Cultural practices and the use of icterogenic agents in glucose 6 phosphate dehydrogenase deficient neonates: Any effect?

Background: Cultural practices involving the use of certain agents known to cause haemolysis in Glucose-6-phosphate dehydrogenase (G6PD) deficient individuals are common during perinatal and neonatal periods. This study was targeted at identifying some of these agents and their role in the development of hyperbilirubinaemia in G6PD deficient neonates in our environment with a view at raising public awareness for an acceptable neonatal outcome.Materials and methods: One hundred and fifty neonates admitted into the Special Care Baby Units (SCBUs) of the Jos University Teaching Hospital, Bingham University Teaching Hospital, and the Plateau State Specialist Hospital with neonatal jaundice were enrolled for this study. Information on age, sex, history of drugs, chemicals and herbs used during or after pregnancy were obtained using a questionnaire. Five millilitres of the blood sample was collected into anticoagulated and plain sample bottles for Full Blood Count (FBC), Reticulocyte Count, Serum Bilirubin (SB) and G6PD assay.Results: Mean age at presentation was 3.28 ± 3.11 days. Mean haemoglobin concentration of the neonates was 15.90 ± 2.23 g/dL while mean reticulocyte count, total leukocyte and platelet count were 2.42 ± 0.71%, 7.10 ± 2.76 (x 109/L) and 228.45 ± 85.57 respectively. Sixty-one (40.7 %) of the studied neonates were G6PD deficient with mean G6PD activity of 3.79 ± 1.37 IU/gHb. Mean total serum bilirubin was 205.01 ± 96.57μmol/L. Icterogenic agent use was identified in 70 (46.7%) of the study subjects with naphthalene balls used in 19 (12.7%) study subjects.Conclusion: Icterogenic agents are being used for neonatal care in our environment despite the consequences of hyperbilirubinaemia in those with G6PD deficiency. Keywords: Glucose-6-phosphate dehydrogenase deficiency, Hyperbilirubinaemia, Icterogenic agents, Neonate

Carbon pool ratios as scientific support to field morphology in the differentiation of dark subsurface soil horizons

In soil surveys, it is usual to find profiles with an uncommon disposition of horizons. Dark horizons in depth might be either the consequence of erosion and redeposition of soil materials from upslope or an indication of the podzolization process, which forms a spodic horizon. Few laboratory analyses are known to characterize dark subsurface horizons which could allow for the differentiation of spodic from buried A horizons. Some researchers propose C-humic and C-fulvic acid fraction ratios and forms of carbon to analyze characteristics of these horizons. Therefore, this research aimed to characterize dark subsurface horizons found in soils under a Eucalyptus minimum tillage system in the state of Rio Grande do Sul, Brazil, and to relate soil organic carbon to landscape features in toposequences. The characterization was performed by using the following ratios: humic acid and fulvic acid fractions (Cha/Cfa); pyrophosphate extractable-C and organic carbon (Cp/OC); fulvic acid fraction and pyrophosphate extractable-C (Cfa/Cp), and fulvic acid fraction and organic carbon (Cfa/OC). Soil organic carbon was related to slope gradient and Geomorphons in a Geographic Information System (GIS). None of the horizons analyzed met the criteria required for spodic horizon classification, where Cha/Cfa < 0.50, Cfa/OC < 0.30, and the ratio Cp/OC ≥ 0.50 simultaneously with Cfa/Cp ≥ 0.50. A relationship was found between landscape features and soil organic carbon content. The methodology proved to be satisfactory for providing scientific support to field morphology classification of dark subsurface horizons, specifically in the case where they could be misinterpreted as spodic horizons

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

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