Triterpenoids From the Leaves of Olax mannii Oliv.

The study of the acetone extract of the leaves of Olax mannii Oliv. led to the isolation of two triterpenoids; glutinol and rhoiptelenol. These compounds are reported for the first time in Olax mannii. Their structures were elucidated on the basis of one- and two-dimensional NMR spectroscopy, IR and GC-MS.Keywords: Glutinol, Rhoiptelenol, Olax manniiNigerian Journal of Basic and Applied Science (2011), 19(2):193- 19

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Maternal and child health interventions in Nigeria: a systematic review of published studies from 1990 to 2014

BACKGROUND: Poor maternal and child health indicators have been reported in Nigeria since the 1990s. Many interventions have been instituted to reverse the trend and ensure that Nigeria is on track to achieve the Millennium Development Goals. This systematic review aims at describing and indirectly measuring the effect of the Maternal, Newborn, and Child Health (MNCH) interventions implemented in Nigeria from 1990 to 2014. METHODS: PubMed and ISI Web of Knowledge were searched from 1990 to April 2014 whereas POPLINE® was searched until 16 February 2015 to identify reports of interventions targeting Maternal, Newborn, and Child Health in Nigeria. Narrative and graphical synthesis was done by integrating the results of extracted studies with trends of maternal mortality ratio (MMR) and under five mortality (U5MR) derived from a joint point regression analysis using Nigeria Demographic and Health Survey data (1990-2013). This was supplemented by document analysis of policies, guidelines and strategies of the Federal Ministry of Health developed for Nigeria during the same period. RESULTS: We identified 66 eligible studies from 2,662 studies. Three interventions were deployed nationwide and the remainder at the regional level. Multiple study designs were employed in the enrolled studies: pre- and post-intervention or quasi-experimental (n = 40; 61%); clinical trials (n = 6;9%); cohort study or longitudinal evaluation (n = 3;5%); process/output/outcome evaluation (n = 17;26%). The national MMR shows a consistent reduction (Annual Percentage Change (APC) = -3.10%, 95% CI: -5.20 to -1.00 %) with marked decrease in the slope observed in the period with a cluster of published studies (2004-2014). Fifteen intervention studies specifically targeting under-five children were published during the 24 years of observation. A statistically insignificant downward trend in the U5MR was observed (APC = -1.25%, 95% CI: -4.70 to 2.40%) coinciding with publication of most of the studies and development of MNCH policies. CONCLUSIONS: The development of MNCH policies, implementation and publication of interventions corresponds with the downward trend of maternal and child mortality in Nigeria. This systematic review has also shown that more MNCH intervention research and publications of findings is required to generate local and relevant evidence

Asymptomatic genital infection among pregnant women in Sagamu, Nigeria.

Background: Untreated genital tract infections in pregnancy may be associated with adverse effects on foetal and maternal health leading to poor pregnancy outcome.Aim: The aim of this study is to determine the prevalence and microbial isolates associated with asymptomatic genital infectionsin pregnancy.Methodology: This was a cross-sectional study on 252 pregnant women attending their first antenatal clinic. Data on socio-demographic characteristics of study participants was recorded. Microbial culture was carried out on High Vaginal and Endocervical swab samples. Statistical analysis was done using IBM-SPSS Windows version 20.Results: The prevalence of asymptomatic genital infection was 44.8%. Multiparity had statistically significant association with increased prevalence of the condition. Candida albicans and Staphylococcus aureus were the most predominant microbial isolates. Erythromycin and Levofloxacin were the most sensitive antibiotics against the bacterial isolates.Conclusion: This prevalence of asymptomatic genital infectionsis high in pregnant women in Sagamu. It is recommended that routine screening and treatment of these infections should be included in the antenatal clinic services offered to pregnant women so as to prevent the adverse foetal and maternal effects associated with asymptomatic genital infections in pregnancy.Keywords: Genital infection, Pregnancy, Asymptomatic, Sagamu

Determinants of neonatal mortality at Wesley Guild Hospital, Ilesa, Nigeria

No Abstract. Nigerian Journal of Medicine Vol. 15(3) July-September 2006: 271-27

Diseases of poultry in Akure, Nigeria: a ten year analysis of clinical records

An analysis of poultry diseases diagnosed at the avian clinic of Veterinary Hospital of the Ministry of Agriculture and Natural Resources, Akure, Ondo-State, was carried out using data from 22,927 cases reported at the clinic over a period of ten years. The commonest diseases reported were Newcastle, 9.8%, chronic respiratory disease, 8.8%, helminthoses, 8.5%, fowl pox, 7.0%, coccidiosis, 0.5%, Gumboro, 0.07% and pneumonia, 0.004%. Incidence of Newcastle disease (NCD) was highest in the dry season with peak of outbreak in January and occurred most in chicks less than 7 weeks old. Chronic respiratory disease (CRD) showed the highest incidence in birds over 12 weeks old and was not recorded for birds less than 7 weeks old. Infectious bursal disease (IBD), fowl pox (FP) and coccidiosis occurred more in young birds less than 7 weeks of age. It was concluded that viral diseases (NCD, IBD and FP), ectoparasitism and helminthoses were the most important poultry diseases in Akure and young birds were more susceptible.Key Words: Disease, poultry, Akure

Forensic Investigation of Premature Failure of a Roadway Pavement in Minna, Niger state, Nigeria

Field and laboratory studies were conducted to investigate the premature failure of a township roadway pavement in Minna, Niger state, Nigeria. Tests conducted on the pavement layers of the failed road included moisture content, particle size distribution of soil samples, Atterberg limit tests, in-situ density and dynamic cone penetrometer (DCP) tests. An empirical equation from published literature was used to compute the California bearing ratio (CBR) of various pavement layers from DCP data. Data from the tests indicate that the field moisture content of the pavement layers (i.e., subgrade, sub-base and base) were high, recording values above the optimum moisture content (OMC). Some soil materials from the pavement layers at the various failed sections had fines content above specification requirements for such layers. Atterberg limits tests revealed high liquid limits as well as plasticity index values. Generally, the field density values of the subgrade layers were found to be low equivalent to 82 - 98 percent degree of compaction, while the density of the sub-base and base layers at some failed locations were equally low achieving a degree of compaction of about 85 - 99 per cent, against specification requirement of 100 per cent. CBR values were mostly lower than recommended values by local codes. Overall, high proportion of fines and plasticity index values together with inadequate compaction of pavement layers as well as low CBR were identified as key factors responsible for the failure.Keywords: California bearing ratio, degree of compaction, minna, pavement, pre-mature failur