Sociodemographic characteristics and handling of life‑threatening obstetric cases by traditional birth attendants in Cross River State, Nigeria

Background: Majority of pregnant women, especially in remote rural areas still desire to be delivered by traditional birth attendants (TBAs) who neither have the skills nor the equipment to treat life‑threatening complications.Objective: To determine the sociodemographic characteristics of TBAs and how they manage life‑threatening obstetric cases.Methodology: This was a prospective study carried out over a 3‑month period during the training of TBAs in the state on the reduction of maternal mortality. A total of 540 TBAs from 18 Local Government Area of the state participated in the study. Data obtained were sex, age, levels of education, number of deliveries conducted per month, difficult cases encountered, and how they managed them. The data were analyzed using Epi Info version‑7 and presented in tables.Results: TBAs are mostly females, i.e. 538 (99.6%) and only 2 (0.4%) were males. Majority of the TBAs were above the age of 55 years, i.e. 488 (88.9%); had primary education 416 (77.0%); married 396 (71.6%); and grand multiparous 293 (54.3%). Most TBAs deliver 4 newborn monthly, i.e. 148 (22.6%), and the mean number of newborn delivered monthly was 3.9. Concerning the mode of handling of the difficult cases, majority, i.e. 338 (62.6%) have a nurse/midwife they always call for assistance while only 147 (27.2%) refer their life‑threatening cases directly to the nearby hospital.Conclusion: TBAs still plays a role in deliveries in most rural and urban areas. Majority of TBAs do not refer their life‑threatening cases directly to the nearby hospital. Therefore, TBAs should be trained on how to identify life‑threatening cases and promptly refer to hospitals for better outcome.Keywords: Cross River State; delivery; emergency obstetrics; maternal mortality; traditional birth attendant

Effect of rural-urban migration on household food security in Umuahia South Local Government Area of Abia State, Nigeria

This study analyzed the effects of rural-urban migration on household food security in Umuahia South Local Government Area of Abia State, Nigeria. Specifically the study examined the socio-economic characteristics of the migrants’ household; identified the causes of rural-urban migration in the study area and determined the food security status of the respondents in the study area. A total of 120 respondents were randomly selected across 10 villages in the study area. A structured questionnaire was used to collect primarydata. Data collected were analyzed using descriptive statistics and ordinary least square multiple regression model. The results of the descriptive statistics showed that the respondents have a mean age of 49 years and majority of the migrants’ household were educated and married, with male dominated household constituting 79.16 % and mean household size of 5 persons. It also showed that most (81.66%) of the respondents were engaged in farming occupation with mean income of ₦50,737.The three main causes of rural-urban migration in the study area were: search for job, better education and join spouse. The results of the food security status showed that 66.67% of the respondents have food security index of less than 1. The results of the regression analysis showed that age, household size and food from friends were the major determinants of food security in the study area. The study thus recommends that government through its relevant agencies should encourage sustainable food production through subsidizing farm inputs and giving improved seedlings to farmers to boost their productivity and achieve the sustainable development goal of zero hunger by 2030.Keywords: rural-urban migration, household and food securit

Prevalence and risk factors for stillbirths in a tertiary hospital in Niger Delta area of Nigeria: a ten year review

Background: Stillbirth is a silent but major cause of perinatal mortality and source of foetal wastage. Aim: To determine the prevalence of stillbirth, demographic characteristics and identify the possible risk factors in our Hospital.Methods: This was a ten year cross-sectional retrospective study of stillbirths between 1st January, 2004 and 31st December, 2013. All cases of stillbirths from 28 weeks of gestation or the foetal weight of at least 1000g were included in the study.Results: There were a total of 19,347 deliveries with 937 stillbirths, giving a stillbirth rate of 48.4/1,000 total births or 4.8%. Of the 937 stillbirths identified, only 582 (62.1%) case files could be retrieved and was used for analyses. There were 381(65.5%) macerated and 201(34.5%) fresh stillbirths. Stillbirth rate were higher among grand multiparous women, women with primary education and unbooked women. There were 309(53.1%) male stillbirths and 273(46.9%) female stillbirths. Male foetuses were higher among fresh stillbirth (54.9%) while female foetuses had more macerated stillbirths (48.8%) than fresh stillbirths (45.1%). The major causes of stillbirths were hypertensive disorders of pregnancy (18.9%), prolonged/obstructed labour (13.6%), anaemia in pregnancy (12.2%) and abruption placentae (9.3%). A total of 121(20.8%) of the stillbirths were unexplained.Conclusion: The prevalence of stillbirth in our environment is high. Identified factors such as grandmultiparity, low education, unbooked pregnancy, anaemia in pregnancy, obstructed labour and ruptured uterus are modifiable. Every effort directed at reducing these factors must be made by all healthcare givers including policy makers to reduce stillbirths.Key words: Stillbirth, miscarriage, perinatal mortality, anaemia in pregnancy, obstructed labour, uterine ruptur

Amelioration of Hyperglycemia and Dyslipidemia in Alloxan-Induced Diabetic Rats Using Citrulluslanatus and Persea Americana

Dyslipidemia has been observed to play an integral role in the pathogenesis of micro and macrovascular complications in diabetes mellitus patients. The complications were assessed via atherogenic index (AI), Coronary risk index (CRI) and Cardiovascular risk index (CVRI).The study was to investigate the amelioration of hyperglycemia and dyslipidemia in alloxan induced rats using watermelon and avocado seeds. A total of Forty rats were divided into eight groups of 5 rats accordingly. Diabetes was induced with a single dose of alloxan (100mg/kg) body weight and serum glucose was taken 72h after induction of confirm diabetes. Amelioration of hyperglycemia and dyslipidemia started on the 6th and 9th day of the experiment respectively. The result obtained from the phytochemical analysis showed that the aqueous extract of Citrulluslanatus and Persea Americana gave positive reactions for Alkaliods, tannins, flavonoids and saponins. The data showed that Alloxan caused significant increase in Glucose, TC, TGs and LDL in the untreated diabetic rats. On the other hand HDL was significantly decreased. The result showed that Citrulluslanatus and Persea Americana seeds extracts significantly and progressively lowered the glucose level, TC, TGs and LDL dose dependently while significantly causing a dose-related elevation in HDL concentration. The result shows that atorvastatin and the seeds extracts are capable of reducing risk of AI, CRI and CVRI in diabetic rats

Influence of Chrysophyllum albidum Seed Endosperm Extract on Hematologic, Hepatic, Nephrotic and Histologic Alterations in Monosodium Glutamate-Compromised Rats

To minimize its waste burden, underutilized Chrysophyllum albidum (C. albidum) seed could be exploited as a plant-based pharmafood together with widely used but potentially toxic food flavouring, monosodium glutamate (MSG). This study was designed to ascertain the influence of C. albidum seed endosperm extract (CASEE), on the hematologic, hepatic, nephrotic and histologic alterations in MSG-compromised rats. Adult male albino rats (120-160 g) were randomly allotted to six groups of 10 rats each. Group 1 rats received normal saline (1 ml), Group 2 received CASEE (200 mg/kg), Group 3 received MSG (8000 mg/kg), while groups 4, 5 and 6 rats in addition respectively received 200, 400 and 600 mg/kg of CASEE. Exposure was orally and daily for 14 days. Results revealed significant (P < 0.05) alterations in the hematologic, hepatic, nephrotic and histologic parameters in MSG-treated rats compared to others. CASEE (200 mg/kg)-fed rats had comparable effect as the control and caused significant (P < 0.05) but selective dose dependent reduction in MSG effect. This study demonstrated that CASEE (200 mg/kg) improved but MSG (800 mg/kg) compromised the rats’ hematologic, hepatic, nephrotic and histologic integrity. CASEE reduced the MSG effect in the rats via probable concerted mechanism leading to beneficial response on the rats’ hematology, liver and kidney functions and histology. The dietary and pharmacologic prospects of the results in rats warrant further studies to elucidate the structure of the responsible bioactive compound(s) and confirm the suggested probable mechanism (s) of action

Vesicovaginal fistula presenting as urogenital prolapse

Vesicovaginal fistula (VVF) is an abnormal fistulous communication between the bladder and the vagina that allows continuous involuntary discharge of urine into the vagina. It is one of the most abhorred morbidities in obstetric practice because of the profound effect on the patient’s emotional well‑being. Here, we present a case of VVF presenting as urogenital prolapse following an automobile accident. A large fistulous defect with complete bladder base prolapse was successfully repaired with adequate flap mobilization after two failed attempts by a surgical team. VVF should be considered in cases of urogenital prolapse especially following traumatic pelvic injuries.Keywords: Bladder base; trauma; urogenital; vesicovaginal fistul

Monosaccharide Distribution of Soils on a Toposequence in the Humid Tropical Rainforest, Southeastern, Nigeria

Soil monosaccharide distribution provides useful information about its carbohydrate origin and tendency for carbon sequestration. Monosaccharide (glucose, galactose, mannose, arabinose and xylose) distribution of soils on a toposequence in Mbano, southeastern, Nigeria was estimated by extracting 1g soil with 25 mls of 80% hot alcohol. Experimental design was a 2 x 3 x 5 factorial of horizon, physiography and monosaccharides in a randomized complete block setup with 3 replications. Also monosaccharide contents were correlated and regressed with soil properties. Mean monosaccharide contents averaged over horizons and physiography varied as 0.03, 0.07, 0.68, 0.74 and 0.88% in increasing order of glucose < galactose < mannose < xylose < arabinose. Also, averaged over horizon and monosaccharides, mean values were 0.62, 0.79 and 0.98% in increasing sequence of toe-slope < summit < mid-slope physiographic positions. Averaged over physiographic positions and monosaccharide contents, concentrations  of AB (0.670%) was distinctly (LSD 0.05) better than A (0.30%) horizons. Galactose+mannose/arabinose+xylose and mannose/xylose ratios were less than unity indicating that the carbohydrates were of plant origin. Also, mean arabinose/xylose and xylose/mannose ratios were greater than unity, signifying fresh plant tissues with high decomposition rates respectively. Soil monosaccharides correlated (P < 0.05) with the bulk density, clay, ECEC, moisture content, pH, total porosity, P and organic carbon with less than 20% of the monosaccharides accounted by the soil properties. In general, the soil carbohydrates originated from fresh rapidly decomposing plant tissues with poor tendency for carbon sequestration. Keywords: Monosaccharide, toposequence, carbon sequestration, humid tropics and southeastern Nigeri

Malaria management in animal model using antioxidant vitamins

Management of malaria has become a major public health problem with the emergence of Plasmodium falciparum resistant malaria to most antimalaria drugs. The work was employed to evaluate the management of malaria infection with the use of antioxidant vitamins in animal model. Gnotobiotically reared male Swiss albino mice, aged six to eight weeks, and weighed between 18 and 22 g were inoculated with a standard dose of malaria parasites P. berghei, through intra-peritoneal route. Malaria infected mice were treated over three days with 300 mg base Vitamin A, and 500 mg base vitamin C and E respectively, per kilogram body weight. There was a highly significant decrease (p<0.0001) in parasitaemia in treatedgroups. In positive untreated control group, hundred percent mortality was recorded. Post mortem examinations revealed haemorrhagic lesions at the lower part of the brain. An effective treatment of malaria was noted with orthomolecular management. Keywords: Plasmodium berghei; animal model; malaria; antioxidant vitamins

Safety of hospital discharge before return of bowel function after elective colorectal surgery

© 2020 BJS Society Ltd Published by John Wiley & Sons LtdBackground: Ileus is common after colorectal surgery and is associated with an increased risk of postoperative complications. Identifying features of normal bowel recovery and the appropriateness for hospital discharge is challenging. This study explored the safety of hospital discharge before the return of bowel function. Methods: A prospective, multicentre cohort study was undertaken across an international collaborative network. Adult patients undergoing elective colorectal resection between January and April 2018 were included. The main outcome of interest was readmission to hospital within 30 days of surgery. The impact of discharge timing according to the return of bowel function was explored using multivariable regression analysis. Other outcomes were postoperative complications within 30 days of surgery, measured using the Clavien–Dindo classification system. Results: A total of 3288 patients were included in the analysis, of whom 301 (9·2 per cent) were discharged before the return of bowel function. The median duration of hospital stay for patients discharged before and after return of bowel function was 5 (i.q.r. 4–7) and 7 (6–8) days respectively (P < 0·001). There were no significant differences in rates of readmission between these groups (6·6 versus 8·0 per cent; P = 0·499), and this remained the case after multivariable adjustment for baseline differences (odds ratio 0·90, 95 per cent c.i. 0·55 to 1·46; P = 0·659). Rates of postoperative complications were also similar in those discharged before versus after return of bowel function (minor: 34·7 versus 39·5 per cent; major 3·3 versus 3·4 per cent; P = 0·110). Conclusion: Discharge before return of bowel function after elective colorectal surgery appears to be safe in appropriately selected patients