Sources and Functionality of Rural Water Supply in Communities from three Senatorial Zones of Imo State, Nigeria

Sustainability of domestic water access in communities is essential for good health, society’s dignity and progress. This study investigated the sources and functionality of rural water supply in nine communities of three local government area (LGA) in three senatorial zones of Imo State, Nigeria using structured questionnaires. The questionnaires were administered on 100 women in each community. Data obtained were analysed using multivariate analysis of variance (MANOVA) to reveal the frequency of using the various sources of rural water supply, and Wilcoxon’s test for matched pairs to reveal the functionality status of the most frequently used water source. The findings indicate the importance of borehole water facilities in these rural communities and the necessity for intervention programs to strengthen their functionality in tandem with the State’s aspirations in achieving sustainable development goals

Kinetics and Equilibrium of Crude Oil Sorption from Aqueous Solution Using Borassus Aeothopum Coir

In this study, Borassus aethopum coir (BAC) which is an abundant, cheap, readily available and biodegradable agricultural waste was modified by acetylation using acetic anhydride and NBS catalyst at room temperature. This was to increase their hydrophobic properties and improve their sorption capacity in aqueous environment. The crude oil sorption kinetic data were fitted by intra-particle diffusion and pseudo-first order for raw BAC but the pseudo-second order kinetic model best fits crude oil sorption data for acetylated BAC.  The Langmuir and Freundlich models were used to elucidate the sorption behaviour of crude oil with raw and acetylated BAC. Freundlich isotherm gave the best fit for the equilibrium crude oil sorption data for acetylated BAC and raw BAC. Fourier transform infrared and scanning electron microscope analyses showed clear evidence of successful acetylation. The results presented and discussed in the study suggests that acetylated BAC (ABAC) is more suitable for crude oil sorption than raw BAC, therefore, possesses more potential for application and further development in treatment of oil spillage. Keywords: acetylated borassus aethopum coir, kinetics, crude oil sorption, sorbents, sorption capacity. DOI: 10.7176/CMR/11-2-02

Partial clinical remission in type 1 diabetes: a comparison of the accuracy of total daily dose of insulin of \u3c0.3 units/kg/day to the gold standard insulin-dose adjusted hemoglobin A1c of ≤9 for the detection of partial clinical remission

BACKGROUND: It is unclear whether the gold standard test for the detection of partial clinical remission (PCR) in new-onset type 1 diabetes (T1D), the insulin-dose adjusted Hemoglobin A1c (IDAA1c) of ≤9, is superior to a new tool, total daily dose of insulin (TDD) of METHODS: A retrospective analysis of 204 subjects of ages 2-14 years, mean age 7.9±3.2 years, (male 7.8±3.4 years, [n=98]; female 7.9±3.0 years, [n=106], p=0.816) with new-onset T1D. Anthropometric and biochemical data were collected for the first 36 months of disease. PCR was defined by both IDAA1c≤9 and TDD RESULTS: There were 86 (42.2%) (age 9.1±3.0 years; male 57%) remitters by IDAA1c≤9 criterion, and 82 (40.2%) remitters (age 7.3±2.8 years) by TDD of CONCLUSIONS: There were no significant differences in the number of remitters, duration of PCR, or the time of peak remission defined by IDAA1c of ≤9 or TDD o

Determinants and effects of sexual exploitation among female students of tertiary institutions in Rivers State

Background: Labor induction methods are continuously evolving to ensure safer and more effective outcomes for both mother and neonate. The present study aimed to assess the effectiveness and safety of combined use of misoprostol with intracervical catheter for labor induction. Methods: This single-blinded, parallel-group randomized control trial conducted at Shaheed Suhrawardy Medical College, Dhaka, Bangladesh, included 200 women with term gestation and Bishop score ≤6. Participants were divided into two groups: the intervention group (group B) received misoprostol juice and Foley’s catheter, while the control group (group A) received misoprostol in the posterior fornix. Results: In Group A, 58% had vaginal deliveries, while in Group B, 65% had vaginal deliveries. Group B experienced a longer mean length of labor in the 1st stage (13.25±1.095) compared to Group A (12.98±1.982, p=0.008). The 3rd stage was shorter for Group B (10.00±0.000) than Group A (12.02±2.469, p<0.001). The most common induction reason was labor pain with an unfavorable cervix (31 in Group A and 33 in Group B). Group B had a higher percentage of inductions at less than 12 hours and a lower percentage at more than 24 hours. Neonatal outcomes were generally better for Group B. The Cox regression hazard model showed a lower likelihood of positive outcomes in Group B (hazard ratio 0.337, 95% CI 0.243-0.469, p=0.000), indicating a statistically significant difference between the groups. Conclusions: The combined use of misoprostol with Foley’s catheter for labor induction is safe and effective, resulting in shorter labor duration and higher rates of vaginal delivery compared to misoprostol alone

Growth characteristics in individuals with osteogenesis imperfecta in North America: results from a multicenter study.

PurposeOsteogenesis imperfecta (OI) predisposes people to recurrent fractures, bone deformities, and short stature. There is a lack of large-scale systematic studies that have investigated growth parameters in OI.MethodsUsing data from the Linked Clinical Research Centers, we compared height, growth velocity, weight, and body mass index (BMI) in 552 individuals with OI. Height, weight, and BMI were plotted on Centers for Disease Control and Prevention normative curves.ResultsIn children, the median z-scores for height in OI types I, III, and IV were -0.66, -6.91, and -2.79, respectively. Growth velocity was diminished in OI types III and IV. The median z-score for weight in children with OI type III was -4.55. The median z-scores for BMI in children with OI types I, III, and IV were 0.10, 0.91, and 0.67, respectively. Generalized linear model analyses demonstrated that the height z-score was positively correlated with the severity of the OI subtype (P < 0.001), age, bisphosphonate use, and rodding (P < 0.05).ConclusionFrom the largest cohort of individuals with OI, we provide median values for height, weight, and BMI z-scores that can aid the evaluation of overall growth in the clinic setting. This study is an important first step in the generation of OI-specific growth curves

Assessment of the efficacy and toxicity of 131I-metaiodobenzylguanidine therapy for metastatic neuroendocrine tumours

131I-metaiodobenzylguanidine (131I-MIBG) is a licensed palliative treatment for patients with metastatic neuroendocrine tumours. We have retrospectively assessed the consequences of 131I-MIBG therapy in 48 patients (30 gastroenteropancreatic, 6 pulmonary, 12 unknown primary site) with metastatic neuroendocrine tumours attending Royal Liverpool University Hospital between 1996 and 2006. Mean age at diagnosis was 57.6 years (range 34–81). 131I-MIBG was administered on 88 occasions (mean 1.8 treatments, range 1–4). Twenty-nine patients had biochemical markers measured before and after 131I-MIBG, of whom 11 (36.7%) showed >50% reduction in levels post-therapy. Forty patients had radiological investigations performed after 131I-MIBG, of whom 11(27.5%) showed reduction in tumour size post-therapy. Twenty-seven (56.3%) patients reported improved symptoms after 131I-MIBG therapy. Kaplan–Meier analysis showed significantly increased survival (P=0.01) from the date of first 131I-MIBG in patients who reported symptomatic benefit from therapy. Patients with biochemical and radiological responses did not show any statistically significant alteration in survival compared to non-responders. Eleven (22.9%) patients required hospitalisation as a consequence of complications, mostly due to mild bone marrow suppression. 131I-MIBG therefore improved symptoms in more than half of the patients with metastatic neuroendocrine tumours and survival was increased in those patients who reported a symptomatic response to therapy

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Data from: A Predictive Model for Lack of Partial Clinical Remission in New-onset Pediatric Type 1 Diabetes

Manuscript abstract: IMPORTANCE: \u3e50% of patients with new-onset type 1 diabetes (T1D) do not enter partial clinical remission (PCR); early identification of these patients may improve initial glycemic control and reduce long-term complications. AIM: To determine whether routinely obtainable clinical parameters predict non-remission in children and adolescents with new-onset T1D. SUBJECTS AND METHODS: Data on remission were collected for the first 36 months of disease in 204 subjects of ages 2-14 years with new-onset type 1 diabetes. There were 86 remitters (age 9.1±3.0y; male 57%), and 118 non-remitters (age 7.0±3.1y; male 40.7%). PCR was defined as insulin-dose adjusted hemoglobin A1c of ≤9. RESULTS: Non-remission occurred in 57.8% of subjects. Univariable analysis showed that the risk for non-remission was increased 9-fold in patients with 4 diabetes-associated auto-antibodies (OR = 9.90, p = 0.010); 5-fold in patients(odds ratio = 5.38, p = 0.032), 3-fold in those with bicarbonate of/dL at diagnosis (OR = 3.71, p = 0.008). Combined estimates of risk potential for HC03 and the number of autoantibodies by multivariable analysis, adjusted for BMI standard deviation score, showed HC03/dL with a clinically significant 10-fold risk (OR = 10.1, p = 0.074); and the number of autoantibodies with a 2-fold risk for non-remission (OR = 1.9, p = 0.105). Male sex and older age were associated with decreased risk for non-remission. A receiver-operating characteristic curve model depicting sensitivity by 1-specificity for non-remission as predicted by bicarbonate/dL, age3 diabetes-associated autoantibodies had an area under the curve of 0.73. CONCLUSIONS: More than 50% of children and adolescents with new-onset T1D do not undergo partial clinical remission and are thus at an increased risk for long-term complications of diabetes mellitus. A predictive model comprising of bicarbonate/dL, age3 diabetes-associated autoantibodies has 73% power for correctly predicting non-remission in children and adolescents with new-onset T1D. Early identification of these non-remitters may guide the institution of targeted therapy to limit dysglycemia and reduce the prevalence of long-term deleterious complications

Anti Coagulation And Antithrombotic Effects Of Triclisia Dictyophylla

Triclisia Dictyophylla (moonseed) root was investigated for the anticoagulation and antithrombotic properties. The median lethal dose (LD50) based on Lorke\'s methods was 550mg/kg. The aqueous root extract of T. dictyophylla prolonged the in-vitro whole human blood clotting time at concentrations of 50mg/2ml and 100mg/2ml of whole blood and at a concentration of 200mg/2ml of whole blood, complete anticoagulation effect was achieved. The prothrombin time of the different concentrations was unattainable even after 48hours. At a concentration of 200mg/2ml of semi clotted whole blood (invitro), the clot was dislodged. The roots extract of T. dictyophylla has in-vitro anticoagulation and antithrombotic properties, perhaps justifying its use in the treatment of edematous pain. Keywords: Triclisia Dictyophylla, Menispermaceae, human blood, coagulation, Fibrinolysis, antithrombosisNigerian Journal of Natural Products and Medicine Vol. 11 2007 pp. 29-3