Intradialytic hyperalimentation as adjuvant support in pregnant hemodialysis patients: case report and review of the literature

Pregnancy in chronic dialysis patients is unusual and associated with many complications. Infants are often born both prematurely and small for gestational age. We report a case of a 36-year-old diabetic hemodialysis patient G4P3 who had prolonged hyperemesis gravidarum, for whom intradialytic parenteral nutrition (IDPN) was started at week 14 and continued throughout her pregnancy. She delivered a 3.5-kg baby girl at the 36th week of gestation by cesarean section. We discuss the use of IDPN as adjunct therapy for pregnant dialysis patients

Microbiological and Physicochemical Characterization of Abattoir Wastewater in Obio/Akpor Local Government Area of Rivers State, Nigeria

Introduction. The spread of pathogenic bacteria from food production processes has become a problem worldwide. Abattoir effluents are potential carriers of resistant pathogenic bacteria and could contribute to these strains’ global spread in the environments. This study extensively analyzed abattoir wastewater in Obio/Akpor (Nigeria), focusing on its microbiological and physicochemical aspects. Materials and Methods. 250 ml of abattoir wastewater samples were aseptically collected from each of four different abattoirs within Obio/Akpor using standard methods. The study was conducted from September 2023 to November 2023. Frequency of occurrence, percentage occurrence, charts, mean count and standard deviation of microbiological parameters were generated. Physicochemical parameters were identified using American Public Health Association (APHA) gold standard. Results. Microbiological assessments showed that the total heterotrophic bacteria count obtained ranged from 2.6 ± 0.14 × 107 to 6.5 ± 0.28 × 108 CFU/ml. E. coli count obtained ranged from 2.3 ± 0.07 × 106 to 2.6 ± 0.14 × 106 CFU/ml. The total coliform counts ranged from 2.5 ± 0.07 × 103 CFU/ml to 4.3 ± 0.07 × 108 CFU/ml. Vibrio count of 4.5 ± 0.70 × 103 CFU/ml was only recorded from Choba while fungal count was only recorded from Rumuokoro (1.1 ± 0.70 × 104 CFU/ml) and Rumuodara (2.8 ± 0.70 × 105 CFU/ml). For the physicochemical parameters, pH ranged from 5.58 to 7.05, Total Dissolved Solids (TDS) ranged from 4.26 to 7.21 mg/l, Total Suspended Solids (TSS) ranged from 2.01 to 4.86 mg/l, Phosphate ranged from 1.13 to 2.42 mg/l, Nitrate ranged from 4.97 to 10.27 mg/l, Dissolved Oxygen (DO) ranged from 13.93 to 26.25 mg/l, Biochemical Oxygen Demand (BOD) ranged from 7.06 to 15.43 mg/l and Chemical Oxygen Demand (COD) ranged from 165.42 to 256.38 mg/l. Conclusion. The study emphasizes the diverse microbial composition and physicochemical characteristics of abattoir wastewater, highlighting environmental and public health concerns. Effective wastewater treatment pre-discharge into water bodies is vital to mitigate adverse impacts

Melanoma screening using patient self-assessed risk and total body photography

The current standard of care for high-risk melanoma patients is a two-step process using Total Body Photography (TBP) followed by dermoscopy and is limited to a select group of patients. Methods: A cross-sectional study of patient characteristics and self-reported melanoma risk factors associated with TBP usage and pathology-confirmed outcomes was conducted on a sample of 4,692 patients in a single practitioner private dermatology setting. Results: TBP patients were significantly more likely to be male, partnered, tobacco users, highly educated, and have increased self-reported risk factors (such as fair skin, personal history of skin cancer or melanoma, family history of skin cancer, numerous moles, or previous history of sunburn, P<0.05). Personal history of skin cancer and melanoma, male gender, ?40 moles, Medicare insurance, and increasing age were positively associated with malignancy outcomes, whereas higher education, family history of melanoma, and traditional (private) insurance were associated with reduced prevalence of malignant lesions. Patients' self-assessed skin cancer risk and access to skin detection modalities can result in detection of melanoma at early, curable stages. Higher level of education and partner status may result in a greater awareness of risk factors associated with melanoma