Laparoscopic salpingectomy and adhesiolysis for concomitant left-sided cornual ectopic gestation and adhesive partial intestinal obstruction: A case report.

Cornual gestation is one of the most hazardous types of ectopic gestation. It carries a significant challenge and a greater maternal mortality risk than ampullary ectopic pregnancy. The diagnosis and treatment are challenging and frequently constitute a medical emergency. Traditionally, the treatment of cornual pregnancy has been hysterectomy or cornual resection at laparotomy. However endoscopic approach is a viable option and consists of conservative techniques such as laparoscopic cornual resection, laparoscopic cornuostomy, laparoscopic salpingectomy or hysteroscopic removal of interstitial ectopic tissue. Case presentation: We report a case of a 28-year-old multipara who had an unruptured left cornual ectopic gestation with moderate pelvic adhesions and concomitant partial intestinal obstruction. She was managed via laparoscopic adhesiolysis and left total salpingectomy. Conclusions: Cornual pregnancy occurs rarely, there is a need for early and prompt diagnosis to prevent potentially fatal complications

Phytochemical, nutraceutical and antioxidant studies of the aerial parts of Daucus carota L. (Apiaceae)

Introduction: Carrot is a rich source of anthocyanins, carotenoids, vitamins A, B and C. The aerial parts are used as livestock feed in some parts of Northern Nigeria with little or no scientific evidence of its nutritional potential. This study established the phytochemical, nutritional and antioxidant potentials of carrot aerial parts. Methods: The proximate and elemental analyses of the aerial parts were determined using Association of Official Analyst Chemist (AOAC) method and 2,2-diphenyl-1-picrylhydrazyl (DPPH) method for quantification of antioxidant properties in the crude extracts. Results: The preliminary phytochemical screening revealed presence of steroid/triterpenes, flavonoids, tannins and saponins in ethylacetate and methanol crude extracts. The proximate analysis revealed crude protein (14.59%), lipid (10.37%), fibre (9.07%), carbohydrate (51.81%), moisture (10.23%) and the ash content (12.99%). The aerial parts were rich in P (11.00 mg/L), Na (5.38 mg/L), Fe (3.19 mg/L), K (2.25 mg/L), Ca (2.02 mg/L), Mn (1.15 mg/L), Mg (1.02 mg/L), As (0.83 mg/L), Se (0.40 mg/L), Zn (0.26 mg/L), Cu (0.13 mg/L), Cd (-0.02 mg/L), Cr (0.02 mg/L), Ni (0.17 mg/L) and Pb (0.04 mg/L). The antioxidant activity showed that ethylacetate and methanol extracts had EC50 of 86.89 ug/mL and 166.79 ug/mL, respectively. Conclusion: Daucus carota aerial parts are rich in nutritional compositions and may be used as livestock feed supplements and also as vegetables for mankind. Its utilization could be incorporated in daily diets and boost food security in developing countries

Transmission dynamics of monkeypox virus in Nigeria during the current COVID-19 pandemic and estimation of effective reproduction number

Monkeypox virus (MPXV) continues to pose severe threats to global public health, especially in non-endemic areas. Like all other regions, Africa faces potential public health crises due to the ongoing COVID-19 pandemic and other infectious disease outbreaks (such as Lassa fever and malaria) that have devastated the region and overwhelmed the healthcare systems. Owing to the recent surge in the MPXV and other infections, the COVID-19-control efforts could deteriorate and further worsen. This study discusses the potential emergencies of MPXV transmission during the current COVID-19 pandemic. We hypothesize some of the underlying drivers that possibly resulted in an increase in rodent-to-human interaction, such as the COVID-19 pandemic’s impact and other human behavioral or environmental factors. Furthermore, we estimate the MPXV time-varying effective reproduction number ([Formula: see text]) based on case notification in Nigeria. We find that [Formula: see text] reached a peak in 2022 with a mean of 1.924 (95% CrI: 1.455, 2.485) and a median of 1.921 (95% CrI: 1.450, 2.482). We argue that the real-time monitoring of [Formula: see text] is practical and can give public health authorities crucial data for circumstantial awareness and strategy recalibration. We also emphasize the need to improve awareness programs and the provision of adequate health care resources to suppress the outbreaks. These could also help to increase the reporting rate and, in turn, prevent large community transmission of the MPXV in Nigeria and beyond

Antibiotics Susceptibilities of Isolates from Eye Swabs of Babies Delivered through Spontaneous Vaginal and Caesarean Section Deliveries.

Purpose: The study aims to investigate the antibiotics susceptibilities of isolates from eye swabs of babies delivered through Spontaneous Vaginal (SVD) and non- elective Caesarean Section (CS).Materials and Methods: This was a three-month prospective cross-sectional study, with samples as eye swabs of new born babies delivered in the maternity ward of Aminu Kano Teaching Hospital. Samples were collected not more than 30 minutes after delivery from 82 neonates (50 SVD and 32 CS) and stored in the refrigerator. It was evacuated in ice pack containers in batches within 24 hours to the microbiology laboratory for culturing, characterisation and sensitivity.Results: The result showed that E. coli was isolated in 25(30.5%) of the samples, P. aeruginosa, 22(26.8%), S. aureus, 21(25.6%) and K. pneumoniae 14(17.1%). In the SVD group, E. coli was isolated in 16(32%) of samples, P. aeruginosa, 14(28%), S. aureus, 11(22%) and K. pneumonia, 9(18%). In the CS group, S. aureus was isolated in 10(31.3%) samples, E. coli, 9(28.1%), P. aeruginosa, 8(25.0%) and K. pneumonia, 5(15.6). There were 47(77%) SVD and 14(23%) CS samples that were resistant to three (3) or more antibiotics but this difference was not statistically significant (p=0.157). Babies born through SVD had higher bacterial isolates when compared with those delivered through CS, but this was also not statistically significant (p=0.787).Conclusion: The mode of delivery had non-significant association with bacterial isolates from eye swabs of new born babies. We recommend Randomized  Controlled Trial to establish the risk of bacterial isolates in new born babies’ eyes

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Impact of Women Empowerment on Poverty Reduction: Empirical Evidence from Nigeria and Ivory Coast

Poverty is one of the major causes of many social vices in less developed countries, which increasingly affecting vulnerable class in the society, particularly women. This study examines the impact of women empowerment on poverty reduction in Africa using time series panel data across Nigeria and Ivory Coast covering 2011 to 2021. The study used Livin, Lin and Chu (LLC) panel unit root test and found that all the variables are stationary at level and Pedroni test of cointegration confirmed the long run relationship among the variables. The causality result showed evidence of bi-directional causality running from poverty rate to multidimensional women empowerment and poverty rate and unemployment. Lastly, the study recommends that more importance should be attached to women empowerment in order to reduce the poverty rate across the countries of the study

PREVALENCE AND CORRELATES OF FALL AMONG ELDERLY LIVING IN GANO WARD OF DAWAKIN KUDU LOCAL GOVERNMENT AREA KANO STATE

Background: The elderly population is growing, both in size and proportion with the total population and fall is a major problem for elderly. The aim of this study was to determine the prevalence and correlates of falls among elderly. Methodos: A cross sectional survey with Snowball sampling technique was used to recruit 100 elderly persons, 52 male and 48 female, 65 years and above. A modified self administered closed ended questionnaire was used. The data obtained were summarized using descriptive statistics of mean and Standard Deviation. Inferential statistics of Chi square, phi and Cramer’s V were used to analyze the data. Result: The result showed that 49% of the elderly had one or more falls with 65.3%falls occurring once and 34.7% occurring two or more times. Women fall more than men, accounting for 61.2% and 38.8% of the population respectively. A significant association was found between fall, age, sex, and reduced balance. Conclusion: The study concluded that there is high prevalence of falls in elderly with women experiencing more fall than men. It is recommended that modifications in the environment, counseling to the elderly and their families should be done to prevent further falls

Phytochemical, nutraceutical and antioxidant studies of the aerial parts of Daucus carota L. (Apiaceae)

Introduction: Carrot is a rich source of anthocyanins, carotenoids, vitamins A, B and C. The aerial parts are used as livestock feed in some parts of Northern Nigeria with little or no scientific evidence of its nutritional potential. This study established the phytochemical, nutritional and antioxidant potentials of carrot aerial parts. Methods: The proximate and elemental analyses of the aerial parts were determined using Association of Official Analyst Chemist (AOAC) method and 2,2-diphenyl-1-picrylhydrazyl (DPPH) method for quantification of antioxidant properties in the crude extracts. Results: The preliminary phytochemical screening revealed presence of steroid/triterpenes, flavonoids, tannins and saponins in ethylacetate and methanol crude extracts. The proximate analysis revealed crude protein (14.59%), lipid (10.37%), fibre (9.07%), carbohydrate (51.81%), moisture (10.23%) and the ash content (12.99%). The aerial parts were rich in P (11.00 mg/L), Na (5.38 mg/L), Fe (3.19 mg/L), K (2.25 mg/L), Ca (2.02 mg/L), Mn (1.15 mg/L), Mg (1.02 mg/L), As (0.83 mg/L), Se (0.40 mg/L), Zn (0.26 mg/L), Cu (0.13 mg/L), Cd (-0.02 mg/L), Cr (0.02 mg/L), Ni (0.17 mg/L) and Pb (0.04 mg/L). The antioxidant activity showed that ethylacetate and methanol extracts had EC50 of 86.89 ug/mL and 166.79 ug/mL, respectively. Conclusion: Daucus carota aerial parts are rich in nutritional compositions and may be used as livestock feed supplements and also as vegetables for mankind. Its utilization could be incorporated in daily diets and boost food security in developing countries