Women under 16 years of age were at an increased risk of being raped, possibly because they are defenseless and vulnerable. Three quarters (3/4) of the assailants had some form of relationship with the victims, which may account for the delays in reporting. Children and young adolescents were more at risk than adults to be raped.
BackgroundJos has witnessed a series of civil crises which have generated mass casualties that the Jos University Teaching Hospital has had to respond to from time to time. We review the challenges that we encountered in the management of the victims of the 2001 crisis.MethodologyWe reviewed the findings of our debriefing sessions following the sectarian crisis of September 2001 and identified the challenges and obstacles experienced during these periods.ResultsCommunication was a major challenge, both within and outside the hospital. In the field, there was poor field triage and no prehospital care. Transportation and evacuation was hazardous, for both injured patients and medical personnel. This was worsened by the imposition of a curfew on the city and its environs. In the hospital, supplies such as fluids, emergency drugs, sterile dressings and instruments, splints, and other consumables, blood and food were soon exhausted. Record keeping was erratic. Staff began to show signs of physical and mental exhaustion as well as features of anxiety and stress. Tensions rose between different religious groups in the hospital and an attempt was made by rioters to attack the hospital. Patients suffered poor subsequent care following resuscitation and/or surgery and there was neglect of patients on admission prior to the crisis as well as non trauma medical emergencies.ConclusionMass casualties from disasters that disrupt organized societal mechanisms for days can pose significant challenges to the best of institutional disaster response plans. In the situation that we experienced, our disaster plan was impractical initially because it failed to factor in such a prolongation of both crisis and response. We recommend that institutional disaster response plans should incorporate provisions for the challenges we have enumerated and factor in peculiarities that would emanate from the need for a prolonged response.
The World Health Organization (WHO) recommends periodic surveillance of transmitted drug resistance (TDR) in communities in which antiretroviral therapy (ART) has been scaled-up for greater than 3 years. We conducted a survey of TDR mutations among newly detected HIV-infected antiretroviral (ARV)-naive pregnant women. From May 2010 to March 2012, 38 ARV-naive pregnant women were recruited in three hospitals in Jos, Plateau state, north central Nigeria. Eligible subjects were recruited using a modified version of the binomial sequential sampling technique recommended by WHO. HIV-1 genotyping was performed and HIV-1 drug resistance mutations were characterized according to the WHO 2009 surveillance drug resistance mutation (SDRM) list. HIV subtypes were determined by phylogenetic analysis. The women's median age was 25.5 years; the median CD4 + cell count was 317 cells/ll and the median viral load of 16 was 261 copies/ml. Of the 38 samples tested, 34 (89%) were successfully genotyped. The SDRM rate was < 5% for all ART drug classes, with 1/34 (2.9%) for NRTIs/NNRTIs and none for protease inhibitors 0/31 (0%). The specific SDRMs detected were M41L for nucleoside reverse transcriptase inhibitors (NRTIs) and G190A for nonnucleoside reverse transcriptase inhibitors (NNRTIs). HIV-1 subtypes detected were CRF02_AG (38.2%), G¢ (41.2%), G (14.7%), CRF06-CPX (2.9%), and a unique AG recombinant form (2.9%). The single ARV-native pregnant woman with SDRMs was infected with HIV-1 subtype G¢. Access to ART has been available in the Jos area for over 8 years. The prevalence of TDR lower than 5% suggests proper ART administration, although continued surveillance is warranted.
PurposeIn critical care situations, there are often neither the means nor the time to weigh each patient before administering strict weight-based drugs/procedures. A convenient, quick and accurate method is a priority in such circumstances for safety and effectiveness in emergent interventions as none exists in adults while those available are complex and yet to be validated. We aimed to study the correlation and accuracy of a quick bedside method of weight estimation in adults using height.MethodThe technique is estimated body weight—eBW(kg) = (N − 1)100, where ‘N’ is the measured height in metres.Adult undergraduates were enrolled 10/09/2015. Their heights and weights were measured while the formula was used to obtain the estimated weight. The SPSS version 21.0, Chicago, IL, USA was utilised for data analysis.ResultsWe analysed 122 participants aged 21–38 years with height = 1.55 m–1.95 m. The actual body weight range = 48.0 kg–91.0 kg, mean = 65.3 kg ± 9.7 kg and S.E. = 2.0 while eBW = 55 kg–95 kg, mean = 69.1 kg ± 8.4 kg and S.E. = 1.5. On BMI classes, a positive predictive value of 94.7% for the ‘normal’ category and 95.5% for ‘overweight’.Correlation coefficient at 99% confidence interval yielded (r) = + 1, (P = 0.000) while the linear regression coefficient (r2) = + 1 at 95% confidence interval (P = 0.000).The strength of agreement/precision was established by the Bland-Altman plot at 95% ± 2 s (P = 0.000) and kappa statistic with value = 0. 618.ConclusionThis unprecedented statistical characterisation of the two weight estimate measures to have a good agreement scientifically proposes the utility of our method with the formula eBW(kg) = 100(N−1) in critical care and ATLS protocol.
Objective: There is limited data on fetal cranial dimensions of Nigerian population. This is important because the study of normal and abnormal growth of children has become an increasingly important part of the practice and research in all fields related to child health; more so that prenatal and postnatal growth is one continuous process. Material & Methods:In a cross-sectional study conducted on 13,740 Nigerian fetuses ranging from 12 weeks to 42 weeks at the Centre for Reproductive Health Research Jos; biparietal diameter and occipitofrontal diameter were measured using ultrasound machine in order to calculate fetal cephalic index. The values were statistically analyzed after deriving the relevant indices. Results:The regression equation was calculated between gestational age and cephalic index of fetuses of Nigerian women. This equation y = 1.3x + 59.88; showed a linear relationship which was stronger from 12 to 16 weeks of gestation. Above 16 weeks gestation, the relationship was found to be quite weak. Coefficient of correlation is r2 = 0.9844 (p < 0.0001). Conclusion:The fetal skulls were found to be mesocephalic in the early weeks and brachycephalic at term.
Objective: Fundal height measurements in centimeters have always been an objective method of evaluating fetal growth in pregnancy. The accepted Mcdonald's rule refers primarily to Caucasians regrettably. Since fundal height may actually vary in an anthropological sense it was considered necessary to apply Mcdonald's rule to African subjects to see whether there is any significant difference. The aim of this study is to construct symphysio-fundal height nomogram for normal pregnant Nigerian women. Material & Methods:In a cross sectional mode, four hundred and five pregnant Nigerian women were studied to examine how their fundal height values compared with those in the literature. A regression equation was derived for the 10th and 90th centiles. Values outside the range of 10 -90th centiles are to be used for the prediction of small-for-dates and large-for-dates babies respectively. The prediction formulae for the various centiles derived from regression analysis and their usefulness in clinical anthropological practice using fundal height measurement are highlighted. Results:The study demonstrated a significant difference in fundal height values of Nigerian women especially in late pregnancy compared with other published values in the literature. A positive linear correlation between symphysio-fundal height and fetal gestational age was found in Nigerians with a correlation coefficient of R2 = 0.9962 (p<0.001). The relationship is best described by the second order polynomial regression equation y = -0.0024x2 + 1.1255x -1.8334 where y is the symphysio-fundal height in centimeters while x is the gestational age in weeks. Conclusion:Symphysio-fundal height chart is a valuable tool for assessing fetal growth in the antenatal clinic in as much as it is cautiously constructed for a given population and the same method of measurement is strictly adhered to by different observers in the same organization.
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