Haematological Changes in Patients with Lymphoid Malignancies on Chemotherapy in Benin City, Edo State, Nigeria

Chemotherapy continues to serve as the best option therapy in treating human malignancies that have undergone metastasis and cannot be managed solely by surgical removal or radiation. The aim of this study is to evaluate the clinical important of haematological parameters in the management of lymphoid malignancy patients on chemotherapy to ascertain the impact of such chemotherapy on them.. This study was carried out in one secondary and one tertiary health institution in Edo State. It was divided into three groups: lymphoid malignancy on chemotherapy, novel lymphoid malignancy and apparently healthy individuals as controls. Using aseptic precaution, 5ml of blood is collected into K2EDTA container for full blood count analysis using KX-21NSysmex automated Haematology analyser 2004 model and data were analysed using student t test. The comparison between novel lymphoid malignant patient and controls indicate WBC, lymphocytes and platelet count increase significantly (P <0.05) while RBC, HGB, HCT decrease significantly (P <0.05) when compared with control. However, MCV, MCH, MCHC, monocytes and granulocytes were not significant (P>0.05). The comparison  between lymphoid malignant patient on chemotherapy and controls shows RBC, HGB, HCT decrease significantly when compared with control (P <0.05) while WBC, lymphocytes, platelet, MCV, MCH, MCHC, monocytes and granulocytes were not significant (P>0.05).When lymphoid malignant patient on chemotherapy and novel lymphoid malignant patient are compared, it shows RBC, HGB, HCT increase significantly when compared with novel lymphoid malignant patients (P <0.05) while WBC and MCHC decrease significantly (P <0.05). However, lymphocytes, platelet, MCV, MCH, monocytes and granulocytes were not significant (P>0.05). we can deduce that full blood count is highly clinically important for an effective management of lymphoid malignant patients on chemotherapy. DOI: 10.7176/JMPB/61-04 Publication date: November 30th 201

Detection of Haemoparasites of Blood Donors in 9 Locations in and Around Plateau State, Nigeria

Haemoparasites in the tropics are also endemic in Nigeria. Asymptomatic infections may abound, due to resistance to these infections. This asymptomatic infection has been one of the factors, which has maintained transmission of these pathogens, through many ways, including blood donation and transfusion. In this report, haemoparasitic infections in blood donors have been described, from blood donors within Plateau State, Nigeria. Five hundred and twelve blood donors were selected by means of a random sampling method and their blood samples collected. Serological assay was done using rapid test kits to check for presence of antibodies (in the case of microfilariae) or antigens (in the case of malaria) to the different haemoparasites. Also, Elisa technique was used for the microfilariae. Thick and thin films were made from each blood sample on grease-free slides allowed to dry and stained by 3% Giemsa solution for 45 min which is the Giemsa technique. Results indicate that 270 (52.7%) of the sample population had no infection; 121( 23.6%) of the population were infected with Plasmodium falciparum; 11 (2.1%) were infected with Plasmodium malariae; 69 (13.5%) were infected with HBsAg; 29 (5.7%) were infected with HCV; 7 ( I.4% ) were infected with Trypanosoma brucei gambiense; 1% were infected with microfilariae, 4( 0.8% ) of the 1% were unsheathed and identified to be Mansonella perstans, while 1(0.2%) were sheathed and identified to be Loa loa. Most blood group types were susceptible to haemoparasitic infections. The result of the study therefore stresses the need to screen blood for haemoparasites before transfusion, owing to the dangers of doing otherwise. The occupations and dwelling places of the donors are predisposing factors to these haemoparasitic infections. Since they have the passion to save lives through blood donation, they should therefore make the necessary adjustments that will make them more suitable lifesavers. It is recommended that the basic transmission factors of these parasites are explained to donors to reduce further incidences. DOI: 10.7176/JBAH/9-22-01 Publication date: November 30th 201

The role of peptides in bone healing and regeneration: A systematic review

Background: Bone tissue engineering and the research surrounding peptides has expanded significantly over the last few decades. Several peptides have been shown to support and stimulate the bone healing response and have been proposed as therapeutic vehicles for clinical use. The aim of this comprehensive review is to present the clinical and experimental studies analysing the potential role of peptides for bone healing and bone regeneration. Methods: A systematic review according to PRISMA guidelines was conducted. Articles presenting peptides capable of exerting an upregulatory effect on osteoprogenitor cells and bone healing were included in the study. Results: Based on the available literature, a significant amount of experimental in vitro and in vivo evidence exists. Several peptides were found to upregulate the bone healing response in experimental models and could act as potential candidates for future clinical applications. However, from the available peptides that reached the level of clinical trials, the presented results are limited. Conclusion: Further research is desirable to shed more light into the processes governing the osteoprogenitor cellular responses. With further advances in the field of biomimetic materials and scaffolds, new treatment modalities for bone repair will emerge

Surgical site infection after gastrointestinal surgery in high-income, middle-income, and low-income countries: a prospective, international, multicentre cohort study

Background: Surgical site infection (SSI) is one of the most common infections associated with health care, but its importance as a global health priority is not fully understood. We quantified the burden of SSI after gastrointestinal surgery in countries in all parts of the world. Methods: This international, prospective, multicentre cohort study included consecutive patients undergoing elective or emergency gastrointestinal resection within 2-week time periods at any health-care facility in any country. Countries with participating centres were stratified into high-income, middle-income, and low-income groups according to the UN's Human Development Index (HDI). Data variables from the GlobalSurg 1 study and other studies that have been found to affect the likelihood of SSI were entered into risk adjustment models. The primary outcome measure was the 30-day SSI incidence (defined by US Centers for Disease Control and Prevention criteria for superficial and deep incisional SSI). Relationships with explanatory variables were examined using Bayesian multilevel logistic regression models. This trial is registered with ClinicalTrials.gov, number NCT02662231. Findings: Between Jan 4, 2016, and July 31, 2016, 13 265 records were submitted for analysis. 12 539 patients from 343 hospitals in 66 countries were included. 7339 (58·5%) patient were from high-HDI countries (193 hospitals in 30 countries), 3918 (31·2%) patients were from middle-HDI countries (82 hospitals in 18 countries), and 1282 (10·2%) patients were from low-HDI countries (68 hospitals in 18 countries). In total, 1538 (12·3%) patients had SSI within 30 days of surgery. The incidence of SSI varied between countries with high (691 [9·4%] of 7339 patients), middle (549 [14·0%] of 3918 patients), and low (298 [23·2%] of 1282) HDI (p < 0·001). The highest SSI incidence in each HDI group was after dirty surgery (102 [17·8%] of 574 patients in high-HDI countries; 74 [31·4%] of 236 patients in middle-HDI countries; 72 [39·8%] of 181 patients in low-HDI countries). Following risk factor adjustment, patients in low-HDI countries were at greatest risk of SSI (adjusted odds ratio 1·60, 95% credible interval 1·05–2·37; p=0·030). 132 (21·6%) of 610 patients with an SSI and a microbiology culture result had an infection that was resistant to the prophylactic antibiotic used. Resistant infections were detected in 49 (16·6%) of 295 patients in high-HDI countries, in 37 (19·8%) of 187 patients in middle-HDI countries, and in 46 (35·9%) of 128 patients in low-HDI countries (p < 0·001). Interpretation: Countries with a low HDI carry a disproportionately greater burden of SSI than countries with a middle or high HDI and might have higher rates of antibiotic resistance. In view of WHO recommendations on SSI prevention that highlight the absence of high-quality interventional research, urgent, pragmatic, randomised trials based in LMICs are needed to assess measures aiming to reduce this preventable complication

A sequential modular flowsheeting system for the LSI-11 minicomputer system

Thesis (B.A.)--University of Illinois at Urbana-Champaign, 1981.Bibliography: leaf 42.Microfiche of typescript. [Urbana, Ill.] : Photographic Services, University of Illinois, U of I Library, [1984]. 3 microfiches (121 frames) : negative ; 11 x 15 cm

Is fertility declining in Benin?

This study analyzes reproductive changes in Benin, a West African country with high fertility and low prevalence of use of modern contraceptive methods, using a combination of quantitative and qualitative approaches. Findings indicate that an irreversible fertility transition has started as the result of an emerging pattern of birth limitation and continued desire for the traditional long birth intervals. The data suggest that changes in childhood mortality in combination with an increase in women's education, although modest, have created a demand for fertility control among women; that induced abortion may be one of the means through which such demand is being met, particularly in urban areas; and that the economic crisis of the 1980s was the main catalyst that precipitated the onset of transition. Changes in reproductive preferences and practice suggest a diffusion process, from urban and more educated women to rural and less-educated ones

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

Use of Telemedicine for Post-discharge Assessment of the Surgical Wound: International Cohort Study, and Systematic Review with Meta-analysis

Objective: This study aimed to determine whether remote wound reviews using telemedicine can be safely upscaled, and if standardised assessment tools are needed. Summary background data: Surgical site infection is the most common complication of surgery worldwide, and frequently occurs after hospital discharge. Evidence to support implementation of telemedicine during postoperative recovery will be an essential component of pandemic recovery. Methods: The primary outcome of this study was surgical site infection reported up to 30-days after surgery (SSI), comparing rates reported using telemedicine (telephone and/or video assessment) to those with in-person review. The first part of this study analysed primary data from an international cohort study of adult patients undergoing abdominal surgery who were discharged from hospital before 30-days after surgery. The second part combined this data with the results of a systematic review to perform a meta-analysis of all available data conducted in accordance with PRIMSA guidelines (PROSPERO:192596). Results: The cohort study included 15,358 patients from 66 countries (8069 high, 4448 middle, 1744 low income). Of these, 6907 (45.0%) were followed up using telemedicine. The SSI rate reported using telemedicine was slightly lower than with in-person follow-up (13.4% vs. 11.1%, P&lt;0.001), which persisted after risk adjustment in a mixed-effects model (adjusted odds ratio: 0.73, 95% confidence interval 0.63-0.84, P&lt;0.001). This association was consistent across sensitivity and subgroup analyses, including a propensity-score matched model. In nine eligible non-randomised studies identified, a pooled mean of 64% of patients underwent telemedicine follow-up. Upon meta-analysis, the SSI rate reported was lower with telemedicine (odds ratio: 0.67, 0.47-0.94) than in-person (reference) follow-up (I2=0.45, P=0.12), although there a high risk of bias in included studies. Conclusions: Use of telemedicine to assess the surgical wound post-discharge is feasible, but risks underreporting of SSI. Standardised tools for remote assessment of SSI must be evaluated and adopted as telemedicine is upscaled globally