Gynaecological bacterial infections: the physical and psychosocial consequences and challenges of management in resource-limited settings

Gynecological bacterial infections (GBIs) are prevalent in our environment and as a result pose a number of physical, social and psychological consequences. These infections are acquired through several ways. Treating GBIs is a daunting task making its control the most important strategy to alleviating its physical and psychosocial consequences. To highlight the physical, social, and psychological consequences of gynaecological bacterial infections in our resource limited setting. To highlight the hugely unresolved challenges associated with the management of gynecological bacterial infections in our resource-limited setting. Several databases (Medline, Google Scholar, Pubmed, WHO’s Hinari and Wikipedia) and some selected websites were searched using the following keywords: gynecological infections, vaginal infections and discharges, vaginal flora, sexually transmitted infections, pelvic inflammatory disease, syndromic management and challenges, psychosocial consequences, alternative medicine. A total of 5470 relevant articles were obtained between 1947 and 2018. Out of these only 256 relevant articles on the topic were reviewed. However, 213 were dropped for having an incomplete submission. Forty-three (43) articles were fully accessed and referenced. The high prevalence of GBIs poses a lot of burden on the reproductive and socio-economic lives of our women. This should be matched by behavioral changes, prompt diagnosis and early treatment; facilitated by accessible and affordable health care through improved government funding

Zika virus and birth defects: an obstetric issue

Zika virus is an emerging mosquito-borne virus that is relatively unknown, unstudied and under-diagnosed, but has potentials to spread to new geographical areas that favour survival of Aedes mosquitoes. It is associated with an alarming rise in babies with microcephaly that require much care and support with a lot of financial assistance. This is a review article on Zika virus and birth defects; a worrisome issue in today’s obstetric and medical practices. Since Zika’s discovery in Uganda, the virus was known to occur within a narrow equatorial belt from Africa to Asia with no or mild symptoms. It has emerged as a global public health threat over the last decade with accelerated geographic spread of the virus in the last nine years. The risk of Zika virus to the fetus is poorly understood, difficult to quantify and problematic. The causal link between Zika virus and microcephaly was initially speculative, strongly suspected and scientifically unproven. However, on 13th April, 2016, it was concluded that Zika virus is the cause of microcephaly and other severe fetal brain defects. The Center for Disease Control and Prevention (CDC) authors reviewed and weighed evidences using established scientific criteria to conclude after a careful review of the report published in the New England Journal of Medicine. There is no prophylaxis, treatment or vaccine to protect against Zika virus infection. However, preventive personal measures are highly recommended to avoid mosquito bites

Community-level Distribution of Misoprostol to Prevent Postpartum Hemorrhage at Home Births in Northern Nigeria

In Nigeria, most deaths due to postpartum hemorrhage (PPH) occur in the absence of skilled birth attendants. A study using community mobilization and the training of community drug keepers to increase access to  misoprostol for PPH prevention was conducted in five communities around Zaria in Kaduna State, Nigeria. Community-oriented resource persons (CORPs) and traditional birth attendants (TBAs) recruited and counseled pregnant women on bleeding after delivery, the importance of delivery at a health facility, and the role of misoprostol. Drug keepers stored and dispensed misoprostol during a woman’s third trimester of pregnancy. TBAs and CORPs enrolled 1,875 women from January through December 2009. These results are based on 1,577 completed postpartum interviews. Almost all women delivered at home (95%) and skilled attendance at delivery was low (7%). The availability of misoprostol protected 83% of women who delivered at home against PPH who otherwise would not have been protected. Policymakers working in similar contexts should consider utilizing commuity-level distribution models to reach women with this life-saving intervention. Afr J Reprod Health 2014; 18[2]: 166-175).Keywords: misoprostol, community-level distribution, Nigeria, maternal mortality Au Nigeria, la plupart des décès dus à une hémorragie du post-partum (HPP) se produisent en l'absence d'accoucheuses qualifiées. Une étude à travers la mobilisation communautaire et la formation des gardiens de drogues dans la communauté pour améliorer l'accès à misoprostol pour la prévention de l'HPP a été menée dans cinq communautés à l’alentour de Zaria dans l'État de Kaduna, au Nigeria. Les experts orientés vers les communautés (EOVC) et les accoucheuses traditionnelles (AT) ont été recrutés et ont conseillés aux femmes enceintes sur les saignements après l'accouchement, l'importance de l’accouchement dans un établissement de santé, et le rôle de misoprostol. Les gardiens de médicaments ont stocké et distribué misoprostol au cours du troisième trimestre de la grossesse de la femme. Les et les accoucheuses traditionnelles et les EOVC ont inscrit 1875 femmes de janvier à décembre 2009. Ces résultats sont basés sur 1 577 entrevues post-partum déjà terminées. Presque toutes les femmes ont accouché à domicile (95%) et l'assistance à l’accouchement par le personnel qualifié était faible (7%). La disponibilité de misoprostol a protégé 83% des femmes qui ont accouché à domicile contre l’HPP qui, autrement, n'auraient pas été protégées. Les décideurs qui travaillent dans des contextes similaires devraient envisager d'utiliser des modèles de distribution au niveau de la communauté pour atteindre les femmes à travers cette intervention de sauvetage. Afr J Reprod Health 2014; 18[2]: 166-175).Mots clés: misoprostol, distribution au niveau de la communauté, Nigeria, mortalité maternelle

Flow shop rescheduling under different types of disruption

This is an Accepted Manuscript of an article published by Taylor & Francis in International Journal of Production Research on 2013, available online:http://www.tandfonline.com/10.1080/00207543.2012.666856Almost all manufacturing facilities need to use production planning and scheduling systems to increase productivity and to reduce production costs. Real-life production operations are subject to a large number of unexpected disruptions that may invalidate the original schedules. In these cases, rescheduling is essential to minimise the impact on the performance of the system. In this work we consider flow shop layouts that have seldom been studied in the rescheduling literature. We generate and employ three types of disruption that interrupt the original schedules simultaneously. 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Universal Sequencing on a Single Machine

We consider scheduling on an unreliable machine that may experience unexpected changes in processing speed or even full breakdowns. We aim for a universal solution that performs well without adaptation for any possible machine behavior. For the objective of minimizing the total weighted completion time, we design a polynomial time deterministic algorithm that finds a universal scheduling sequence with a solution value within 4 times the value of an optimal clairvoyant algorithm that knows the disruptions in advance. A randomized version of this algorithm attains in expectation a ratio of e. We also show that both results are best possible among all universal solutions. As a direct consequence of our results, we answer affirmatively the question of whether a constant approximation algorithm exists for the offline version of the problem when machine unavailability periods are known in advance. When jobs have individual release dates, the situation changes drastically. Even if all weights are equal, there are instances for which any universal solution is a factor of Ω(log n/ log log n) worse than an optimal sequence. Motivated by this hardness, we study the special case when the processing time of each job is proportional to its weight. We present a non-trivial algorithm with a small constant performance guarantee. © 2010 Springer-Verlag