Time of passage of first stools (Mecontum) and serum levels of calcium and magnesium in Nigerian neonates (African nionates)

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Risk factors for neonatal jaundice in babies presenting at the University of Benin Teaching Hospital, Benin City

Background: Jaundice is the yellowish discoloration of the skin, sclera and mucous membranes resulting from deposition of bilirubin. Neonatal jaundice is a leading cause of neonatal admissions in the first week of life and risk factors such as sepsis, prematurity, glucose-6-phosphate dehydrogenase enzyme deficiencies, use of native herbs and contact with naphthalene balls contaminated clothes have been identified for neonatal jaundice. Objective: To determine the risk factors for neonatal jaundice at University of Benin Teaching Hospital, Benin City. Methods: This retrospective study was conducted at the Special Care Baby Unit of the University of Benin Teaching Hospital, Benin City. Case notes of babies admitted from January 2006 to December 2008 were retrieved and information on biodata, gestational age, anthropometric values, potential risk factors, level of serum bilirubin at presentation and discharge, mode of treatment and outcome were extracted. Results: Of the 1784 babies admitted during the period, 472 (26.5%) were admitted for neonatal jaudice. Fifty seven percent of the babies with neonatal jaundice were delivered in UBTH (in-born babies), while 202 (42.8%) of the babies were born before arrival (out-born babies) in UBTH. The Male: Female ratio was 1.02:1. The mean age at presentation with jaundice was 3.43 ± 3.76 days of life. Outborn babies tended to present at an older age (6.08 ± 5.19 days) than in -born babies (2.47 ± 2.48 days). The mean serum bilirubin value in out-born babies (14.00 ± 4.58 mg/dL) was significantly higher than that observed among the in-born babies (9.35 ± 4.38 mg/dL: p = 0.000). The risk factors identified were use of mentholatum, naphthalene balls and native herbs in 40.0%, 16.7% and 7.0% respectively. ABO incompatibility was found in 7.6% of babies. No risk factor was identified in 36.3% of the babies. The case fatality rate in this study was relatively high particularly in association with sepsis, prematurity and asphyxia. Mortality was higher in out-born babies than in in-born babies (p= 0.00). Conclusion: Early presentation of babies and adequate management of sepsis and prematurity will reduce mortality associated with neonatal jaundice.Key words: In-born, jaundice, outborn, risk, sepsis

Evaluation of adolescent medicine sub-specialty training in Nigeria: trainees’ perspectives

Objective: To evaluate the extent of coverage of curriculum contents pertinent to Adolescent Medicine, as well as the adequacy of facilities and professionals in Nigeria using residents’ viewpoint.Design: A descriptive cross-sectional study.Setting: The Intensive Course in Paediatrics of the National Post-graduate Medical College of Nigeria at the University of Benin Teaching Hospital, Benin City Nigeria.Subjects: One hundred and three paediatric residents from training institutions in all zones of the country.Results: Altogether,68.0% and 32.0% of the participants were from Southern and Northern geopolitical zones respectively. Only 14% of them stated that a rotation in an AM unit is a part of training in their centres. None specified its duration. Coverage of AM topics, physical facilities and trainers were rated as inadequate by 77.0%, 82.8% and 70.8% of the respondents respectively. Residents from north were more likely to rate interview/confidentiality in AM as covered (either partly or well) than their colleagues from the South, (p < 0.01, OR = 5.3, 95% CI = 1.5-19.5). We found no difference between federal and state residents’ perceived adequacy of AM training.Conclusion: AM in paediatric residency programme in Nigeria is still an unmet challenge. There is a need for a revision of the training curriculum to specify mandatory duration of clinical rotation in AM units

Evaluating the impact of alternative antimicrobials on biofilms formed by Clostridium perfringens

Clostridium perfringens is a Gram-positive, anaerobic bacterium that is a pathogen in humans and animals. C. perfringens has been associated with humans causing gas gangrene, food poisoning, necrotizing enterocolitis (NEC) in very premature neonates and necrotic enteritis (NE) in poultry. Although it is well established that pathogenic bacteria form biofilms extensively in nature to survive and resist adverse conditions by attaching to each other and to a substrate with extracellular polymeric substance (EPS). Biofilm formation in anaerobic organisms is under-researched. One of the objectives of this study was to compare the biofilm-forming potential of C. perfringens isolates from broiler chickens, free-range poultry environments and neonatal humans using the traditional protocols of crystal violet staining assays in microtiter plates. In addition, the susceptibility of C. perfringens to a range of veterinary or human antimicrobial drugs in conventional or biofilm modes were tested using the broth microdilution method. All fifty-four (54) C. perfringens isolates tested from a variety of sources were shown to form biofilms. 7/54 (13%) were strong biofilm producers, 31/54 (57%) were moderate biofilm producers and 16/54 (30%) were weak biofilm producers according to current criteria. There was no significant difference observed in the density of biofilms formed by isolates from different sources but out of the 9 isolates tested previously for the presence of adhesin genes (virulence factors/appendages that facilitates bacteria attachment to host cell/surfaces), moderate biofilm producers harbored multiple adhesin genes whilst weak biofilm producers harbored only one adhesin gene each. As anticipated, the formation of biofilms significantly protected C. perfringens from the action of the antibiotics and resistance ranged between 83% to 100%. Another objective of this study was to determine the in vitro activity of silver and gold nanoparticles against C. perfringens established biofilm. The antibiofilm activity of silver and gold nanoparticles alone and the enhanced antibiotic effect of antibiotics in the presence of nanoparticles were determined by enumerating viable cells on agar plates after antimicrobial treatment. Treatment of C. perfringens with silver nanoparticles resulted in 19% to 58% (1.3log to 4.8log) biofilm reduction while treatment with gold nanoparticles recorded 11% to 39% (0.7log to 3.2log) biofilm reduction. Combination of antibiotic and nanoparticles improved biofilm reduction compared to antibiotic alone, but this was not generally significant at the concentration tested. The third objective of this study was to test the antibiofilm potential of the ethanolic leaf extract of three medicinal plants (Vernonia amygdalina, Ocimum gratissimum and Azadirachta indica). The study showed that the plant’s extracts inhibited or reduced biofilm differently for each tested C. perfringens isolate at the concentration tested. Using the viable count method to determine the effect of treatment showed minimal (2%/0.1 log) to good (28% /2.5 log) biofilm inhibition and reduction. The final part of this study was aimed at testing the antibacterial and antibiofilm activity of a recently developed antimicrobial (QAC) solution (Acquorsol) on C. perfringens. The antibacterial and antibiofilm activity of Acquorsol was determined by enumerating viable cells using total viable count assay. 50% to 0.1% of Acquorsol solution completely inhibited the growth of four C. perfringens planktonic grown strains while 50% to 0.78% of Acquorsol solution completely prevented the growth of four C. perfringens biofilm grown strains. 50% to 6.25% of Acquorsol inhibited the growth of 100% of tested planktonic strains while 50% concentration of Acquorsol prevented the formation of C. perfringens biofilm in 91% (30 out of 33) of tested strains. In summary, the results in this thesis show that C. perfringens grown in biofilm mode independent of the source of isolation could reduce the effective susceptibility of antimicrobials. Furthermore, it showed that alternative therapeutic strategies have the potential to control biofilm related contamination and infections in animals and people. These alternative bacteriocides could be useful for decontaminating surfaces in hospital and may have a role in decontamination of skin surfaces and may be used in poultry environments as well as other public places

Conjoined twins in Edo state of Nigeria; a report of the first surviving set

The term conjoined twins refers to babies who are physically joined at some point. It is a rare condition with an estimated incidence of 1 per 200,000live births. We report our experience with conjoined twins over a twelve year period in tertiary hospital in Nigeria and a case of the first set of conjoined twin survivors in Benin City, Nigeria. Over the last twelve years  (1999-2011), three cases of conjoined twin have been recorded in our teaching hospital. A set of thoracoomphalopagus twins (females) were delivered in 1999 and they survived for only 36hrs. Another set of female omphalopagus twins were delivered in 2009 and survived a separation surgery. A third set of female thoracoomphalopagus was delivered in another institution same year and referred to our unit but they only survived for 48 hours. The first surviving twins were omphalopagus, sharing a single liver, and common bile duct emptying into a common duodenum. The stomach, as well as the jejunum was normal and unshared. Surgicalseparation of the liver was done and biliary reconstruction procedure performed for twin II. A three -year follow up showed good outcome

Public willingness to pay for perceived ecosystem services in rubber agroforestry systems in Edo and Delta States, Nigeria

In this study, contingent valuation method using the payment card method was adopted to elicit willingness to pay (WTP) for ecosystem services  obtainable in a Rubber agroforestry system (RAS) in Edo and Delta State. The value obtained from the study provided monetary estimate of  ecosystem services derivable from RAS. The hypothesis tested was that there was no significant relationship between the respondent  socioeconomic variables and their willingness to pay for ecosystem services in RAS. A multi-stage sampling procedure was used in this study. Data was obtained with a structured and pre-tested questionnaire administered interpersonally to the respondent and also focus group discussion to validate the respondent’s response. One hundred and twenty (120) copies of questionnaire were administered in each State making it a total of 240 questionnaires administered for the study. The result revealed that 191 respondents (79.6 %) were willing to pay amounts ranging from ₦ 100 to ₦1000 monthly. The modal value was ₦200 with the highest response (38.08 %). An individual monthly WTP of ₦334.4 and ₦337.9 (₦360 = $1) in Edo and Delta State were obtained in the study area. These values resulted into an aggregate of ₦2,413,810,220.8 and ₦1,384,846,318.9 in Edo State and Delta State respectively. These amounts represented the monthly monetary values of the ecosystem service derived in a Rubber Agroforestry System (RAS). Farming experience and attitude of RAS farmers are some of the socio-economic variables by which the monetary values of ecosystem service in RAS can be predicted as revealed by the multiple regression analysis. Thus, this study has been able to provide additional information for the private land users and public policy makers on the non-market environmental benefits of alternative land use options. Keywords: Ecosystem services, regulatory services, Willingness to pay, non-market benefits, Rubber agroforestry syste

Assessment of Benthic Macro-Invertebrates of Freshwater Ecosystem: A Case Study of Ovia River (Iguoriakhi), Edo State, Nigeria

In this study, the diversity and seasonal variation of benthic macro-invertebrates of Ovia River (Iguoriakhi), Edo State, Southern Nigerian, were studied between July, 2014 and February, 2015. Four stations were selected and sampled monthly and investigated for benthic macro-invertebrates’ community structure using basic statistical measurement of abundance and diversity indices to characterize the benthic macro invertebrates. The species richness, evenness and diversity of the benthic macro-invertebrates in the study area were high and typical of a tropical fast-flowing freshwater river. There was a total of 45 taxa, made up of 1,135 individuals; 10 Ephemeroptera, 10 Diptera, 7 Coleoptera, 7 Odonata, 4 Hemiptera, plasiopora, Haplotaixa, Decapoda, Hydrachnellae, Lepidoptera, Gastropoda, and Trichoptera were represented with a taxa each. The dominant taxa include Ephemeroptera, while the Diptera was the only sub-dominant order identified. Analysis of Variance (ANOVA) revealed that the overall density was significantly different (P<0.05) in the study stations. A posteriori Duncan Multiple Range (DMR) test indicated that the abundance of Dipterans and Ephemeropterans at station 2 and 4 respectively were the source of the significant difference. The EPT to total ratio indicated that the water quality of all the studied stations were non impacted. The study concluded that benthic macro-invertebrates are good candidate and less expensive indices for water quality monitoring

Perinatal mortality in a rural community

Objective: To determine the peri-natal mortality rate (PMR), still birth rate (SBR) and early neonatal death rate (ENDR) in Igueben Local Government Area (LGA) of Edo State.Design: A descriptive cross-sectional studySetting: Igueben LGA is a rural governmental unit in mid-western Nigeria.Subjects: All women of child-bearing age, resident in three randomly selected political wards in Igueben LGA were identified.Results: Of the 921 women of child-bearing age recruited, 258 deliveries with three perinatal deaths were recorded, giving a PMR, SBR and ENDR of 11.6/1000TB, 11.6/1000TB and 0/1000LB, respectively. Almost all the mothers studied (99.6%) received skilled obstetric care in delivery.Conclusion: The actual PMR, SBR and ENDR were considerably lower than the National estimated averages of 76/1000TB, 43/1000TB and 35/1000LB, respectively. While this may perhaps be related to the quality of obstetric care, it underscores the importance of community-based studies in the determination of vital statistics which are important in health planning including resource allocation

Physio-Chemical Analysis of Industrial Effluents in parts of Edo States Nigeria

Water pollution, particularly, surface water results from all activities of man involving indiscriminate waste disposal from industry such as effluents into waterways, waste, agricultural waste, and all forms of man’s activities that results in contamination of the surface water. Wastewater samples were collected from two (2) carefully selected industries and the Physico-Chemical parameters were analyzed and compared to FEPA (Federal Environmental Protection Agency) standard. DO of the analysis ranged from 6.5 – 9.7mg/l, BOD value range from 3.2 – 8.8mg/l, there was no significant difference among study stations (P>0.05), TDS showed a high significant difference (P<0.001). The results obtained from the analysis indicated that the effluents from the industries were relatively treated as the contaminants sampled were within statutory limits. It was however observed that the effluent from this brewery was relatively treated.Keywords: Physico-Chemical Analysis; Industrial Effluent; Edo Stat