Short Communication: The Role Of Men In Reproductive Health

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Skilled Birth Attendance in Nigeria: A Function of Frequency and Content of Antenatal Care

The utilization rate of maternal services remains low in sub-Saharan Africa and may be contributing to the region’s high maternal mortality rate. This study examines the influence of antenatal care (ANC) on skilled birth attendance (SBA) in Nigeria. The data used were collected from a nationally representative sample of women (aged 15-49) in 2011. The sample is restricted to women who were within two years postpartum (weighted n=9879). Multivariate logistic regression was used to assess the association between ANC (number of visits attended and services received during last pregnancy) and SBA. Despite 70% of the women receiving any ANC, only 49% had SBA during their last childbirth. The number of ANC services received, rather than the number of ANC visits attended, was positively associated with having SBA during last childbirth after controlling for relevant covariates (p<0.05). The focus, therefore, should be on increasing the number of services received during ANC. Keywords: Antenatal care, skilled birth attendance, pregnancy, Nigeri

Comparison of actual (measured) weights and heights with the standard formula methods of estimation among children in Enugu

Background: In paediatric practice, weight and height are required for therapeutic and diagnostic interventions. In some circumstances actual anthropometric measurements are not possible and estimates are used. Several formulae are in use for weight and height estimations. The adequacy of these estimates has not been tested for our children. The aim of the current study was to compare the adequacy of formula methods ofweight and height estimation with measured values in children.Materials and Methods: This was a comparative observational study.Children who met the inclusion criteria were selected consecutively and studied over a two month period using a semi-structured questionnaire.Weight and height of each child were measured and recorded to the nearest 0.1kg and 0.1cm respectively using standard protocols. Weight and height for age were also estimated using the universally accepted formulae. Data were analyzed using SPSS 19.0. Paired t- test was used to compare the means of actual and estimated weights and heights according to age. The level of significance was set at p<0.05.Results: A total of 370 children were studied. They were aged one year two months to 12years. Among children .2 years the measured weights and estimated values showed no significant difference. However, in children3-5years, the estimated weights were significantly lower than the measured weights. There was no consistent relationship for children 7.12 years where a different formula was used to estimate weight. For heights, the estimated values were significantly lower than the measured except for two year oldswhere both where almost similar. Scatter diagrams comparing actual and estimated plots showed linear relationship.Conclusion: The current methods of estimation are underestimating weights and heights of children in our environment. There is need for a multi-centre cohort study to test the various formulae in our children.Key words: Measured, Estimated, Weight, Height, Children

Challenges of childhood obesity in a developing economy: A review

Background: Obesity once considered a high income country’s malady is now on the rise in most developing countries particularly in urban settings. Most of these emerging economies have been reported to have different shades of under – nutrition coexisting side by side with over-nutrition. It is pertinent therefore that we determine the factors driving the increase in obesity rates in developing countries as they generally lack the infrastructure to adequately handle the associated complications.Objectives: This communication is aimed at reviewing the burden and risk factors for obesity in children in developing countries, double burden of malnutrition, challenges including medical as well as economic costs and sustainable preventive programmes of obesity in our environment with the hope of sensitizing both the health community and policy makers of this emerging epidemic.Methods: We searched relevant literature on the subject published only in English language or translated into English language manually and electronically. The Index Medicus, AJOL, Medline, PUBMED, and HINARI were specifically searched for the period between 1980 and 2014 and reviewed. The following key words were applied in the search: Obesity in childhood, its burden and associated risk factors, complications of obesity in childhood, double burden of malnutrition in developing countries, assessment of obesity, childhood challenges of obesity including its direct and indirect costs in developing countries as well as practical preventive models in developing economies.Results: Several relevant studies were identified. The health as well as economic costs of obesity is diverse. Obesity is the major risk factor for a variety of non – communicable diseases including cardiovascular diseases, type 2 diabetes and malignancies in later life. Also obese children have higher risk of orthopaedic problems and psychological disturbances like low -self esteem and bullying. This can also lead to poor social adjustments among our teeming youths who are the bedrock of our future economy. Most of these diseases cause premature deaths in addition to long term morbidities. Many of these obesity associated complications impose substantial burden on the health care system in developing countries with weak health systems, and if allowed unmitigated the implications are that the cost of its care may overwhelm not only the health budget but also affect the provisions of basic social amenities.Conclusions: Preventive programmes have been shown to reduce the burden of obesity in developed countries. Dearth of data on burden of obesity and its associated complications in children and adolescents still a challenge in most developing economies. Efforts should be made to prevent childhood obesity using multi- pronged approach at population level through targeted education, sustainable interventions related to healthy nutritional practices as well as physical activity promotion.Key words: Challenges; Obesity; Children; Developing Economie

Cancer of the Ovary in Nnewi, Nigeria

Background: Ovarian cancer is the leading cause of death from gynaecological cancer worldwide.Objectives: This study was to determine the prevalence, risk factors, clinical presentations, treatment modalities and outcome of ovarian cancer in a tertiary health care institution.Materials and Methods: A 5-year retrospective study of patients with ovarian cancer managed in Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South Eastern Nigeria, st between 1 January 2003 and 31st December 2007 was undertaken. The data was collected by scrutinizing the case files collected from the medical records department,Results: There were 29 cases of ovarian cancer out of total of 122(23.8% of all gynaecological malignancies) gynaecological malignancies and2.9% of 1003 gynaecological admissions. The mean age of the patients was 52.9 + 1.7 years. More than 60% of the patients were above 50years and 66.7% were grandmultipara. Abdominal swelling (47.8%) followed by abdominal pain (13.7) were the commonest presenting symptoms. Only 2 (7.4%) patients had a family history of cancer. Stage III (76.9%) was the modal stage at presentation. Approximately 63% wereepithelial tumours. Most of the patients (88.9%) had cytoreductive surgery and 92.3% of these had adjuvant chemotherapy. Two (7.6%) patients died intra-operatively, while 75.0% of the patients died within 6 months of therapy.Conclusion: The prevalence of ovarian cancer was high in Nnewi and environs. Majority of patients presented late and mortality was high despite multimodal therapy. Public enlightenment to increase awareness and introduction of screening programme for early detection is advocated

Mothers’ perception and management of abdominal colic in infants in Enugu, Nigeria

Background: Abdominal colic is common in infants but generally harmless. The exact aetiology is unknown but it has been associated with vicious cycle of crying and swallowing of air by the infant. The excessive crying associated with it can result in a lot of distress for family members creating unnecessary panics. We sought to find the perception and management of abdominal colic by mothers in Enugu.Objective: Objective of this study is to determine the perception and ‘home management’ of abdominal colic in infants by mothers in Enugu, south-east Nigeria and the factors associated with them.Materials and Methods: A cross-sectional survey involving 177 mothers that presented with their infants at the pediatric outpatient clinic of the University of Nigeria Teaching Hospital, Ituku Ozalla, Enugu between June and November 2011. A pretested questionnaire was used after obtaining their consent.Results: A total of one hundred and seventy-seven mothers participated in this study. They were aged 20 to 60 years with mean age of 34 ± 7.3 years. Most of them (99.4%) believed that babies can have abdominal colic. While 41.3% attributed no problems to colic, the rest believed that it causes loose/greenish stools (12.4%), fever (16.4%) and vomiting (9.6%) etc. Most of the mothers (87.7%) do apply medications for colic which range from paracetamol (33.1%), Gbomoro (16.2%), teething powder (15.4%), salt water (13.2%), Buscopan (7.7%) and gripe water (4.6%).Conclusions: Mothers attribute symptoms of childhood illnesses to abdominal colic. This may have led to unnecessary and sometimes harmful management. There is need for health education of mothers and potential mothers.Key words: Abdominal colics, enugu, infant

PINCH is an independent prognostic factor in rectal cancer patients without preoperative radiotherapy - a study in a Swedish rectal cancer trial of preoperative radiotherapy

<p>Abstract</p> <p>Background</p> <p>The clinical significance between particularly interesting new cysteine-histidine rich protein (PINCH) expression and radiotherapy (RT) in tumours is not known. In this study, the expression of PINCH and its relationship to RT, clinical, pathological and biological factors were studied in rectal cancer patients.</p> <p>Methods</p> <p>PINCH expression determined by immunohistochemistry was analysed at the invasive margin and inner tumour area in 137 primary rectal adenocarcinomas (72 cases without RT and 65 cases with RT). PINCH expression in colon fibroblast cell line (CCD-18 Co) was determined by western blot.</p> <p>Results</p> <p>In patients without RT, strong PINCH expression at the invasive margin of primary tumours was related to worse survival, compared to patients with weak expression, independent of TNM stage and differentiation (<it>P </it>= 0.03). No survival relationship in patients with RT was observed (<it>P </it>= 0.64). Comparing the non-RT with RT subgroup, there was no difference in PINCH expression in primary tumours (invasive margin (<it>P </it>= 0.68)/inner tumour area (<it>P </it>= 0.49). In patients with RT, strong PINCH expression was related to a higher grade of LVD (lymphatic vessel density) (<it>P </it>= 0.01)</p> <p>Conclusions</p> <p>PINCH expression at the invasive margin was an independent prognostic factor in patients without RT. RT does not seem to directly affect the PINCH expression.</p

Influence of moisture contents on the fast pyrolysis of trommel fines in a bubbling fluidized bed reactor

In this study, the effect of moisture contents [2.69 wt% (bone-dry), 5 wt% and 10 wt%] on product yields and process conversion efficiency during fast pyrolysis of a pre-treated trommel fines feedstock was investigated at 500 °C. Experiments were carried out using a 300 g h −1 bubbling fluidised bed rig. Yields of organic liquids ranged from 15.2 to 19.6 wt% of feedstock, which decreased with increasing moisture content. Hence, the bone-dry feedstock gave the maximum yield and consequently the highest process conversion efficiency of 43%. Increased moisture content also led to increase formation of unidentified gas products, indicating increased conversion of organic liquids. Due to the high ash content of the feedstocks, about 52 wt% solid residues, containing around 82% ash was recovered in the char pot in each case. Hence, to maximize oil yields during fast pyrolysis, trommel fines would require extensive drying to remove the original 46 wt% moisture as well as reducing the ash content considerably. XRF analysis of the ash in the feedstock and solid residues showed that the main elements present included Ca, Si, Fe, Pb, K, Cl and Al. Apart from the presence of Pb (which may be from the glass contents of the feedstock), the solid residues could be used for land reclamation or co-incinerated at cement kilns for cement manufacture

Best practices for the care of pregnant people living with TB

BACKGROUND: Each year more than 200,000 pregnant people become sick with TB, but little is known about how to optimize their diagnosis and therapy. Although there is a need for further research in this population, it is important to recognize that much can be done to improve the services they currently receive.METHODS: Following a systematic review of the literature and the input of a global team of health professionals, a series of best practices for the diagnosis, prevention and treatment of TB during pregnancy were developed.RESULTS: Best practices were developed for each of the following areas: 1) screening and diagnosis; 2) reproductive health services and family planning; 3) treatment of drug-susceptible TB; 4) treatment of rifampicin-resistant/multidrug-resistant TB; 5) compassionate infection control practices; 6) feeding considerations; 7) counseling and support; 8) treatment of TB infection/TB preventive therapy; and 9) research considerations.CONCLUSION: Effective strategies for the care of pregnant people across the TB spectrum are readily achievable and will greatly improve the lives and health of this under-served population