Comparing the outcomes of labour induction with misoprostol and dinoprostone at Amino Kano teaching Hospital Kano Norhtwest Nigeria

Context: Induction of labour is an old procedure performed to artificially terminate pregnancy for various indications in the interest of the mother, the fetus or both. The aim is to achieve vaginal delivery. Various methods have been in use which include the use of Misoprostol, Dinoprostone, oxytocin infusion and others. In an effort to determine which agent gives better outcome studies were carried out comparing the agents with one another.Objectives: To compare the outcomes of labour induced with Misoprostol and Dinoprostone and to determine the incidence of induction of labour at Aminu Kano Teaching Hospital Kano Nigeria.Materials and Methods: The study was restrospective involving a total of 364 patients admitted for labour induction between January 2005 to December 2009. Out of this 274 were induced with Misoprostol and 90 were induced with Dinoprostone.Results: The incidence of labour induction is 2.35%. The indications include postdatism, Hypertensive disorders of pregnancy, PROM, IUFD and others such as Sickle cell disease, and Diabetes Mellitus. The most common indication was postdatism 45.9%. The success rate was 83.9% for Misoprostol and 82.2% for Dinoprostone. There is a statistically significant difference in terms of shorter induction delivery interval in favour of Misoprostol. There were less number of babies with APGAR score less than 6 in the Misoprostol group. There is no statistically significant difference in terms of the spontaneous vaginal deliveries and caesarean section rates between the two groups.Conclusion: The rate of induction of labour in the centre is 2.35%. Misoprostol was found to be a more efficient and safer agent for induction of labour if the procedure is well managed. It was associated with shorter induction delivery interval without compromising the fetomaternal outcome compared to Dinoprostone.Keywords: Induction of Labour, Misoprostol, Dinoprostone, OutcomeTrop J Obstet Gynaecol, 30 (1), April 201

Phytotherapy as an alternative for the treatment of human papilloma virus infections in Nigeria: a review

Human papillomavirus (HPV) has been incriminated as the causal agent of cervical cancer which has been rated as the second most common cancers among women in developing countries and seventh most common cancers in the developed world. In spite of the fact that HPV has been the major cause of cervical cancer, the dilemma lies in finding a cost-effective therapy. Approximately 291 million women are infected with HPV worldwide, 32% of whom are infected with HPV16 or HPV18. The estimated prevalence of HPV in sub-Saharan Africa is 24% and 11.7% globally. There have been studies reporting specific HPV prevalence rates in some part of Nigeria, with 37% in Abuja, 10% in Port Harcourt, and 26.3% in Ibadan. In the Nigeria population, awareness of HPV infections is low, HPV vaccines are inadequate, and the cost of HPV vaccination per person is beyond what an average citizen can afford. It has been suggested that herbal therapy such as Echinacea therapy reduces HPV replication and enhances the immune system. Although there is yet no scientific proof of the efficacy of Echinacea therapy against HPV infections, future emphasis should be placed on scientific research into this alternative therapy. There is need for more studies on development of antiviral agents against HPV, with a prospect of easy accessibility and affordability in Nigeria.Keywords: Phytotherapy; HPV; Cervical cancer; Nigeri

Detection of metallo betalactamases among gram negative bacterial isolates from Murtala Muhammad Specialist Hospital, Kano and Almadina Hospital Kaduna, Nigeria

Over the last few years, the increase in the number of multi-resistant (MR) enterobacteria has become a major clinical problem. This study detects the occurrence and prevalence of Metallo betalactamase production among some clinical bacterial isolates in Murtala Muhammad SpecialistHospital, Kano and Al-Madina Specialist Hospital Kaduna, Nigeria. A total of 200 clinical isolates comprising of E. coli (83), Klebsiella pneumoniae (52), Pseusomonas aeruginosa (28) and Proteus mirabilis (37) were screened phenotypically for carbapenemase and specifically for Metallo betalactamase using Modified Hodges Test and EDTA Disc Synergy Test respectively. The result showed that 67(33.5%) of the isolates were found to produce carbapenemase. High production occurred in 24(35.8%) and low production occurred in 43(64.2%) of the isolates. Highest prevalence of carbapenemase was found in Pseudomonas aeruginosa (38.55%) followed by E. coli (34.8%), Proteus mirabilis. (29.1%) and least prevalence in Klebsiella pneumoniae (25.0%). The prevalence of MBLs in the study was 24.5% with highest prevalence in E. coli (31.32%) followed by Proteus mirabilis. (21.6%), Pseudomonas aeruginosa (21.2%) and least among Klebsiella pneumoniae. (14.3%). Most of carbapenemase producers produce MBL type. Urine samples were found to be with the highest prevalence of 38.3% when compared with ear swab (12.0%). Prevalence of 67.9% and 76.9% were recorded for Murtala Muhammad specialist hospital Kano and Al-madina hospital Kaduna respectively. This showed that carbapenemase-mediated resistance occurred in the selected hospitals and uncontrolled spread may lead to treatment failure and frustration.Keywords: Metallobetalactamase, Carbapenemase, Enterobacteriaceae, prevalence, Hospita

A Continental-Wide Perspective: The Genepool of Nuclear Encoded Ribosomal DNA and Single-Copy Gene Sequences in North American Boechera (Brassicaceae)

74 of the currently accepted 111 taxa of the North American genus Boechera (Brassicaceae) were subject to pyhlogenetic reconstruction and network analysis. The dataset comprised 911 accessions for which ITS sequences were analyzed. Phylogenetic analyses yielded largely unresolved trees. Together with the network analysis confirming this result this can be interpreted as an indication for multiple, independent, and rapid diversification events. Network analyses were superimposed with datasets describing i) geographical distribution, ii) taxonomy, iii) reproductive mode, and iv) distribution history based on phylogeographic evidence. Our results provide first direct evidence for enormous reticulate evolution in the entire genus and give further insights into the evolutionary history of this complex genus on a continental scale. In addition two novel single-copy gene markers, orthologues of the Arabidopsis thaliana genes At2g25920 and At3g18900, were analyzed for subsets of taxa and confirmed the findings obtained through the ITS data

Pooled analysis of WHO Surgical Safety Checklist use and mortality after emergency laparotomy

Background The World Health Organization (WHO) Surgical Safety Checklist has fostered safe practice for 10 years, yet its place in emergency surgery has not been assessed on a global scale. The aim of this study was to evaluate reported checklist use in emergency settings and examine the relationship with perioperative mortality in patients who had emergency laparotomy. Methods In two multinational cohort studies, adults undergoing emergency laparotomy were compared with those having elective gastrointestinal surgery. Relationships between reported checklist use and mortality were determined using multivariable logistic regression and bootstrapped simulation. Results Of 12 296 patients included from 76 countries, 4843 underwent emergency laparotomy. After adjusting for patient and disease factors, checklist use before emergency laparotomy was more common in countries with a high Human Development Index (HDI) (2455 of 2741, 89.6 per cent) compared with that in countries with a middle (753 of 1242, 60.6 per cent; odds ratio (OR) 0.17, 95 per cent c.i. 0.14 to 0.21, P <0001) or low (363 of 860, 422 per cent; OR 008, 007 to 010, P <0.001) HDI. Checklist use was less common in elective surgery than for emergency laparotomy in high-HDI countries (risk difference -94 (95 per cent c.i. -11.9 to -6.9) per cent; P <0001), but the relationship was reversed in low-HDI countries (+121 (+7.0 to +173) per cent; P <0001). In multivariable models, checklist use was associated with a lower 30-day perioperative mortality (OR 0.60, 0.50 to 073; P <0.001). The greatest absolute benefit was seen for emergency surgery in low- and middle-HDI countries. Conclusion Checklist use in emergency laparotomy was associated with a significantly lower perioperative mortality rate. Checklist use in low-HDI countries was half that in high-HDI countries.Peer reviewe

Global variation in anastomosis and end colostomy formation following left-sided colorectal resection

Background End colostomy rates following colorectal resection vary across institutions in high-income settings, being influenced by patient, disease, surgeon and system factors. This study aimed to assess global variation in end colostomy rates after left-sided colorectal resection. Methods This study comprised an analysis of GlobalSurg-1 and -2 international, prospective, observational cohort studies (2014, 2016), including consecutive adult patients undergoing elective or emergency left-sided colorectal resection within discrete 2-week windows. Countries were grouped into high-, middle- and low-income tertiles according to the United Nations Human Development Index (HDI). Factors associated with colostomy formation versus primary anastomosis were explored using a multilevel, multivariable logistic regression model. Results In total, 1635 patients from 242 hospitals in 57 countries undergoing left-sided colorectal resection were included: 113 (6·9 per cent) from low-HDI, 254 (15·5 per cent) from middle-HDI and 1268 (77·6 per cent) from high-HDI countries. There was a higher proportion of patients with perforated disease (57·5, 40·9 and 35·4 per cent; P < 0·001) and subsequent use of end colostomy (52·2, 24·8 and 18·9 per cent; P < 0·001) in low- compared with middle- and high-HDI settings. The association with colostomy use in low-HDI settings persisted (odds ratio (OR) 3·20, 95 per cent c.i. 1·35 to 7·57; P = 0·008) after risk adjustment for malignant disease (OR 2·34, 1·65 to 3·32; P < 0·001), emergency surgery (OR 4·08, 2·73 to 6·10; P < 0·001), time to operation at least 48 h (OR 1·99, 1·28 to 3·09; P = 0·002) and disease perforation (OR 4·00, 2·81 to 5·69; P < 0·001). Conclusion Global differences existed in the proportion of patients receiving end stomas after left-sided colorectal resection based on income, which went beyond case mix alone

Pharmacological mechanisms involved in the analgesia induced by ethanol extract of Hybanthus enneaspermus leaves

Ayobami Oladele Afolabi,1 Isiaka Abdullateef Alagbonsi,2 Jubril Ayodeji Aliyu1 1Department of Physiology, College of Health Sciences, Ladoke Akintola University of Technology, Ogbomoso, Nigeria; 2Department of Physiology, Faculty of Medicine and Health Sciences, University of Gitwe, Gitwe, Republic of Rwanda Background: Hybanthus enneaspermus (HE) leaves are being used traditionally to relieve pain, and scientific studies have demonstrated their analgesic potential. This study attempted to elucidate the pharmacological mechanism(s) involved in the analgesic action of ethanol extract of H. enneaspermus leaves (EEHE). Materials and methods: Forty-two male Wistar rats were separately randomized into seven groups (n=6 rats in each group) for tail immersion and formalin tests. Group I (control) received distilled water (10 mL/kg) while groups II and III received acetaminophen (the reference drug, 100 mg/kg ip) and EEHE (1000 mg/kg po), respectively. Groups IV&ndash;VII were pretreated with cimetidine (50&nbsp;mg/kg ip), naloxone (5 mg/kg ip), propranolol (0.15 mg/kg ip), and prazosin (0.15 mg/kg ip), respectively, 1 hour before EEHE (1000 mg/kg po) treatment. Results: The EEHE-induced increase in tail-flick latency was reduced by blockade of histamine and adrenergic receptors but prevented by blockade of opiate receptor in the tail-flick test. However, the EEHE-induced decrease in paw licking time was prevented only by blockade of opiate receptor but unaffected by histamine and adrenergic receptors blockers. Conclusion: These findings suggest that the analgesic effect of EEHE in different pain types may involve different neural mechanisms and that the opioidergic pathway contributes more to EEHE-induced analgesia than the other pathways. Keywords: analgesia, formalin test, Hybanthus enneaspermus, pain, tail immersion tes

Optimization of lead (ii) ions adsorption on to chemically activated carbon from sugarcane bagasse

The adsorption of Lead (II) ion on to chemically activated carbon has been studied and optimized in a batch reactor system. The zinc chloride impregnated sugarcane bagasse was thermal activated in a fixed bed reactor in the presence of argon gas. The surface morphology, surface functional group and thermal stability were determined. The SEM micrograph revealed porous structures which enhance the sorption capacity of the developed activated carbon. The derivative thermal analysis (DTA) and thermogravimetric analysis (TGA) profile of the activated carbon were employed in the proximate analysis. The BET surface area shows a high microporous surface area and micropore volume of 840.38 m2/g and 0.30 cc/g respectively which aids sorption efficiency. The adsorption of lead ion was optimized using 2k factorial experimental design where pH, mass of absorbent, temperature and time was studied in a batch reactor. pH has the highest positive impact on the adsorption of Pb2+ while considering single effect as studied using atomic absorption spectrophotometer. After estimating the main effects, the interacting factors affecting the removal of Pb2+ were determined by performing the analysis of variance (ANOVA) with R-Square of 99.97%. This study has demonstrated that Zinc chloride activated carbon has high affinity for lead ion sorption.Keywords: Sugarcane Bagasse, Activated Carbon, Characterization, Adsorption and Optimization

Transmission dynamics of SARS-CoV-2 : a modeling analysis with high-and-moderate risk populations

202110 bcvcVersion of RecordPublishe