Effect of Frequency of Antenatal Care Contacts on Maternal and Fetal Outcome in Low-Risk Pregnancies at Federal Teaching Hospital Gombe, Nigeria.

BACKGROUND: The frequency of antenatal care (ANC) contacts for low-risk pregnancies has been a subject of debate. OBJECTIVE: To determine the effect of frequency of ANC contacts on pregnancy outcomes amongst low-risk pregnancies and the reasons for the low antenatal visits at the Federal Teaching Hospital, Gombe, Nigeria. METHODOLOGY: This was a cross-sectional study of 510 low-risk pregnant women. They were divided into two groups; group I consisted of 255 women that had eight or more ANC contacts with at least five contacts in 3rd trimester, and group II consisted of 255 women that had seven or fewer ANC visits. Socio-demographic characteristics, haemoglobin levels at delivery, mode of delivery, maternal satisfaction, and birth outcomes were compared between the two groups. Reasons for the low antenatal visits were also documented. RESULTS: The prevalence of anemia was higher in group II compared to group I {29.4% versus 18.8% with OR 1.80 (95% CI 1.19-2.72)} while caesarean section rate was higher in group I compared to group II {16.9% versus 9.4% with OR=1.96 (95% CI: 1.11-3.48)}. There was no statistically significant difference in the fetal outcome between the two groups. Women with eight or more ANC contact were more satisfied with the ANC than those with fewer visits (OR=2.20, 95%CI 1.52-6.24). Late booking and facility-based lapses were mainly responsible for the fewer contacts. CONCLUSION: Having eight or more ANC contacts is associated with decreased maternal anaemia, better maternal satisfaction, and increased risk of caesarean delivery compared to women that have fewer ANC contacts.

CONTEXTE: La fréquence des contacts de soins prénatals (CPN) pour les grossesses à faible risque a fait l'objet d'un débat. OBJECTIF: Déterminer l'effet de la fréquence des contacts de soins prénatals sur les résultats de la grossesse parmi les grossesses à faible risque et les raisons pour lesquelles les visites prénatales sont peu nombreuses au Federal Teaching Hospital, Gombe, Nigéria. MÉTHODOLOGIE: Il s'agit d'une étude transversale portant sur 510 femmes enceintes à faible risque. Elles ont été divisées en deux groupes : le groupe I comprenait 255 femmes ayant eu huit contacts ANC ou plus, dont au moins cinq au cours du troisième trimestre, et le groupe II comprenait 255 femmes ayant eu sept visites ANC ou moins. Les caractéristiques sociodémographiques, les taux d'hémoglobine à l'accouchement, le mode d'accouchement, la satisfaction maternelle et les résultats de l'accouchement ont été comparés entre les deux groupes. Les raisons des faibles visites prénatales ont également été documentées. RÉSULTATS: La prévalence de l'anémie était plus élevée dans le groupe II que dans le groupe I {29,4 % contre 18,8 % avec un OR de 1,80 (IC à 95 % : 1,19-2,72)}, tandis que le taux de césarienne était plus élevé dans le groupe I que dans le groupe II {16,9 % contre 9,4 % avec un OR de 1,96 (IC à 95 % : 1,11-3,48)}. Il n'y a pas eu de différence statistiquement significative entre les deux groupes en ce qui concerne l'issue fœtale. Les femmes ayant eu huit contacts ou plus avec la CPN étaient plus satisfaites de la CPN que celles ayant eu moins de visites (OR=2,20, 95%CI 1,52-6,24). La prise de rendezvous tardive et les défaillances au niveau de l'établissement étaient principalement responsables du nombre inférieur de contacts. CONCLUSION: Le fait d'avoir huit contacts CPN ou plus est associé à une diminution de l'anémie maternelle, à une meilleure satisfaction maternelle et à un risque accru d'accouchement par césarienne par rapport aux femmes qui ont moins de contacts CPN. Mots-clés: Anémie, Anténatal, Résultat de l'accouchement, Contacts, Effet, Fréquence, Satisfaction maternelle.

Predictive value of doppler cerebroplacental ratio for adverse perinatal outcomes in postdate pregnancies in Northwestern Nigeria.

Background: Postdate pregnancy is a very common obstetric condition, increasing the risk of perinatal morbidity and mortality from uteroplacental insufficiency. Aim: To determine the predictive values of Doppler cerebroplacental ratio (CPR), that is, the ratio between middle cerebral artery (MCA) and UA pulsatility indices (UA PI), and other potential velocimetric predictors of adverse perinatal outcomes in women with postdated pregnancies. Patients and Methods: A prospective cohort study was conducted on consenting 212 low-risk pregnant women beyond 40 weeks' gestational age. The pulsatility indices of MCA, UA, and CPR as well as non-stress tests (NST) and amniotic fluid index (AFI) were measured and recorded. The women were divided into two groups based on the presence or absence of adverse perinatal outcome defined as: meconium stained liquor, meconium aspiration syndrome, perinatal asphyxia, cesarean section for suspected fetal distress, and perinatal death. Results: : Of the 200 women whose data were available for analysis, 40 (20%) of them had adverse perinatal outcome and 160 (80%) had normal perinatal outcome. The CPR showed statistically significant difference in predicting adverse perinatal outcome (P < 0.001). CPR had a better predictive value than UA-PI and outperformed MCA-PI and NST for adverse perinatal outcomes. The sensitivity, specificity, negative predictive value (NPV), and accuracy of prediction of adverse perinatal outcomes by CPR were 90%, 81.25%, 97.01%, and 83%, respectively. Conclusion: The Doppler CPR shows the highest diagnostic accuracy in prediction of adverse perinatal outcome in pregnant women after 40 weeks' gestation than UA PI and velocimetric indices when used as stand-alone test.

Predicting COVID-19 Cases From Atmospheric Parameters Using Machine Learning Approach.

The dynamical nature of COVID-19 cases in different parts of the world requires robust mathematical approaches for prediction and forecasting. In this study, we aim to (a) forecast future COVID-19 cases based on past infections, (b) predict current COVID-19 cases using PM2.5, temperature, and humidity data, using four different machine learning classifiers (Decision Tree, K-nearest neighbor, Support Vector Machine, and Random Forest). Based on RMSE values, k-nearest neighbor and support vector machine algorithms were found to be the best for predicting future incidences of COVID-19 based on past histories. From the RMSE values obtained, temperature was found to be the best predictor for number of COVID-19 cases, followed by relative humidity. Decision tree models was found to perform poorly in the prediction of COVID-19 cases considering particulate matter and atmospheric parameters as predictors. Our results suggests the possibility of predicting virus infection using machine learning. This will guide policy makers in proactive monitoring and control.

Multifractal analysis of air and soil temperatures.

Air and soil temperatures are important agrometeorological variables with several applications. Understanding the complex behavior of air and soil temperatures, as well as their interaction, will help in agricultural planning. Multifractal detrended fluctuation and multifractal cross-correlation analysis of air and soil temperatures were carried out in three locations (Akure, Abuja, and Bauchi) within a tropical country, Nigeria. Monthly and annual air and soil temperatures measured at 5 min intervals for a period of 1 year were obtained and analyzed for multifractality. There is evidence of seasonal dependence in the multifractal behavior of monthly soil temperature. Monthly temperatures (air and soil) were found to have higher degrees of multifractality than annual temperatures. Furthermore, latitudinal dependence was observed in the multifractal behavior of air and soil temperatures. The cross-correlation between air and soil temperatures also shows multifractality with persistence at the monthly scale and anti-persistence at the annual scale. This work has shed light on the complex relationship between air and soil temperatures, and the results will be useful in modeling the two variables.

Insulin-induced oxidative stress in the brain is nitric oxide-dependent.

Insulin is known to increase brain nitric oxide (NO) level and to cause oxidative stress but the relationship between these phenomena has not been well elucidated. This study aimed to examine the role of NO in the insulin-NO-oxidative stress axis in the brain. Mice were grouped into four (n = 5) and treated for seven days with 0.2 ml deionized water (control); 10 I.U./kg insulin; 10 I.U./kg insulin + 50 mg/kg L-NAME; and 50 mg/kg L-NAME. The mice were anaesthesized using ketamine + xylazine and sacrificed at the end of the study. Forebrain was immediately harvested from which brain homogenates were prepared in order to determine NO and malondialdehyde (MDA) concentrations as well as glutathione peroxidase (GPx) activity using commercially available kits. Data were processed using IBM SPSS Statistics 20.0. Nitric oxide values were higher in the insulin group (p < 0.05) but not in the insulin+L-NAME (p > 0.05) group when compared with the control. Values of MDA in the insulin and insulin+L-NAME groups were higher (p < 0.05) and the same (p > 0.05), respectively, than those in the control group. The activity of GPx in the insulin group was lower (p < 0.05) than, but that of the insulin+L-NAME was the same (p > 0.05) as in the control group. Insulin increased NO concentration and oxidative stress as indicated by increased MDA concentration and decreased GPx activity in the treated mice. This insulin effect was reversed by L-NAME (a non-specific NO inhibitor). These data suggest that insulin increased oxidative stress in the brain through an NO-dependent process. Insulin treatment may be harmful to the brain.

Antioxidant vitamin levels among preschool children with uncomplicated Plasmodium falciparum malaria in Sokoto, Nigeria.

OBJECTIVE: To assess antioxidant vitamin levels among preschool children with plasmodium malarial infection. METHODS: We assessed antioxidant vitamin levels by using a standard procedure in 130 malaria-parasitized preschool children. Packed cell volume and parasite density were also evaluated. Forty healthy age- and gender-matched nonparasitized children were included as controls. RESULTS: Plasmodium falciparum was the causative species in all subjects. The mean malaria parasitemia was 4529.45 ± 1237.5/µL. The mean antioxidant concentrations for vitamins A, C, and E among plasmodium-parasitized subjects were 33.15 ± 1.79 µg/dL, 0.51 ± 0.02 mg/dL, and 0.61 ± 0.02 mg/dL, respectively. The mean concentrations of vitamins A, C, and E among the non-malaria-parasitized controls were 69.72 ± 1.71 µg/dL, 1.25 ± 0.04 mg/dL, and 1.31 ± 0.04 mg/dL respectively. We observed that the mean antioxidant concentrations of vitamins A, C, and E were significantly lower among plasmodium-parasitized subjects compared with non-parasitized controls (P = 0.01). Malaria parasitemia correlated negatively with antioxidant concentrations and packed cell volume (r = -0.736 and -0.723, P = 0.001). We observed that the higher the level of parasitemia, the lower the antioxidant concentration. CONCLUSION: Our study has shown that the antioxidant levels in plasmodium-parasitized children in the North-West of Nigeria are low and that the more severe the malarial infection, the lower the antioxidant level and the packed cell volume. One key strategic intervention is the provision of early diagnosis and prompt effective treatment. We recommend that malaria-parasitized children, particularly those in the North-West of Nigeria, be placed routinely on antioxidant vitamins to manage the micronutrient deficiencies seen in these children. There is also the need for the promotion of insecticide-treated bed nets, intermittent preventive treatment, and effective case management of malarial illness among children.

Tuberculosis of the testis: a case report.

A 45-year-old man visited our clinic with a painless swelling of the left scrotum and an ulcer as chief complaints. A hard and indurated mass was palpable with ulcerating foci that were proximal and distal, measuring 3 × 2 cm and 2 × 1 cm respectively and about 2 cm apart. Laboratory data were normal except for an elevated erythrocyte sedimentation rate (ESR), and white blood cell (WBC) differential showed neutropenia and lymphocytosis. A diagnosis of left testicular tumor was made and the patient had a left orchidectomy with fistulectomy. Histopathology results showed a stratified squamous epithelium with tuberculous granuloma and necrotic caseation. Patient is currently on anti-tubercular medication. The rarity of this condition makes these findings important to report.