Phytochemical analysis and in vivo anti-malarial activities of aqueous extracts of Tithonia diversifolia and Parquetina nigrescens leaves in mice

This study was carried out to assess the acclaimed anti-malarial potentials of aqueous extracts of leaf of Tithonia diversifolia (TD) and Parquetina nigrecsens (PN) in mice. The phytochemical constituents and in vivo anti-malarial activities of individual and combined of aqueous leaf extracts of Tithonia diversifolia (TD) and Parquetina nigrecsens (PN) were investigated. Fifteen albino mice were infected by intraperitoneal injection of standard inocula (5 × 106) of chloroquine sensitive Plasmodium berghei (NK 65). The animals were randomly divided into 5 groups of 3 mice. Group I served as the control while group II received 5mg/kg body weight per oral of chloroquine diphosphate. Groups III – V were orally treated with 150mg/kg body weight extracts of TD, TD+PN and PN respectively. Phytochemical analysis revealed the presence of saponins, alkaloids and tannins in the aqueous extracts of TD and PN. There were 100, 90, 86 and 77 percent parasite inhibition in groups treated with Chloroquine, combination of Tithonia diversifolia and Parquetina nigrescens (TD+PN), Parquetina nigrescens (PN) and Tithonia diversifolia (TN) respectively on day 5. The mean survival time (MST) for the control animals was 7 days and chloroquine 25 days, while the TD+PN, PN and TD aqueous extracts recorded 19, 18 and 11 days respectively. The results indicated that the combined aqueous (TD+PN) extracts of Tithonia diversifolia and Parquetina nigrescens produced the best antimalarial activity, which provides a justification for their use in folklore medicine and may be promising alternative anti-malarial drug.Keywords: Tithonia diversifolia; Parquetina nigrescens, Plasmodium berghei, Anti-malarial, Phytochemica

Rectovaginal fistula following sexual intercourse.

Female genital fistula is an important feature of the developing countries gynecology. Most of the rectovaginal fistulae encountered in the tropics are due to obstetrics causes and genital malignancies. In developed countries, radiation injury and Crohn’s disease are also common etiological factors. Theindex case is reported to highlight the rare situation, where a 24-year old married nullipara sustained low rectovaginal fistula following normal coitus. She was later divorced by her husband

Mupirocin-resistant Staphylococcus aureus in Africa: a systematic review and meta-analysis

Background Mupirocin is widely used for nasal decolonization of Staphylococcus aureus to prevent subsequent staphylococcal infection in patients and healthcare personnel. However, the prolonged and unrestricted use has led to the emergence of mupirocin-resistant (mupR) S. aureus. The aim of this systematic review was to investigate the prevalence, phenotypic and molecular characteristics, and geographic spread of mupR S. aureus in Africa. Methods We examined five electronic databases (EBSCOhost, Google Scholar, ISI Web of Science, MEDLINE, and Scopus) for relevant English articles on screening for mupR S. aureus from various samples in Africa. In addition, we performed random effects meta-analysis of proportions to determine the pooled prevalence of mupR S. aureus in Africa. The search was conducted until 3 August 2016. Results We identified 43 eligible studies of which 11 (26%) were obtained only through Google Scholar. Most of the eligible studies (28/43; 65%) were conducted in Nigeria (10/43; 23%), Egypt (7/43; 16%), South Africa (6/43; 14%) and Tunisia (5/43; 12%). Overall, screening for mupR S. aureus was described in only 12 of 54 (22%) African countries. The disk diffusion method was the widely used technique (67%; 29/43) for the detection of mupR S. aureus in Africa. The mupA-positive S. aureus isolates were identified in five studies conducted in Egypt (n = 2), South Africa (n = 2), and Nigeria (n = 1). Low-level resistance (LmupR) and high-level resistance (HmupR) were both reported in six human studies from South Africa (n = 3), Egypt (n = 2) and Libya (n = 1). Data on mupR-MRSA was available in 11 studies from five countries, including Egypt, Ghana, Libya, Nigeria and South Africa. The pooled prevalence (based on 11 human studies) of mupR S. aureus in Africa was 14% (95% CI =6.8 to 23.2%). The proportion of mupA-positive S. aureus in Africa ranged between 0.5 and 8%. Furthermore, the frequency of S. aureus isolates that exhibited LmupR, HmupR and mupR-MRSA in Africa were 4 and 47%, 0.5 and 38%, 5 and 50%, respectively. Conclusions The prevalence of mupR S. aureus in Africa (14%) is worrisome and there is a need for data on administration and use of mupirocin. The disk diffusion method which is widely utilized in Africa could be an important method for the screening and identification of mupR S. aureus. Moreover, we advocate for surveillance studies with appropriate guidelines for screening mupR S. aureus in Africa

Global patient outcomes after elective surgery: prospective cohort study in 27 low-, middle- and high-income countries.

BACKGROUND: As global initiatives increase patient access to surgical treatments, there remains a need to understand the adverse effects of surgery and define appropriate levels of perioperative care. METHODS: We designed a prospective international 7-day cohort study of outcomes following elective adult inpatient surgery in 27 countries. The primary outcome was in-hospital complications. Secondary outcomes were death following a complication (failure to rescue) and death in hospital. Process measures were admission to critical care immediately after surgery or to treat a complication and duration of hospital stay. A single definition of critical care was used for all countries. RESULTS: A total of 474 hospitals in 19 high-, 7 middle- and 1 low-income country were included in the primary analysis. Data included 44 814 patients with a median hospital stay of 4 (range 2-7) days. A total of 7508 patients (16.8%) developed one or more postoperative complication and 207 died (0.5%). The overall mortality among patients who developed complications was 2.8%. Mortality following complications ranged from 2.4% for pulmonary embolism to 43.9% for cardiac arrest. A total of 4360 (9.7%) patients were admitted to a critical care unit as routine immediately after surgery, of whom 2198 (50.4%) developed a complication, with 105 (2.4%) deaths. A total of 1233 patients (16.4%) were admitted to a critical care unit to treat complications, with 119 (9.7%) deaths. Despite lower baseline risk, outcomes were similar in low- and middle-income compared with high-income countries. CONCLUSIONS: Poor patient outcomes are common after inpatient surgery. Global initiatives to increase access to surgical treatments should also address the need for safe perioperative care. STUDY REGISTRATION: ISRCTN5181700

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Tobacco consumption prevalence and pattern among residents of Sokoto metropolis, northwest Nigeria

Objective: Tobacco consumption is a global public health problem affecting both developed and developing countries and is a leading cause of preventable morbidity and mortality. These deaths have been linked to direct tobacco use and exposure to second-hand smoke. This study determined the prevalence and pattern of tobacco consumption among residents in Sokoto metropolis.Methods: A cross-sectional survey conducted in Sokoto metropolis which is cosmopolitan in nature. A multi-stage sampling method was used to recruit the 1,000 survey participants that included both sex. WHO STEPS instrument for chronic disease risk factor surveillance was modified and adopted as a tool for data collection. Ethical clearance was obtained from the State Research Ethics Committee.Results: Respondents’ median age was 30 years, IQR 25-43. Those aged 25-39 years were more represented (45.2%) and adolescence and young adult accounted for 23.1% while elderly constituted 3.7%. Thirty nine percent were unskilled labourers, 11% were traders and top Executive (Civil servants/Business) accounted for 12.4%. Almost half (49%) reported an estimated annual household income of less than N100,000 while 13.2% earned N1,000,000 and above. The prevalence of cigarette smoking was 7.1% and the smokers had smoked for an average of 14.3 ± 5.2 years. Ten percent were currently using any form tobacco, while 0.6% reported current use of smokeless tobacco product daily and one third had been exposed to second-hand cigarette smoke in a closed place. Of the respondents’ social demographic, only gender and occupation demonstrated statistically significant association with cigarette smoking, however none did predict their smoking behaviours.Conclusion: Despite efforts to prevent initiation and promote cessation, cigarette smoking is a common practice that cut across socio-economic stratum. Stringent policies on smoking including delineation of smoking zone should be put in place to reduce exposure to secondhand smoke and subsequently burdens of diseases attributed to tobacco consumption.Keywords: Tobacco consumption, pattern and prevalence, Sokoto, Northwest Nigeri

Predictors of death and production performance of layer chickens in opened and sealed pens in a tropical savannah environment

BACKGROUND: Layer chickens are exposed to high risks of production losses and mortality with impact on farm profitability. The harsh tropical climate and severe disease outbreaks, poor biosecurity, sub-minimal vaccination and treatment protocols, poor management practices, poor chick quality, feed-associated causes, and unintended accidents oftentimes aggravate mortality and negatively affect egg production. The objectives of this study were to estimate the probability of survival and evaluate risk factors for death under different intensive housing conditions in a tropical climate, and to assess the production performance in the housing systems. RESULTS: Daily mean mortality percentages and egg production figures were significantly lower and higher in the sealed pens and open houses (P < 0. 001) respectively. The total mean feed consumption/bird/day was similar for the open sided and sealed pens but the mean feed quantity per egg produce was significantly lower in the sealed pens ((P < 0.005). Seasons differently impacted on mortality with the hot-dry season producing significantly higher risk of mortality (61 times) and reduced egg production. Other parameters also differed except the egg production during the cold-dry season. Layers in sealed pens appear to have higher probability of survival and the Kaplan-Meir survival curves differed for each pen; ≥78 weeks old layer have higher probability of survival compared with the younger chickens and the 19–38 weeks age category are at highest risk of death (P < 0.001). The hazard-ratio for mortality of layers raised in sealed pens was 0.568 (56.8%). CONCLUSION: Reasons for spiked mortality in layer chickens may not always be associated with disease. Hot-dry climatic environment is associated with heat stress, waning immunity and inefficient feed usage and increase probability of death with reduced egg production; usage of environmentally controlled building in conditions where environmental temperature may rise significantly above 25°C will reduce this impact. Since younger birds (19–38 weeks) are at higher risk of death due to stress of coming into production, management changes and diseases, critical implementation of protocols that will reduce death at this precarious period becomes mandatory. Whether older chickens’ better protection from death is associated with many prophylactic and metaphylactic regimen of medications/vaccination will need further investigation.http://www.biomedcentral.com/bmcvetres/am201