Factors associated with prelacteal feeding practices in a rural northern Nigerian setting

Introduction: Prelacteal feeding practice contravenes the recommendation of World Health Organisation that breastfeeding be initiated within an hour of childbirth. Consequently, the health, social, emotional and economic benefits of optimal breastfeeding are limited. Therefore, to break this vicious cycle of prelacteal feeding and suboptimal breastfeeding, factors associated with the practice must be identified.Objective: To assess prelacteal feeding practices and its associated factors in a rural community with the view to generate data for community-level interventions that will promote optimal breastfeeding.Methods: Data was collected during a community-based surveillance for maternal, newborn and child health project in Tsibiri, a rural community in north-western Nigeria. The survey questionnaire was uploaded into mobile devices running on an android operating system. Trained female interviewers collected the data over a period of one week in 2011.Results: A total of 270 out of 309 interviewed women had experienced childbirth and were included in the analysis. Majority (85.2%) of respondents utilised prelacteal feeds for their newborns. Plain water was the most common prelacteal feed (44.7%). Prelacteal feeding was associated with births assisted by unskilled birth attendants (AOR 5.322, 95%CI 1.634-17.333); while operative delivery reduced the likelihood of the practice (AOR 0.168, 95%CI 0.060-0.470). No statistically significant association was found between use of prelacteal feed and women’s age, education or access to income.Conclusion: The predominance of prelacteal feeding practices underscores the need for innovative strategies that create awareness among mothers and health care providers, with emphasis on health facility deliveries, advantages of breastfeeding and risks of prelacteal feeding.Keywords: Breastfeeding, Newborns, Prelacteal feeds, Rural community, Wome

Bioinformatic analysis of conformational epitope peptide sequences for the effective diagnosis of Sudan Ebola Virus disease

Ebola Virus disease (EVD) is an acute infectious disease associated with very high rates of mortality and transmissibility. EVD formally known as Ebola haemorrhagic fever is a rare but deadly disease in human and nonhuman primates, with average fatality rate at 50%, and variance between 25% to 90% depending on strain type as established by World Health Organisation (WHO). High fatality rate is attributed to the lack of specific, rapid and affordable test kits availability for quick detection, noting the overlap in symptoms from other endemic diseases such as malaria, typhoid fever and cholera. Real time polymerase chain reaction (RT-PCR), currently the gold standard deployed in the diagnosis of Ebola virus disease, exhibits major disadvantages in analyte processing time which in turn allows for an increased rate in mortality. This paper seeks to address the challenges of rapid and effective diagnostics for EVD with specific focus on the Sudan strain shortly after infection, using immunoinformatics tools to analyse multi-epitope peptides sequences from various strains of EVD in other to design affordable lateral flow test (LFT) kits hence an implied reduction in the mortality and fatality rates to a bearable minimal standard. Study showed the possibility and efficacy of LFT kit to detect rapidly the Ebola Virus Disease as chimeric construct exhibited conformity to standard test and predictions with antigenicity =0.5445, solubility =0.625, instability index =36.93, aliphatic index = 53.37, and grand average of hydropathicity (GRAVY) =-0.932. Post-peptide construct analysis further validates the tertiary construct with Z-Score =-4.54 and Ramachandran plots 93.0% core in 258 residues establishing stability and a good model construct for EVD diagnostics

Leiomyoma of the anterior vaginal wall: a rare case

Background: Leiomyoma is a benign smooth muscle mesenchymal tumor, usually of uterine origin but may rarely develop in the vaginal walls. Case presentation: A case of 40-year-old para 5+0 woman with anterior vaginal wall leiomyoma is reported. The presentation mimics that of uterovaginal prolapse and hence presents a diagnostic challenge. The unusual appearance of the protrusion, failure to reduce at any time even while lying down, and complete absence of urinary symptoms raised the suspicion of a rare case. The diagnosis was made through examination under anesthesia, cystoscopy, and biopsy. Histological examination of the biopsy specimen confirmed vaginal wall leiomyoma. The patient had complete excision of the mass without any complications. Discussion and Conclusion: Vaginal wall leiomyoma is a rare benign vaginal lesion that can easily be misdiagnosed. Diagnosis involves critical clinical evaluation, especially during pelvic examinations. Any vaginal protrusion should be approached with a high index of suspicion, especially in patients of reproductive age

The ASOS Surgical Risk Calculator: development and validation of a tool for identifying African surgical patients at risk of severe postoperative complications

Background: The African Surgical Outcomes Study (ASOS) showed that surgical patients in Africa have a mortality twice the global average. Existing risk assessment tools are not valid for use in this population because the pattern of risk for poor outcomes differs from high-income countries. The objective of this study was to derive and validate a simple, preoperative risk stratification tool to identify African surgical patients at risk for in-hospital postoperative mortality and severe complications. Methods: ASOS was a 7-day prospective cohort study of adult patients undergoing surgery in Africa. The ASOS Surgical Risk Calculator was constructed with a multivariable logistic regression model for the outcome of in-hospital mortality and severe postoperative complications. The following preoperative risk factors were entered into the model; age, sex, smoking status, ASA physical status, preoperative chronic comorbid conditions, indication for surgery, urgency, severity, and type of surgery. Results: The model was derived from 8799 patients from 168 African hospitals. The composite outcome of severe postoperative complications and death occurred in 423/8799 (4.8%) patients. The ASOS Surgical Risk Calculator includes the following risk factors: age, ASA physical status, indication for surgery, urgency, severity, and type of surgery. The model showed good discrimination with an area under the receiver operating characteristic curve of 0.805 and good calibration with c-statistic corrected for optimism of 0.784. Conclusions: This simple preoperative risk calculator could be used to identify high-risk surgical patients in African hospitals and facilitate increased postoperative surveillance. © 2018 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.Medical Research Council of South Africa gran