We studied pre-hospital practices of 72 consecutive snake bite victims at a hospital in north-central Nigeria. The primary outcome assessed was death or disability at hospital discharge. Victims were predominantly male farmers, and in 54 cases (75%) the snake was identified as a carpet viper (Echis ocellatus), with the remainder unidentified. Most subjects (58, 81%) attempted at least one first aid measure after the bite, including tourniquet application (53, 74%), application (15, 21%) or ingestion (10, 14%) of traditional concoctions, bite site incision (8, 11%), black stone application (4, 5.6%), and suction (3, 4.2%). The majority (44, 61%) presented late (after 4 hours). Most (53, 74%) had full recovery at hospital discharge. Three deaths (4.2%) and thirteen (18%) disabilities (mainly tissue necrosis) occurred. The use of any first aid was associated with a longer hospital stay than no use (4.6 ± 2.0 days versus 3.6 ± 2.7 days, respectively, P = 0.02). The antivenom requirement was greater in subjects who had used a tourniquet (P = 0.03) and in those who presented late (P = 0.02). Topical application (Odds Ratio 15, 95% CI 1.4-708) or ingestion of traditional concoctions (OR 20, 95% CI 1.4-963) were associated with increased risk of death or disability. Ingestion and application of concoctions were associated with a longer time interval before presentation, a higher cost of hospitalization, and an increased risk of wound infection.

Overall knowledge was low. Improvements in overall knowledge may require clinicians' exposure to snakebite management and training of accident and emergency clinicians in the region.

Poor sleep quality is a problem among nurses, though less tendency to daytime sleepiness was observed in this report.

Context: Nutrition is a significant factor in determining the health of older people because it affects almost all organs and systems, which could lead to varieties of diseases and premature death. Aim: To determine the nutritional status and its association with the morbidity patterns of elderly patients. Settings and Design: A cross-sectional hospital-based descriptive study involving 348 patients aged 60 years and above who presented at the Family Medicine Clinic. Subjects and Methods: Data of the socio-demographic profile, anthropometric measurements and clinical diagnosis were collected. The co-morbidities were classified based on the number, duration and affected organ or system. The nutritional status was assessed with the Mini-Nutritional Assessment tool. Statistical Analysis: Chi-square test and logistic regression analysis were used to determine associations between nutritional status and morbidity patterns of the elderly. The level of significance was set at a P ≤ 0.05. Results: A total of 348 respondents were recruited with 60.9% of females and mean age of 67.83 (standard deviation ± 7.53) years. The prevalence of malnutrition was 25.3% and of risk of malnutrition 56.6%. Furthermore, the prevalence of multi-morbidity was 74.4%. Advanced age (odd ratio = 8.911, confidence interval [CI] = 1.992–39.872, P = 0.004), underweight (OR = 1.167, CI = 0.291–37.846, P < 0.001), lack of formal education, (OR = 1.569, CI = 0.357–0.908, P = 0.018), low monthly income (OR = 1.975, CI = 1.376–2.836, P < 0.001), chronic respiratory diseases (OR = 4.250, CI = 4.025–4.492, P < 0.001) and physical inactivity (OR = 2.466, CI = 1.063–5.722, P = 0.036) were the predictors of malnutrition. Furthermore, the duration of chronic disease for more than 10 years (OR = 1.632, CI = 0.408–0.979, P = 0.040) was significantly associated with at-risk of malnutrition. Conclusion: The study revealed advanced age, underweight, low educational status, chronic respiratory diseases and physical inactivity as independent risk factors for malnutrition among the elderly.

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