment Area (LGA) of Oyo State, Nigeria and their perception on ways to improve PPMV adherence to stocking ACT medicines. Methods: A cross-sectional survey was conducted among 320 PPMVs using a mixed method of data collection. Survey respondents were consecutively selected as a complete listing of all the PPMVs was not available. A pretested interviewer-administered questionnaire was used to collect quantitative data and two focus group discussions (FGD) were conducted among PPMVs using a pretested FGD guide. Results: Most PPMVs stocked artemether-lumefantrine (90.9%), dihydroartemisinin-piperaquine (5.3%) and artesunate-amodiaquine (2.8%). Drugs contrary to the policy, which included sulfadoxine-pyrimethamine, chloroquine, quinine, halofantrine, artesunate, and artemether were stocked by 93.8, 22.8, 0.6, 1.3, 6.6, and 7.8% of the PPMVs, respectively. Most PPMVs (96.3%) had good knowledge of artemether-lumefantrine as the first-line treatment for malaria and 2.8% had good knowledge of artesunate-amodiaquine as the alternate treatment for malaria. The major factors infuencing stocking decision were government recommendations (41.3%) and consumer demand (40.30%). Conclusion: Stocking of artemisinin-based combinations was high among PPMVs, although they also stocked and dispensed other anti-malarial drugs and this has serious implications for drug resistance development. The PPMVs had considerable knowledge of the recommended treatment for uncomplicated malaria and stocking decisions were overwhelmingly driven by consumer demand. However, there is a need for more enlightenment on discontinuation of government-banned anti-malarial drugs. 1 results 1
- Caregivers of Under-Five Children 1 results 1
- Child abuse in Nigeria is an age long plague which has over the years left traumatic effects on the victims of its harshness on the one hand ; and on the other has become a menace which seeks to seriously threaten the sanctity and stability of a credible future for Nigeria. This article gives a succinct overview of the issue of Child Abuse, particularly in Nigeria. It illuminates on the form of child abuse in Nigeria and gives an insight into new trends in which child abuse takes form of. In addition, the paper gives concise and graphic details on the consequences all forms of child abuse both on child victims and even on the government future of Nigeria. In discussing this, the writer gives an overview of the effect of the childs Right Act in the prevention and protection of children from child abuse in Nigeria. This is done to elaborate on the need for a drastic change and approach towards the issue of Child Abuse in Nigeria. The paper concludes by recommending measures the government can take to quell the menace of child abuse in Nigeria, and also recommends some salient modifications to the laws available on child Abuse in Nigeria. 1 results 1
- Coir fibre 1 results 1
- Compensation 1 results 1
- Compulsory acquisition 1 results 1
- Corrupt Practices 1 results 1
- Corruption 1 results 1
- Corruption has become an enigma in Nigeria, the different strategies and programmes that have been proffered and implemented by governmental organisations to curb it over the years are all to no avail. Scholars have also considered the issue from various angles at different forums. However, an area which seems to have been largely ignored in the entire discourse is the cultural value of satire in Yorubaland. That is, how satire can serve as a panacea to political corruption in Nigeria. There is no denying the fact that corruption has contributed in no small measure to the present level of poverty in Nigeria due to the unequal distribution of resources meant for the generality of the people. This dastardly act has accounted for the untold hardship on the masses that constitute the majority. This study therefore, makes effort to consider the importance of satire in Yorubaland and how it can be used to address political corruption among the stakeholders in Nigerian politics. 1 results 1
- Credible elections are a salient indicator of democratic consolidation and the principal institutionalised means of forming and changing democratic governments. A central determinant of the success of any election is the institutions which structure the behaviour of participants and the choices available to them, hence their belief in pay-offs to individuals and groups. The guiding principles and regulations of the 2007 general elections in Nigeria are to be found in the 1999 Constitution and in the Electoral Act 2006. These documents not only set out the rules, the enactment of the Electoral Act usually signals the beginning of the electoral contest. The Constitution and the Act together make elaborate provision for voter registration, party and candidate registration, campaign financing and regulation, election observation, ballot design, polling stations, voting, counting, and tabulation, election management bodies, and dispute settlement authorities. This paper reviews critically the constitutional provisions on elections and the Electoral Act 2006 in the context of the challenges of achieving credible elections in Nigeria. 1 results 1
- Distribution of Affordable Medicine Facility-malaria Artemisinin CombinationTherapies (AMFm-ACTs) started in Nigeria in 2011, but its use at community level has not been documented. Methods. Four hundred seventy-eight caregivers whose under-five children had fever within two weeks prior to the survey were selected using cluster sampling technique. Information on sociodemographic characteristics, treatment seeking for malaria, and awareness and use of AMFm-ACTs was collected using an interviewer administered questionnaire. Result. More than half of the respondents (51.2%) bought AMFm-ACTs without prescription. Awareness of AMFm was low as only 9.1% has heard about the programme. Overall, 29.2% used AMFm-ACTs as their first line choice of antimalarial drug. On bivariate analysis age, group (25–34 years), public servants, respondents with tertiary education, respondents with high socioeconomic status, respondents with poor knowledge of symptoms of malaria, awareness of AMFm-ACTs, availability of AMFm-ACTs, and sources of drug were significantly associated with utilization of AMFm-ACTs (𝑃 < 0.05). Logistic regression demonstrated that only people who were aware of AMFM-ACTs predicted its use (AOR: 0.073; CI: 0.032–0.166; 𝑃 < 0.001). Conclusion. Interventions which targeted at raising awareness of AMFm-ACTs among people at risk of malaria are advocated for implementation. 1 results 1
- Drug use pattern 1 results 1
- Drug-use pattern of anti-malarial has been associated with development of resistant strain and therapeutic failure. This descriptive cross-sectional study was carried out to assess anti-malarial drug-use practices among dwellers of Adigbe communities within Abeokuta environment. The study documented the knowledge, the attitude and behaviour of three hundred and fifty (350) respondents in terms of drug preference, attitude to drug use and the effects of non-compliance to antimalarial drug. Structured questionnaires were used for data collection, as total of 370 questionnaires were distributed and 350 questionnaires were retrieved for analysis. One hundred and twenty five (125) (35.71) of the respondents frequently experienced malaria attack and practiced self-medication. One hundred and fifteen (115) (32.86%) of the respondents treated their malaria episode with Sulphadoxine-Pyrimethamine (SP) combination while 90 (25.71%) of the respondents frequently purchased Artesunate as monotherapy for malaria treatment due to cost-implication of the newer and available Artemisinin combination therapy (ACT’s). The finding reveals that 43 (12.29%) of the respondents only purchased Artemisinin-Combination Therapy (ACTs). One hundred and eight can 118 (33.71%) of the respondents practiced self-medication with anti-malarial drug. The results revealed therapeutic failure to conventional use of Sulphadoxine-Pyrimethamine (SP) by the respondents as One hundred and thirty nine (139) (33.71%) of the respondents experienced no cure and have to repeat the treatment with anti-malarias. If drug-use pattern of anti-malarials is not monitored, there is possibility of early emergence of resistance to the highly effective anti-malarial drugs presently in use. 1 results 1
- ELISA 1 results 1
- Extramarital sexual behaviour, 1 results 1
- Fibre extracting process 1 results 1
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