Heavy metal bioaccumulation and biomarkers of oxidative stress in the wild African tiger frog, Hoplobatrachus occipitalis

Human activities can have dramatic effects on animal populations around urban areas with heavy metal contamination being a primary cause of harm. Amphibians, as residents of aquatic systems and with their semi-permeable skin are especially susceptible to heavy metal contamination. To better understand the effect of heavy metals on Wild African Tiger frogs (Hoplobatrachus occipitalis) and the resulting production of oxidative stress enzymes, the concentrations of the heavy metals, cadmium (Cd), copper (Cu), iron (Fe), zinc (Zn), lead (Pb) and nickel (Ni) were investigated in the tissues of H. occipitalis as well as in water and sediment samples collected from five different locations in Lagos State, Nigeria. The activities of superoxide dismutase (SOD), reduced glutathione (GSH) and level of lipid peroxidation product, malondialdehyde (MDA) were analyzed in the liver of the sampled frogs. Most measured physicochemical characteristics of the water varied significantly across the sampling locations (P<0.05). The levels of metals (mg/kg dry weight) in muscle tissues also varied significantly across the locations (P<0.05) and ranged as follows: Cd: 0.21-5.03, Cu: 0.74-13.40, Fe: 3.19-109.10, Zn: 3.70-120.20, Pb: 0.12-18.24 and Ni: 3.20-7.28. Zn was the most accumulated metal, followed by Fe, Cu and Ni, while Pb was the least. The mean of SOD and reduced GSH in the frogs indicate some responses to oxidative stress which varied significantly among sampling areas (P<0.05). MDA values however did not consistently correlate with either oxidative stress or heavy metal concentrations in the frogs. The water-sediment-tissue analysis for heavy metals demonstrated that the sediment concentrated more heavy metals than water, while the frog tissues accumulated these metals articularly in more polluted areas.Key words: Heavy metal pollution, bioaccumulation, Hoplobatrachus occipitalis, biomarkers, oxidative stress

Patient preferences and treatment safety for uncomplicated vulvovaginal candidiasis in primary health care

<p>Abstract</p> <p>Background</p> <p>Vaginitis is a common complaint in primary care. In uncomplicated candidal vaginitis, there are no differences in effectiveness between oral or vaginal treatment. Some studies describe that the preferred treatment is the oral one, but a Cochrane's review points out inconsistencies associated with the report of the preferred way that limit the use of such data. Risk factors associated with recurrent vulvovaginal candidiasis still remain controversial.</p> <p>Methods/Design</p> <p>This work describes a protocol of a multicentric prospective observational study with one year follow up, to describe the women's reasons and preferences to choose the way of administration (oral vs topical) in the treatment of not complicated candidal vaginitis. The number of women required is 765, they are chosen by consecutive sampling. All of whom are aged 16 and over with vaginal discharge and/or vaginal pruritus, diagnosed with not complicated vulvovaginitis in Primary Care in Madrid.</p> <p>The main outcome variable is the preferences of the patients in treatment choice; secondary outcome variables are time to symptoms relief and adverse reactions and the frequency of recurrent vulvovaginitis and the risk factors. In the statistical analysis, for the main objective will be descriptive for each of the variables, bivariant analysis and multivariate analysis (logistic regression).. The dependent variable being the type of treatment chosen (oral or topical) and the independent, the variables that after bivariant analysis, have been associated to the treatment preference.</p> <p>Discussion</p> <p>Clinical decisions, recommendations, and practice guidelines must not only attend to the best available evidence, but also to the values and preferences of the informed patient.</p

Polyhydramnios Associated with Multiple Congenital Malformations: Case Report

A case of polyhydramnios associated with multiple congenital abnormalities in the fetus of a 25 year old primigravida, at 33 weeks gestation is reported. She presented with complaint of excessive abdominal distension and ultrasound scan revealed severe polyhydramnios (AFI 46.1cm) with multiple congenital malformations. The patient was delivered of a fresh stillbirthwith multiple congenital anomalies.Niger Med J. Vol. 49, No. 1, Jan. – Mar., 2008: 24 – 26.Keywords: Polyhydramnios, Multiple congenital malformations (MCA), Amniotic fluid index (AFI

Pattern of Obstetric Mortality In A Voluntary Agency Hospital In Abeokuta South West Nigeria

Most of the published works on maternal mortality in Nigeria emanate from Teaching and Specialist Hospitals although maternal deaths also occur frequently in more peripheral health facilities. The importance of studying pattern of deaths in such facilities lies in furnishing additional data to compliment the efforts of specialists in getting a better picture of this problem. An analysis of obstetric deaths over a 5-year period at Nigeria's oldest hospital, the Sacred Heart Hospital, Lantoro, Abeokuta was carried out in order to determine the pattern and causes of such deaths and what may be done to reduce their frequency. Methods - This retrospective study of hospital records of mothers who died due to complications during or immediately after labor in the hospital between January 1994 and December 1998 were analysed for socio demographic factors, parity, booking status, duration of stay in hospital, and cause of death including information surrounding the circumstances of death were also obtained. Results - Between January 1994 and December 1998, a total of 65 obstetric deaths were recorded. There were 21,430 deliveries, giving an overall maternal mortality ratio of 303 per 100,000 births. There was a progressive reduction in the total yearly deliveries during the study period but a paradoxical yearly increase in maternal mortality ratio The youngest death was recorded in a 15 year old while the age group 20-24 was more affected. Primips and grand multigravidas (70%) were the worst affected parity groups. They were mostly unbooked The features of these deaths revealed a high and increasing maternal mortality ratio (MMR) due to largely preventable causes, of haemorrhage, sepsis, anaemia, obstructed labour and eclampsia.. Conclusion - In order for a reduction to occur in maternal deaths a deliberate expansion and modernization of the obstetric, including emergency obstetric services of the Sacred Heart Hospital, Lantoro, Abeokuta should be commenced. Assisting rural communities to establish emergency obstetric care transportation service is vital. A renewed commitment to training and retraining of community-based care providers on current methods of conducting deliveries safely, as well as early recognition and prompt referral of mothers with high risk pregnancies or complications is equally important. The maternal mortality ratio in Abeokuta though less than the national average is unacceptably high; national socio political problems and poorly organized local health systems were the main contributory factors. Key words: Obstetric mortality, mission hospital, Nigeria Nigerian Medical Practitioner Vol.45(5) 2004: 83-9

Community perceptions of pre-eclampsia and eclampsia in Ogun State, Nigeria: a qualitative study

Background: Pre-eclampsia is a complication of pregnancy responsible for high rates of morbidity and mortality, particularly in sub-Saharan Africa. When undetected or poorly managed, it may progress to eclampsia which further worsens the prognosis. While most studies examining pre-eclampsia have used a bio-medical model, this study recognizes the role of the socio-cultural environment, in order to understand perceptions of pre-eclampsia within the community. Methods: The study was conducted in Ogun State, Nigeria in 2011–2012. Data were obtained through twenty-eight focus group discussions; seven with pregnant women (N = 80), eight with new mothers (N = 95), three with male decision-makers (N = 35), six with community leaders (N = 68), and three with traditional birth attendants (N = 36). Interviews were also conducted with the heads of the local traditional birth attendants (N = 4) and with community leaders (N = 5). Data were transcribed verbatim and analysed in NVivo 10 software. Results: There was no terminology reportedly used for pre-eclampsia in the native language - Yoruba; however, hypertension has several terms independent of pregnancy status. Generally, ‘gìrì âlábôyún’ describes seizures specific to pregnancy. The cause of hypertension in pregnancy was thought to be due to depressive thoughts as a result of marital conflict and financial worries, while seizures in pregnancy were perceived to result from prolonged exposure to cold. There seemed to be no traditional treatment for hypertension. However for seizures the use of herbs, concoctions, incisions, and topical application of black soap were widespread. Conclusion: This study illustrates that knowledge of pre-eclampsia and eclampsia are limited amongst communities of Ogun State, Nigeria. Findings reveal that pre-eclampsia was perceived as a stress-induced condition, while eclampsia was perceived as a product of prolonged exposure to cold. Thus, heat-related local medicines and herbal concoctions were the treatment options. Perceptions anchored on cultural values and lack of adequate and focused public health awareness is a major constraint to knowledge of the aetiology and treatment of the conditions. A holistic approach is recommended for sensitization at the community level and the need to change the community perceptions of pre-eclampsia remains a challenge. Trial Registration NCT01911494 .Medicine, Faculty ofNon UBCObstetrics and Gynaecology, Department ofReviewedFacult

Community health workers’ knowledge and practice in relation to pre-eclampsia in Ogun State, Nigeria: an essential bridge to maternal survival

Background: Pre-eclampsia is a leading cause of maternal and fetal morbidity and mortality worldwide. Early detection and treatment have been instrumental in reducing case fatality in high-income countries. To achieve this in a low-income country, like Nigeria, community health workers who man primary health centres must have adequate knowledge and skills to identify and provide emergency care for women with pre-eclampsia. This study aimed to determine community health workers’ knowledge and practice in the identification and treatment of pre-eclampsia, as they are essential providers of maternal care services in Nigeria. Methods: This study was part of a multi-country evaluation of community treatment of pre-eclampsia. Qualitative data were obtained from four Local Government Areas of Ogun State, in south western Nigeria by focus group discussions (N = 15) and in-depth interviews (N = 19). Participants included a variety of community-based health care providers - traditional birth attendants, community health extension workers, nurses and midwives, chief nursing officers, medical officers – and health administrators. Data were transcribed and validated with field notes and analysed with NVivo 10.0. Results: Community-based health care providers proved to be aware that pre-eclampsia was due to the development of hypertension and proteinuria in pregnant women. They had a good understanding of the features of the condition and were capable of identifying women at risk, initiating care, and referring women with this condition. However, some were not comfortable managing the condition because of the limitation in their ‘Standing Order’; these guidelines do not explicitly authorize community health extension workers to treat pre-eclampsia in the community. Conclusion: Community-based health care providers were capable of identifying and initiating appropriate care for women with pre-eclampsia. These competencies combined with training and equipment availability could improve maternal health in the rural areas. There is a need for regular training and retraining to enable successful task-sharing with these cadres. Trial registration NCT01911494 .Medicine, Faculty ofOther UBCNon UBCObstetrics and Gynaecology, Department ofReviewedFacult