Trends in the Management of Miscarriages with the Implementation of the Volunteer Obstetrician Scheme in Selected Primary Health Care Centres in Maiduguri, Northeastern Nigeria.

BACKGROUND: Post-abortion care (PAC) is a crucial component of emergency obstetric care, and many of the primary health care centres (PHC) in the internally displaced person (IDP) camps and host communities in Maiduguri lack it. Improved access to high-quality PACs is essential for meeting the reproductive health needs of the IDPs and reducing the maternal morbidity and mortality that can result from miscarriages. OBJECTIVE: To determine the trend in managing miscarriages in the IDP camps and host communities in Maiduguri and the impact of the volunteer obstetrician scheme (VOS) on PAC. METHODOLOGY: We conducted a longitudinal study in selected PHCs serving IDP camps and host communities in Maiduguri. The study spanned five (5) years, and we compared the management of miscarriages and PAC services one year before the VOS project, two years during the project and two years after the project. During the two-year VOS project, staff manning the PHCs had supportive supervision with hands-on training on PAC. Chi-square for trend and odd ratio with a 95% confidence interval was used as appropriate to compare the trend in PAC services provided during the study period. RESULTS: One thousand eight hundred and eight (1808) women presented with miscarriages, and 1562 (86.4%) required uterine evacuation. Medical evacuation with oral misoprostol was offered to 974 (62.4%), and manual vacuum aspiration (MVA) was used in 422 (27.0%) of the women who needed uterine evacuation. There was a statistically significant rise in the use of medical evacuation throughout the study period (52.2% before VOS, and 71.4% by the second year of VOS) with ꭓ2=41.64 and P<0.001. In comparison, the use of MVA fell from 38.6% in 2015 to 27.7% in 2019 (ꭓ2=34.74 and P<0.001). Similar rising trends were also observed in postabortion family planning acceptance (ꭓ2=22.27, P<0.001). CONCLUSION: The Volunteer Obstetrician Scheme project appears to have improved PAC services, especially medical evacuation and family planning uptake in the PHCs in IDP camps and host communities in Maiduguri, Borno State, Nigeria. We recommend task shifting of PAC services and periodic supportive supervision to ensure the quality of care.

CONTEXTE: Les soins après avortement (PAC) sont une composante cruciale des soins obstétricaux d'urgence, et de nombreux centres de soins de santé primaires (PHC) dans les camps de personnes déplacées internes (PDI) et les communautés d'accueil à Maiduguri en sont dépourvus. Un accès amélioré à des PAC de haute qualité est essentiel pour répondre aux besoins de santé reproductive des PDI et réduire la morbidité et la mortalité maternelles qui peuvent résulter des fausses couches. OBJECTIF: Déterminer la tendance dans la gestion des fausses couches dans les camps de PDI et les communautés d'accueil à Maiduguri et l'impact du Programme de bénévoles obstétriciens (VOS) sur la PAC. MÉTHODOLOGIE: Nous avons mené une étude longitudinale dans des PHC sélectionnés desservant des camps de PDI et des communautés d'accueil à Maiduguri. L'étude a duré cinq (5) ans, et nous avons comparé la gestion des fausses couches et les services de PAC un an avant le projet VOS, deux ans pendant le projet et deux ans après le projet. Pendant les deux ans du projet VOS, le personnel des PHC a bénéficié d'une supervision avec formation pratique sur la PAC. Le chi carré pour la tendance et le rapport de cotes avec un intervalle de confiance de 95% ont été utilisés, le cas échéant, pour comparer la tendance des services de PAC fournis pendant la période de l'étude. RÉSULTATS: Mille huit cent huit (1808) femmes ont présenté des fausses couches, et 1562 (86,4%) ont nécessité une évacuation utérine. Une évacuation médicale avec du misoprostol oral a été proposée à 974 (62,4%), et l'aspiration manuelle sous vide (AMV) a été utilisée chez 422 (27,0%) des femmes ayant besoin d'une évacuation utérine. On a observé une augmentation statistiquement significative de l'utilisation de l'évacuation médicale tout au long de la période de l'étude (52,2% avant le VOS et 71,4% la deuxième année du VOS) avec ꭓ2=41,64 et P<0,001. En revanche, l'utilisation de l'AMV est passée de 38,6% en 2015 à 27,7% en 2019 (ꭓ2=34,74 et P<0,001). Des tendances similaires à la hausse ont également été observées dans l'acceptation de la planification familiale après avortement (ꭓ2=22,27, P<0,001). CONCLUSION: Le projet de Programme de bénévoles obstétriciens semble avoir amélioré les services de PAC, en particulier l'évacuation médicale et l'acceptation de la planification familiale dans les PHC des camps de PDI et des communautés d'accueil à Maiduguri, dans l'État de Borno, au Nigéria. Nous recommandons de déléguer les services de PAC et une supervision de soutien périodique pour garantir la qualité des soins. MOTS-CLÉS: Communauté d'accueil, Camps de PDI, Aspiration manuelle sous vide, Évacuation médicale, Misoprostol, Soins après avortement.

Biocosmetics Made with Saccharina latissima Fractions from Sustainable Treatment: Physicochemical and Thermorheological Features.

This work deals with the formulation of natural cosmetics enriched with antioxidant fractions from the ultrasound treatment (US) of the brown seaweed Saccharina latissima. The challenge was the development of a cosmetic matrix without jeopardizing the thermorheological features of the creams, adding microparticles containing the antioxidant fractions using two different carriers, mannitol and alginate. The fundamental chemical characteristics of seaweed and the extracts obtained via sonication, as well as the antioxidant properties of the latter, were analyzed. The highest TEAC (Trolox equivalent antioxidant capacity) value was identified for the extracts subjected to the longest processing time using ultrasound-assisted extraction (240 min). A similar yield of microparticle formulation (around 60%) and load capacity (about 85%) were identified with mannitol and alginate as carriers. Color testing of the creams exhibited small total color differences. The rheological results indicated that the testing temperature, from 5 to 45 °C, notably influenced the apparent viscosity of the matrices. All creams were adequately fitted with the two parameters of the Ostwald-de Waele model, with the flow consistency index following an Arrhenius dependency with the testing temperature. Neither hysteresis nor water syneresis was observed in the proposed cosmetics during 6 months of cold storage at 4-6 °C.

On the Design of Aqueous Emulsions of Colophony Resin.

Companies regularly face market pressure to develop products faster but they also need to simultaneously incorporate technological constraints, sustainability trends, and customer requirements into their designs, which requires the use of systematic procedures. Firms that exploit natural resources and convert them into high-value products are among them. However, the literature on the application of such systematic approaches to products of this type remains scarce, as they often requrire extensive experimental plans involving the testing and optimization of multiple formulations. Here, we propose a systematic approach to the design of pine-resin-in-water emulsions, which can be used to fabricate pressure-sensitive adhesives. The strategy is customer-centric in the sense that the customers' specifications are integrated into the decision-making tool used to assess the quality of the formulations obtained through experiments. This tool uses loss functions to assess satisfaction with individual quality characteristics and multi-attribute decision-making methods to integrate them into an overall quality metric. Our framework is aligned with industrial practices and consists of three sequential stages: (i) screening of primary factors; (ii) optimization of secondary factors; and (iii) assessment of the experimental repeatability of the formulations. In each of these stages, the decision-making tool is used to "drive" the process of finding the optimal formulation.

Prevalence and risk factors of hypocalcemia among pregnant and non-pregnant women in Maiduguri, Nigeria: A cross-sectional study.

BACKGROUND: Pregnancy is a period of heightened calcium demand necessary for the optimum growth and development of the fetus and placenta. Women with low calcium intake may manifest with hypocalcemia in pregnancy. OBJECTIVE: The aim of this study was to determine the prevalence and risk factors of hypocalcemia among pregnant and non-pregnant women in Maiduguri, Nigeria. SUBJECTS AND METHODS: A comparative cross-sectional study was conducted at the University of Maiduguri Teaching Hospital, Maiduguri from 1st January 2017 to 31st December 2018. For each patient, sociodemographic and clinical characteristics were noted. Serum calcium, phosphate, total protein, and albumin were determined using spectrophometric methods with their specific reagents. The data obtained was analyzed using the SPSS statistical software for windows version 20. Chi-square test, Student t-test and ANOVA were used as appropriate. Odd ratio with multiple logistic regression was used to determine risk factors for hypocalcemia. P value < 0.05 was considered statistically significant. RESULTS: A total of 1,500 (1,000 pregnant and 500 non-pregnant) women were analyzed. The mean age, total protein, and albumin were similar in the pregnant and non-pregnant women. However, the non-pregnant women were of higher parity than the pregnant women (3.75 ± 2.79 versus 2.45 ± 2.24, P < 0.001). The staple food of both group were mainly high carbohydrate diets. The prevalence of hypocalcemia was 29.20% among the pregnant women and 14.20% among the non-pregnant women (X2 = 64.34, P < 0.001). The mean serum calcium was lower among the pregnant compared to the non-pregnant women (2.08 ± 0.22 mmol/L versus 2.2 ± 0.19 mmol/L, F = 5.73, P = 0.02). There were no statistically significant differences in the mean serum calcium across the trimesters of pregnancy (F = 1.58, P = 0.21). CONCLUSION: Hypocalcemia in pregnancy is common in our environment and it is associated with anemia in pregnancy, anorexia, and primigravidity while attainment of at least basic education is protective. We recommend routine calcium supplementation in pregnancy and preconception period.

Assessment of potential predictive value of peripheral blood inflammatory indexes in 26 cases with soft tissue sarcoma treated by pazopanib: a retrospective study.

PURPOSE: The aim of this study was to evaluate the prognostic and predictive value of neutrophil-to-lymphocyte ratio (NLR), derived neutrophil-to-lymphocyte ratio (DNLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) in soft tissue sarcoma (STS) cases treated with pazopanib. MATERIALS AND METHODS: The study population included 26 STS cases treated with pazopanib for at least 3 months. NLR, DNLR, LMR, and PLR were evaluated at baseline, and at third month of therapy and also compared with response to pazopanib. Median measurements were taken as cutoff for NLR (4.8), DNLR (3.1), LMR (3.6), and PLR (195). The associations between these cutoff values and survival times (progression-free survival [PFS] and overall survival [OS]) were assessed by Kaplan-Meier curves and Cox proportional models. RESULTS: Patients with low pretreatment NLR and DNLR had longer OS (P=0.022, P=0.018), but low PLR was found to be associated only with longer OS. Additionally, decrease in NLR and DNLR after 3 months of therapy as compared with pretreatment measurements was found to be associated with an advantage for OS (P=0.021, P=0.010, respectively) and PFS (P=0.005, P=0.001, respectively). Response to pazopanib; changes in NLR, DNLR, LMR, and PLR; and >3 metastatic sites were found to be independent risk factors in univariate analysis, but NLR was the only independent risk factor in multivariate analysis. CONCLUSION: Low pretreatment and decrease in NLR and DNLR values, and regression/stable disease after 3 months of pazopanib are predictive factors for longer OS and PFS.

A ten year review of female sterilization at the university of Maiduguri teaching hospital, Maiduguri, Nigeria

Background: In most developing countries like Nigeria, female sterilization is not a popular method of contraception. Objective: The objective of this study was to determine the prevalence of female sterilization and socio-demographic characteristics of women who had sterilization in our setting.Methodology: This was a retrospective study carried out between 1st January 1997 and 31 December 2006.A total of two hundred and one female sterilisation operations were performed but ten case notes were incomplete and therefore, one hundred and ninety one 191 were analyzed. Information retrieved from the case notes included the age, parity, religion, literacy, and type of bilateral tubal ligation. The data collected were analyzed using SPSS Version 16.0 statistical package and the results represented in simple tables and percentages.Results: There were 16,319 deliveries during the study period and 201women had bilateral tubal ligation (BTL), giving a prevalence of 1.2%. The mean age at BTL was 30.18, while the mean parity was 4±0.6. Women between the ages of 30-39 constituted majority of the patients. In most of the women 138 (72.3%) bilateral tubal ligation was performed during caesarean section, while few women 16 (8.4%) had the procedure at laparotomy. The rest, 37(19.4%) women opted for interval BTL. Significantly more literate women (73%) sought for interval tubal ligation compared to non literate (23%) ones. A large number of the Muslims (87.5%) had BTL at laparotomy compared to the Christians (12.5%). P=0.002.Conclusion: The prevalence of bilateral tubal ligation in this study is low. There is need to encourage the uptake of female sterilization in our environment

Picobirnavirus (PBV) natural hosts in captivity and virus excretion pattern in infected animals.

A picobirnavirus (PBV) analysis was carried out by polyacrylamide gel electrophoresis of 513 stool samples obtained from 150 animal species collected from the Córdoba city zoo. The purpose of the present study was to determine susceptible species for PBV infection, the viral excretion pattern in infected animals, and the potential association with PBV diarrheic illness. Our findings suggest that PBVs are widespread in animals and could have a similar excretion behavior to that previously detected in infected humans. No disease association with PBV infection could be demonstrated. Thus, infected animals could be persistently infected asymptomatic carriers and could serve as reservoirs of infection.

Níveis de arsênio total como indicador biológico, na avaliação da qualidade do pescado (Leporinus obtusidens e Pimelodus maculatus) do Lago Guaíba em Porto Alegre RS-Brasil / Total Arsenic levels as a bioindicator in the evaluation of fish quality (Leporinus obtusidens and Pimelodus maculatus) from the Guaiba Lake, Porto Alegre, Rio Grande do Sul State, Brazil

Foram avaliadas, quanto a presença de arsênio, 27 amostras de Leporinus obtusidens (Valenciennes, 1847) "Piava" e 27 de Pimelodus maculatus (Lacèpéde, 1803) "Pintado", capturados no Lago Guaíba, P. Alegre, RS. Os níveis de arsênio total foram determinados por espectrofotometria de absorção atômica com gerador de hidretos. Os níveis encontrados estavam abaixo de 1,0 mg/kg, limite tolerado pela legislação vigente no Brasil para peixes e seus produtos. A média encontrada nas Piavas foi de 0,14 mg/kg e nos Pintados 0,14 mg/kg. Os resultados sugerem mais estudos de monitoramentos em outras espécies de peixes do lago, para que os dados obtidos possam ser utilizados pelas autoridades de preservação ambiental na proteção da saúde humana e qualidade dos alimentos

Isoenzymes of two aminotransferases among Trypanosoma vivax in Nigerian cattle.

During a period of three months, thin-layer starch-gel electrophoresis was used to examine the isoenzymes of alanine and asparate aminotransferases from samples of T. vivax collected from naturally infected Nigerian cattle. Experimentally infected cattle sheep and goats were also studied. Three patterns, termed Sets 1,2 and 3, differed in both enzymes. The stability of the enzyme patterns was generally confirmed in experimental animals. The results are discussed in relation to subspeciation in T. vivax.