KNOWLEDGE, RISK PERCEPTION AND PREVENTIVE PRACTICES OF COVID-19 AMONG STAFF OF PRIMARY AND SECONDARY SCHOOLS IN KADUNA STATE, NIGERIA

INTRODUCTION

Kaduna State is among the three States with the highest number of confirmed COVID-19 cases. The objective of this study was to assess the knowledge, risk perception and practices of staff towards prevention and control of COVID-19 infection in schools to provide policy makers, education and health managers required information to manage the epidemic as the schools prepare to re-open.

METHODS

This was a school-based survey conducted using purposive sampling of 55 schools located in nine LGAs with the highest number of reported COVID-19 cases as at October 2020. Five schools with the highest students'/pupils' enrollment in each of the LGA were selected and all staff were interviewed. Information on knowledge, risk perception and practices of prevention was collected. Descriptive statistics were generated using Stata v14 software.

RESULTS

A total of 1065 staff in 55 schools completed the interview. Major sources of information are television (73%), radio (61%), and social media (57%); and 76% indicated that a virus is the causative agent of COVID-19. Overall, 70%, 19%, 7%, 9.3% and 0% respectively had adequate knowledge of cause, preventive measures, respiratory hygiene, modes of transmission and symptoms of COVID-19; however only 14% ever attended a workshop on COVID-19. Eighty-two percent and 89% respectively believed in the efficacy of face masks and handwashing as means of prevention; 39% thought that they are likely to contract COVID-19. Ninety-nine percent and 90% have ever used face mask and hand sanitizer to prevent COVID-19; 96% and 85% respectively have use these methods in previous 24hours. Between 42% and 73% of schools needed additional commodities/requirements/supplies to comply fully with COVID-19 prevention protocols.

CONCLUSION

While knowledge of COVID-19 is suboptimal, perception is positive and practice is high. Thus, teachers need to be well informed and encouraged to sustain current levels of preventive measures. Government needs to provide schools with adequate preventive commodities to ensure compliance.

Primary extragonadal vaginal yolk sac tumour: A case report

INTRODUCTION

Yolk sac tumour (YST) or endodermal sinus tumour is rare and typically seen in gonads.

CASE REPORT

We described a case of extragonadal vaginal YST in a one year and seven months old girl who presented with vaginal discharge and bleeding, and discuss its differential diagnosis and potential pitfalls in immunohistochemistry. She was found to have a suprapubic mass on examination. The serum alpha fetoprotein was 11919.4 ng/mL. Computed tomography of the pelvis revealed a large 6.4 cm heterogenous pelvic mass. Colposcopic examination of the pelvis showed a fungating vaginal mass that was subsequently confirmed as a yolk sac tumour. Immunohistochemically, the malignant cells were positive toward CKAE1/AE3, AFP and glypican-3, as well as CD117.

DISCUSSION

Solid pattern extragonadal vaginal YST may morphologically resemble dysgerminoma that is also CD117 positive, while the glandular pattern YST may have clear cytoplasm and is positive for cytokeratin; hence, may resemble clear cell carcinoma. Being mindful of these potential diagnostic caveats is necessary to prevent misdiagnosis.

Sexual Dimorphism in Osteometric Indices of Kuri Cattle Skulls

This work investigated 30 skulls of the Kuri cattle comprising 15 males and 15 females, of three age groups, 10 young (9 months to less than 3 years), 10 middle aged (3 to 5 years) and 10 aged (greater than 5 years). The skulls were prepared using hot water maceration technique. Using Ruler, thread and divider; 59 Osteometric parameters were taken to determine sexual dimorphism, only 6 indices showed statistically significant differences between the sexes. These indices were maximum intercondylar width (MICW), right supraorbital foramen to interfrontal suture (ISRSOF), left supraorbital foramen to interfrontal suture (ISLSOF), lateral intercornual length (LICL), intertemporal line width (ITLW) and horn base circumference (HBC). The female had longer viscerocranial length (VCrL) both on the nasal and palatal aspects, but were wider in the male. The male had longer and wider neurocranium. The paracondylar process length (PCPL) was longer in the female, but the male had wider interparacondylar width (IPCW) and maximum intercondylar width (MICW) While the ISRSOF significant difference appeared only at the middle-age group at p<0.05, the ISLSOF did not differ significantly at any particular age group but only overall mean of all the three age groups (n=15) presented the difference significantly. The MICW showed significant difference (p<0.05) at two age groups; young and the middle-age. The LICL and ITLW values are highly significant (p<0.01) and the HBC value was also significant (p<0.05) all at the middle age. No significant difference was recorded between the two sexes in the aged Kuri cattle; indicating that the female tends to progressively increase in size beyond 5 years old thereby making these values insignificant from the male counterpart at old age. In conclusion, the middle-age Kuri cattle have the most sexually dimorphic osteometric landmarks in the skull with the male having higher values than the female. This data will be useful for anatomical, developmental, anthropological forensic and clinical studies, and form basis for comparison with other breeds of cattle.

The diagnostic utility of cytokeratin 19 in differentiating malignant from benign thyroid lesions

INTRODUCTION

Thyroid carcinoma is classically diagnosed based on certain histological criteria. In some cases, definitive diagnoses may be challenging when morphological features are equivocal. This study evaluated the usefulness of Cytokeratin 19 (CK 19) as an immunohistochemical marker to differentiate the different histological types of malignant thyroid neoplasms, particularly papillary thyroid carcinoma (PTC) from benign thyroid lesions.

MATERIALS AND METHODS

We collected 54 malignant and 65 benign thyroid lesions diagnosed by histology in Universiti Kebangsaan Malaysia Medical Centre between January 2010 and December 2015. All cases were immunohistochemically stained with CK 19 and evaluated by 3 independent observers. The immunostaining patterns were scored based on the intensity and proportion of staining and finally graded as negative, weak positive, moderate positive or strong positive. In addition, the immunostaining scores of the malignant cases were correlated with their TNM pathological tumour stages.

RESULTS

Cytokeratin 19 staining expression was higher in malignant than benign thyroid lesions (p < 0.001) which was most prominent among classical PTC. The four PTC cases that showed negative or weak staining were all follicular variant of PTC. Benign conditions were mostly negative or showed weak positivity. There was no correlation between CK 19 expression and TNM primary tumour stage (pT).

CONCLUSION

Cytokeratin 19 is a useful marker in differentiating malignant from benign thyroid conditions particularly the classical PTC, provided its interpretation is by correlation with morphology and takes into consideration the intensity and proportion of positive staining.

Oesophageal hepatoid carcinoma with liver metastasis, a diagnostic dilemma

Alpha-fetoprotein (AFP)-producing carcinoma which microscopically mimics hepatocellular carcinoma (HCC) is a rare entity known as hepatoid adenocarcinoma (HC). They usually arise in the stomach, while oesophageal origin is only occasionally encountered. This tumour is highly aggressive and is associated with a poor prognosis. They frequently metastasise to the liver, thus giving rise to diagnostic difficulty, especially in cases where simultaneous oesophageal and liver mass are present. We reported a case of oesophageal hepatoid carcinoma with multiple liver metastasis, that was associated with an increased serum AFP. The distinction between HCC and HC is important because HC is more aggressive and has a poorer prognosis with limited therapeutic options. An extensive diagnostic work-up which include a thorough clinical history, radiological investigations (computed tomography or magnetic resonance imaging) as well as tissue biopsy supported by a panel of immunohistochemical markers are necessary to aid in the diagnosis of HC.

Morphometric studies of the mandibular and maxillofacial regions of the Kuri cattle and the implications in regional anaesthesia

This work investigated and analysed some morphometrical measurements of mandibles and maxillofacial regions of ten adult Kuri cattle (above 5 years) skulls that were apparently free from musculoskeletal deformity. A total of 19 (13 mandibular and 6 maxillofacial) parameters were taken. The mean mandibular length and height were found to be 41.3 ± 2.35 cm and 22.6 ± 1.40 cm, while the mean mental foramen height and width were 0.8 ± 0.08 cm and 1.5 ± 0.25 cm, respectively. The mean distances from lateral alveolar root to mental foramen and from the latter to the most caudal border of the mandible were 4.8 ± 0.61 cm and 34.2 ± 1.93 cm, respectively. The mean mandibular foramen width was 1.1 ± 0.14 cm, while the distance from this foramen to the caudal border of mandible at that level was 4.0 ± 0.32 cm. The mean distances from facial tuberoses to the infraorbital foramen and from the latter to the alveolar root ventral to it were 5.3 ± 0.63 cm and 3.7 ± 0.47 cm, whereas the mean infraorbital foramen height and width stood at 1.2 ± 0.18 cm and 1.0 ± 0.22 cm, respectively. The infraorbital foramens in 60% of the specimen were located above the first upper premolar, while 20% were above second premolar, and another 20% at the junction above first and second upper premolars. These findings provide important landmarks needed for clinical manoeuvres on the head of the Kuri cattle for regional anaesthesia in procedures like trephination, dehorning, tooth extraction and oral and dental surgeries.

Morphometrics of foramen magnum in African four-toed hedgehog (Atelerix albiventris)

The purpose of this study was to examine the morphometry of the foramen magnum of African four-toed hedgehog (Atelerix albiventris) in Maiduguri. Fourteen hedgehog skulls (7 male and 7 female each) were used for this study. The overall mean value of foramen magnum height and width were 0.51 ± 0.05 cm and 0.64 ± 0.04 cm while occipital condylar and interparacondylar widths were 1.00 ± 0.12 cm and 1.62 ± 0.07 cm, respectively. There was no significant difference between the two sexes. The foramen magnum index was 83.4 ± 5.51 cm in males and was significantly higher than 76.3 ± 6.37 cm observed in females. The presences of dorsal notches (occipital dysplasia) were observed, that were of three distinct types. It is envisaged, that the study will provide a valuable database on the anatomy of foramen magnum of hedgehogs in Nigeria for morphological, neurological, zooarchaeological, and comparative anatomical studies.

Morphological analysis and osteometry of the foramen magnum of the one-humped camel (Camelus dromedarius)

The foramen magnum (FM) has been an integral component of studies on the ontogeny and evolutionary transformation of the skull. While its shape is variable in different species and breeds, the morphological variations and metrical indices of the foramen have scarcely been studied in camels. A total of 30 adult camel heads with equal sex disparity from three different locations of Northern Nigeria were used in this study for determining the morphological characteristics and osteometry of their foramen magnum. The study reported a mean foramen magnum height and width of 4.04 ± 0.15 and 3.70 ± 0.16 cm, and 3.65 ± 0.27 and 3.45 ± 0.21 cm in the overall males and females, respectively, and a foramen magnum index (FMI) in adult camels, which was over 100. We propose a classification for the morphology of foramen magnum in camels demarcating them into three types. The dorsal border of the foramen presented either a smoothly curved bony margin (type I), a small, ventrally directed, median bony protrusion (type II) or a dorsal notch (type III). No significant osteometric differences were found in any of the variables of the foramen magnum measured in the adult camels (FMH, FMW and FMI) of the various geographical locations, nor between animals of either gender except for the FMH that had a significantly higher mean value in overall males.

Incidence and aetiology of oral clefts: a review

Craniofacial anomalies, most especially cleft lip and palate, are major human birth deformities with a world wide incidence of 1 in 700 and associated substantial clinical and psychosocial impact. Wide ranges of studies in developmental biology have shown that both genetics and environmental factors are involved in the etiology of oral clefts. However, genetics of cleft lip alone or accompanied by cleft palate, are different from those of isolated cleft palate. The prevention of oral clefts is not possible without knowing the precise etiology. Genetic counseling can now identify high risk families; the clefts themselves may be visible at 20 weeks gestation, but beyond early identification, we can only look into the future on the possibility of preventing oral clefts. This article reviews the available literature on the gene-environment contributions to nonsyndromic forms of clefting and their implication for possible preventive measures.

Pregnancy outcome at age 40 and older

OBJECTIVE

Our purpose was to examine pregnancy outcomes among women age 40 or older.

METHODS

Between January, 1997 and December 1999, we performed a case-control study compared pregnancy outcomes of 468 patients delivered at our hospital at > Or = 40 years old with outcomes in a control group consisting of the next two deliveries of women with ages 20 to 29 years. Retrospective analysis of the antepartum and intrapartum records was done to compare clinical outcome.

RESULTS

Approximately 25,356 women delivered during the study period, and 468 (1.8%). Of these women were at age 40 or older. Of this latter group, 50 (10.7%) were nulliparous. Mean birthweight of infants delivered by older nulliparous women was significantly lower than that among nulliparous controls (3,210 +/- 5 vs. 3,320 +/- 1 g), whereas mean birth weight in the group of older multiparous was not different than that among younger multiparous controls (3,370 +/- 1 vs. 3,365 +/- 4 g). Gestational age at delivery was significantly lower among older nulliparous, and multiparous compared with nulliparous and multiparous younger controls. Older women were at increased risk for cesarean delivery (nulliparous 18%; multiparous 14%) compared with nulliparous and multiparous younger control groups (nulliparous 8%; multiparous 6%). In the study group, the operative vaginal delivery rate was higher than that of the control group. The study groups were more likely to develop gestational diabetes, preeclampsia, and placenta praevia. Older nulliparous had an increased incidence of malpresentation, abnormal labour patterns, special care baby unit admission (SCBU), and low 1-minute Apgar score. Older multiparous were more likely to experience birth asphyxia, premature rupture of membranes, and antepartum vaginal bleeding.

CONCLUSION

Nulliparous women age 40 or over have a higher risk of operative delivery than do younger nulliparous women. This increase occurs in spite of lower birth weight and gestational age and may be explained by the increase incidence of obstetric complications. Although maternal morbidity was increased in the older women, the overall neonatal outcome did not appear to be affected.