From these results, we can conclude that TcB measurements are a useful and reliable index for estimating STB levels in pigmented neonates, including those with hyperbilirubinemia and kernicterus. In the absence of reliable STB measurements, the relatively simple and noninvasive TcB measurements can be an important adjunct in directing phototherapy and exchange transfusions, thereby preventing bilirubin-induced morbidity and mortality in low-technology clinical environments.

Adherence to 10 000 steps per day prescription is low but may still be associated with improved glycaemic control in T2DM. Motivational strategies for better adherence would improve glycaemic control.

IMPORTANCE Nigeria has the fourth-largest HIV epidemic globally, yet high levels of social stigma inhibit HIV testing among Nigerian youths and young men who have sex with men (MSM). OBJECTIVE To report pilot data from iCARE Nigeria (Intensive Combination Approach to Roll Back the Epidemic in Nigerian Adolescents), a combination intervention using social media and peer navigation to promote HIV testing and linkage to care among high-risk youths and young men (hereinafter referred to as young men), including predominantly young MSM. DESIGN, SETTING, AND PARTICIPANTS This nonrandomized controlled study assessed anorganizational and community-level 12-month, preintervention-postintervention pilot trial of a combination intervention designed to increase HIV testing uptake, increase the rate of identified seropositive cases, and improve linkage to care among young men, including MSM, using social media outreach and peer navigation. Data were collected from June 1, 2019, to May 30, 2020.Participants were young men aged 15 to 24 years in the city of Ibadan, Nigeria, and surrounding areas.Frequencies and percentages were examined, and a Fisher exact test was used to evaluate outcomes compared with historical surveillance data. Linkage to care was defined as 2 clinic visits, including HIV confirmation, within 2 months of a positive rapid test result. INTERVENTIONFour peer navigators conducted social media outreach promoting sexual health and guiding individuals to HIV counseling and rapid testing in clinical, community, or home-based settings. MAIN OUTCOMES AND MEASURES Primary outcomes included the number of young men tested for HIV at university-based iCARE catchment clinics or by iCARE peer navigators in the community, the postintervention HIV seroprevalence of these groups, and linkage to care of participants diagnosed with HIV infection. RESULTS A total of 339 participants underwent testing for HIV (mean [SD] age, 21.7 [1.9] years), with 283 (83.5%) referred through social media. The main referral sources for social media were WhatsApp (124 [43.8%]), Facebook (101 [35.7%]), and Grindr (57 [20.1%]). Regarding testing location, participants chose home (134 [39.5%]), community-based (202 [59.6%]), or clinic (3 [0.9%]) settings. Eighty-six participants reported no prior HIV testing. Thirty-six participants (10.6%)were confirmed as HIV seropositive; among those, 18 (50.0%) reported negative test results within the past year, and 31 (86.1%) were linked to care. In two 6-month follow-up periods, the intervention (continued) Key Points Question Does iCARE Nigeria, a combination intervention using social media and peer navigation, increase HIV testing and linkage to care among highrisk young men, including men who have sex with other men (MSM)? Findings In this nonrandomized controlled trial that enrolled 339 youths and young men in Nigeria through social media and linked them to HIV testing and counseling, HIV testing increased by 31% to 42%, and seroprevalence increased compared with historical controls. Among 36 participan...

A significant burden of dyslipidemia exists among ART-naive HIV-infected persons. Low HDL-C was the most frequently observed abnormality. The abnormalities related more with viral load levels than with CD4 counts. Dyslipidemia screening should be done in ART-naive HIV-infected persons. Simple healthy lifestyle changes should be emphasized, with other care given to those with the disorder.

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Background: The responsibility of caring for patients with advanced cancer in sub-Saharan Africa is mostly shouldered by family members because of paucity of institutional facilities. There is a growing concern that the number of women needing treatment for advanced breast cancer is rising at an unprecedented rate in Nigeria.Aim: To assess the caregiver burden and its associated factors amongst family caregivers of women with advanced breast cancer.Setting: The study was conducted at the radiation oncology clinic of the University College Hospital, Ibadan, Nigeria.Methods: A cross-sectional descriptive study was conducted amongst 157 eligible family caregivers of women with advanced breast cancer. The family caregivers completed an interviewer-administered questionnaire, which included the socio-demographic data, the caregiving process and the Zarit Burden Interview (ZBI). Logistic regression was used to identify factors, and ethical approval was obtained.Results: Over half (53%) of the respondents were males with spousal caregivers dominantly constituting 27.4% of all respondents, closely followed by daughters (25.5%) of the care recipients. The mean ZBI score was 29.84 ± 13.9. Most (72%) of the caregivers experienced burden. Factors associated with caregiver burden were previous hospitalisation of the care recipient (odds ratio [OR] = 3.74, confidence interval [CI]: 1.67 to 8.38) and perceived dysfunction in patients activities of daily living (OR = 2.57, CI: 1.14 to 5.78).Conclusion: Family caregivers of women with advanced breast cancer experience burden of care. Recognition of this vulnerable population and the care recipient as a dyad is a sine qua non in mitigating the burden associated with their caregiving role.

We evaluated adult Nigerian patients with antiretroviral switch to second-line treatment with protease inhibitor (PI/r)-based regimens due to virologic failure (confirmed HIV-1 RNA viral load >1000 copies/mL) during first-line antiretroviral therapy. Proportion of patients with viral load (VL) >400 copies/mL and characteristics associated with non-suppression during second-line treatment are described. Approximately 15% of patients (34/225) had VL >400 copies/mL at 1-year after treatment switch to PI/r-based regimens. In adjusted analyses, VL ≥5 log10 copies/mL at treatment switch (OR 2.90 [CI 1.21–6.93]); duration of first-line treatment after virologic failure >180 days (OR 2.56 [CI 1.0–6.54]); and PI/r regimen adherence <90% (OR 3.27 [CI 1.39–7.68]) were associated with VL >400 copies/mL at 1-year of second-line treatment. We therefore recommend that the maximum permissible time between suspicion of virologic failure and completion of antiretroviral treatment switch should not exceed 6-months when patients develop first-line antiretroviral failure in resource-limited settings.

A mixture of 2% lignocaine (LIG) and 0.5% bupivacaine (BUP), at respective dose rates of 2 mg/kg and 0.5 mg/kg (LIG-BUP), was compared to LIG (4 mg/kg) and BUP (1 mg/kg) for lumbosacral epidural anaesthesia in 5 sedated cats. Each cat received all 3 treatment regimens at 1-week intervals. The cats were premedicated with an intramuscular injection of atropine sulphate (0.04 mg/kg) and ketamine hydrochloride (10 mg/kg). Onset and duration of analgesia, and time to walking were determined. Associated changes in heart rate (HR), respiratory frequency (ƒR) and rectal temperature (RT) were recorded. Onset of analgesia with epidurally administered LIG-BUP (4.5 ± 0.7 min), LIG (3.9 ± 1.0 min) and BUP (5.0 ± 1.0 min) was similar. Duration of analgesia with LIG-BUP (49.4 ± 4.5 min) was significantly (P < 0.05) longer than with LIG (40.2 ± 1.0 min) but shorter than with BUP (79.4 ± 6.3 min). There were no significant differences in times to standing with LIG-BUP (26.3 ± 6.4 min), LIG (20.4 ± 4.7 min) and BUP (22.6 ± 10.3 min). Minimal changes were observed in HR, ƒR and RT. In conclusion, duration of analgesia produced by LIG-BUP was shorter compared with BUP but longer compared with LIG. Neither LIG nor LIG-BUP has any advantage over epidural BUP in terms of onset of analgesia, time to standing and physiological responses. Therefore, lumbosacral epidural administration of BUP appears to be the best choice for a long surgical procedure lasting more than 1 hour when compared with either LIG or LIG-BUP.