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UCH delivers first IVF triplets

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L-R father of the triplets, Dr. Omokehinde Osiki, the chairman, Medical Advisory Committee, Dr. Abiodun Moshood Adeoye and the Chief Medical Director, Prof.Jesse Abiodun Otegbayo holding the babies...on Wednesday.

University College Hospital, Ibadan on Wednesday took delivery of triplets in the first In Vitro Fertilisation (IVF) carried out in the hospital.

The mother and the babies – all females – are in good condition after the 45-minute delivery procedure that began around 1pm.

The babies weighed 1.4kg, 2.5kg and 2.4kg.

The father, Dr Kehinde Osiki of the Department of History and Strategic Studies, University of Lagos, was said to have witnessed the delivery of the babies.

He said technology had brought relief to the problems often attributed to spirituality, adding that instead of people carrying the burden of superstition, they should seek scientific solution to their problems.

Osiki urged couples who could not fertilise not to lose hope, asking them to go for the IVF solution.

The triplets’ mother is an employee of the Forestry Research Institute of Nigeria (FRIN), Ibadan.

UCH Chief Medical Director, Prof. Jesse Otegbayo, described the delivery as another success story for the hospital.

He said the commitment to take the UCH to an enviable level led to the beginning of the IVF last year and delivery of the first set of babies through the process and commended the delivery team.

The IVF project was said to have been initiated about 13 years ago.

Health

FG directs states to halt vaccination halfway

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-Bauchi, Benue comply as AstraZeneca vaccine shortage looms

-Remaining doses will be reserved for second jabs – Minister

The Federal Government has asked all the states administering the COVID-19 vaccine to stop the exercise the moment they use half of the doses allocated to them.

The National Primary Health Care Development Agency, Dr Faisal Shuaibu, asked all the states to suspend vaccination when they reach half of the doses delivered to them.

This implies that a state that was given 100,000 doses would have to halt the vaccine rollout once the doses hit 50,000 in order for those who have received their first jab to be able to complete their vaccination.

The move, it was learnt, had become necessary due to a possible delay in the supply of the next batch of the AstraZeneca vaccines, which could affect the availability of the vaccine for a second jab for those who have taken the first.

The shortage of the AstraZeneca vaccine in the international market is caused by a surge in the demand by the European Union and a new policy by India which manufactures the vaccine. India had said last week that it would prioritise domestic vaccination for its over 1.2 billion citizens, thereby causing a shortage in developing nations like Nigeria.

Confirming the development to one of our correspondents who made an enquiry on the matter, the Minister of State for Health, Dr Olorunnimbe Mamora, said states were asked to stop vaccination halfway until more vaccines arrive because it was the smartest thing to do since it is a double-dose vaccine.

Mamora said, “On the issue of stopping at half doses, we thought this is what wisdom dictates because in a situation where we seem to be in short supply, it stands to good reason to ensure that those who have had their first dose should be given the opportunity of having the second dose.

“It is better to have a pool of people who have received full vaccination rather than just do it halfway for everybody, which I think would not be the best in the circumstance. And you are not really covered if you have your full dosage.”

When asked when Nigerians should expect more vaccines, Mamora said he could not say because it is currently a ‘sellers’ market’.

He, however, said Nigeria was already having talks with other parties including Russia, which is producing the Sputnik V vaccine.

The minister stated, “The truth is there is a challenge. However, we are not hopeless. The COVAX facility is not the only one we rely on. There is also AVATT, the regional facility which is the African Vaccine Acquisition Task Team. So, we definitely will be looking to AVATT to help increase the initial allocation in the circumstances with what is happening vis-a-vis production and supply from India.

“Both AVATT and COVAX are multilateral facilitators, but we also have bilateral negotiations. For example, the Sputnik is bilateral in the sense that it is government to government. Sputnik is Russian and as soon as we have the dossier and approval from NAFDAC, then we will consider it.”

Mamora stated that the Federal Government might have to increase its budget for vaccines since AstraZeneca, which is the cheapest in the market, is not readily available.

He said, “One of the reasons we settled for AstraZeneca is not just because it is cheap but is as good as the others. They are giving it out at cost value. The challenge is that the initial element in terms of cost projection would have to increase because AstraZeneca is the cheapest. So, we may have to reconsider our initial cost projection. That is the challenge I see.”

The Federal Government had received 3.9 million doses of the AstraZeneca vaccines through COVAX, a global initiative co-led by the Global Vaccine Alliance, Coalition for Epidemic Preparedness Innovations and World Health Organisation. The initiative was designed to ensure fair and equitable access for every country.

The vaccine arrived in Nigeria on March 2, 2021 while in the second week of March the government began distribution to states, except Kogi, whose governor, Yahaya Bello, had described COVID-19 as glorified malaria.

Persons who opt for AstraZeneca vaccines must take two doses which are usually administered at least two months apart. It was learnt that Ekiti, Bauchi and Kwara states had already administered half of their vaccine supply and had complied with the government’s directive to halt further roll-out.

Meanwhile, the Chairman, Bauchi State Primary Health Care Development Agency and Contacts and Surveillance Sub-Committee Chairman, Bauchi State Task Force on COVID-19, Dr Rilwan Mohammed, told Sunday PUNCH that the Executive Director, NPHCDA, Dr Faisal Shuaibu, wrote to Commissioners for Health in the states to suspend vaccination so that people who had received the first jab could get the second one.

Mohammed stated that Bauchi State was given 89,570 doses but had to stop administering the vaccines immediately after it received the letter having administered about half already. “We have 32,000 coverage but the call-up data is actually 41,000 just that we are still uploading to the national site because of network problems,” he added.

He stated, “There is a shortage of supply of the COVID-19 vaccine, and the Executive Director of the National Primary Health Care Development Agency, Dr Faisal Shuaibu, wrote to all the states that we should suspend vaccination when we reach half of the doses we got.

“The Federal Government realised that within eight to 12 weeks, you must be able to give the second dose but if there is no second dose to give, that means we have wasted the first dose, so they told us to stop if we have reached halfway.

“There is a crisis in the AstraZeneca production. India is having COVID-19 mutation in their country, so they decided to allocate more doses to themselves before exporting it. Secondly, the European Union which initially claimed that the vaccine had some issues has now come back after they found out that the vaccine is okay and they had made a forward request.”

Nevertheless, he explained that the state had set aside a small portion of the vaccine for intending pilgrims because vaccination had become a requirement for those visiting holy cities.

He added, “There are 4,000 Muslim pilgrims, meaning we would need 8,000 doses for them, while there are 170 Christian pilgrims, meaning we would need 340 doses for them, including their staff.

“We have a complaint from the Hajj and Christian commissions and Jerusalem and Saudi authorities have given an order that all those coming for pilgrimage and their staff must show evidence of COVID-19 test and vaccination (first and second doses).”

He said he would write to the Executive Director of NPHCDA to request for vaccines to be administered on the pilgrims.

Mohammed said there had only been 145 reactions – mostly mild – out of the tens of thousands vaccinated in the state so far, noting that the rule that sick persons should not be vaccinated had saved the state from controversies.

He added, “We have only 145 reactions due to COVID-19 vaccine and most of them are mild. Somebody went to our vaccination post in Darazo but unfortunately he was ill, so we told him that one of the conditions was that if you were sick we wouldn’t be able to give you a vaccine. The next day, he died. If we had allowed him to be vaccinated, people would say it was due to COVID-19 vaccination.”

He ruled out the possibility of the state going to look for a vaccine on its own, noting that it was best to use the one already certified by NAFDAC and that there was already a strategic plan for vaccination roll-out in the country.

Asked when the vaccination would resume, he said they had been told to start administering the second dose from May 24 because the vaccine would expire in June, since every batch has its expiry date.

Benue stops vaccination

Meanwhile, the Benue State Government says it has suspended the vaccination exercise, in line with the caution from the Executive Director, NPHCDA.

The state Commissioner for Health, Dr Joseph Ngbea, told one of our correspondents on the telephone on Friday that the state had stopped vaccination, though it did not make a formal announcement.

Ngbea said, “Yes, we have stopped the vaccination of people but we did not announce it, although there are a few people looking to be vaccinated. For example, on Thursday, we still vaccinated one of the former governors of the state who demanded for it. Unlike when we were encouraging people to come out and take the vaccine, we have stopped that.

“We had a meeting with the Executive Director of National Primary Health Care Development Agency who cautioned us to stop giving out the vaccine because of the Indian ban on export of the vaccine.”

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Govt agencies with threat messages to end strike – Resident doctors

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The National Association of Resident Doctors has raised the alarm that it is being threatened by some government agencies to call off its ongoing strike.

This comes four days into the nationwide strike which according to the association is to protest against the failure of the Federal Government to honor their agreements, including the payment of salary arrears and indemnity for their colleagues who died in the line of COVID-19 duty.

The National President, NARD, Dr Uyilawa Okhuaihesuyi, in an interview on Thursday that even though they had the duty to save lives, they are first human beings who had needs and should not be denied their entitlements.

He said this was a fight for survival, noting that they were tired of signing a memorandum of understanding with the government as the previous ones had yielded no result.

The leadership of the association had met with the Federal Government delegation on Wednesday night, during which the government appealed that the planned strike be shelved, but the association commenced the strike on Thursday, April 1.

The Minister of Labour and Employment, Dr Chris Ngige, had said on Friday that government would not hesitate to invoke the ‘No work no pay’ provision in the labour laws if they failed to call off the strike.

But in a telephone interview with one of our correspondents, Okhuaihesuyi said the government had not been fair, noting that since the association issued its ultimatum on January 25 and having written series of letters to the relevant ministries and agencies, nothing was done.

The development has however paralysed activities in many teaching hospitals across the country, inflicting serious hardship on Nigerians who need medical care in such institutions.

Asked if Nigerians had helped in putting pressure on the government to do what was necessary to end the stalemate and address the inadequacies in the health sector, Okhuaihesuyi said, “Nigerians are actually scared. Basically, people cannot talk because they are scared of the unknown and there is fear of being harassed.

“Since this strike started, I have received calls from many government agencies to shelve the strike. Some are in form of threats. It’s that bad. They think it is politics, forgetting that we cannot play politics with human lives. We are professionals and being a doctor means you have sworn an oath to take care of lives but when you are hungry or you become a patient, what is your fate?”

Efforts to get the NARD President to expatiate on the threats were not successful as his line could no longer be reached till press time on Saturday.

Okhuaihesuyi also said in the interview that government was unfair in the way it was treating them. He added, “Resident doctors make up about 70 per cent of all the doctors in the workforce in Nigeria. That is independent of the challenge many doctors have in securing placement for their residency programme and that is also a big challenge.

“That was why we mentioned doctors on Government Integrated Financial Management Information System platform in our communiqué. That is the platform used in paying doctors that are not fully employed in the hospitals, and so there was leakage and fraud in the platform and it was closed. That means the number of doctors on the GIFMIS platform, which was over 3,000, have all stayed for four months without being paid.

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Why human teeth bite should not be neglected

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A consultant oral and maxillofacial surgeon, Dr. Akanbi Olojede, says human bite could be potentially dangerous and should be treated with urgency to avoid life-threatening infection from microorganism or tetanus.

This is corroborated by experts at online health portal, Mayo Clinic; and scientists at the Cleveland Clinic, Ohio, USA.

Olojede noted that even if a bite victim had taken a tetanus injection before the incident, a booster injection should be administered to reduce the risk of tetanus infection.

Speaking in an interview with our correspondent, the consultant warned that there is no cure for tetanus, but that effort could only be made to manage complications that might arise until effects of the tetanus toxin wear off.

“If the booster injection is not taken, the human bite wound risks having superimposed infection due to the array of microorganisms present in saliva,” he stated.

Continuing, Olojede said, “Tetanus infection, which is also known as ‘lockjaw,’ can lead to painful muscle contractions, particularly of the jaw and neck muscles. It can cause respiratory distress that could lead to the bite victim’s death.

“Tetanus booster shot should be administered. Aside from cleaning the wound with strong antiseptic, and dressing it, the victim should be given antibiotics medication to protect against secondary infection by other bacteria.”

According to Mayo Clinic, human bites can be as dangerous as or even more dangerous than animal bites because of the types of bacteria and viruses contained in the human mouth. Human bites that break the skin can become infected, the portal adds.

It advised that a victim of human teeth bite should seek emergency medical care, adding, “If you haven’t had tetanus injection within five years, your doctor may recommend a booster. In this case, get the booster injection within 48 hours of the injury.”

Again, experts at Cleveland Clinic say that complications from a human bite can be very serious, including severe infection and permanently damaged bones, joints and/or tendons.

“It’s unlikely that a human bite will be fatal, especially if you seek out proper medical care, particularly around the infection,” the clinic counsels.

According to Wounds, a peer-reviewed journal focusing on wound care and wound research, human bites are the third most common bite wound diagnosed in emergency departments, after dog and cat bites.

It noted that management of human bite can be challenging, given the high risk of infection associated with multi-organism-rich oral flora.

Recognition and early aggressive treatment are essential steps in preventing infections and other associated complications, the journal emphasised.

Also, Medscape, a website providing access to medical information for clinicians, states that approximately 10-15 percent of human bite wounds become infected owing to multiple factors.

“The bacterial inoculum of human bite wounds contains as many as 100 million organisms per milliliter and is made up of as many as 190 different species. Many of these are anaerobes that flourish in the low redox environment of tartar that lies between human teeth or in areas of gingivitis.”

The portal notes that most injuries due to human bites involve the hands. “Hand wounds, regardless of the etiology, have a higher rate of infection than do those in other locations,” it stated; noting that infections associated with human bites are often far advanced by the time they receive appropriate care.

“Patients often wait until infection is well established before seeking medical treatment,” the portal laments.

Olojede, however, said that humans don’t have venom. “Basically, it is not an emergency per se. Human bite can’t be classified as being venomous or likened to a bite by dangerous animals.

“The most important thing is, what extent of damage has the bite inflicted on the victim and the intensity?

“But where danger comes in is when someone completely bites off the ear, upper or lower lip of an individual and spits it out, and some will go to the extent of swallowing it.

“In this case, the aim of the assailant is to disfigure the victim, which is causing grievous bodily harm. Such bites can be quite dangerous because of the bleeding that will occur.

“Such individuals should also be given pain killer because human bite could be very painful and unbearable by the following day, especially when it is deep and big.

“The risk of secondary infection is also high, but not the type that can lead to death. Nevertheless, treatment should commence immediately, beginning with a tetanus booster,” he emphasised.

Olojede, a former President, Nigerian Dental Association, further explained that the human mouth contains normal oral flora or bacteria, the absence of which can lead to death.

He said, “If we don’t have them, there is no way we can survive. We have them in our stomach, large and small intestines, and they have their functions. Someone without these organisms will come down with some terrible illness that can kill.”

According to News Medical Life Science, over 700 bacterial species co-inhabit healthily in the human mouth, and exist at diverse locations in the mouth, including hard palate, soft palate, teeth, tongue, and tonsillar areas.

It explained that most of the microorganisms that inhabit the oral cavity live in symbiotic relationship – where both the host and guest co-exist mutually for the benefit of each other.

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