Common Causes of Neonatal Death in Calabar, South-South Nigeria: An Autopsy Study

Background: Neonatal deaths are deaths of live born babies occurring before 28 completed days. The vast majority occur in low-income countries like Nigeria with a high neonatal mortality rate. There is paucity of autopsy studies due to refusal of family to give consent for such procedures. Aim: To identify the commonest causes of neonatal death in 53 neonatal autopsies in Calabar, Nigeria. Materials and Methods: Detailed postmortem was carried out using lettules techniques and bits taken for histological analysis to ascertain the cause of death. Other relevant contributory factors such as the gestational age, mode of delivery, place of birth, antemortem cause of deaths and maternal obstetric history were obtained from the medical records and autopsy request forms. Results: In the one-year retrospective study of 53 neonatal autopsies, male: female ratio was 1: 0.83 and mean age at death was 6.5 + 7.3 days, ranging from 1 to 28 days. The commonest cause of neonatal death was severe birth asphyxia seen in 10 cases (18.9%), followed by kernicterus in 6 cases (11.3%), birth trauma seen in 6 cases (11.3%), congenital heart disease seen in 5 cases (9.4%), and prematurity seen in 5 cases (9.4%). Conclusion: The study confirms the usefulness of neonatal autopsy in ascertaining the definitive cause of death. Severe birth Asphyxia was identified as the commonest cause of death in the neonatal period followed by birth trauma, kernicterus and congenital heart diseases.

Critical Congenital Heart Disease Sadly Diagnosed at Autopsy in Calabar, South-South Nigeria

Congenital heart disease (CHD) is the most common type of birth defect causing more deaths in the first year of life than any other birth defect. Medical practice in a third-world country is faced with numerous challenges, created by poor health facilities and the unavailability of basic imaging studies at the community level where the majority of the poor resides. We present a case series of 4 neonates with a ratio of 1: 3 admitted into the neonatology unit of the University of Calabar Teaching Hospital, Calabar, Nigeria. Two of the patients were delivered at home by a traditional birth attendant via spontaneous vertex delivery and the rest two were booked cases in a private and obstetric unit of the University of Calabar Teaching Hospital. Their age ranged were 18 hours to 27 days of life and their common presentation were poor sucking, difficulty in breathing, central cyanosis and failure to thrive. A fetal echocardiogram was carried out for one of the cases and there was strong clinical suspicion of congenital heart disease but the precise type is unknown. The other three could not afford the necessary investigations required. They were all oxygen-dependent till death. Pathologic-anatomic findings showed a rare Critical congenital heart defect of the univentricular heart chamber of various types for the three cases and a case of TGA. The Immediate cause of death for all four cases was congestive cardiac failure.

Identification of Cryptosporidium parvum Oocysts among Hospitalized Children under-5years in Northeastern Nigeria

Cryptosporidium parvumis among the major pathogens causing diarrheal diseases in children. It is of major public health significance due to its low infectious dose and its oocysts are highly resistant to chlorination, common household disinfectants and survive long periods in the environment. This study was designed to evaluate the occurrence of Cryptosporidium parvum oocysts in stool of hospitalized children under-5years. One hundred and fifty (150) stool samples were collected from one hundred and fifty children (Male:Female= 1:1.08, Mean Age±S.D=22.08 months ± 21.02) and were processed using the modified Ziehl-Nelson method for identification of protozoan oocysts. Out of the one hundred and fifty (150) stool samples analyzed, 16 tested positive to oocysts of C. parvum, which gives a parasite prevalence rate of 10.7%. This was observed to be higher among male patients (52.0%) and children between the age 32-41months (31.3%). Parasite prevalence in relation to age of patients was statistically not significant (X2=0.105, DF=1, P-value= 0.74591, p<0.05). Other intestinal protozoan parasites identified include Entamoeba histolytica(1.33%) and Giardia lamblia (2.60%

Polyprenols of Grape Vitis vinifera L. Leaves.

The study is aimed to isolate of polyprenols from grape Vitis vinifera L. leaves by different methods and to determine of polyprenol content of plant leaves growing in various regions of Uzbekistan. Study Design: Isolation of polyprenols. Place and Duration of Study: Department of Organic Chemistry, Institute of the Chemistry of Plant Substances (ICPS). The study was carried out between January, 2011 and December, 2012. Methodology: We have studied isolation of polyprenols of grape leaves by using of simple, microwave and ultra sound extraction. Spectral, HPLC and HPTLC methods have used. Results: It was determined that leaves polyprenols are in type polyprenyl homologues with 10-13 isoprene units where undecaprenol and dodecaprenol were dominant. Extraction carried out of grape leaves in various conditions (usual, microwave, ultrasound). Ethanol was high effective for microwave and ultrasound extraction. It was observed forming of polyprenol and high aliphatic alcohols esters (probably proceeding particularly esterification of polyprenols and aliphatic alcohols by organic acids which contain in extracts). Conclusion: It was determined that extraction of grape leaves by alcohol in microwave and ultra sound stirring are high effective methods for isolation of polyprenols.

Predição da degradação da matéria seca pelo volume de gases utilizando a técnica in vitro semi-automática de produção de gases / Prediction of dry matter degradation from volume of gas production using the in vitro semi-automatic gas production technique

Estimou-se a degradação da matéria seca (DMS) via produção de gases (PG) por meio de equações. Foram agrupados dados de volume de gases e DMS de oito forrageiras (Brachiaria brizantha, Brachiaria decumbens, feno de Cynodon spp, silagem de milho, silagem de milheto, sorgo de corte, capim-elefante e cana-de-açúcar) e de milho em grão. Os dados de DMS obtidos em laboratório foram comparados à DMS obtida pelas equações de regressão. Apesar dos altos coeficientes de determinação, os resultados demonstraram a impossibilidade de estimar a DMS via PG pelas equações geral, de dois e de três pontos.

The dry matter degration (DMD) was estimated through volume of gas produced (GP) during the in vitro fermentation. The DMD from eight forages (Brachiaria brizantha, Brachiaria decumbens, cynodon hay, maize silage, Pennisetum glaucon, sorghum, elephant grass and sugarcane) and corn grain were obtained and were compared with the DMD estimated using regression equations. The results showed the GP can not predict the DMD due to inocula effects, chemical composition of substrate or losses of particles of soluble material during filtration process.

Comparação de substratos com diferentes quantidades de carboidratos solúveis utilizando a técnica in vitro semi-automática de produção de gases / Comparison among substrates with different soluble carbohydrates concentration using the in vitro semi-automatic gas production technique

Estudou-se a diferença entre a produção de gases (PG) e a degradação da matéria seca (DMS) para substratos com diferentes quantidades de carboidratos solúveis avaliados pela técnica in vitro de produção de gases. Foram utilizados cinco substratos (cana-de-açúcar, silagem de milho, capim-colonião, milho em grão e ração comercial para vacas em lactação) antes e após a retirada parcial dos carboidratos solúveis (lavados). A PG foi maior e a DMS menor para o material lavado. A concentração de carboidratos solúveis influenciou os resultados obtidos pela técnica de produção de gases.

The difference between the gas production (GP) and the dry matter degradation (DMD) of substrates with different amounts of soluble carbohydrates using the in vitro gas production technique was studied. Five substrates (sugarcane, maize silage, Panicum maximum grass, corn grain, 20 percent CP commercial lactating cow ration and soybean meal) and the same substrates with part of its soluble carbohydrate removed (washed materials) were evaluated. The GP was higher and DMD was lower for washed materials than for the original materials. The carbohydrate concentration affects the results of the gas production technique.

Antibodies to hepatitis C virus in patients who have had multiple transfusions in Sri Lanka.

OBJECTIVE: To determine the prevalence of antibodies to hepatitis C virus (HCV) in patients who have had multiple transfusions in Sri Lanka. SETTING: University Medical Unit at the National Hospital, Colombo, the Cancer Institute, Maharagama, and the Lady Ridgeway Children's Hospital, Colombo. PATIENTS: One to 5 ml of blood for serology was collected from 200 multiply transfused patients (those who have received five or more blood transfusions). METHOD: The sera were tested for HCV specific antibodies using a third generation anti-HCV enzyme immuno-assay (EIA) kit. All sera giving positive or intermediate EIA results were re-tested by a commercial HCV Western blot confirmatory test. RESULTS: Of the 200 patients, 10 (5%) were repeatedly positive and confirmed by the Western blot. 33% (7/21) of haemophiliacs and 10% (3/31) of thalassaemics were positive for antibodies to HCV. Antibodies were not detected in other groups of multiply transfused patients (haemolytic disease, aplastic anemias, chronic renal failure, haematological and other malignancies). Of the 200 patients, those who have had more than 80 blood transfusions had a significantly higher prevalence of antibodies to HCV. The frequency of HCV infection was also higher among those who had received factor concentrates. CONCLUSION: 33% of haemophiliacs and 10% of thalassaemics who have received multiple transfusions were infected with HCV. These findings warrant a larger study among blood donors, and justify screening and decontamination of blood and blood products given to haemophiliacs and thalassaemics in Sri Lanka.

Depresión postparto: prevalencia y factores de riesgo / Postpartum depression: prevalence and risk factors

Se solicitó a 103 puérperas que respondieran a los 3 días de postparto un instrumento con datos biográficos, la escala de Graffar de nivel socioeconómico, la escala de Hamilton para depresión mayor (HAM-D) y la escala de Edimburgo para depresión postparto (EDPE). Se logró seguir a 43 de ellas repitiendo la aplicación de las escalas para depresión a las 12 semanas. Se obtuvo, con las 103 puérperas una prevalencia de depresión mayor al terer día postparto de 3,9 por ciento con HAM-D y de 27,2 por ciento con EDPE, mientras que en la muestra de 43 mujeres se obtuvo una prevalencia a los 3 días de 4,6 por ciento con HAM-D y de 19 por ciento con EDPE y, a las 12 semanas, de 27,9 por ciento y 48 por ciento respectivamente. La incidencia de depresión mayor a las 12 semanas correspondió a un 23,2 por ciento con HAM-D y 32,5 por ciento con EDPE. Por otro lado se encontraron factores asociados en forma significativa con la depresión postparto: embarazo inesperado, tener 3 hijos o más, ausencia del padre, parto vaginal eutópico, dificultades con el padre y ser madre soltera. El puntaje en la EDPE al tercer día postparto se correlacionó positivamente (r=0,5) con el puntaje a las 12 semanas postparto

Effect of acute exercise on skin potential in sedentaries and trained athletes.

Endosomatic electrodermal activity (skin potential level and skin potential response) as an indirect indicator of sympathetic nervous system activity was measured in 35 sedentary male students and 22 trained athletes of two groups during resting and after an acute exercise. The aim of this study was to investigate the difference of skin potential parameters between sedentaries and trained athletes before and after the acute exercise in bicycle ergometer. In sedentaries' group while skin potential level (SPL) and latency showed no significant variations, skin potential response (SPR) decreased significantly after the exercise (P < 0.001). In athletes' group SPL increased (P < 0.01) and SPR decreased (P < 0.05) after the exercise but latency had no significant difference. In addition, athletes had significantly higher SPL and lower SPR values before and after the exercise comparing with the sedentaries. The increase of SPL in athletes' group was thought to depend on sweat duct pores which have been more active and open than sedentaries. Also the decrease in SPR in athletes' group was thought to depend on the lower sweating threshold in athletes.

A negociacao coletiva como forma de prevencao de acidentes do trabalho. / Collective negotiation as a way to prevent occupational accidents

Considerando a convencao coletiva de trabalho como forma legitima para conter normas sobre prevencao de acidentes laborais, sao relatadas algumas normas legais de Seguranca e Medicina do Trabalho. Basicamente e sugerida maior participacao dos sindicatos na prevencao de acidentes, atraves de convencoes e acordos coletivos

Hydrocortisone in the management of dengue shock syndrome.

A total of 98 patients with dengue shock syndrome admitted into Children's Hospital from February 1973 to February 1974 were randomly selected into 2 groups. A double blind controlled trial of the efficacy of pharmacologic doses of hydrocortisone hemisuccinate was carried out. The 2 groups were confirmed to be completely matched by age, sex and severity of the disease. Nine deaths occurred out of 48 cases in the steroid group (Case Fatality Rate 18.75%) and 22 deaths out of 50 cases in the non-steroid group (Case Fatality Rate 44%), the difference being statistically significant. No significant difference was detected in fluid requirements and other morbidity pattern.