Takayasu arteritis in pregnancy: a case report, and clinical lessons learnt

A case report of known case of Takayasu arteritis (known to the woman in case report) in a primigravida, but unrevealed to the obstetrician till advanced stage of pregnancy is reported. The authors share the lessons learnt by them from this case which would improve diagnosis, evaluation and management of pregnancy hypertension. A brief account on clinical manifestations and diagnosis of Takayasu arteritis is also included

A HYBRID MACHINE LEARNING MODEL FOR NETWORK INTRUSION DETECTION

 Intrusion detection is a significant challenge in network security, as it involves detecting unseen attacks in a network or system. In this research, we aimed to build a hybrid machine learning model for intrusion detection using artificial intelligence (AI). To do this, we used the KDD CUP 99 dataset and applied two machine learning algorithms: AdaBoost and Stochastic Gradient Descent Classifier (SGDC). These algorithms were combined to form two hybrid models: SGDC_ADA and ADA_SGDC.  The results of our study showed that the SGDC_ADA model had an accuracy of 0.97 and outperformed the ADA_SGDC model, which had an accuracy of 0.96. In addition, the SGDC_ADA model had an average precision of 0.97, average recall of 0.96, and average F1-score of 0.97, while the ADA_SGDC model had an average precision of 0.96, average recall of 0.95, and average F1-score of 0.96.  Overall, our research suggests that the SGDC_ADA hybrid model is an effective method for intrusion detection, with high accuracy and low error rates. This model may be useful in improving network security and protecting against unseen attacks

Empowerment of women in Nigeria’s small-scale fisheries: a tool to sustainability

In Nigeria, women play major roles of at least 75% in the fisheries and aquaculture value- chains from production, processing, storage, marketing and trade. Unlike the men, women have not received commensurate levels of attention and empowerment largely because their roles are perceived as ‘invisible’, poorly evaluated and undocumented without substantial sex-disaggregated data as proof. For these reasons above and in furtherance of identifying key areas in which empowerment needs to be strengthened thus closing the gender gap, this study was undertaken to contribute to information on the nature and empowerment of women and the factors influencing their participation in the small-scale fisheries. The study also aimed at determining relationship between the extent of the women’s empowerment and some selected determinants using a cumulative empowerment index (CEI). A mix of transdisciplinary, quantitative and qualitative methods was used for this study in Ikosi in Agbowa and Igboolomi fishing communities of Epe and Ibeju-Lekki Local Government Areas of Lagos State respectively. Ten indicators of empowerment : contribution to household income, decision making ability, spending ability, ownership of assets, access to resources, membership in economic or social groups, time allocated to household, productive tasks and leisure activities, coping capacity to household shocks and political awareness were chosen for this purpose. Results obtained in this study showed that women are still very low in the CEI and it is hoped that this will pave way for a strategic framework for including gender –responsiveness in policies and developmental planning

Prevalence and factors associated with non-utilization of healthcare facility for childbirth in rural and urban Nigeria: Analysis of a national population-based survey

Aim: The aim of this study was to assess the rural–urban differences in the prevalence and factors associated with non-utilization of healthcare facility for childbirth (home delivery) in Nigeria. Methods: Dataset from the Nigeria demographic and health survey, 2013, disaggregated by rural–urban residence were analyzed with appropriate adjustment for the cluster sampling design of the survey. Factors associated with home delivery were identified using multivariable logistic regression analysis. Results: In rural and urban residence, the prevalence of home delivery were 78.3% and 38.1%, respectively (p < 0.001). The lowest prevalence of home delivery occurred in the South-East region for rural residence (18.6%) and the South-West region for urban residence (17.9%). The North-West region had the highest prevalence of home delivery, 93.6% and 70.5% in rural and urban residence, respectively. Low maternal as well as paternal education, low antenatal attendance, being less wealthy, the practice of Islam, and living in the North-East, North-West and the South-South regions increased the likelihood of home delivery in both rural and urban residences. Whether in rural or urban residence, birth order of one decreased the likelihood of home delivery. In rural residence only, living in the North-Central region increased the chances of home delivery. In urban residence only, maternal age ⩾ 36 years decreased the likelihood of home delivery, while ‘Traditionalist/other’ religion and maternal age < 20 years increased it. Conclusion: The prevalence of home delivery was much higher in rural than urban Nigeria and the associated factors differ to varying degrees in the two residences. Future intervention efforts would need to prioritize findings in this study

The acute effects of a lunch containing capsaicin on energy and substrate utilisation, hormones, and satiety

BACKGROUND: Addition of capsaicin to the diet has been shown to increase satiety and thermogenesis. The effects of capsaicin on ghrelin, peptide YY (PYY) and glucagon-like peptide 1 (GLP-1), in relation to changes in hunger and satiety are unknown. AIM: To test the acute effects of a lunch containing capsaicin on gut derived hormones (GLP-1, ghrelin, and PYY), energy expenditure (EE), substrate oxidation and satiety at lunch in the postprandial state. METHODS: Thirty subjects (age: 31 +/- 14 years, BMI: 23.8 +/- 2.8 kg/m(2)) were studied twice in a crossover design. After 30 min resting on a bed, resting metabolic rate was measured by a ventilated hood system. Subsequently lunch (35% of daily energy intake) was served. The two lunch conditions were: (1) lunch without capsaicin and (2) lunch with capsaicin (CAPS). The macronutrient composition (energy percentage) of the lunches was 60% carbohydrates, 10% protein and 30% fat. During 3 h after the lunch diet-induced thermogenesis was measured. Furthermore, anchored 100 mm visual analogue scales on the appetite profile were collected (t = 0, 30, 60, 120, 150, 180 and 240) and blood samples were taken for analysis of GLP-1, PYY, and ghrelin concentrations (t = 0, 45, 60, 120, and 180). RESULTS: Satiety and EE were not different after CAPS lunch as compared to the control lunch. Fifteen minutes after lunch CAPS lunch increased GLP-1 (p < 0.05) and tended to decrease ghrelin (p = 0.07) as compared to the control lunch. PYY responses were not different between the CAPS lunch and the control lunch. CONCLUSIONS: An acute lunch containing capsaicin had no effect on satiety, EE, and PYY, but increased GLP-1 and tended to decrease ghrelin

Maternal and neonatal factors associated with mode of delivery under a universal newborn hearing screening programme in Lagos, Nigeria

<p>Abstract</p> <p>Background</p> <p>Emerging evidence from a recent pilot universal newborn hearing screening (UNHS) programme suggests that the burden of obstetric complications associated with mode of delivery is not limited to maternal and perinatal mortality but may also include outcomes that undermine optimal early childhood development of the surviving newborns. However, the potential pathways for this association have not been reported particularly in the context of a resource-poor setting. This study therefore set out to establish the pattern of delivery and the associated neonatal outcomes under a UNHS programme.</p> <p>Methods</p> <p>A cross-sectional study in which all consenting mothers who delivered in an inner-city tertiary maternity hospital in Lagos, Nigeria from May 2005 to December 2007 were enrolled during the UNHS programme. Socio-demographic, obstetric and neonatal factors independently associated with vaginal, elective and emergency caesarean deliveries were determined using multinomial logistic regression analyses.</p> <p>Results</p> <p>Of the 4615 mothers enrolled, 2584 (56.0%) deliveries were vaginal, 1590 (34.4%) emergency caesarean and 441 (9.6%) elective caesarean section. Maternal age, parity, social class and all obstetric factors including lack of antenatal care, maternal HIV and multiple gestations were associated with increased risk of emergency caesarean delivery compared with vaginal delivery. Only parity, lack of antenatal care and prolonged/obstructed labour were associated with increased risk of emergency compared with elective caesarean delivery. Infants delivered by vaginal method or by emergency caesarean section were more likely to be associated with the risk of sensorineural hearing loss but less likely to be associated with hyperbilirubinaemia compared with infants delivered by elective caesarean section. Emergency caesarean delivery was also associated with male gender, low five-minute Apgar scores and admission into special care baby unit compared with vaginal or elective caesarean delivery.</p> <p>Conclusions</p> <p>The vast majority of caesarean delivery in this population occur as emergencies and are associated with socio-demographic factors as well as several obstetric complications. Mode of delivery is also associated with the risk of sensorineural hearing loss and other adverse birth outcomes that lie on the causal pathways for potential developmental deficits.</p

Prevalence and associated factors of modern contraceptive discontinuation among sexually active married women in Nigeria

Abstract Background Contraceptive discontinuation for reasons other than the desire for pregnancy is associated with a high rate of unintended pregnancies leading to unsafe abortions, maternal morbidity and mortality. In Nigeria, little is known about modern contraceptive discontinuation using the calendar data. Methods A cross-sectional research design from the 2018 Nigeria Demographic and Health Surveys (NDHS) women’s dataset was used to examine the prevalence and associated factors of modern contraceptive discontinuation among sexually active married women in Nigeria. A weighted sample size of 3,353 currently sexually active married or in union women who have ever used a modern contraceptive 5 years before the survey and with complete reproductive histories and are not sterilised or declared infecund was analysed. Data were analysed and displayed using frequency tables and charts, chi-square test, and binary logistic regression model at 5% level of significance. Results The prevalence of modern contraceptive discontinuation was 35.8% (1199) with 45.8% (549) of the women discontinuing using modern contraceptives while at risk of pregnancy. The most modern method discontinued was Injectables (25.2%) while the commonest reason for modern method discontinuation was because they wanted to become pregnant (36.1%). Associated factors of modern contraceptive discontinuation among sexually active married women in Nigeria were: marital duration (aOR = 3.0; 95%CI: 1.5–6.2), visitation to a health facility in the last 12 months before the survey (aOR = 0.6; 95%CI: 0.4–0.8), education (aOR = 2.0; 95%CI: 1.2–3.4) and region of residence (aOR = 2.7; 95%CI: 1.6–4.7). Conclusion Modern contraceptive discontinuation among the study respondents was high. Region of residence, health facility visitation and marital duration were significantly associated with modern contraceptive discontinuation. The study suggests that health care providers should address the discontinuation of contraception through counselling, particularly among women who reside in the region of high prevalence of contraceptive discontinuation, short-term users as well as strengthen the use of contraception among those who are still at risk of becoming pregnant. Governments and stakeholders should also partner with private sectors to make health care accessible to women by bring health facilities closer to them to improve facility visitation.