Outcome of intrauterine adhesion management at a Nigerian tertiary hospital: a five-year review

Background: Intrauterine adhesion is a cause of menstrual abnormalities and infertility, which are leading complaints in gynaecological practice in Nigeria. Determining the aetiology and management option would help reduce this problem. The objective of this study was to determine the aetiology, mode of presentation, management option and outcome of intrauterine adhesionsMethods: A retrospective analysis of intrauterine adhesions at the University of Abuja Teaching Hospital over a five-year period from 2012 to 2016 was carried out. The case notes of the patients were retrieved from the records department and information extracted from these case notes using a questionnaire included the age, level of education, marital status, parity, complaints, predisposing factors, method of diagnosis, treatment method and outcome. Additional information was obtained from the theatre registered. The least follow up period was one year.Results: There were 82 patients diagnosed with Intrauterine Adhesion over the study period giving an incidence of 1.6%. Fifty-nine case notes were available for analysis. The case note retrieval rate was 72%. Majority of the patients were between the age range of 30-34 years (21, 35.6%). Those with tertiary level of education constituted the majority (34, 57%). Nullipara constituted 54.2% (32) of the total population. Menstrual abnormalities were the most common complaint with 93.2% and this includes those with menstrual abnormalities and other complaints. The commonest predisposing factor identified was a history of dilatation and curettage or uterine evacuation (28, 47.5%). Majority of the patients had partial intrauterine adhesions (51, 86.4%). All patients were treated with adhesiolysis, Foleys catheter insertion and hormonal therapy for 3 cycles. There was not statistical significance between those who had blind adhesiolysis and hysteroscopic adhesiolysis in terms of outcome. Restoration of menstrual flow was in 25, (42.4%) while 3, (5.1%) had miscarriges and an equal no of patients had term delivery.Conclusions: Dilatation and curettage is still a major predisposing factor in the development of intrauterine Adhesions. Blind adhesiolysis still has its place in the management of intrauterine adhesion in developing countries

IoT Networks: Using Machine Learning Algorithm for Service Denial Detection in Constrained Application Protocol

The paper discusses the potential threat of Denial of Service (DoS) attacks in the Internet of Things (IoT) networks on constrained application protocols (CoAP). As billions of IoT devices are expected to be connected to the internet in the coming years, the security of these devices is vulnerable to attacks, disrupting their functioning. This research aims to tackle this issue by applying mixed methods of qualitative and quantitative for feature selection, extraction, and cluster algorithms to detect DoS attacks in the Constrained Application Protocol (CoAP) using the Machine Learning Algorithm (MLA). The main objective of the research is to enhance the security scheme for CoAP in the IoT environment by analyzing the nature of DoS attacks and identifying a new set of features for detecting them in the IoT network environment. The aim is to demonstrate the effectiveness of the MLA in detecting DoS attacks and compare it with conventional intrusion detection systems for securing the CoAP in the IoT environment. Findings The research identifies the appropriate node to detect DoS attacks in the IoT network environment and demonstrates how to detect the attacks through the MLA. The accuracy detection in both classification and network simulation environments shows that the k-means algorithm scored the highest percentage in the training and testing of the evaluation. The network simulation platform also achieved the highest percentage of 99.93% in overall accuracy. This work reviews conventional intrusion detection systems for securing the CoAP in the IoT environment. The DoS security issues associated with the CoAP are discussed

ODABRANI JETRENI I BUBREŽNI BIOKEMIJSKI PROFILI HIBRIDNOG SOMA IZLOŽENOG LISNOM PRAHU JATROPHA CURCAS

This study investigated the effect of sublethal concentrations (7.50, 5.00, 2.50 and 0.00 gL (control)) of Jatropha curcas leaf dust on some liver and kidney biochemical profiles such as total protein, total bilirubin, total albumin and total globulin of hybrid catfish (Clarias gariepinus (♀) and Heterobranchus bidorsalis (♂)) after a 14-day experimental period. The result was significantly different in the mean value of determined liver total bilirubin, while total protein, albumin and globulin were insignificantly different in the exposed fish compared with the control. The kidney revealed varying levels of insignificant difference in its level of total protein, total albumin, total bilirubin and total globulin. Therefore, this investigation has revealed that sublethal concentration of Jatropha curcas has no effect on the basic function of the determined biochemical profiles of hybrid catfish and that the changes were directly proportional to J. curcas concentration.Ova studija istražuje učinak subletalnih koncentracija (7,50, 5,00, 2,50 i 0,00 gL (kontrola)) lisnog praha Jatropha curcas na neke jetrene i bubrežne biokemijske profile, kao što su ukupni protein, ukupni bilirubin, ukupni albumin i ukupni globulin hibridnog soma (Clarias gariepinus (♀) i Heterobranchus bidorsalis (♂)), nakon četrnaestodnevnog eksperimentalnog razdoblja. Rezultat se značajno razlikovao u srednjoj vrijednosti određenog jetrenog ukupnog bilirubina, dok se ukupni protein, albumin i globulin nije značajnije razlikovao u promatranoj ribi u usporedbi s kontrolnom. Bubreg je pokazao promjenjivi raspon malih razlika (p>0,05) u razini ukupnog proteina, ukupnog albumina, ukupnog bilirubina i ukupnog globulina. Prema tome, ovim se istraživanjem utvrdilo da subletalne koncentracije J. curcas nemaju učinka na osnovne funkcije određenih biokemijskih profila hibridnog soma te da su promjene izravno proporcionalne koncentracijama J. curcas

Comparative study of the level of bacterial/helminths contamination of vegetables produced from polluted and unpolluted irrigation site of Kano

A comparative study was contaminations of five major crops (Lactuca veriso, Darcus carota, Solanum lycopersicum, Phylanthus amarus, Alium cepa) produced from polluted (industrial/residential effluents) Sharada and unpolluted (tube well water)Yarimawa using the method described by FAO, (1979). The result shows that the five crops, produced with polluted water viz, Lactuca veriso, Darcus carota, Solanum lycopersicum Phylanthus amarus, Alium cepa, had mean aerobic plate count of 2.0 x 102 cfu/g, 8.40 x 102 cfu/g , 1.13 x 103 cfu/g , 5.8 x 104 cfu/g cfu/g, 5.7 x 101 cfu/g, respectively, and all the five crops had mean coliform count of 180 MPN/g, while that of unpolluted water had mean aerobic plate count of of 1.22 x 102 cfu/g 5.1 x 102 cfu/g , 1.4 x 102 cfu/g, 1.43 x 102 cfu/g, 1.32 x 101 cfu/g respectively, and had mean coliform count of 30, 21,21, 21 and 21MPN/g respectively. The organisms isolated in all the crops produced with polluted water were E. coli, Salmonella sp, Shigella sp, S. aureus, Ascaris egg, Strongloides and Ancylostoma while E. coli, Shigella sp, S. aureus, wer the organisms isolated in the crops produced with unpolluted water, only Lactuca verosa and Solanum lycopersicum, shows the presence of helmiths in the crops produced with the unpolluted water.Key words: Kano, Bacteria, Helminth, effluent, Yarimawa, Sharad

Influence of socio-demographic variables on the choice of contraceptives among women attending ANC unit at specialist hospital Sokoto, Sokoto State, Nigeria

Background: A contraceptive choice that couples make is a key component of the Sustainable Development Goal agenda and a major contributor to national health. In spite of the importance of increased contraceptive uptake among couples of reproductive ages, meeting the reproductive health rights of women remains an issue due to multi-faceted obstacles within complex environments. The issues which impact women’s reproductive health rights in relation to contraception relate to availability, accessibility, affordability, literacy, tradition, and culture. This study explores the influence of socio-demographic data on the choice of contraceptives among women who are accessing family planning services at a Specialist hospital, Sokoto-Nigeria.Methods: A cross sectional study was used in this quantitative research to generate data on contraceptive choices of women within the reproductive age (18-49 years) who are accessing family planning services at Specialist hospital, Sokoto. A structured questionnaire was used to elicit information from 352 respondents who were randomly sampled at a Specialist hospital, Sokoto-Nigeria. Data was analyzed using SPSS version 20.0. Descriptive statistics, correlation and regression analyses were used in the data analyses.Results: The findings of this study established age, occupation and level of education to be related with the usage and choice of contraceptives among women attending family planning unit at a Specialist hospital in Sokoto.Conclusions: The result of the study indicated that the socio–demographic data of the respondent, has a significant role in the choice of contraceptives among the women attending family planning unit of Specialist Hospital Sokoto

Measuring oxygen access: lessons from health facility assessments in Lagos, Nigeria

The COVID-19 pandemic has highlighted global oxygen system deficiencies and revealed gaps in how we understand and measure ‘oxygen access’. We present a case study on oxygen access from 58 health facilities in Lagos state, Nigeria. We found large differences in oxygen access between facilities (primary vs secondary, government vs private) and describe three key domains to consider when measuring oxygen access: availability, cost, use. Of 58 facilities surveyed, 8 (14%) of facilities had a functional pulse oximeter. Oximeters (N=27) were typically located in outpatient clinics (12/27, 44%), paediatric ward (6/27, 22%) or operating theatre (4/27, 15%). 34/58 (59%) facilities had a functional source of oxygen available on the day of inspection, of which 31 (91%) facilities had it available in a single ward area, typically the operating theatre or maternity ward. Oxygen services were free to patients at primary health centres, when available, but expensive in hospitals and private facilities, with the median cost for 2 days oxygen 13 000 (US$36) and 27 500 (US$77) Naira, respectively. We obtained limited data on the cost of oxygen services to facilities. Pulse oximetry use was low in secondary care facilities (32%, 21/65 patients had SpO2 documented) and negligible in private facilities (2%, 3/177) and primary health centres (<1%, 2/608). We were unable to determine the proportion of hypoxaemic patients who received oxygen therapy with available data. However, triangulation of existing data suggested that no facilities were equipped to meet minimum oxygen demands. We highlight the importance of a multifaceted approach to measuring oxygen access that assesses access at the point-of-care and ideally at the patient-level. We propose standard metrics to report oxygen access and describe how these can be integrated into routine health information systems and existing health facility assessment tools

Structural breaks in CO2 emissions: Are they caused by climate change protests or other factors?

In recent times, there has been increase in climate change protest across the globe. However, whether decrease in emissions is connected with climate change protest or not is yet to be documented in the literature. Consequently, the aim of this article is to fill this gap by examining ex-post detection of how climate change protests and its interconnectedness with CO2 emissions. Using the Bai and Perron (1998) structural break test, we estimate the number of breaks as well as the date of such structural breaks in CO2 emissions series for 41 countries. Our aim is to match the date of the climate change protests to those of the structural breaks. We observe that climate change protests are fairly consistent with the dates of breaks in Europe and Asia, but not in BRICS economies or US, Canada and other countries. Therefore, this method allows us to solve a gap in the energy industry related to the modelling and correct allocation of positive shocks in CO2 emissions to climate change protests

A1298C Polymorphism of Fetal Methylenetetrahydrofolate Reductase (MTHFR) Gene as a Risk Factor for Spontaneous Abortion

Objective: To investigate the role of A1298C polymorphism of fetal methylenetetrahydrofolate reductase (MTHFR) gene in spontaneous abortion. Method: The case control study design recruited 96 subjects in Siti Fatimah and Pertiwi mother and child hospital, Dr. Wahidin Sudirohusodo, Pelamonia, Bhayangkara, Syekh Yusuf, Haji and Labuang Baji hospital from March to September 2014. All subjects fulfilling the inclusion criteria were taken tissue samples from mothers experiencing spontaneous abortion and blood samples from normally born baby. The data were analyzed using Pearson chi-square with significant rate of 5% (

The burden and risks of pediatric pneumonia in Nigeria: A desk‐based review of existing literature and data

Background: Pneumonia is a leading killer of children under‐5 years, with a high burden in Nigeria. We aimed to quantify the regional burden and risks of pediatric pneumonia in Nigeria, and specifically the states of Lagos and Jigawa. / Methods: We conducted a scoping literature search for studies of pneumonia morbidity and mortality in under‐5 children in Nigeria from 10th December 2018 to 26th April 2019, searching: Cochrane, PubMed, and Web of Science. We included grey literature from stakeholders' websites and information shared by organizations working in Nigeria. We conducted multivariable logistic regression using the 2016 to 2017 Multiple Cluster Indicators Survey data set to explore factors associated with pneumonia. Descriptive analyses of datasets from 2010 to 2019 was done to estimate trends in mortality, morbidity, and vaccination coverage. / Results: We identified 25 relevant papers (10 from Jigawa, 8 from Lagos, and 14 national data). None included data on pneumonia or acute respiratory tract infection burden in the health system, inpatient case‐fatality rates, severity, or age‐specific pneumonia mortality rates at state level. Secondary data analysis found that no household or caregiver socioeconomic indicators were consistently associated with self‐reported symptoms of cough and/or difficulty breathing, and seasonality was inconsistently associated, dependant on region. / Conclusion: There is a clear evidence gap around the burden of pediatric pneumonia in Nigeria, and challenges with the interpretation of existing household survey data. Improved survey approaches are needed to understand the risks of pediatric pneumonia in Nigeria, alongside the need for investment in reliable routine data systems to provide data on the clinical pneumonia burden in Nigeria