Comparative analysis of glucose-6-phosphate dehydrogenase levels in pre-term and term babies delivered at University of Ilorin Teaching Hospital

Glucose-6-phosphate (G6P) is an enzyme in the hexose monophosphate shunt required for the production of reducing equivalents needed to mop up free radicals. thereby keeping hemoglobin in its free state. Deficiency of the enzyme can cause severe neonatal jaundice. The aim of this study was to compare G6PD levels in pre-term and term babies, and evaluate the extent to which G6PD deficiency determines the severity of jaundice in various gestational age groups. Samples of cord blood collected from consecutively delivered babies in the University of Ilorin Teaching Hospital, Nigeria, were assayed for G6PD levels, and the babies were observed for jaundice during the first week of life. Those who developed jaundice had serial serum bilirubin measured. Nine hundred and thirty-three babies had G6PD assayed, with 348 being G6PD deficient, giving a hospital based prevalence of 37.3%. Of the 644 who were followed up, 143 (22.2%) were pre-term and 501(77.8%) were term babies. Babies with gestational age (GA) 27–29 weeks had the highest G6PD levels. However, there was no significant variation among the different gestational age groups (F=0.64, P=0.64). Jaundice occurred more in pre-term compared to term babies with a relative risk of 2.41 (χ2=60.95, P=0.00001). Occurrence of jaundice in pre-term babies was irrespective of G6PD status (χ2=0.2, P=0.66, RR=1.09, CI=0.83<RR<1.43). There is an inverse relationship between gestational age and the occurrence of jaundice (R2=-0.874). Pre-term babies are more likely to have higher G6PD levels, but occurrence of jaundice in pre-term babies is irrespective of G6PD status. More severe jaundice (especially for gestational age) occurring in pre-term babies requires critical care

Integrity and Security of the Application Level Active Networks

The advances in programmable networks enforce the importance of ensuring and maintaining the integrity and security of the network and the supporting systems. In the future programmable network scenarios, the threats to integrity and security will rapidly increase as third-party value added service providers and end-users start deploying their customised applications on the operator infrastructure. Here we discuss some typical integrity issues relevant in the programmable network scenarios. We introduce the Application Level Active Networking (ALAN) principles, and the basic management principles of ALAN-enabled networks, developed by the IST project ANDROID (Active Network Distributed Open Infrastructure Development). In this context, we discuss the candidate approach to managing the integrity issues in ALANenabled networks and reflect on some integrity-oriented techniques. Finally, we focus on security management, and briefly describe the ANDROID security architecture.

Radiation Mapping of Osun State, Southwestern Nigeria, Measuring The Status of Radioactivity

The Fukushima Daiichi nuclear disaster happened in Japan long ago in 2011, and it resulted in the emission of radioactive substances into the atmosphere. These substances were transported by air currents and were detected in several parts of the world, including Nigeria. In the aftermath of the event, it has become necessary to determine the spatial distribution of radioactivity within Osun state. This present study aims to investigate and identify areas of high gamma radiation in Osun State. This study utilised a Garmin GPS and a Geiger Muller counter radiation detector over the entire state. This study presents a radiation map of Osun state. It shows that the region has an elevation range of 190 m to 600 m, and the elevation chart shows that in comparison to the extreme south of the research region, the extreme north is distinguished by high heights. The average ionising radiation within the state ranges from 0.08 to 0.3l µSv/hr. Places including Ila, Boluwaduro and Obokun recorded the highest elevation, which in turn also had the highest dose of gamma radiation, while Ife North, Ife South, Isokan, and Irewole axis recorded their lowest figures of elevation and also had low doses of gamma radiation. The average annual effective dose rate was 0.33 mSvy-1 which is greater than 0.07 mSvy-1 for outdoor exposure. Therefore, it is important to take appropriate safety measures by wearing protection shields to avoid or minimise exposure to high levels of gamma radiation.   Keywords: Fukushima Daiichi, Gamma Radiation, Geiger Muller Counter, Radiation Map, Annual Effective Dos

Psychiatric morbidity among pregnant and non pregnant women in Ibadan, Nigeria

A comparative cross-sectional study was conducted among 991 pregnant and 674 non-pregnant women of reproductive age attending healthcare facilities in Ibadan, Nigeria using the General Health Questionnaire-12 (GHQ), and WHO self-reporting questionnaire (SRQ). Logistic regression analysis was conducted to identify predictors of psychiatric morbidity at p < 0.05. A significantly higher proportion of pregnant women experienced psychological distress on the GHQ (51.8%) and psychiatric morbidity on SRQ (33.3%) compared with 28.6% and 18.2% of non-pregnant women, respectively. Predictors of psychiatric morbidity among pregnant women were the type of facility, poor satisfaction and communication with partners, the experience of violence in the home, previous abortions, and previous history of depression. Psychiatric morbidity among non-pregnant women was predicted by younger age, previous history of depression, poor satisfaction and communication with partners. There is a need for early identification of psychiatric morbidity among women of reproductive age, to ensure early interventions and prevent long-term disability.Impact statement What is already known on this subject? Psychiatric morbidity has immense effects on a woman’s quality of life, social functioning, obstetric outcome, and economic productivity. What do the results of this study add? Psychiatric morbidity among women of reproductive age is high. Pregnant women when compared to non-pregnant women had significantly higher rates of psychiatric morbidity. This high prevalence of psychiatric morbidity in both groups was predicted by poor satisfaction and communication with partners, and a previous history of depression. What are the implications of these findings for clinical practice and/or further research? Simple screening for women of reproductive age attending healthcare facilities may help with the early identification of psychiatric morbidity leading to prompt interventions, and preventing long-term disability

Adaptation of the Wound Healing Questionnaire universal-reporter outcome measure for use in global surgery trials (TALON-1 study): mixed-methods study and Rasch analysis

BackgroundThe Bluebelle Wound Healing Questionnaire (WHQ) is a universal-reporter outcome measure developed in the UK for remote detection of surgical-site infection after abdominal surgery. This study aimed to explore cross-cultural equivalence, acceptability, and content validity of the WHQ for use across low- and middle-income countries, and to make recommendations for its adaptation.MethodsThis was a mixed-methods study within a trial (SWAT) embedded in an international randomized trial, conducted according to best practice guidelines, and co-produced with community and patient partners (TALON-1). Structured interviews and focus groups were used to gather data regarding cross-cultural, cross-contextual equivalence of the individual items and scale, and conduct a translatability assessment. Translation was completed into five languages in accordance with Mapi recommendations. Next, data from a prospective cohort (SWAT) were interpreted using Rasch analysis to explore scaling and measurement properties of the WHQ. Finally, qualitative and quantitative data were triangulated using a modified, exploratory, instrumental design model.ResultsIn the qualitative phase, 10 structured interviews and six focus groups took place with a total of 47 investigators across six countries. Themes related to comprehension, response mapping, retrieval, and judgement were identified with rich cross-cultural insights. In the quantitative phase, an exploratory Rasch model was fitted to data from 537 patients (369 excluding extremes). Owing to the number of extreme (floor) values, the overall level of power was low. The single WHQ scale satisfied tests of unidimensionality, indicating validity of the ordinal total WHQ score. There was significant overall model misfit of five items (5, 9, 14, 15, 16) and local dependency in 11 item pairs. The person separation index was estimated as 0.48 suggesting weak discrimination between classes, whereas Cronbach's α was high at 0.86. Triangulation of qualitative data with the Rasch analysis supported recommendations for cross-cultural adaptation of the WHQ items 1 (redness), 3 (clear fluid), 7 (deep wound opening), 10 (pain), 11 (fever), 15 (antibiotics), 16 (debridement), 18 (drainage), and 19 (reoperation). Changes to three item response categories (1, not at all; 2, a little; 3, a lot) were adopted for symptom items 1 to 10, and two categories (0, no; 1, yes) for item 11 (fever).ConclusionThis study made recommendations for cross-cultural adaptation of the WHQ for use in global surgical research and practice, using co-produced mixed-methods data from three continents. Translations are now available for implementation into remote wound assessment pathways