Healthcare waste management has become an important aspect of medical care delivery globally. This is simply because of its hazardous and infectious components that have greater potential for adverse health and environmental impacts. As such, certain guidelines and procedures have been developed by international aid agencies and conventions to guide national governments and local administrations in formulating policies and practices for effective healthcare waste management. In this work, we reviewed the existing literature to appraise the status of healthcare waste management practices in Nigeria. This included generation, segregation, collection, storage, transportation, treatment, and disposal. The current work further reviewed the other essential elements of healthcare waste management, such as policy landscapes, training, awareness, and waste characterization, and discusses challenges and opportunities for effective healthcare waste management in Nigeria. Among the challenges are poor funding, inadequate training, ineffective legislature, and absence of data. However, there are available low-cost technologies that are suitable for the treatment of waste in a developing country like Nigeria. This technology variant offers an opportunity for a circular economy as it can simultaneously achieve energy production, waste management, and other socioeconomic advantages.
Introduction: Prostate cancer has an increasing global burden. The clinical course varies from an indolent disease to a rapidly aggressive cancer. It is associated with higher mortality in less developed nations due to late presentation. The Gleason scoring system for prostatic adenocarcinoma has prognostic implications in diagnosed cases. Obesity has been associated with the evolution of many cancers including prostate cancer. There are conflicting reports on the relationship between obesity, as measured by body mass index (BMI), and prostate cancer aggressiveness, as measured by Gleason score. This study is aimed to determine if a correlation exists between BMI and Gleason score in men with prostate cancer. Methodology: This was a prospective, hospital-based, cross-sectional study involving consecutive patients with prostate cancer. Clinical evaluation including anthropometry, digital rectal examination, and relevant investigations were done for each patient and data collected with pro forma. This was followed by prostate needle biopsy and those diagnosed with adenocarcinoma of the prostate had their Gleason grades and scores obtained. Data were analyzed statistically using Spearman Correlation. Results: The mean age of the patients was 69.54 ± 8.61 years (range 47–83 years). The BMI ranged from 16.98 to 36.45 kg/m 2 , with a mean of 27.03 ± 5.03 kg/m 2 . Twenty-six of the patients (36.1%) were overweight and 34.7% were obese. The mean total prostate-specific antigen was 118.65 ± 84.43 ng/ml, with a range of 31–406 ng/ml. The modal Gleason score was 9 with a range of 4–10. There was a strong positive correlation between BMI and Gleason score ( r = 0.817, P = 0.0003). Conclusion: The BMI of patients with prostate cancer correlated positively with their Gleason score.
Background:Pressure ulcers are lesions caused by unrelieved pressure over bony prominences, resulting in damage to underlying tissues. The etiology is multifactorial including prolonged immobility. They usually complicate spinal cord injuries with long periods of bed confinement. The use of bed replacements markedly reduces the incidence of pressure ulcers, but the unaffordability of these replacements in low-income countries has necessitated the need to explore cheaper alternatives.Aim and Objective:The aim of this study was to ascertain whether the use of our cheap and locally improvised waterbeds would reduce the incidence of pressure ulcers in patients on prolonged bed confinement due to spinal injury.Methodology:Over a 16-month period, 51 patients (age range 1-80 years) with spinal injuries were managed conservatively in our service using improvised waterbeds in 21 (41.2%), while using the regular hospital bed/foam in 30 (58.8%). Biodata, the time interval between injury and presentation to the hospital, nature of the injury, use of improvised waterbed and development of pressure ulcer, were collected, collated, and analyzed. Statistical significance was calculated with the Chi-square test.Results:Most were males (98%), in the age range of 21–30 years (25.5%), and due to fall from heights (35.3%). Of 21 patients who were managed on improvised waterbeds, 6 (28.6%) had pressure ulcers, and of the 30 who did not use the waterbed, 17 (56.7%) developed ulcers. The χ2 = 3.9381, while P = 0.0472. This difference was statistically significant.Conclusion:The improvised waterbed, which is much cheaper than the standard waterbed, was observed to have significantly reduced the incidence of pressure ulcers among our patients. Nonetheless, further studies would still be needed to confirm this observation.
Transurethral resection of the prostate (TURP) is the gold standard of surgical therapy of benign prostatic hyperplasia (BPH) for prostates <100 ml. This study was carried out to describe our experience with and outcome of staged TURP for large prostates (>100 ml). A review of the records of all the patients who underwent staged TURP for large BPH at a specialist urology center. They had two-stage monopolar resection using a size 26F continuous flow resectoscope and 5% Dextrose water irrigation. Staged-TURP were performed by a single Consultant Urologist under spinal anesthesia. Patients’ age, Co-morbidities, Prostate-specific Antigen (PSA), Abdominal Ultrasound scan (USS) estimated prostate volume, Pre-operative Packed Cell Volume (Pre-op PCV), Post-operative Packed Cell Volume (Post-op PCV), Resection Weight for 1st stage (RW I), Resection Weight for 2nd stage (RW II), Resection Time for 1st stage (RT I), Resection Time for 2nd stage (RT II), blood transfusion were obtained and analyzed. Follow up was for a minimum of 9 months and the outcome and development of complications noted. Statistical analysis was done using the IBM Statistical Package for the Social Sciences (SPSS) version 20.0 (IBM, Chicago, USA). Means and percentages were calculated, and paired sample T test was used to compare variables between 1st stage and 2nd stage. P value < 0.05 was considered significant. Twenty-five patients with a mean age of 72.32±7.98 years were analyzed. Most (88%) were on indwelling Foley’s urethral catheter before surgery. The mean PSA and prostate volume were 25.61±22.08 ng/ml and 221.56±62.78 cm3. There were significant differences between Pre-op PCV and Post-op PCV (p<0.001); RWI and RWII (p<0.001); and RTI and RTII (p<0.001). Nineteen patients (76%) received perioperative transfusion. Most patients voided satisfactorily following catheter removal except one who developed acute urinary retention (AUR). No cases of TUR syndrome, post-operative sepsis, DVT or PE and urethral stricture were recorded. Staged TURP is safe and effective treatment modality for patients with large prostates in the absence of more recent endoscopic options.
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