Perinatal Outcomes of Multiple Births in Southwest Nigeria

Compared to singletons, multiple births are associated with a substantially-higher risk of maternal and perinatal mortality worldwide. However, little evidence exists on the perinatal profile and risk of neurodevelopmental disabilities among the survivors, especially in developing countries. This cross-sectional study, therefore, set out to determine the adverse perinatal outcomes that are potential markers for neurodevelopmental disabilities in infants with multiple gestations in a developing country. In total, 4,573 mothers, and their 4,718 surviving offspring in an inner-city maternity hospital in Lagos, Nigeria, from May 2005 to December 2007, were recruited. Comparisons of maternal and infant outcomes between single and multiple births were performed using multivariable logistic regression and generalized estimation equation analyses. Odds ratio (OR) and the corresponding 95% confidence interval (CI) for each marker were estimated. Of the 4,573 deliveries, there were 4,416 (96.6%) singletons and 157 (3.4%) multiples, comprising 296 twins and six triplets together (6.4% of all live 4,718 infants). After adjusting for maternal age, ethnicity, occupation, parity, and antenatal care, multiple gestations were associated with increased risks of hypertensive disorders and caesarean delivery. Similarly, after adjusting for potential maternal confounders, multiple births were associated with low five-minute Apgar score (OR: 1.47, 95% CI 1.13-1.93), neonatal sepsis (OR: 2.16, 95% CI 1.28-3.65), severe hyperbilirubinaemia (OR: 1.60, 95% CI 1.00-2.56), and admission to a special-care baby unit (OR: 1.56, 95% CI 1.12-2.17) underpinned by preterm delivery before 34 weeks (OR: 1.91, 95% CI 1.14-3.19), birthweight of less than 2,500 g (OR: 6.45, 95% CI 4.80-8.66), and intrauterine growth restriction (OR: 9.04, 95% CI 6.62-12.34). Overall, the results suggest that, in resource-poor settings, infants of multiple gestations are associated with a significantly-elevated risk of adverse perinatal outcomes. Since these perinatal outcomes are related to the increased risk of later neurodevelopmental disabilities, multiple-birth infants merit close developmental surveillance for timely intervention

An assessment of legal and societal responses to reproductive coercion in Australia

Recently, various forms of domestic violence have commanded heightened public awareness and sparked legislative reforms. Nonetheless, one form of domestic violence that has gained very little attention is reproductive coercion. Reproductive coercion is any behaviour that interferes with the independent decision-making of a person regarding their reproductive health. Although it is not a new phenomenon, reproductive coercion was only recognised as a distinct form of domestic violence in a scientific study published in 2010. The scarcity of subsequent studies means that stakeholders, such as victims, health practitioners, policymakers and law enforcement officers are ill-equipped to understand and properly respond to reproductive coercion-related behaviour. Using legal research methodologies, this thesis will assess reproductive coercion within the broader legislative and societal framework of domestic violence. This thesis aims to address pertinent questions, such as whether the current policy and legislative environment within Australian jurisdictions adequately supports women’s reproductive autonomy, and whether the existing health and societal responses are sufficient to effectively address reproductive coercion. In doing so, this thesis offers a comparative analysis of United Kingdom legislation and societal mechanisms to consider what lessons can be learnt for future legislative, policy and societal reform in Australia

An Improved Location Model for the Collection of Sorted Solid Waste in Densely Populated Urban Centres

This paper presents a facility location model for improving the collection of solid waste materials. The model is especially suitable for densely populated regions with several housing units as well as encourages initial sorting of wastes. Each individual house in the collection area is designated a customer, with randomly selected customers comprising the set of candidate hubs. The fundamental feature of the model is to group the customers into clusters by assigning each customer (house) to the nearest hub. Each cluster is then assigned to exactly one waste collection site drawn from the set of potential collection locations. The objective is to minimize the total number of activated waste collection sites such that all the customers’ requests are satisfied without violating the capacity limit of each site. A simple Lagrangian relaxation heuristic is developed for the problem and solved with the CPLEX solver on the AMPL platform to find a feasible solution. Results from the numerical implementation of model show the model is efficient and competitive with existing solid waste collection facility location model

Odontogenic tumours: a review of 266 cases

Objectives: The aim of this study was to examine the relative frequency of odontogenic tumours at a tertiary hospital in Ibadan, as well as to study the various histologic types based on WHO 2005 classification and to compare results from this study with those of previous studies. Study design: The records of the Oral Pathology Department of University College Hospital were reviewed. Lesions diagnosed as odontogenic tumours were categorized into four groups based on WHO 2005 classification and were analyzed for age, sex and site using SPSS for Window (version 18.0; SPSS Inc. Chicago, IL) and frequency tables were generated. Results: Two hundred and sixty six (41.7%) cases of odontogenic tumours were seen. The mean age of occurrence was 32.6 (±15.815) years (range3-82 years) and peak age was in the third decade of life. Eleven (4.1%) malignant odontogenic tumours were seen. Ameloblastoma with 65.4% of cases was the most common odontogenic tumour followed by fibromyxoma (14.7%), no case of odontoma was seen in this series. Conclusion: The findings were mostly similar to those of African and Asian series and showed variations from reports from the Americas. The reason for the disparity in African and American series needs further investigations

Techniques for mandibular block anaesthesia - the practice of Nigerian dentists

Objective: To assess the knowledge and practices of Nigerian dentists in the use of alternative techniques for inferior alveolar nerve block. Method: A survey was conducted using a self administered structured questionnaire distributed among a cross-section of Nigerian dentists. Participants were to distinguish between four alternative methods of mandibular block anaesthesia namely; Gow-Gate block (GGB), Akinosi block (AB), Vazirani block (VB) and Retromolar block (RB). The questionnaire sought demographic information about participants, types of practice, when and how the dentists received formal teaching on these techniques, how often they used the techniques, and the reasons for conventional block failure they have encountered. Result: There were 273 respondents comprising 165 (60.4%) males and 105 (39.6%) females within the age range of 24-56 years (mean 34.4 + 6.8 years). Two hundred and forty nine (91.2%) respondents were aware of alternative methods of achieving IAN block but 45 (16.5%) employed alternative techniques in less than 5% of cases, 57 (20.9%) in 5-10% of cases and 12 (4.4%) in more than 10% of cases. Akinosi block was the preferred alternative (p = 0.045). Most of the alternative techniques were taught without clinical demonstrations. The relationship between years of experience and encounter with conventional block failure on one hand [p = 0.126] and experience and usage of alternative techniques [p= 0.063] were not statistically significant. The common causes of conventional block failure highlighted were aberrant anatomy (76.9%), local infection (67%), uncooperative patients (64.8%), trismus (59.3%) and poor technique (56%). Conclusion: There is a deficiency in the undergraduate curriculum of Nigeria Dental Schools with respect to training in dental anaesthesia. Majority use conventional nerve block routinely while alternative techniques are rarely employed

Gender and Maternal Health: A Study of Family Planning and the Use of Contraceptive Among Rural Women in Iwaro-Oka Akoko, Ondo State

The issue of family planning all over the world has attracted attention due to importance in decision making about infant mortality, maternal morbidity and mortality, population growth and development issues. Women are disadvantaged as they have little or nothing to say regarding when to have a child, and how many to have in the process. This is particularly so among rural dwellers in Nigeria and Sub-Saharan Africa due to household gender dynamics. The study adopted a descriptive research survey and 150 rural women were randomly selected from Iwaro-Oka settlement. Data was collected using a self-constructed questionnaire. Data was analysed using frequencies, simple percentage and chi-square analysis. The result shows that majority 94(80.3%) of the respondents within the community have the knowledge of family planning, and they have practiced one or more family planning methods. Also, few 23(19.3%) of the respondents who do not practice family planning believe in the benefit of the method. Test of the hypotheses revealed that there was significant relationship between the educational back ground of the respondents and their attitude towards family planning and contraceptive use. In addition, there was a significant relationship between husband’s involvement in decision making in wife’s family planning life and attitude towards family planning and contraceptive use. Based on the findings, the study recommends that family planning programme should be intensified to improve people’s knowledge of contraception and reduce their fear of modern methods. Moreover, all stakeholders should plan interventions that will further make family planning health services husband-targeted by involving men and ensuring confidentiality, privacy and respect. In addition, such intervention should provide information necessary for informed men consent especially in traditional settings, in order to curtail infant mortality, maternal morbidity and mortality. Keywords: Family Planning, Contraceptive, Attitude, and Rural Women

Phase inversion of colored Pickering emulsions stabilized by organic pigment particle mixtures

Pickering emulsions stabilized by a mixture of coloured organic pigment particles of different hydrophobicity have been investigated at equal oil:water ratio and a fixed overall particle concentration by several complementary methods. Transitional phase inversion of emulsions from water-in-oil to oil-in-water can be effected by increasing the fraction of hydrophilic pigment orange in mixtures with either hydrophobic pigment yellow, red, indigo or blue. In two mixtures, we find that a distinct change in the colour of emulsions occurs at phase inversion. Although the fraction of pigment orange required depends on the particular hydrophobic pigment selected, phase inversion occurs at a similar surface energy of the particle mixture which lies between that of the hydrophilic pigment and those of the hydrophobic pigments. We show that both pigment types are present at the oil-water interface simultaneously giving rise to emulsions which are extremely stable to coalescence. The average drop size for both emulsion types increases towards phase inversion in line with an increase in the extent of sedimentation/creaming at long time

OPTIMISATION OF LYE-PEELING OF CASSAVA (Manihot esculenta Crantz) USING RESPONSE SURFACE METHODOLOGY

Cassava (Manihot esculenta Crantz) is an important root crop in many tropical developing countries. Conventional peeling, done manually using knives is wasteful and unsuitable for industrial scale operation. Optimum condition for the peeling of cassava by immersion in hot lye (NaOH) solution was determined using Response Surface Methodology (RSM) for pre-determined three levels of Peeling Efficiency Index (PEI). Some cassava was peeled manually and some with hot lye solution. The effects of lye–concentration (4-12%), immersion temperature (75-100°C) and immersion time (2.5-10min.) on PEI (removal of 11-15% of root) obtained from 23 experimental points and three replication were analyzed with design expert and statistical analysis system software. Complete lye–peeling (removal of 11% of the root) was achieved at 9.7%, 86°C and 5min respectively which were within the critical optimization range (R2=43%, CV=44% and root mean square error 0.3935) generated by the RSM

OPTIMIZATION OF LYE PEELING OF BREADFRUIT (Artocarpus comminis Frost) USING RESPONSE SURFACE METHODOLOGY

Breadfruit (Artocarpus communis  Frost) is an important food crop in many tropical developing coun-        tries. Conventional peeling, done manually using knives is wasteful and unsuitable for industrial scale        operation. Optimum condition for the peeling of breadfruit by immersion in hot lye (NaOH) solution was        determined using Response Surface methodology (RSM) for pre-determined three levels of Peeling        Efficiency Index   (PEI). Some   breadfruit   was   peeled   manually   and   some   with   hot lye   solution.   The        effects of lye–concentration (0.5-2.0%), immersion temperature (70-90°C) and immersion time (2.5-        10min.) on PEI (removal of 6-11% of peel) with subsequent soft and abrasive washing of the peeled        crop obtained from 14 experimental points and three replication were analyzed with design expert and        statistical analysis system software. Complete lye–peeling (removal of 6% of the fruit ) was achieved                                                                                                   2        at   1.6%,   80°C   and   5min   respectively   which   were   within   the   critical   optimization   range   (R =52%,        CV=75.9%) generated by the RSM.&nbsp

Perinatal Outcomes of Multiple Births in Southwest Nigeria

Compared to singletons, multiple births are associated with a substantially-higher risk of maternal and perinatal mortality worldwide. However, little evidence exists on the perinatal profile and risk of neurodevelopmental disabilities among the survivors, especially in developing countries. This cross-sectional study, therefore, set out to determine the adverse perinatal outcomes that are potential markers for neurodevelopmental disabilities in infants with multiple gestations in a developing country. In total, 4,573 mothers, and their 4,718 surviving offspring in an inner-city maternity hospital in Lagos, Nigeria, from May 2005 to December 2007, were recruited. Comparisons of maternal and infant outcomes between single and multiple births were performed using multivariable logistic regression and generalized estimation equation analyses. Odds ratio (OR) and the corresponding 95% confidence interval (CI) for each marker were estimated. Of the 4,573 deliveries, there were 4,416 (96.6%) singletons and 157 (3.4%) multiples, comprising 296 twins and six triplets together (6.4% of all live 4,718 infants). After adjusting for maternal age, ethnicity, occupation, parity, and antenatal care, multiple gestations were associated with increased risks of hypertensive disorders and caesarean delivery. Similarly, after adjusting for potential maternal confounders, multiple births were associated with low five-minute Apgar score (OR: 1.47, 95% CI 1.13-1.93), neonatal sepsis (OR: 2.16, 95% CI 1.28-3.65), severe hyperbilirubinaemia (OR: 1.60, 95% CI 1.00-2.56), and admission to a special-care baby unit (OR: 1.56, 95% CI 1.12-2.17) underpinned by preterm delivery before 34 weeks (OR: 1.91, 95% CI 1.14-3.19), birthweight of less than 2,500 g (OR: 6.45, 95% CI 4.80-8.66), and intrauterine growth restriction (OR: 9.04, 95% CI 6.62-12.34). Overall, the results suggest that, in resourcepoor settings, infants of multiple gestations are associated with a significantly-elevated risk of adverse perinatal outcomes. Since these perinatal outcomes are related to the increased risk of later neurodevelopmental disabilities, multiple-birth infants merit close developmental surveillance for timely intervention