Effect of early amniotomy on the outcome of spontaneous labour: a randomized controlled trial of pregnant women in Enugu, South-east Nigeria

Background: Early amniotomy is common in obstetric practice but, its effectiveness has not been proven.Objectives: To determine the effects of early amniotomy on the duration of labour, and other maternal / neonatal out- comes of uncomplicated pregnancies in Enugu, South-east Nigeria.Methods: A randomized controlled study of 214 consenting term pregnant women at the University of Nigeria Teaching Hospital Enugu, Nigeria. Intervention group received amniotomy early in active labour while the control group had their membranes conserved.Results: Mean duration of labour for the amniotomy group (279.4 ± 53.7 minutes) was significantly lower than that of con- trol group (354.4 ± 67.5 minutes), (t = -8.988, p <0.001). Three (3.8%) women in amniotomy group needed oxytocin aug- mentation as against 21 (19.6%) women in the control group RR = 0.14, (CI 95%: 0.04 – 0.46), NNT = 16. The two groups did not vary with respect to cesarean section rate, newborn Apgar scores, and need for new born special care unit admission. Conclusion: Early amniotomy when compared to fetal membrane conservation reduced the duration of labour and need for oxytocin augmentation among term singleton pregnant women in Enugu, Nigeria. Its routine use in well selected cases may reduce prolonged labour and its complications.Keywords: Early amniotomy, duration of labour, oxytocin augmentation, term pregnancy, caesarean section rate, Enugu- Nigeria

Asymptomatic bacteriuria among pregnant women with sickle cell trait in Enugu, South Eastern Nigeria

Context: Asymptomatic bacteriuria (ASB) in pregnancy is a major risk factor for developing acute cystitis and pyelonephritis, especially, among women with sickle cell disease. This study compared the prevalence, pattern, and microbiological characteristics of ASB in pregnancy between sickle cell trait (HbAS) and normal hemoglobin AA(HbAA) genotype subjects.Materials and Methods: Culture and sensitivity of mid‑stream urine samples were collected from 300 HbAS women and 300 matched HbAA control at the antenatal clinic of University of Nigeria Teaching Hospital Enugu, Nigeria from August 2010 to December 2011. Analysis was both descriptive and inferential at 95% confidence levels.Results: Prevalence of ASB in HbAS and HbAA women were 32.7% (98/300) and 32% (96/300) respectively (odd ratio (OR) =1.03 [95% confidence interval (CI) 0.73, 1.45]). Escherichia coli was the most common organism isolated in both the HbAS group (56.1%, 55/98) and control group (61.4%, 59/96), (OR = 0.80 [95% CI 0.45, 1.42]). The  antibiotics with the highest microbial sensitivity were ciprofloxacin 90.8% (89/98) and gentamicin 100% (98/98) for HbAS and HbAA women respectively.Conclusions: The prevalence of ASB in pregnant women with HbAS in Enugu, Nigeria was high and did not vary significantly from that of woman with HbAA. Therefore, pregnant women irrespective of their sickle cell status would benefit from routine screening for ASB.Key words: Asymptomatic bacteriuria, Enugu‑Nigeria, pregnant women, sickle cell trai

Benefit incidence analysis of free insecticide treated nets distribution in urban and rural communities of Enugu state, South East Nigeria

Background: Malaria is a leading cause of mortality as well as a barrier to economic and social development in developing countries. The use of insecticide‑treated nets (ITNs) for malaria vector control is effective in controlling malaria attacks in pregnant women and under‑5 children. The Nigerian government, in its bid to achieve the Millennium Development Goal (MDG) 4 and 5 distributes free ITNs to pregnant mothers and under‑five children in the Roll Back Malaria programme (RBM).Aim: This study compared the benefit incidence analysis of this government program between urban and rural areas.Materials and Methods: Pretested, semi‑structured questionnaires were administered to 150 pregnant women and also 150 mothers of under‑5 children, who were randomly selected from each of the two communities (rural and urban) from a local government area (LGA) in Enugu state, Nigeria. The study was conducted within the rainy season periods (March–August) of 2008. The information obtained included some socio‑economic variables, accessibility, usage and benefits of usage of ITNs. Data entry and analyses were done using the Statistical Package for Social Sciences (SPSS) version 15.0(Chicago IL, USA). Student’s t‑test and Chi‑square were used for comparison where appropriate. Significant values were taken as P value. Value of less than 0.05 was considered significant.Results: The respondents’ mean monthly expenditures on food utilities and anti‑malarials in the rural area and urban areas were N266.1 (74.02), range (143.3-395) and N473 (90) range (380-495.7) respectively (P < 0.001). Within each socio‑economic stratum (SES), the average monthly expenditure in the urban community was higher than that of the rural community except for least poor SES (P < 0.05). For the urban community, 106 (71.6%) respondents used ITNs as against 99 (66.9%) in the rural community [P = 0.778, OR = 1.3 (95% CI: 0.76, 2.05)]. Also, ITNs were always accessible to 112 (75.7%) and 54 (36.5%) respondents in the urban and rural communities respectively [P < 0.001, OR = 5.4 (95% CI: 3.28, 8.96)]. In the urban community, 130 (87.7%) respondents expressed some benefit from ITNs as against 123 (83.1%) respondents from the rural community [P = 0.258, OR = 1.5 (95% CI: 0.76, 2.28)].Conclusion: Most pregnant women and mothers of under‑five children in the rural study area belong to the poorest socio‑economic classes and they spend less on anti‑malarial treatment. Majority of the free ITN’s beneficiaries in both urban and rural study areas have used and benefitted from themKey words: BIA, ITNs, nigeria, pregnanc

Observations of Spontaneous Raman Scattering in Silicon Slow-light Photonic Crystal Waveguides

We report the observations of spontaneous Raman scattering in silicon photonic crystal waveguides. Continuous-wave measurements of Stokes emission for both wavelength and power dependence is reported in single line-defect waveguides in hexagonal lattice photonic crystal silicon membranes. By utilizing the Bragg gap edge dispersion of the TM-like mode for pump enhancement and the TE-like fundamental mode-onset for Stokes enhancement, the Stokes emission was observed to increase by up to five times in the region of slow group velocity. The results show explicit nonlinear enhancement in a silicon photonic crystal slow-light waveguide device.Comment: 12 pages, 4 figure

Understanding reservoir heterogeneity using variography and data analysis: an example from coastal swamp deposits, Niger Delta Basin (Nigeria)

For efficient reservoir management and long-term field development strategies, most geologists and asset managers pay special attention to reservoir chance of success. To minimise this uncertainty, a good understanding of reservoir presence and adequacy is required for better ranking of infill opportunities and optimal well placement. This can be quite challenging due to insufficient data and complexities that are typically associated with areas with compounded tectonostratigraphic framework. For the present paper, data analysis and variography were used firstly to examine possible geological factors that determine directions in which reservoirs show minimum heterogeneity for both discrete and continuous properties; secondly, to determine the maximum range and degree of variability of key reservoir petrophysical properties from the variogram, and thirdly, to highlight possible geological controls on reservoir distribution trends as well as areas with optimal reservoir quality. Discrete properties evaluated were lithology and genetic units, while continuous properties examined were porosity and net-to-gross (NtG). From the variogram analysis, the sandy lithology shows minimum heterogeneity in east-west (E–W) and north-south (N–S) directions, for Upper Shoreface Sands (USF) and Fluvial/Tidal Channel Sands (FCX/TCS), respectively. Porosity and NtG both show the least heterogeneity in the E–W axis for reservoirs belonging to both Upper Shoreface and Fluvial Channel environments with porosity showing a slightly higher range than NtG. The vertical ranges for both continuous properties did not show a clear trend. The Sequential Indicator Simulation (SIS) and Object modelling algorithm were used for modelling the discrete properties, while Sequential Gaussian Simulation (SGS) was used for modelling of the continuous properties. Results from this exercise show that depositional environment, sediment provenance, topographical slope, sub-regional structural trends, shoreline orientation and longshore currents, could have significant impacts on reservoir spatial distribution and property trends. This understanding could be applied in reservoir prediction and for generating stochastic estimates of petrophysical properties for nearby exploration assets of similar depositional environments

From sick kids to SicKids!

This report outlines the varied activities undertaken by SicKids in Cambodia up to and including the April 2017 visit by Dr Joan Livesley and Professor Andrew Rowland. Both the November 2016 and April 2017 visits were part-funded by a Humanitarian Grant from the British Medical Association. SicKids is a children’s health charity currently working in the North West of England and Cambodia. It believes every child deserves the right to grow up healthy, and safe from abuse, exploitation and trafficking. The charity raises funds and work on projects to support children and young people

Near-infrared Hong-Ou-Mandel interference on a silicon quantum photonic circuit

Near-infrared Hong-Ou-Mandel quantum interference is observed in silicon nanophotonic directional couplers with raw visibilities on-chip at 90.5%. Spectrally-bright 1557-nm two-photon states are generated in a periodically-poled KTiOPO4 waveguide chip, serving as the entangled photon source and pumped with a self-injection locked laser, for the photon statistical measurements. Efficient four-port coupling in the communications C-band and in the high-index-contrast silicon photonics platform is demonstrated, with matching theoretical predictions of the quantum interference visibility. Constituents for the residual quantum visibility imperfection are examined, supported with theoretical analysis of the sequentially-triggered multipair biphoton contribution and techniques for visibility compensation, towards scalable high-bitrate quantum information processing and communications.Comment: 15 pages, 6 figure

Effect of early amniotomy on the outcome of spontaneous labour: a randomized controlled trial of pregnant women in Enugu, South-east Nigeria

Background: Early amniotomy is common in obstetric practice but, its effectiveness has not been proven. Objectives: To determine the effects of early amniotomy on the duration of labour, and other maternal / neonatal out- comes of uncomplicated pregnancies in Enugu, South-east Nigeria. Methods: A randomized controlled study of 214 consenting term pregnant women at the University of Nigeria Teaching Hospital Enugu, Nigeria. Intervention group received amniotomy early in active labour while the control group had their membranes conserved. Results: Mean duration of labour for the amniotomy group (279.4 \ub1 53.7 minutes) was significantly lower than that of con- trol group (354.4 \ub1 67.5 minutes), (t = -8.988, p <0.001). Three (3.8%) women in amniotomy group needed oxytocin aug- mentation as against 21 (19.6%) women in the control group RR = 0.14, (CI 95%: 0.04 \u2013 0.46), NNT = 16. The two groups did not vary with respect to cesarean section rate, newborn Apgar scores, and need for new born special care unit admission. Conclusion: Early amniotomy when compared to fetal membrane conservation reduced the duration of labour and need for oxytocin augmentation among term singleton pregnant women in Enugu, Nigeria. Its routine use in well selected cases may reduce prolonged labour and its complications

Recent Arctic amplification and extreme mid-latitude weather

This is the author accepted manuscript. The final version is available from Nature via the DOI in this record.The Arctic region has warmed more than twice as fast as the global average — a phenomenon known as Arctic amplification. The rapid Arctic warming has contributed to dramatic melting of Arctic sea ice and spring snow cover, at a pace greater than that simulated by climate models. These profound changes to the Arctic system have coincided with a period of ostensibly more frequent extreme weather events across the Northern Hemisphere mid-latitudes, including severe winters. The possibility of a link between Arctic change and mid-latitude weather has spurred research activities that reveal three potential dynamical pathways linking Arctic amplification to mid-latitude weather: changes in storm tracks, the jet stream, and planetary waves and their associated energy propagation. Through changes in these key atmospheric features, it is possible, in principle, for sea ice and snow cover to jointly influence mid-latitude weather. However, because of incomplete knowledge of how high-latitude climate change influences these phenomena, combined with sparse and short data records, and imperfect models, large uncertainties regarding the magnitude of such an influence remain. We conclude that improved process understanding, sustained and additional Arctic observations, and better coordinated modelling studies will be needed to advance our understanding of the influences on mid-latitude weather and extreme events