Introducing Misoprostol for the Treatment of Incomplete Abortion in Nigeria

Despite legal restriction, induced abortions and resulting complications are common in Nigeria. Misoprostol administration for incomplete abortion was introduced in 3 Nigerian hospitals. The feasibility of the hospitals, patient and provider acceptability were assessed using questionnaire and interview guides administered to 205 women and 17 providers respectively. Amongst the women, 194 (95%) were satisfied and very satisfied with misoprostol, 176 (86%) would choose misoprostol again if another incomplete abortion occurred and 191 (93%) would recommend it to another woman in a similar situation. Providers were highly satisfied with misoprostol. The ease of use and ability to redirect surgical resources to more complicated issues were positive features cited by them. The providers agreed that integration of misoprostol was straightforward and required few resources. Therefore, misoprostol for incomplete abortion is safe, efficacious and acceptable to providers and patients. In remote areas of Nigeria with limited post-abortion care (PAC), misoprostol administration is an important potential PAC treatment modality. Features of misoprostol-low cost, room temperature stability, and ease of introduction-render it an important treatment option, particularly in low resource and rural settings

Unimodular Loop Quantum Cosmology

Unimodular gravity is based on a modification of the usual Einstein-Hilbert action that allows one to recover general relativity with a dynamical cosmological constant. It also has the interesting property of providing, as the momentum conjugate to the cosmological constant, an emergent clock variable. In this paper we investigate the cosmological reduction of unimodular gravity, and its quantization within the framework of flat homogeneous and isotropic loop quantum cosmology. It is shown that the unimodular clock can be used to construct the physical state space, and that the fundamental features of the previous models featuring scalar field clocks are reproduced. In particular, the classical singularity is replaced by a quantum bounce, which takes place in the same condition as obtained previously. We also find that requirement of semi-classicality demands the expectation value of the cosmological constant to be small (in Planck units). The relation to spin foam models is also studied, and we show that the use of the unimodular time variable leads to a unique vertex expansion.Comment: 26 pages. Revised version taking into account referee's comment

Molecular characterization and Antibiotic resistance profiles of Escherichia coli extended-spectrum β-lactamases producer strains isolated from urine samples in Benin

Urinary tract infections are the second common reason of medical consultations and antibiotics prescription. Escherichia coli is known to cause most urinary tract infections. The aim of this study was to characterize and determine the antibiotic resistance profile of E. coli extended-spectrum βlactamases (ESBL) producer strains isolated from urine samples. The urine samples collected came from hospitalized and non-hospitalized patient referred to Hubert Koutoukou Manga (HKM), National and University Hospital Center (Cotonou, Benin). The resistance to antibiotics was determined according to the disk diffusion method. The production of penicillinase and ESBLs was researched respectively by the acidimetric test and double disk synergy method. The presences of genes encoding βlactamases were detected by Polymerase Chain Reaction (PCR). Our data revealed that 60 % of E. coli strains (101) were isolated from female patients. Also, 69.31 % of the strains were isolated from non-hospitalized patients. The high resistance levels were recorded with amoxicillin (96.04 %) and amoxicillin + clavulanic acid (66.34 %). Twenty percent (20%) of strains were ESBLs. Among ESBLs strains, 70% comes from non-hospitalized patients. Eighty percent of E. coli strains produced penicillinase among which 25 % were ESBL producers. All the ESBL producers strains carried blaTEM gene whereas only 30 % carried the blaSHV gene. This study updates the data on the prevalence to antibiotic resistance of E. coli ESBL producers strains for better management of urinary tract infections

Ethnobotanical Survey of Two Medicinal Plants (Heliotropium indicum L., Abrus precatorius L.,) Used in Traditional Medicine in West Africa

Since the time of our ancestors, natural products issued from plant play a therapeutic crucial role. About 25-30% of all medicines (drugs) available for the treatment of diseases are derived from natural products (from plants, animals, bacteria and fungi) or are derivatives of natural products. The aim of this research was to scientifically identify and supply tangible documentation on these two plants employed in the traditional medicine. From November 2020 to February 2021, an ethnobotanical survey was conducted within four markets at the south of Benin, employing a semistructured questionnaire. Two hundred respondents including 80% of females and 20% of males were interviewed. The 2 studied plants are mainly used for different types of sickness related to infections. Females’ herbalists are the most represented. From this research, it appears that the 2 plants are widely used for the treatment of severe infections. On the market, 95% of the leafy steam are sold against 5% of the roots for both plants. The main preparation way is decoction. Oral use is reported to be common in all region. The value of samples sold varies from 200F CFA (Financial Cooperation of Africa) to 1000F CFA. The decoctions are usually obtained through one of a mix of different types of plants. Traditional knowledge is transmitted from one generation to another by oral education. Till today there was no record found. During our study, we did no record prohibition or side effect related to these plants’ use. These medicinal plants occupy a crucial place within the therapeutic arsenal of west Africa. Our results constitute a vital tool to determine the true potentials of these plants. These results could lead to new improved traditional medicine

Noncommutative Dipole Field Theories And Unitarity

We extend the argument of Gomis and Mehen for violation of unitarity in field theories with space-time noncommutativity to dipole field theories. In dipole field theories with a timelike dipole vector, we present 1-loop amplitudes that violate the optical theorem. A quantum mechanical system with nonlocal potential of finite extent in time also shows violation of unitarity.Comment: typos corrected, more details added in Sec 5, version to appear in JHE

Strengthening healthcare providers’ capacity for safe abortion and post-abortion care services in humanitarian settings: lessons learned from the clinical outreach refresher training model (S-CORT) in Uganda, Nigeria, and the Democratic Republic of Congo

Background Fragile and crisis-affected countries account for most maternal deaths worldwide, with unsafe abortion being one of its leading causes. This case study aims to describe the Clinical Outreach Refresher Training strategy for sexual and reproductive health (S-CORT) designed to update health providers’ competencies on uterine evacuation using both medications and manual vacuum aspiration. The paper also explores stakeholders’ experiences, recommendations for improvement, and lessons learned. Methods Using mixed methods, we evaluated three training workshops that piloted the uterine evacuation module in 2019 in humanitarian contexts of Uganda, Nigeria, and the Democratic Republic of Congo. Results Results from the workshops converged to suggest that the module contributed to increasing participants’ theoretical knowledge and possibly technical and counseling skills. Equally noteworthy were their confidence building and positive attitudinal changes promoting a rights-based, fearless, non-judgmental, and non-discriminatory approach toward clients. Participants valued the hands-on, humanistic, and competency-based training methodology, although most regretted the short training duration and lack of practice on real clients. Recommendations to improve the capacity development continuum of uterine evacuation included recruiting the appropriate health cadres for the training; sharing printed pre-reading materials to all participants; sustaining the availability of medication and supplies to offer services to clients after the training; and helping staff through supportive supervision visits to accelerate skills transfer from training to clinic settings. Conclusions When the lack of skilled human resources is a barrier to lifesaving uterine evacuation services in humanitarian settings, the S-CORT strategy could offer a rapid hands-on refresher training opportunity for service providers needing an update in knowledge and skills. Such a capacity-building approach could be useful in humanitarian and fragile settings as well as in development settings with limited resources as part of an overall effort to strengthen other building blocks of the health system

Trypanocidal and leishmanicidal activity of six limonoids

Six limonoids [kotschyienone A and B (1, 2), 7-deacetylgedunin (3), 7-deacetyl-7-oxogedunin (4), andirobin (5) and methyl angolensate (6)] were investigated for their trypanocidal and leishmanicidal activities using bloodstream forms of Trypanosoma brucei and promastigotes of Leishmania major. Whereas all compounds showed anti-trypanosomal activity, only compounds 1–4 displayed anti-leishmanial activity. The 50% growth inhibition (GI 50) values for the trypanocidal and leishmanicidal activity of the compounds ranged between 2.5 and 14.9 μM. Kotschyienone A (1) was found to be the most active compound with a minimal inhibition concentration (MIC) value of 10 μM and GI 50 values between 2.5 and 2.9 μM. Only compounds 1 and 3 showed moderate cytotoxicity against HL-60 cells with MIC and GI 50 values of 100 μM and 31.5–46.2 μM, respectively. Compound 1 was also found to show activity against intracellular amastigotes of L. major with a GI 50 value of 1.5 μM. The results suggest that limonoids have potential as drug candidates for the development of new treatments against trypanosomiasis and leishmaniasis

Energy Losses Through Junction Manholes, Volume II: Experimental Data

DTFH61-88-C-00004, DTFH61-92-C-00094The objective of this report is to develop and test methodologies for computing energy losses at junction manholes. Laboratory data obtained over a 6-year period at the Federal Highway Administration's (FHWA's) Hydraulics Laboratory are analyzed within the framework of three methodologies: the energy grade line, power loss, and neural networks. Descriptions of the methods are presented, along with a statistical analysis comparing the accuracy with which each method computes observed depth in the junction manhole. Volume I provides an overview of the hydraulic conditions at junction manholes and identifies the need to supplement existing data for development of predictive equations for computing energy losses. Also discussed are prior research results, three analytical methods for determining junction losses, and the experimental configurations in the laboratory. This report also provides a detailed analysis and performance comparison of each of the three methodologies analyzed. Guidance is given as to which methodology may be most appropriate in computing the energy losses through a pipe system. Volume II documents the physical and hydraulic data collected for each of the 739 laboratory experiments performed