Relative Effectiveness of Water Hyacinth, Bacteria and Fungi in Purifying Sewage

The relative effectiveness of water hyacinth (Eichhornia crassipes) (phytoremedian), bacteria and fungi (bioremedians) used for the purification of domestic sewage was carried out using Completely Randomised Design (CRD) replicated three times. Physical, bacteriological and chemical properties of domestic sewage were investigated before and after purification. The results show that for suspended solids, cultured tanks treated with 2kg water hyacinth reduced the sewage concentration from 73mg/l to 37.5mg/l, dissolved solids was reduced from 312mg/l to 266mg/l, Biological Oxygen Demand (BOD) was reduced from 11.2mg/l to 4.37mg/l, Chemical Oxygen Demand (COD) was reduced from 7.6mg/l to 2.7mg/l. Dissolved Oxygen increased from 6.8mg/l to 7.17mg/l for 2kg hyacinth treatment due to photosynthesis but reduced to 3.7 for fungi. The cultured tanks treated with bacteria performed best in reducing turbidity and bacteriological properties of sewage. Turbidity was reduced from 5.8NTU to 1.2NTU for tanks cultured with bacteria. During the first three weeks, the hyacinth's growth was very rapid. It effectively depleted the nutrients present in the sewage, by the 4th week, gradual wilting of water hyacinth was noticed and by the end of the 5th week, serious wilting occurred due to deficiency in essential nutrients. The 2kg water hyacinth tanks wilted permanently due to total consumption of sewage. The results show that purification potential of water hyacinth is related to plants population with the 2kg hyacinth's tanks purifying better than the 1kg hyacinth density and also that bacteria purifies sewage better than fungi. Generally the 2kg water hyacinth was best in reducing the physio-chemical properties of the sewage better than the other treatments applied while the tanks treated with bacteria performed best in reducing bacteriological properties of sewage.Key words: Purification, sewage, phytoremediation, water hyacinth, bioremediation, bacteria and fungi

Evaluation of menstrual pattern before and after treatment for intrauterine adhesion

To determine the pattern of menstrual disorders and treatment outcome among women managed for intrauterine adhesion at a tertiary centre in Ilorin, Nigeria. Methodology: A descriptive study of women with intrauterine adhesion managed at the University of Ilorin Teaching Hospital over a three-year period. Diagnosis was confirmed with hysterosalpingography; the case files were retrieved from the medical records department to review the management, extract relevant data and analyse the data using SPSS version 20.0 and P<0.05 was significant. Results: The incidence of intrauterine adhesion was 1.5% of all gynaecological clinic attendees; the modal age group was 25 to 29 years (36; 48.0%), 28(37.3%) were nulliparous, 47(62.7%) followed dilatation and curettage among which 34(45.3%) were performed for induced abortion. Menstrual disorder was reported in 73(97.3%) of participants; these were secondary amenorrhea (34; 45.3%), hypomenorrhea (29; 38.7%) and oligomenorrhea (10; 13.3%) while 2(2.7%) had normal menstruation. Treatment was by hysteroscopic 55(73.30%) or blind 20(26.70%) adhesiolysis. After treatment, normal menstruation resumed in 79.3% of those who presented with hypomenorrhea, 70% for oligomenorrhea and 66.7% for secondary amenorrhea. The treatment outcome was significantly improved following hysteroscopic compared to blind adhesiolysis (p 0.029). Conclusion: Complications from dilatation and curettage for induced abortion remains the commonest risk factor for intrauterine adhesion; safe abortion services and post abortion care may reduce the morbidity. Hysteroscopic adhesiolysis should be the preferred treatment modality for uterine synaechiae

Spectrum of Uropathogens and its Antibiotic Susceptibility in Pregnant Women with Symptomatic Urinary Tract Infection in a Nigerian Teaching Hospital. Running headline: Urinary Tract Infection in Pregnancy

Background: Urinary tract infections (UTI) are the most common bacterial infections in pregnancy and associated with maternal and perinatal morbidity and mortality.Objectives: To determine the current uropathogens and their antibiotic susceptibility pattern and to compare the pregnancy outcome among clinical UTI and non clinical UTI cohorts.Patients and methods: This was a prospective matched cohort study carried out between 1st January, 2012 and 30th June, 2012 at the department of Obstetrics and Gynaecology of the University of Ilorin Teaching Hospital, Ilorin, Nigeria. The study population was made up of 200 pregnant women with clinical signs and symptoms of urinary tract infections and 200 pregnant women without clinical signs and symptoms ofurinary tract infection as control matched with maternal age group, parity and gestational age.Results: Of 3442 obstetric patients seen 200 had clinically diagnosed UTI in pregnancy giving a rate of 5.8%. Age bracket 21- 30years and multipara had highest frequency of significant bacteriuria. Low social status and third trimester of pregnancy were identified risk factors for UTI in pregnancy. Frequency of maternal anaemia (p=0.02) and hypertension (p=0.03) were significantly higher among subjects than control. The common bacterial uropathogen isolated were Escherichia coli (46.7%), Staphylococcus aureus (17.9%), Proteus spp.(13.3%) and Klebsiella spp. (11.1%). The antibiotics with highest coverage included Co-amoxyclave (81%), Gentamicin (68.8%) and Cefuroxime (54.4%).Conclusion: Maternal anaemia and hypertension were significantly higher among subjects than control. Gram negative isolates were predominantand E. coli was the most common isolated bacteria. Co-amoxyclave had highest coverage against the bacteria. Therefore, co-amoxyclave is  recommended for empirical use for urinary tract infection in pregnancy in this locality.Keywords: Uropathogens, urinary tract infection, pregnancy, antibiotic sensitivity

Predictors of maternal mortality among critically ill obstetric patients

Aim: Evaluation of the predictors of maternal mortality among critically ill obstetric patients managed at the intensive care unit (ICU).Methods: A case control study to evaluate the predictors of maternal mortality among critically ill obstetric patients managed at the intensive care unit (ICU) of the University of Ilorin Teaching Hospital, Ilorin, Nigeria from 1st January 2010 to 30th June 2013. Participants were critically ill obstetric patients who were admitted and managed at the ICU during the study period. Subjects were those who died while controls were age and parity matched survivors. Statistical analysis was with SPSS-20 to determine chi square, Cox-regression and odds ratio; p value < 0.05 was significant.Results: The mean age of subjects and controls were 28.92 ± 5.09 versus 29.44 ± 5.74 (p = 0.736), the level of education was higher among controls (p = 0.048) while more subjects were of low social class (p = 0.321), did not have antenatal care (p = 0.131) and had partners with lower level of education (p = 0.156) compared to controls. The two leading indications for admission among subjects and controls were massive postpartum haemorrhage and severe preeclampsia or eclampsia. The mean duration of admission was higher among controls (3.32 ± 2.46 versus 3.00 ± 2.58; p = 0.656) while the mean cost of ICU care was higher among the subjects (p = 0.472). The statistical significant predictors of maternal deaths were the patient’s level of education, Glasgow Coma Scale (GCS) score, oxygen saturation, multiple organ failure at ICU admission and the need for mechanical ventilation or inotrophic drugs after admission.Conclusion: The clinical state at ICU admission of the critically ill obstetric patients is the major outcome determinant. Therefore, early recognition of the need for ICU care, adequate pre-ICU admission supportive care and prompt transfer will improve the outcome

Attitudes to female genital mutilation/cutting among male adolescents in Ilorin, Nigeria

Background. The central role of males in female reproductive health issues in patriarchal societies makes them an important group in the eradication of female genital mutilation/cutting (FGM/C).Objectives. To determine knowledge about and attitudes to FGM/C among male adolescents, and their preparedness to protect their future daughters from it.Methods. A cross-sectional survey among male adolescent students in Ilorin, Nigeria. Participants completed a self-administered questionnaire after consent had been obtained from them or their parents. Statistical analysis was with SPSS version 20.0 (IBM, USA). A p-value of <0.05 was taken as significant.Results. Of 1 536 male adolescents (mean age 15.09 (standard deviation 1.84) years, range 14 - 19), 1 184 (77.1%) were aware of FGM/C, 514 (33.5%) supported female circumcision, 362 (23.6%) would circumcise their future  daughters, 420 (27.3%) were of the opinion that FGM/C had benefits, mostly as a necessity for womanhood (109, 7.1%), and 627 (40.8%) perceived it as  wickedness against females; 546 (35.5%) were aware of efforts to eradicate FGM/C, and 42.2% recommended education as the most important intervention to achieve this.Conclusion. Education and involvement in advocacy may transform male adolescents into agents for eradication of FGM/C

Pregnancy Outcome in Cervical Incompetence: Comparison of Outcome Before and After Intervention

Context: Cervical incompetence is a major cause of recurrent mid-trimester pregnancy loss and preterm deliveries; it contributes significantly to fetal loss and neonatal morbidity and mortality. Despite its wide use, the effectiveness of cervical cerclage in its management remains unsettled.Objective: To evaluate the effectiveness of cervical cerclage by comparing the pregnancy outcome before and after its insertion in women with cervical incompetence.Study design: An observational study [retrospective] of 95 women  diagnosed with cervical incompetence that had cervical cerclage inserted from 1st January 2007 to31st December 2010. The pregnancy outcomebefore and after cervical cerclage were compared, the data was analyzed using SPSS version 18; p value <0.05 was considered significant.Main outcome measure: The gestational age at the end of pregnancy, the duration of prolongation of the pregnancy after cervical cerclage and the pregnancy outcome.Results: Of 103 cases of cervical incompetence managed, 95 satisfied the inclusion criteria. The prevalence of cervical incompetence was 8.4/1000 deliveries or 0.85%. There were 85 elective and 10 emergency cerclage with mean gestational age at end of pregnancy of 36.06±3.96 vs. 25.10±3.99 and mean duration of prolongation of pregnancy 20.98±4.71 vs. 4.00±3.37 weeks. After cervical cerclage insertion, there was reduction in miscarriages [P<0.0001] and preterm deliveries [P<0.0001] and increase in term deliveries [P=0.4100] and viable pregnancies [P=0.001]. The child take home rate was 89.4% following elective and 20% after emergency cervical cerclage.Conclusion: Cervical cerclage resulted in improved pregnancy outcome in women with previous midtrimester losses or preterm delivery.Keywords: Cervical cerclage; cervical incompetence; pregnancy outcome; intervention

Umbilical cord parameters in Ilorin: correlates and foetal outcome

Background: The anthropometric parameters of the umbilical cord have clinical significance. Current parameters of the cord, its correlates and related foetal outcome are lacking in our parturients.Objectives: To describe the anthropometric parameters and abnormalities of the umbilical cord; and determine their maternal correlates and foetal outcome.Design: A cross sectional analytical study.Setting: The Obstetric and Gynaecology Department of the University of Ilorin Teaching Hospital, between September 2012 and June 2013.Subjects: Healthy pregnant women with singleton pregnancies.Results: Four hundred and twenty- eight (428) singleton deliveries were studied. The respective mean values of the cord length and width were 526.87±115.5mm and 19.56±11.12mm. Short cord (< 40cm) occurred in 7.2% while long cord (> 69cm) was found in 9.3% of the parturient. The incidences of single umbilical artery, cord round the body and knots were 7%, 8.4% and 14.5% respectively. Nuchal cord was the most common (91.4%). Only gestational age had significant statistical relationship with cord length abnormalities (P = 0.0093). The cord length was an important correlate of cord helices, knots and vessels (P< 0.05).Parity had correlations with the number of vessels(R= 0.099, P=0.042). The cord coiling index was statistically related to the presence of congenital abnormalities (P=0.011). Other perinatal events were not related to umbilical cord parameters. Perinatal asphyxia was the most common indication for NICU admission (3.5%) but there was no significant statistical difference between NICU admission and cord parameters.Conclusion: The umbilical cord parameters in apparently healthy parturients in Ilorin were comparable with others elsewhere. The cord length and helix are important correlates of gestational age and congenital abnormalities. Parity may be related to abnormal umbilical vessels. Cord length, coils, coil index and umbilical vessels should be examined post-natally

Oxygen-rich microporous carbons with exceptional hydrogen storage capacity

Porous carbons have been extensively investigated for hydrogen storage but, to date, appear to have an upper limit to their storage capacity. Here, in an effort to circumvent this upper limit, we explore the potential of oxygen-rich activated carbons. We describe cellulose acetatederived carbons that combine high surface area (3800 m2 g-1) and pore volume (1.8 cm3 g-1) that arise almost entirely (> 90%) from micropores, with an oxygen-rich nature. The carbons exhibit enhanced gravimetric hydrogen uptake (8.1 wt% total, and 7.0 wt% excess) at -196 ºC and 20 bar, rising to a total uptake of 8.9 wt% at 30 bar, and exceptional volumetric uptake of 44 g l-1 at 20 bar, and 48 g l-1 at 30 bar. At room temperature they store up to 0.8 wt% (excess) and 1.2 wt% (total) hydrogen at only 30 bar, and their isosteric heat of hydrogen adsorption is above 10 kJ mol-1

Atrial arrhythmogenicity of KCNJ2 mutations in short QT syndrome: Insights from virtual human atria

Gain-of-function mutations in KCNJ2-encoded Kir2.1 channels underlie variant 3 (SQT3) of the short QT syndrome, which is associated with atrial fibrillation (AF). Using biophysically-detailed human atria computer models, this study investigated the mechanistic link between SQT3 mutations and atrial arrhythmogenesis, and potential ion channel targets for treatment of SQT3. A contemporary model of the human atrial action potential (AP) was modified to recapitulate functional changes in IK1 due to heterozygous and homozygous forms of the D172N and E299V Kir2.1 mutations. Wild-type (WT) and mutant formulations were incorporated into multi-scale homogeneous and heterogeneous tissue models. Effects of mutations on AP duration (APD), conduction velocity (CV), effective refractory period (ERP), tissue excitation threshold and their rate-dependence, as well as the wavelength of re-entry (WL) were quantified. The D172N and E299V Kir2.1 mutations produced distinct effects on IK1 and APD shortening. Both mutations decreased WL for re-entry through a reduction in ERP and CV. Stability of re-entrant excitation waves in 2D and 3D tissue models was mediated by changes to tissue excitability and dispersion of APD in mutation conditions. Combined block of IK1 and IKr was effective in terminating re-entry associated with heterozygous D172N conditions, whereas IKr block alone may be a safer alternative for the E299V mutation. Combined inhibition of IKr and IKur produced a synergistic anti-arrhythmic effect in both forms of SQT3. In conclusion, this study provides mechanistic insights into atrial proarrhythmia with SQT3 Kir2.1 mutations and highlights possible pharmacological strategies for management of SQT3-linked AF

Laparoscopy in management of appendicitis in high-, middle-, and low-income countries: a multicenter, prospective, cohort study.

BACKGROUND: Appendicitis is the most common abdominal surgical emergency worldwide. Differences between high- and low-income settings in the availability of laparoscopic appendectomy, alternative management choices, and outcomes are poorly described. The aim was to identify variation in surgical management and outcomes of appendicitis within low-, middle-, and high-Human Development Index (HDI) countries worldwide. METHODS: This is a multicenter, international prospective cohort study. Consecutive sampling of patients undergoing emergency appendectomy over 6 months was conducted. Follow-up lasted 30 days. RESULTS: 4546 patients from 52 countries underwent appendectomy (2499 high-, 1540 middle-, and 507 low-HDI groups). Surgical site infection (SSI) rates were higher in low-HDI (OR 2.57, 95% CI 1.33-4.99, p = 0.005) but not middle-HDI countries (OR 1.38, 95% CI 0.76-2.52, p = 0.291), compared with high-HDI countries after adjustment. A laparoscopic approach was common in high-HDI countries (1693/2499, 67.7%), but infrequent in low-HDI (41/507, 8.1%) and middle-HDI (132/1540, 8.6%) groups. After accounting for case-mix, laparoscopy was still associated with fewer overall complications (OR 0.55, 95% CI 0.42-0.71, p < 0.001) and SSIs (OR 0.22, 95% CI 0.14-0.33, p < 0.001). In propensity-score matched groups within low-/middle-HDI countries, laparoscopy was still associated with fewer overall complications (OR 0.23 95% CI 0.11-0.44) and SSI (OR 0.21 95% CI 0.09-0.45). CONCLUSION: A laparoscopic approach is associated with better outcomes and availability appears to differ by country HDI. Despite the profound clinical, operational, and financial barriers to its widespread introduction, laparoscopy could significantly improve outcomes for patients in low-resource environments. TRIAL REGISTRATION: NCT02179112