Histopathological changes associated with exposure of some viscerals and testicular tissues to bisephenol A and di(2-ethylhexyl)phthalate

Purpose: To evaluate the pathological effect associated with the exposure of viscerals and testicular tissues of albino rats to BPA and DEHP. Methods: A total of sixty adult male Wistar rats weighing 200 – 250 g were divided into four (4) groups of 15 rats per cage in a sanitized environment. Group I animals received normal rodent pellet and water and served as untreated group. Thereafter, the rats in the second group (II) were administered 5 mg/kg per day of BPA mixed with rodent pellet orally; group III received 0.5 mg/kg daily dose of DEHP mixed with rodent pellet; while group IV received orally mixture of 0.5 mg/kg of BPA and 0.5 mg/kg DEHP + pelleted rodent feed. The rats were fed and water provided regularly for 30 days; finally, the animals were weighed and sacrificed by cranial dislocation. Result: BPA and DEHP resulted in significant (p < 0.05) weight losses, inflammation and fatty deposits in the liver, degenerated bowman capsule and glomeruli of the kidneys, lung oedema, and deteriorated leydig cells in testes. Conclusion: The results suggest that BPA and DEHP cause significant weight loss and are injurious to the cellular make-up of rat tissues, which may be the same in higher animals

Assessment of the quality of antenatal and postnatal care services in primary health centres in rural Nigeria

Study findings show predictors of sub-optimal offerings of standard Primary Health Care (PHC) that include: local government area, marital status and previous childbirths. A higher proportion of maternal deaths in Nigeria occur among women living in rural areas, where barriers to maternal health include quality of care in health facilities. There is evidence of continuing under-utilization of primary care by pregnant women in poor and rural communities. Due to the small number of women who use PHC, and the non-availability of accurate records of women who use the facilities for maternal care, a sample size could not be determined beforehand.Global Affairs Canada (GAC)Canadian Institute for Health research (CIHR

Hand bacterial repopulation dynamics following two methods of surgical hand preparation during elective orthopedic surgeries

Context: Antiseptic hand preparations are routine prior to surgical procedures to reduce microbial load on the operating gloved hands. Two methods of surgical hand preparations available are the antibacterial detergent hand wash and an alcohol‑based hand rub. Aim: The aim of the study was to compare quantitatively, the efficacy of the two methods in hand bacterial reductions during elective orthopedic surgeries. Setting and Design: This comparative study was conducted at the orthopedic surgery department of a tertiary health facility. Subjects and Methods: One‑hundred and sixty dominant hands of operating surgeons and nurses involved in forty elective orthopedic surgeries were studied. The subjects were randomly assigned to either the antibacterial detergent hand‑washing (HW) or the alcohol‑based hand‑rubbing (HR) groups. Swab samples were obtained from the hands before and after hand preparations and at the end of surgeries following removal of the operating gloves. These samples were then subjected to culture. The bacterial counts on these were then obtained through an automated colony counter, and the results were expressed in logarithmic values (log10). Statistical Analysis Used: The analysis was done using IBM SPSS software version 20. The mean results obtained were subjected to an independent t‑test analysis with the statistical significance level set at P < 0.05. Results: Both methods of hand antisepsis showed comparable efficacies in attaining surgical hand hygiene at 1‑min postapplication (P = 0.73). HR group, however, showed greater sustained effects during the period of surgeries, though not statistically significant (P = 0.18). Conclusion: Scrubbing using the HR method is a viable alternative to the HW method during elective orthopedic surgery

Maternal death review and surveillance : The case of Central Hospital, Benin City, Nigeria.

BACKGROUND: Despite the adoption of Maternal and Perinatal Death Surveillance and Response (MPDSR) by Nigeria's Federal Ministry of Health to track and rectify the causes of maternal mortality, very limited documentation exists on experiences with the method and its outcomes at institutional and policy levels. OBJECTIVE: The objective of this study was to identify through the MPDSR process, the medical causes and contributory factors of maternal mortality, and to elucidate the policy response that took place after the dissemination of the results. METHODS: The study was conducted at the Central Hospital, Benin between October 1, 2017, and May 31, 2019. We first developed a strategic plan with the objective to reduce maternal mortality by 50% in the hospital in two years. An MPDSR committee was established and the members and all staff of the Maternity Department of the hospital were trained to use the nationally approved protocol. All consecutive cases of maternal deaths in the hospital were then reviewed using the MPDSR protocol. The results were submitted to the hospital Management and its supporting agencies for administrative action to correct the identified deficiencies. RESULTS: There were 18 maternal deaths in the hospital during the period, and 4,557 deliveries giving a maternal mortality ratio (MMR) of 395/100,000 deliveries. This amounted to a seven-fold reduction in MMR in the hospital at the onset of the project. The main medical causes identified were obstetric hemorrhage (n = 10), pulmonary embolism (n = 2), ruptured uterus (n = 2), eclampsia (n = 1), anemic heart failure (n = 1) and post-partum sepsis (n = 2). Several facility-based and patient contributory factors were identified such as lack of blood in the hospital and late reporting with severe obstetric complication among others. Response to the recommendations from the committee include increased commitment of hospital managers to immediately rectify the attributable causes of deaths, the establishment of a couples health education program, mobilization and sensitization of staff to handle pregnant women with great sensitivity, promptness and care, the refurbishing of an intensive care unit, and the increased availability of blood for transfusion through the intensification of blood donation drive in the hospital. CONCLUSION: We conclude that the results of MPDSR, when acted upon by hospital managers and policymakers can lead to an improvement in quality of care and a consequent decline in maternal mortality ratio in referral hospitals

Maternal death review and surveillance: The case of Central Hospital, Benin City, Nigeria.

BackgroundDespite the adoption of Maternal and Perinatal Death Surveillance and Response (MPDSR) by Nigeria's Federal Ministry of Health to track and rectify the causes of maternal mortality, very limited documentation exists on experiences with the method and its outcomes at institutional and policy levels.ObjectiveThe objective of this study was to identify through the MPDSR process, the medical causes and contributory factors of maternal mortality, and to elucidate the policy response that took place after the dissemination of the results.MethodsThe study was conducted at the Central Hospital, Benin between October 1, 2017, and May 31, 2019. We first developed a strategic plan with the objective to reduce maternal mortality by 50% in the hospital in two years. An MPDSR committee was established and the members and all staff of the Maternity Department of the hospital were trained to use the nationally approved protocol. All consecutive cases of maternal deaths in the hospital were then reviewed using the MPDSR protocol. The results were submitted to the hospital Management and its supporting agencies for administrative action to correct the identified deficiencies.ResultsThere were 18 maternal deaths in the hospital during the period, and 4,557 deliveries giving a maternal mortality ratio (MMR) of 395/100,000 deliveries. This amounted to a seven-fold reduction in MMR in the hospital at the onset of the project. The main medical causes identified were obstetric hemorrhage (n = 10), pulmonary embolism (n = 2), ruptured uterus (n = 2), eclampsia (n = 1), anemic heart failure (n = 1) and post-partum sepsis (n = 2). Several facility-based and patient contributory factors were identified such as lack of blood in the hospital and late reporting with severe obstetric complication among others. Response to the recommendations from the committee include increased commitment of hospital managers to immediately rectify the attributable causes of deaths, the establishment of a couples health education program, mobilization and sensitization of staff to handle pregnant women with great sensitivity, promptness and care, the refurbishing of an intensive care unit, and the increased availability of blood for transfusion through the intensification of blood donation drive in the hospital.ConclusionWe conclude that the results of MPDSR, when acted upon by hospital managers and policymakers can lead to an improvement in quality of care and a consequent decline in maternal mortality ratio in referral hospitals

Assessing the knowledge and skills on emergency obstetric care among health providers: Implications for health systems strengthening in Nigeria.

ObjectiveTo assess the existing knowledge and skills relating to Emergency Obstetrics Care (EMOC) among health providers in eight referral maternity hospitals in Nigeria.Study designA cross-sectional study of skilled health providers (doctors, nurses and midwives) working in the hospitals during the period.SettingSix general hospitals (4 in the south and 2 in the north), and two teaching hospitals (both in the Northern part) of the country.PopulationAll skilled providers offering EMOC services in the hospitals during the study.MethodsA pre-tested self-administered questionnaire was used to obtain information relating to socio-demographic characteristics, the respondents' knowledge and skills in offering specific EMOC services (as compared to standard World Health Organization recommendations), and their confidence in transferring the skills to mid-level providers. Data were analyzed with univariate, bivariate, binary and multinomial logistic regression analyses. Main outcome measures: knowledge and skills in EMOC services by hospital and overall.ResultsA total of 341 health providers (148 doctors and 193 nurses/midwives) participated in the study. Averagely, the providers scored less than 46% in a composite EMOC knowledge score, with doctors scoring considerable higher than the nurses/midwives. Similarly, doctors scored higher than nurses/midwives in the self-reporting of confidence in carrying out specific EMOC functions. Health providers that scored higher in knowledge were significantly more likely to report confidence in performing specific EMOC functions as compared to those with lower scores. The self-reporting of confidence in transferring clinical skills was also higher in those with higher EMOC knowledge scores.ConclusionThe knowledge and reported skills on EMOC by health providers in referral facilities in Nigeria was lower than average. We conclude that the in-service training and re-training of health providers should be included in national policy and programs that address maternal mortality prevention in referral facilities in the country.Trial registrationNigeria Clinical Trials Registry 91540209