Female genital schistosomiasis mimicking an ovarian neoplasm: A case report.

OBJECTIVE: A case description of a rare occurrence of female genital schistosomiasis affecting the upper genital tract that presented with features mimicking an ovarian neoplasm. CASE REPORT: Female genital schistosomiasis is a neglected clinical manifestation of the water-born parasitic disease which occurs due to the presence of schistosome eggs in the genitalia of women. A 23-year-old nulliparous woman presented with progressive abdominal distension. An abdominopelvic CT scan revealed a multilobulated right adnexal mass with gross ascites. Diagnosis of schistosomiasis was made by histology of biopsied specimens following laparotomy. Cervical colposcopic findings were consistent with female genital schistosomiasis. She was successfully treated with praziquantel. CONCLUSION: Female genital schistosomiasis of the upper genital tract can mimic an ovarian malignancy. Hence there is a need for its consideration as a differential diagnosis in patients with non-classical presentations of pelvic tumours in schistosomiasis-endemic areas.

An intervention study investigating the effectiveness of contextualizing multimodal strategy on improving hand hygiene at a tertiary hospital in Nigeria.

BACKGROUND: Hand hygiene (HH) is a proven low-cost means to curtail the problem of hospital-acquired infection (HAI). However, a low HH compliance rate of 17.1% was found among surgical health workers at Ahmadu Bello University Teaching Hospital (ABUTH) in Zaria, Nigeria. METHODS: This was an intervention study conducted utilizing mixed methods to investigate the effectiveness of the World Health Organization (WHO) multimodal strategy to improve the HH compliance rate of doctors at ABUTH Zaria. The study was conducted between June and August 2022 and included delivering a behavioural change HH workshop to doctors followed by data collection in the surgical wards that had received environmental modification through the provision of an alcohol-based hand rub (ABHR), HH posters and nurses for visual and/or verbal reminders. RESULTS: The cumulative HH compliance rate was 69% (n=1774) and was significantly different from the baseline HH compliance rate of 17.1% (confidence interval 45.5 to 57.7, p<0.001). Observed HH was highest in the ward with both visual and verbal reminders (78%) and lowest (59%) where neither visual nor verbal reminders were provided (n=444 per ward). All respondents reported motivation to perform HH with the presence of ABHR. CONCLUSIONS: The WHO multimodal strategy is good for enhancing HH among health workers in the context of low- and middle-income countries. More research is needed to understand how much of a reduction in HAI is directly associated with efficient HH by health workers.

Antimicrobial susceptibility pattern of extended-spectrum beta-lactamase-producing uropathogens in aminu Kano teaching hospital, Northwestern Nigeria.

Background: UTI is the most common nosocomial infection among hospitalized patients. Emerging increasing resistance has been observed among uropathogens of the family enterobacterales. Extended spectrum beta lactamase genes encode for multidrug resistance and unrestricted use of antibiotics in hospitals provides an environment for spread of infections with limited treatment options. This necessitates therapies based on culture and antimicrobial sensitivity to improve patients' outcomes We aimed to determine susceptibility pattern of ESBL uropathogens among hospitalized patients in Aminu Kano Teaching Hospital, Kano. Methodology: Three hundred and eighty-nine urine samples were obtained from in-patients with UTI between April 2020 and April 2021. Five samples were rejected and remaining analyzed. Susceptibility testing was done by modified Kirby Bauer technique. Clinical Laboratory Standards Institute guidelines 2019 (CLSI 2019) and the European Committee on Antimicrobial Susceptibility testing guidelines version 2 (EUCAST version 2) were used for screening and confirmation of ESBL production respectively. Results: Of the 384-urine processed, 105 (27.3%) were gram negatives and 81 were Enterobacterales, Isolation rates were E. coli-55.6%, K. pneumoniae-29.6%, Citrobacter spp.-12.3%, P. mirabilis-1.2% and Morganella spp.-1.2%. Among Enterobacterales, 32 (39.5%) were ESBL producers. Prevalence of ESBL were 62.5% for Escherichia coli, 28.1% for Klebsiella pneumoniae and 9.4% for Citrobacter species. Susceptibility showed that ESBL-producing Isolates were highly susceptible to amikacin (96.9%). Resistance to other antibiotics varied from 3.1% to 100%. Conclusion: We recommend strengthening laboratory capacity, antibiotics stewardship and Infection control to prevent spread of resistant pathogens including ESBLs.

Résumé L'infection urinaire est l'infection nosocomiale la plus fréquente chez les patients hospitalisés. L'émergence d'une résistance croissante a été observée parmi les uropathogènes de la famille des entérobactéries. Les gènes de bêta-lactamase à spectre étendu codent pour la multirésistance et l'utilisation sans restriction d'antibiotiques dans les hôpitaux crée un environnement propice à la propagation des infections avec des options de traitement limitées. Nous avons cherché à déterminer le profil de sensibilité des uropathogènes BLSE chez les patients hospitalisés à l'hôpital universitaire Aminu Kano, à Kano. Méthodologie: Trois cent quatre-vingt-neuf échantillons d'urine ont été obtenus auprès de patients hospitalisés souffrant d'infections urinaires entre avril 2020 et avril 2021. Cinq échantillons ont été rejetés et les autres analysés. Les tests de sensibilité ont été effectués à l'aide de la technique Kirby Bauer modifiée. Les directives 2019 du Clinical Laboratory Standards Institute (CLSI 2019) et les directives de l'European Committee on Antimicrobial Susceptibility testing version 2 (EUCAST version 2) ont été utilisées respectivement pour le dépistage et la confirmation de la production de BLSE. Résultats: Sur les 384 urines traitées, 105 (27,3 %) étaient à Gram négatif et 81 étaient des Enterobacterales, les taux d'isolement étaient de 55,6 % pour E. coli, 29,6 % pour K. pneumoniae, 12,3 % pour Citrobacter spp, 1,2 % pour P. mirabilis et 1,2 % pour Morganella spp. Parmi les entérobactéries, 32 (39,5 %) étaient productrices de BLSE. La prévalence des BLSE était de 62,5 % pour Escherichia coli, de 28,1 % pour Klebsiella pneumoniae et de 9,4 % pour les espèces de Citrobacter. La sensibilité a montré que les isolats producteurs de BLSE étaient très sensibles à l'amikacine (96,9 %). La résistance aux autres antibiotiques variait de 3,1 % à 100 %. Conclusion: Nous recommandons de renforcer les capacités des laboratoires, la gestion des antibiotiques et le contrôle des infections afin de prévenir la propagation de pathogènes résistants, y compris les BLSE. Mots-clés: Hôpital universitaire Aminu Kano, sensibilité aux antimicrobiens, bêta-lactamase à spectre étendu, Kano, uropathogènes.

Exploring Potential Determinants of Mosquito Net Ownership and Use in Somalia: A Cross-Sectional Study.

In Somalia, malaria remains a major public health threat. Understanding what influences the ownership and use of mosquito nets is of vital importance to accelerate malaria prevention efforts in the country. To explore the potential determinants of mosquito net ownership and use, this study conducted a secondary data analysis of the Somalia Micronutrient Survey 2019. Survey participants were identified through the multi-stage stratified cluster sampling, and logistic regression was performed for bivariate and multivariate analysis. The results suggested that household head's age, educational attainment, household size, employment status of household members, socioeconomic status, geographic regions and type of residence are significantly associated with mosquito net ownership (p < 0.05). The analysis also highlighted household head's age as an influential factor to mosquito net use. By further exploring and understanding the psychosocial determinants of mosquito net ownership and use, malaria prevention interventions can be made more effective in Somalia.

An Assessment of Ovarian Cancer Histotypes Across the African Diaspora.

OBJECTIVE: Ovarian cancer in Black women is common in many West African countries but is relatively rare in North America. Black women have worse survival outcomes when compared to White women. Ovarian cancer histotype, diagnosis, and age at presentation are known prognostic factors for outcome. We sought to conduct a preliminary comparative assessment of these factors across the African diaspora. METHODS: Patients diagnosed with ovarian cancer (all histologies) between June 2016-December 2019 in Departments of Pathology at 25 participating sites in Nigeria were identified. Comparative population-based data, inclusive of Caribbean-born Blacks (CBB) and US-born Blacks (USB), were additionally captured from the International Agency for Research on Cancer and Florida Cancer Data Systems. Histology, country of birth, and age at diagnosis data were collected and evaluated across the three subgroups: USB, CBB and Nigerians. Statistical analyses were done using chi-square and student's t-test with significance set at p<0.05. RESULTS: Nigerians had the highest proportion of germ cell tumor (GCT, 11.5%) and sex-cord stromal (SCST, 16.2%) ovarian cancers relative to CBB and USB (p=0.001). CBB (79.4%) and USB (77.3%) women were diagnosed with a larger proportion of serous ovarian cancer than Nigerians (60.4%) (p<0.0001). Nigerians were diagnosed with epithelial ovarian cancers at the youngest age (51.7± 12.8 years) relative to USB (58.9 ± 15.0) and CBB (59.0± 13.0,p<0.001). Black women [CBB (25.2 ± 15.0), Nigerians (29.5 ± 15.1), and USB (33.9 ± 17.9)] were diagnosed with GCT younger than White women (35.4 ± 20.5, p=0.011). Black women [Nigerians (47.5 ± 15.9), USB (50.9 ± 18.3) and CBB (50.9 ± 18.3)] were also diagnosed with SCST younger than White women (55.6 ± 16.5, p<0.01). CONCLUSION: There is significant variation in age of diagnosis and distribution of ovarian cancer histotype/diagnosis across the African diaspora. The etiology of these findings requires further investigation.

Effectiveness of preoperative tranexamic acid in reducing blood loss during caesarean section at Aminu Kano Teaching Hospital, Kano: a randomized controlled trial.

INTRODUCTION: bleeding during and after caesarean section is one of the contributors to maternal mortality and morbidity. Tranexamic acid can be given before surgery to significantly reduce the amount of blood loss during caesarean section. The objective was to evaluate the effectiveness of preoperative tranexamic acid in reducing blood loss during caesarean section at Aminu Kano Teaching Hospital, Kano. METHODS: this was a randomized double blind placebo controlled study that was carried out among 244 women who were to have emergency caesarean section between December 2017 and June 2018 and were randomly assigned to the study group or control group. Women in the study group received lg (10mls) of tranexamic acid intravenously while women in the control group received 10ml of normal saline. Oxytocin was administered in the two groups according to protocol. Measurement of blood loss was done immediately after surgery. Postoperative drop in haemoglobin and haematocrit were also determined. Statistical analysis was done using SPSS Version 22. RESULTS: the average intra operative blood loss was 414.0 ml in the study group and 773.8 ml in the control group (t = - 16.18, p ≤ 0.01). Average postoperative haemoglobin was 10.1 g/dl in the study group and 9.5 g/dl in the control group (t = 4.99, p ≤ 0.01). Average postoperative haematocrit was 31.5% in the study group and 29.9% in the control group (t = 4.70, p ≤ 0.01). CONCLUSION: there was a significant reduction in the blood loss when preoperative tranexamic acid was given to patients who were to undergo emergency caesarean section.

Optimization and Characterization of Mesoporous Sulfonated Carbon Catalyst and Its Application in Modeling and Optimization of Acetin Production.

In this study, an optimized mesoporous sulfonated carbon (OMSC) catalyst derived from palm kernel shell biomass was developed using template carbonization and subsequent sulfonation under different temperatures and time conditions. The OMSC catalyst was characterized using acid-base titration, elemental analysis, XRD, Raman, FTIR, XPS, TPD-NH3, TGA-DTA, SEM, and N2 adsorption-desorption analysis to reveal its properties. Results proved that the OMSC catalyst is mesoporous and amorphous in structure with improved textural, acidic, and thermal properties. Both FTIR and XPS confirmed the presence of -SO3H, -OH, and -COOH functional groups on the surface of the catalyst. The OMSC catalyst was found to be efficient in catalyzing glycerol conversion to acetin via an acetylation reaction with acetic acid within a short period of 3 h. Response surface methodology (RSM), based on a two-level, three-factor, face-centered central composite design, was used to optimize the reaction conditions. The results showed that the optimized temperature, glycerol-to-acetic acid mole ratio, and catalyst load were 126 °C, 1:10.4, and 0.45 g, respectively. Under these optimum conditions, 97% glycerol conversion (GC) and selectivities of 4.9, 27.8, and 66.5% monoacetin (MA), diacetin (DA), and triacetin (TA), respectively, were achieved and found to be close to the predicted values. Statistical analysis showed that the regression model, as well as the model terms, were significant with the predicted R2 in reasonable agreement with the adjusted R2 (<0.2). The OMSC catalyst maintained excellent performance in GC for the five reaction cycles. The selectivity to TA, the most valuable product, was not stable until the fourth cycle, attributable to the leaching of the acid sites.

Malaysian propolis and metformin mitigate subfertility in streptozotocin-induced diabetic male rats by targeting steroidogenesis, testicular lactate transport, spermatogenesis and mating behaviour.

BACKGROUND: Diabetes mellitus is one of the risk factors for male subfertility/infertility. Malaysian propolis is reported to decrease hyperglycaemia in diabetic state. OBJECTIVES: The present study investigated the protective effect of Malaysian propolis on diabetes-induced subfertility/infertility. Additionally, its combined beneficial effects with metformin were investigated. MATERIALS AND METHODS: Forty adult male Sprague Dawley rats were randomly assigned into five groups, namely normal control, diabetic control, diabetic + Malaysian propolis (300 mg/k.g. b.w.), diabetic + metformin (300 mg/kg b.w.) and diabetic + Malaysian propolis + metformin. Diabetes was induced using a single intraperitoneal injection of streptozotocin (60 mg/kg b.w.) and treatment lasted for 4 weeks. During the 4th week, mating behavioural experiments were performed using sexually receptive female rats. Thereafter, fertility parameters were assessed in the female rats. RESULTS: Malaysian propolis increased serum and intratesticular free testosterone levels, up-regulated the mRNA levels of AR and luteinizing hormone receptor, up-regulated the mRNA and protein levels of StAR, CYP11A1, CYP17A1, 3ß-HSD and 17ß-HSD in the testes of diabetic rats. Furthermore, Malaysian propolis up-regulated testicular MCT2, MCT4 and lactate dehydrogenase type C mRNA levels, in addition to improving sperm parameters (count, motility, viability and normal morphology) and decreasing sperm nDNA fragmentation in diabetic rats. Malaysian propolis improved mating behaviour by increasing penile guanosine monophosphate levels. Malaysian propolis also improved fertility outcome as seen with decreases in pre- and post-implantation losses, increases in gravid uterine weight, litter size per dam and foetal weight. Malaysian propolis's effects were comparable to metformin. However, their combination yielded better results relative to the monotherapeutic interventions. CONCLUSION: Malaysian propolis improves fertility potential in diabetic state by targeting steroidogenesis, testicular lactate metabolism, spermatogenesis and mating behaviour, with better effects when co-administered with metformin. Therefore, Malaysian propolis shows a promising complementary effect with metformin in mitigating Diabetes mellitus-induced subfertility/infertility.

Delays in accessing antenatal care services in a developing nation tertiary health center

Background: Delay in seeking medical care is common and constitutes a major unresolved public health problem. It could contribute immensely to maternal mortality, especially in developing countries, where access and availability of functional health­care facility have remained a challenge. Objective: This study aimed at identifying the forms of delays encountered by pregnant women seeking antenatal care (ANC) services and also factors responsible for such delays. Materials and Methods: This was a cross­sectional study among women attending antenatal care clinic of our hospital. Data were obtained through an interviewer­administered questionnaire and were analyzed by the Statistical Package for the Social Sciences version 17. Results: The mean age of the respondents was 28.6 (standard deviation [SD] ± 5.44) years. About a third (31.5%) experienced Type II delays due to inaccessibility to the mode of transportation and traffic deadlock; while majority (77.1%) experienced intrahospital delays due to delay in retrieving cases notes, seeing an obstetrician, inadequate health personnel, and consulting rooms. The average waiting time was 3.1 ± 0.91 SD hours (188 min). The waiting time was not statistically associated with time of arrival to the clinic. Conclusion: Most women experience intrahospital delays while seeking ANC. Intervention by policymakers and adequate staffing coupled with provision of necessary health­care amenities will go a long way in reducing patients waiting time

Investigation of construction wastes generated in the Malaysian residential sector.

The construction sector is among the fastest growing sectors in Malaysia; it consumes a vast amount of natural resources and produces a massive volume of construction and demolition waste. The waste is collected in a decentralised manner by sub-contracted companies. It is challenging to obtain reliable information on the amount of construction waste generated, because it is hard to determine its exact quantity and composition. Therefore, this study proposes a quantitative construction waste estimation model for residential buildings according to available data collected from the Construction Industry Development Board, Malaysia. In the development of this model, a theoretical investigation of the construction procedure and the construction waste generation process was conducted. The waste generated rate was determined as 25.79 kg m-2 for new residential constructions, which translates into about 553,406 t of anticipated waste annually.