Cesarean Myomectomy Outcome in a Nigerian District Hospital

Background: Myomectomy is best planned and carried out when the uterus is not gravid, as this will increase the chance of a normal pregnancy with no complication attributable to the fi broid during pregnancy. However, in the developing parts of the globe, especially in Africa where uterine fi broid is most common. Although myomectomy during pregnancy is discouraged, there are situations when it becomes inevitable. Aim: The aim of the study was to analyze the outcome of 42 consecutive Cesarean myomectomy done under the supervision of a Sabbatical obstetrician and gynaecologist at a district hospital in Nigeria.Subjects and Methods: This was a prospective, descriptive study of all patients who underwent Cesarean Myomectomy between November 2011 and October 2012 in a Obio Cottage Hospital, Port Harcourt, Nigeria. Myomectomy done at the time of Cesarean section (CS). The main outcome measures were number, location, and size of the fi broids removed, intraoperative blood loss, intra and post-operative complications, need for blood transfusion, and length of hospital stay. Data was entered into SPSS Vs 16 software and analysed. T-test was used to compare means and fi shers exact test was carry out associations on non parametric data. Level of significance was set at P<0.05.Results: Four Hundred and Fourty Six womens were delivered by Cesarean section and 42 of these had Cesarean myomectomy. Between 1 and 23 uterine fi broids were removed from each patient. The biggest fi broid was 18 cm in diameter and it weighed 3.8 kg. The mean blood loss was 695.7 mls. (250-1600 mls). There were no signifi cant intra-operative complication and the mean length of hospitalization was 4.17 days (2.48). Three patients had one unit of blood transfusion while the fourth had seven. One patient had postoperative wound infection two weeks after discharge from the hospital.Conclusion: This series has added to the growing evidence of the safety of myomectomy during Cesarean section. Keywords: Blood loss, cesarean myomectomy, complications, Nigeria, port harcourt, safet

Bacterial Isolates and Antibiotic Sensitivity among Gambian Children with Severe Acute Malnutrition

Background. Establishing the pattern of infection and antimicrobial sensitivities in the local environment is critical to rational use of antibiotics and the development of management algorithms. Methods. Morbidity history and physical examination of 140 children with severe acute malnutrition were recorded. Their blood, stool, and urine samples were cultured and antibiotic sensitivity patterns determined for any bacterial pathogens isolated. Results. Thirty-eight children had a pathogen isolated from blood culture, 60% of which were considered contaminants. Coagulase negative staphylococcus was the predominant contaminant, while the major causes of bacteraemia were nontyphoidal Salmonella (13%), S. pneumoniae (10%), and E. coli (8%). E. coli accounted for 58% of the urinary isolates. No pathogen was isolated from stool. In vitro sensitivity by disk diffusion showed that 87.5% of the isolates were sensitive to ampicillin and/or gentamicin and 84.4% (27/32) to penicillin and/or gentamicin. Conclusions. A combination of ampicillin and gentamicin provides adequate antibiotic cover for severely malnourished children in The Gambia

Pathological Lesions in the Lungs of Neonatal Wistar Rats from Dams Administered Ethanol during Gestation

Abstract: This study was carried out to investigate the effects of ethanol ingestion during pregnancy on the fetal lungs development. Adult Wistar rats were used and grouped into four groups and each group having four females and two males. Group A was the control group received only distilled water, while groups B, C and D received 0.2 mL of 20, 25 and 30% ethanol orally respectively daily for seven days during the 4 th to 10 th day of gestation. After delivery, the fetal lungs were removed and fixed in 10% buffered formalin. The neonates' lungs were prepared through histological techniques and stained with Haematoxylin and Eosin and were studied under the light microscope. The result showed alveolar degeneration, bronchiole-capillary thickening, bronchiolar degeneration and extravasations of erythrocyte in the ethanol treated groups while the control was normal. Ethanol ingestion during pregnancy could lead to ethanol-induced lung damage in the fetuses. Hence, alcohol ingestion should be avoided during pregnancy

Evaluation of Yield Productivity and Economic Returns of Some Yam (Dioscorea esculenta Poir) Genotypes Grown in a Kaolinitc Ultisol

A two-year (2008 and 2009) study was carried out at the University of Uyo Teaching and Research Farm, Use-Offot to evaluate yield productivity of eight yam genotypes (TDr 200/3/7A, M2/75/3, M2/25/1, M2/50/5x, 99/AMO/053, 99/AMO/094, 95/18894, and local -Eteme).and their economic returns to management. Randomized Complete Block Design with three replicates was used. Results of the study indicated significant differences in all the yield and yield components of the different yam genotypes considered in both years., Cost of production in 2009 was 2% above the cost of production in 2008 due to increase in cost of land preparation. The cost -benefit ratio of all the genotypes were above 10.00 except in local variety, Eteme with values of 4.9 and 6.3 in 2008 and 2009, respectively. The average cost- benefit ratio of 14.25 recorded in TDr 95/18894 suggesting strongly that the genotype is more adaptable to Uyo, agro- ecology than others

Perceptions of the Impact of Positive Action in EU and non-EU Countries

yesAbstract: Around the world, inequalities exist around boundaries of race, social class, gender, disability, religious beliefs and sexual orientation, often resulting from past and current discriminatory practices. Governments have taken certain measures, including enacting policies such as positive action, to remedy such discrimination. This paper provides a comparative analysis of perceptions of the impact of positive action in seven EU and three non-EU countries. The study adopted participatory methods including consensus workshops, interviews and policy analysis to obtain data from designers of positive action. Findings are discussed, conclusions drawn and wide-ranging recommendations are made at the EC, individual countries and organisational levels

Methodological Challenges of Researching Positive Action Measures

This paper highlights some ofthe methodological challenges which have arisen in collecting data for an international study on positive action measures. It will describe strategies employed to encourage participation in the study from as wide a range of organisations and individuals using a mixed method approach. The paper will also discuss the methodological and sensitive issues related to this type of research in organisations and strategies adopted by the research team to ameliorate any problems that have arisen whilst maintaining trustworthiness and rigour in the study

Positive Action Measures Across Different Equality Grounds, Organisations and Sectors in European and Non-european Countries

yesAbstract: This article is based on a large-scale European Commission project on international perspectives on positive action measures. The paper presents an analysis of the perceptions of positive action held by respondents from all the countries participating in an international survey, focussing specifically upon differences across equality grounds, sector and organisation type. This paper will also provide examples of positive action being applied in European and non-European countries that participated in the study. The study adopted extensive literate and online survey to obtain data from designers of positive action. Findings are discussed, conclusions drawn and wide-ranging recommendations are made at the European Commission, individual countries and organisational levels

Acute Exposure to Artesunate and its Effect on the Hematological Indices, Hepatotoxicity and Histology of the Liver of Adult Wistar Rats

Abstract: The effect of artesunate on the hematological indices, hepatotoxicity and histology of liver was investigated in 20 adult male wistar rats. The animals were divided into 4 groups of 5 each and group 1 which served as control were administered normal saline while groups 2, 3 and 4 were administered 1, 2 and 5 mg/kg/day respectively for a period of 5 days. The animals were humanely sacrificed on the sixth day and blood samples were obtained for hematological indices and serum enzyme analysis. The liver were excised and processed for light microscopy using the H & E stain. Hematological indices indicated insignificant difference in the RBC, WBC and DC counts, while a significant dose dependent increase in PCV and hemoglobin were observed (p<0.05). No changes were observed in the serum levels of Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT) and Alkaline Phosphatase (ALP) among the groups. Histological examination of the liver revealed points of focal necrosis among the treated groups. The mild liver tissue damage was more evident among the over dosed group. Artesunate is thus safe, when administered within the therapeutic range