Alterations in haematological parameters of multiple in-utero insonated rabbits (Oryctolagus cuniculus)

The fact that ultrasound is generally perceived as a safe imaging modality due to its use of non-ionizing radiation encouraged its increasing use in the diagnosis of cyesis in Veterinary practice. Ultrasound heating during obstetric scans has the potential of increasing body temperature via absorption. The study was conducted to determine the effect of multiple prenatal ultrasounds scanning on haematological parameters of rabbit fetuses. The research involves in vivo experimental model using 16 pregnant does and exposing them to ultrasound for average of 5 minutes at day 7, 12, 15, 20, 25, 27 and 29 of gestation. They were divided into two groups as insonated and control, the restrain and scanning procedures were mimicked on the group of does that were not scanned (positive control). Upon parturition, blood samples were collected from the kits via jugular venesection into ethylene diamine tetra acetic acid containing tubes for haematology. There was a significant reduction (p < 0.05) of red blood cell count and haemoglobin concentration of insonated group. Values of packed cell volume and platelet were lower but not significant (p > 0.05) in insonated as against the control while a non-significant slight increase in total white blood cell count was seen in the control. Therefore, ultrasound heating from multiple in-utero exposure can possibly cause alterations in haematological values in Rabbits. Keywords: Fetus, Haematology, Insonation, In-utero, Rabbit, Ultrasoun

Sonographic measurements of ocular biometry of indigenous Nigerian dogs in Zaria, Nigeria

This study was aimed at conducting ophthalmic sonographic examination of Nigerian indigenous dogs to provide baseline information on some major ocular parameters. Healthy eyes of eighty (80) indigenous dogs were used for the study. The dogs were adequately restrained physically and the structure of the ocular globe was evaluated at a depth of 4-6 cm. For each dog, baseline data were obtained for D1= corneal thickness, D2= anterior chamber depth, D3= lens thickness, D4= vitreous chamber depth, and D5= the sagital axial length of the eye. Similarly, the baseline data were obtained for A1= anterior chamber area, A2= lens area, A3= vitreous chamber area and A4= globe area. Result revealed that the baseline ocular parameters of the Indigenous Nigerian dogs’ (in puppy, adult and older dogs respectively) were D1: 1.2 ± 0.2 mm, 1.4 ± 0.2 mm, 1.8 ± 0.2 mm; D3: 12.6 ± 0.6 mm, 13.6 ± 0.8 mm, 15.1 ± 0.9 mm and D5: 39.1 ± 1.4 mm, 42.5 ± 1.5 mm, 43.2 ± 2.1 mm. similarly, area biometry were obtained for A1: 30.8 ±3.0 mm2, 34.5 ± 3.6 mm2 and 32.0 ± 4.6 mm2 and A2: 213.7 ± 21.1 mm2, 250.3 ± 23.6 mm2, 264.8 ± 21.0 mm2. Analysis of variance (ANOVA) with turkey’s multiple comparison post-hoc test was used to compare the level of significance among the test groups. Values of P < 0.05 were considered significant at 95 % confidence. As such, it was deduced that these baseline ocular parameter values varied in two patterns: corneal thickness (D1), lens thickness and area (D3 and A2) and axial length and area (D5 and A4) increased with age from puppy to the adult and the older dogs in both sexes. However, the anterior chamber depth and area (D2 and A1) and vitreous depth and area (D4 and A3) increased initially with age from puppy to the adult dogs and then decreased slightly in the older dogs. The three (3) major ocular segments- anterior chamber, lens capsule and vitreous chamber was demonstrated in this study to represent approximately 2%, 17% and 76% respectively of the entire ocular globe area. The ciliary body and muscles, suspensory ligament and posterior chamber makes up the remainder 5%. This study has presented the baseline sonographic values of some major parameters of Indiginous Nigerian dogs in Zaria, and the values will be useful in the disgnosis ocular conditions that these may present.Keywords: Ultrasonography, Baseline Value, Nigerian indigenous Dog, Ocular Biometr

Silent Human Trypanosoma brucei gambiense

Trypanosoma brucei gambiense causes Gambian trypanosomosis, a disease ravaging affected rural parts of Sub-Saharan Africa. We screened 1200 human blood samples for T. b. gambiense using the card agglutination test for trypanosomosis, characterized trypanosome isolates with Trypanosoma gambiense serum glycoprotein-PCR (TgsGP-PCR), and analyzed our data using Chi square and odds ratio at 95% confidence interval for statistical association. Of the 1200 samples, the CATT revealed an overall infection rate of 1.8% which ranged between 0.0% and 3.5% across study sites. Age and sex based infection rates ranged between 1.2% and 2.3%. We isolated 7 (33.3%) trypanosomes from the 21 seropositive samples using immunosuppressed mice which were identified as T. b. gambiense group 1 by TgsGP-PCR. Based on study sites, PCR revealed an overall infection rate of 0.6% which ranged between 0.0% and 1.5%. Females and males revealed PCR based infection rates of 0.3% and 0.8%, respectively. Infection rates in adults (1.3%) and children (0.1%) varied significantly (p<0.05). We observed silent T. b. gambiense infections among residents of this focus. Risks of disease development into the second fatal stage in these patients who may also serve as reservoirs of infection in the focus exist

Feeding Patterns and Xenomonitoring of Trypanosomes among Tsetse Flies around the Gashaka-Gumti National Park in Nigeria

In order to understand the epidemiology of trypanosomoses in Gashaka-Gumti National Park, Nigeria, we determined the density, infection rates, and feeding patterns of tsetse flies using biconical traps, ITS, and mitochondrial cytochrome b PCRs. A total of 631 tsetse flies were captured, of which 531 (84.2%) and 100 (15.8%) were analyzed for trypanosomes and blood meals, respectively. Tsetse distribution varied significantly (p<0.05) across study sites with average trap and daily catches of 4.39 and 26.34, respectively. Overall tsetse infection rate was 5.08% and ranged between 3.03% and 6.84% across study sites. We identified 10 T. brucei, 3 T. congolense savannah, 2 T. congolense forest, and 2 mixed infections among the 13 pools made from the 27 flies positive for trypanosomes with light microscopy. The distribution of vertebrate blood meals in tsetse flies varied significantly (p<0.05) and ranged between 6.0% and 45% across hosts. We also observed dual feeding patterns involving at least 2 hosts in 24% and multiple feeding involving at least 3 hosts in 17% of the flies. We observed predominance of G. palpalis which also recorded higher infection rate. T. brucei was more prevalent among tsetse flies. Tsetse flies fed predominantly on cattle and less frequently on humans and also showed mixed feeding habits

Feeding Patterns and Xenomonitoring of Trypanosomes among Tsetse Flies around the Gashaka-Gumti National Park in Nigeria

In order to understand the epidemiology of trypanosomoses in Gashaka-Gumti National Park, Nigeria, we determined the density, infection rates, and feeding patterns of tsetse flies using biconical traps, ITS, and mitochondrial cytochrome b PCRs. A total of 631 tsetse flies were captured, of which 531 (84.2%) and 100 (15.8%) were analyzed for trypanosomes and blood meals, respectively. Tsetse distribution varied significantly ( &lt; 0.05) across study sites with average trap and daily catches of 4.39 and 26.34, respectively. Overall tsetse infection rate was 5.08% and ranged between 3.03% and 6.84% across study sites. We identified 10 T. brucei, 3 T. congolense savannah, 2 T. congolense forest, and 2 mixed infections among the 13 pools made from the 27 flies positive for trypanosomes with light microscopy. The distribution of vertebrate blood meals in tsetse flies varied significantly ( &lt; 0.05) and ranged between 6.0% and 45% across hosts. We also observed dual feeding patterns involving at least 2 hosts in 24% and multiple feeding involving at least 3 hosts in 17% of the flies. We observed predominance of G. palpalis which also recorded higher infection rate. T. brucei was more prevalent among tsetse flies. Tsetse flies fed predominantly on cattle and less frequently on humans and also showed mixed feeding habits

Sonographic diagnosis of pregnancy and study of gestational changes in rabbit-does

This study was carried out to evaluate early pregnancy diagnosis using ultrasound and baseline information on the sonographic features of the reproductive cycle of  rabbit-doe. Eight adult does, that had kittened at least once and an Ultrasound machine (Medison S600V®) with a 6.5 MHz transcutaneous curve-linear probe, were used for the study. Rabbit-does were mated naturally by the introduction of a doe to a buck. Abdominal regions were shaved liberally from the level of xyphoid cartilage to the pelvic area and aquasonic gel applied. The uterus was scanned on day 5 post-coitus and  thereafter on days 7, 12, 15, 20, 25, 27 and 29, using the bladder as a land mark. Embryonic vesicles, visualized as small anechoic (darkened) structures were first seen on day 7 of gestation. Hypoechoic structures within vesicles corresponding to embryo and placenta were seen on day 12 with an increase in size at day 15 of gestation. Bony formation, bi-parietal diameter, vertebrae column, fetal heart and fetal heart rate were visible with progressive gestational age. This study demonstrated that ultrasound can be used effectively to diagnose pregnancy in rabbit-doe as early as day 7 of gestation. Also there is a correlation between the sonographic observable changes with gestational age.Key words: Ultrasonography, Rabbit, Pregnancy Diagnosis, Gestation

Progression of the first stage of spontaneous labour: A prospective cohort study in two sub-Saharan African countries.

BACKGROUND: Escalation in the global rates of labour interventions, particularly cesarean section and oxytocin augmentation, has renewed interest in a better understanding of natural labour progression. Methodological advancements in statistical and computational techniques addressing the limitations of pioneer studies have led to novel findings and triggered a re-evaluation of current labour practices. As part of the World Health Organization's Better Outcomes in Labour Difficulty (BOLD) project, which aimed to develop a new labour monitoring-to-action tool, we examined the patterns of labour progression as depicted by cervical dilatation over time in a cohort of women in Nigeria and Uganda who gave birth vaginally following a spontaneous labour onset. METHODS AND FINDINGS: This was a prospective, multicentre, cohort study of 5,606 women with singleton, vertex, term gestation who presented at ≤ 6 cm of cervical dilatation following a spontaneous labour onset that resulted in a vaginal birth with no adverse birth outcomes in 13 hospitals across Nigeria and Uganda. We independently applied survival analysis and multistate Markov models to estimate the duration of labour centimetre by centimetre until 10 cm and the cumulative duration of labour from the cervical dilatation at admission through 10 cm. Multistate Markov and nonlinear mixed models were separately used to construct average labour curves. All analyses were conducted according to three parity groups: parity = 0 (n = 2,166), parity = 1 (n = 1,488), and parity = 2+ (n = 1,952). We performed sensitivity analyses to assess the impact of oxytocin augmentation on labour progression by re-examining the progression patterns after excluding women with augmented labours. Labour was augmented with oxytocin in 40% of nulliparous and 28% of multiparous women. The median time to advance by 1 cm exceeded 1 hour until 5 cm was reached in both nulliparous and multiparous women. Based on a 95th percentile threshold, nulliparous women may take up to 7 hours to progress from 4 to 5 cm and over 3 hours to progress from 5 to 6 cm. Median cumulative duration of labour indicates that nulliparous women admitted at 4 cm, 5 cm, and 6 cm reached 10 cm within an expected time frame if the dilatation rate was ≥ 1 cm/hour, but their corresponding 95th percentiles show that labour could last up to 14, 11, and 9 hours, respectively. Substantial differences exist between actual plots of labour progression of individual women and the 'average labour curves' derived from study population-level data. Exclusion of women with augmented labours from the study population resulted in slightly faster labour progression patterns. CONCLUSIONS: Cervical dilatation during labour in the slowest-yet-normal women can progress more slowly than the widely accepted benchmark of 1 cm/hour, irrespective of parity. Interventions to expedite labour to conform to a cervical dilatation threshold of 1 cm/hour may be inappropriate, especially when applied before 5 cm in nulliparous and multiparous women. Averaged labour curves may not truly reflect the variability associated with labour progression, and their use for decision-making in labour management should be de-emphasized

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

Global economic burden of unmet surgical need for appendicitis

Background: There is a substantial gap in provision of adequate surgical care in many low-and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods: Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results: Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion: For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially