16 research outputs found
The role of cytokines as inflammatory mediators in preeclampsia
Introduction: this study is to determine the concentrations of IL-6, TNF 5, and C reactive protein (CRP) in women with severe preeclampsia, andcompare with those of gestational age- matched normotensive pregnant women and to correlate CRP levels with markers of organ damage inwomen with preeclampsia.Methods: this was a case control study of fifty women with severe preeclampsia and fifty gestational age matched pregnant women with normal blood pressure. The women were drawn from The Antenatal Clinic of The Lagos University Teaching Hospital. Severe pre eclampsia was defined as systolic blood pressure ;160 mmHg and/or diastolic blood pressure ;110mmHg and ;2+ of proteinuria. After obtaining an informed consent, each participant completed a structured questionnaire. The questionnaire sought information on socio-demographic and clinical data. From each participant, mid-stream urine was collected for urinalysis and culture, and blood sample was collected for biochemical analysis. Comparisons of continuous variables and categorical variables were done using the Student's t test and Chi square test respectively. Correlation analysis was used to determine the associations between variables. Statistical significance was set at P Results: the women were similar in their socio demographic characteristics. There was a statistically significant difference in the systolic blood pressure ( p < 0.0001), diastolic blood pressure ( p < 0.0001), uric acid ( p < 0.0001), AST ( p < 0.0001), ALP ( p < 0.0001), creatinine ( p < 0.0013), GGT ( p < 0.005), IL 6 ( p < 0.021), CRP ( p < 0.0002), and TNF 5 ( p < 0.023), between the group with severe preeclampsia and the group with normal blood pressure. This study also reports a significant association between CRP and systolic blood pressure, diastolic blood pressure, uric acid AST and ALP (pConclusion: the inflammatory cytokines, IL6, TNF 5 and CRP are elevated in severe preeclampsia and may mediate some of the clinical manifestations of the disorder. A role may exist for anti inflammatory agents in the management of women with preeclampsia
Awareness and knowledge regarding of cervical cancer, Pap smear screening and human papillomavirus infection in Gabonese women
Implementation of a national school-based Human Papillomavirus (HPV) vaccine campaign in Fiji: knowledge, vaccine acceptability and information needs of parents
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries
Abstract
Background
Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres.
Methods
This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries.
Results
In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia.
Conclusion
This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries
Sexual and Reproductive Health in HIV Serodiscordant Couples
Serodiscordant couples are a significant source of new HIV infection in
sub-Sahara Africa. The prevention of HIV transmission to the uninfected
partner should be an integral part of their health care. Serodiscordant
couples desire pregnancy, treatment for infertility, effective family
planning services, sexual health screening, and so on. This paper
reviews the sexual and reproductive health needs of heterosexual
serodiscordant couples, based on current evidence and recommendations.Les couples sérodiscordants sont une source importante de
nouvelles infections du VIH en Afrique sub-saharienne. La
prévention de la transmission du VIH au partenaire non
infecté doit être une partie intégrante de leurs soins
de santé. Les couples sérodiscordants désirent une
grossesse, le traitement de la stérilité, des services de
planification familiale efficaces, le dépistage de la santé
sexuelle et ainsi de suite. Ce document passe en revue les besoins en
matière de santé sexuelle et reproductive des couples
hétérosexuels sérodiscordants, fondées sur des
preuves et des recommandations en vigueur
The role of inflammation in the metabolic syndrome
Aims and Objectives: The aim of this study is to determine the plasma levels of interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα) and C-reactive protein (CRP) in adult Nigerians with the metabolic syndrome and to determine the relationship between components of the metabolic syndrome and CRP in adult Nigerians. Materials and Methods: This was a cross-sectional analytical study of 50 adult men and women with metabolic syndrome and 50 age- and sex-matched men and women without metabolic syndrome. Metabolic syndrome was defined based on the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) criteria. Written informed consent was obtained from the participants. Blood pressure and anthropometric measurements were taken and venous blood was collected after an overnight fast. The Ethics Committee of the Lagos University Teaching Hospital, Lagos, Lagos State, Nigeria approved the study protocol. Comparisons of the continuous variables and the categorical variables were done using the Student's t-test and Chi-square test, respectively. Regression analysis was used to determine the associations between the variables. Statistical significance was set at P < 0.05. Results: The study subjects differed in some clinical and laboratory parameters such as diastolic blood pressure (P = 0.048), waist circumference (P = 0.002), body mass index (BMI) (P = 0.012), waist/hip ratio (P = 0.023), high-density lipoprotein (HDL) (P = 0.012), and insulin resistance (P = 0.042). There was a statistically significant increase in the inflammatory marker, CRP (P = 0.019), cytokines, IL-6 (P = 0.040), and TNFα (P = 0.031) between the subjects with and without metabolic syndrome. There was also a positive significant association between CRP, waist circumference, and insulin resistance and a negative significant association between CRP and HDL in metabolic syndrome (P < 0.05). Conclusion: This study reports increased plasma levels of the inflammatory cytokines, IL-6, TNFα and in the inflammatory marker and CRP in metabolic syndrome. Understanding the role of inflammation in the metabolic syndrome may provide novel strategies for the management of metabolic syndrome and related disorders
Preliminary report on plasma homocysteine and hormonal variations in infertile women in Lagos, Nigeria
Background: The relationship between infertility and hormonal variations has been variously documented, but little has been reported on the interactions between hormonal factors, homocysteine (Hcy), and female infertility. Objective: This study aimed to evaluate the relationship between plasma Hcy levels and hormonal variations in infertile women. Materials and Methods: This descriptive cross-sectional study was carried out among eligible infertile and fertile women seeking care at the Lagos University Teaching Hospital, Lagos, Nigeria. The subjects were 100 women referred for management of infertility, and the controls were 50 fertile women who had given birth within the past year. Fasting plasma levels of Hcy were estimated using enzyme immunoassay. Serum levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, and progesterone were measured using Access 2 (Immunoassay systems-beckman coulter, inc.250S.Kraemer blvd.Brea, ca 92821. U.S.A). Results: Mean plasma Hcy levels for subjects and controls were 9.50 ± 1.88 μmol/L and 9.44 ± 1.85 μmol/L, respectively, with no significant variation (P = 0.952). Plasma Hcy was not significantly associated with infertility and hormone levels. The mean serum levels of LH, FSH, and prolactin were significantly higher among subjects compared to controls. Conclusion: Hormonal variations observed in infertile women did not appear to significantly alter plasma Hcy levels, and hyperhomocysteinemia (HHcy) may not have significantly contributed to female infertility in our environment