A comparative study on the occurrence, genetic characteristics, and factors associated with the distribution of Listeria species on cattle farms and beef abattoirs in Gauteng Province, South Africa.

These cross-sectional studies reported the occurrence, genetic characteristics, and factors associated with the distribution of Listeria species on cattle farms and beef abattoirs in Gauteng Province, South Africa. A total of 328 samples (faeces, feeds, silage, and drinking water) were collected from 23 cattle farms (communal, cow-calf, and feedlot), and 262 samples (faeces, carcass swabs, and effluents) from 8 beef abattoirs (low throughput and high throughput) were processed using standard bacteriological and molecular methods to detect Listeria species. The factors associated with the prevalence of Listeria species were investigated, and multiplex polymerase chain reaction (mPCR) was used to determine Listeria species, the pathogenic serogroups, and the carriage of eight virulence-associated genes by Listeria monocytogenes. The overall prevalence of Listeria species in cattle farms was 14.6%, comprising Listeria innocua (11.3%), Listeria monocytogenes (3.4%), Listeria welshimeri (0.0%) compared with 11.1%, comprising Listeria innocua (5.7%), Listeria monocytogenes (4.6%), Listeria welshimeri (0.8%) for beef abattoirs. Of the three variables (area, type of farm/abattoir, and sample type) investigated, only the sample types at abattoirs had a significant (P < 0.001) effect on the prevalence of L. innocua and L. welshimeri. The frequency of distribution of the serogroups based on 11 L. monocytogenes isolated from farms was 72.7% and 27.3% for the serogroup 1/2a-3a and 4b-4d-4e, respectively, while for the 12 L. monocytogenes isolates recovered from abattoirs, it was 25%, 8.3%, 50% and 16.7% for the serogroup 1/2a-3a, 1/2b-3b, 1/2c-3c, and 4b-4d-4e respectively (P < 0.05). All (100%) isolates of L. monocytogenes from the farms and abattoirs were positive for seven virulence genes (hlyA, inlB, plcA, iap, inlA, inlC, and inlJ). The clinical and food safety significance of the findings cannot be ignored.

THYROID DYSFUNCTION IN WOMEN OF REPRODUCTIVE AGE: LABORATORY PROTOCOL FOR INFERTILITY EVALUATION.

Background: Infertility in developing counties worldwide is associated with many social, financial, and medical challenges. With a prevalence rate of between 10 - 14 % and biochemical etiology of about 80% of the cases among Nigerian women, laboratory diagnosis has gradually assumed an important role in improved diagnosis. Objective: The aim was to evaluate the prevalence of thyroid dysfunction in infertility and need to evaluate. Methods: This was a descriptive cross-sectional case study of one hundred and twenty-five (125) women selected by stratified random sampling method into two groups of primary and secondary infertility. A total of 125 healthy fertile women served as the control group. Serum freeT3 (fT3), feeT4 (fT4), and TSH were analyzed using commercial ELISA kits. Data were analyzed using SPSS version 20.0 and the p-value of ≤0.05 was considered statistically significant. Results: Twenty participants (16%) were observed to have associated thyroid dysfunction with infertility. The commonest thyroid dysfunction was overt hypothyroidism (9.6%) and subclinical hypothyroidism (4.0%) respectively and this was found to be commoner in secondary infertility (21.8%). Conclusion: Thyroid function evaluation (especially serum TSH) should be included as a routine assessment in infertility protocol, especially in secondary infertility cases.

Seroepidemiology of Leptospira infection in slaughtered cattle in Gauteng province, South Africa.

Leptospirosis is an important economical disease of livestock globally, especially in Asia, the Caribbean, and the African continent. Its presence has been reported in a wide range of livestock. However, information on leptospirosis in South Africa is scanty. We conducted a cross-sectional study in 11 randomly selected abattoirs to determine the seroprevalence and risk factors for leptospirosis in slaughtered cattle in Gauteng province, South Africa. During abattoir visits to selected abattoirs, blood samples were collected from 199 cattle and demographic data obtained on the slaughtered animals. The microscopic agglutination test (MAT) was performed on all sera using a 26-serotype panel using cutoff titer ≥ 1:100. Animal- and abattoir-level risk factors were investigated for their association with seropositivity for leptospirosis. The seroprevalence of leptospirosis in the cattle sampled was 27.6% (55/199). The predominant serogroups detected in seropositive cattle were Sejroe (sv. Hardjo) (38.2%) and Mini sv. Szwajizak) (14.5%) but low to Canicola (sv. Canicola) (1.8%) and Pomona (sv. Pomona) (1.8%). The differences were statistically significant (P < 0.05). Of the five variables investigated, only one (abattoirs) had statistically significantly (P < 0.001) differences in the seroprevalence of leptospirosis among abattoirs. The study documented for the first time in South Africa, the occurrence of serogroups Sejroe (Hardjo bovis strain lely 607), Tarassovi, Hebdomadis, and Medanensis in slaughtered cattle. It was concluded that six of the nine serovars (representing seven serogroups) of Leptospira spp. circulating in cattle population in South Africa are not vaccine serogroups. The clinical, diagnostic, and public health importance of the findings cannot be ignored.

Treatment of colorectal cancer in Sub-Saharan Africa: Results from a prospective Nigerian hospital registry.

BACKGROUND: Colorectal cancer (CRC) is the third most common cancer worldwide. Mortality for CRC is improving in high income countries, but in low and middle income countries, rates of disease and death from disease are rising. In Sub-Saharan Africa, the ratio of CRC mortality to incidence is the highest in the world. This study investigated the nature of CRC treatment currently being offered and received in Nigeria. METHODS: Between April 2013 and October 2017, a prospective study of consecutively diagnosed cases of CRC was conducted. Patient demographics, clinical features, and treatment recommended and received was recorded for each case. Patients were followed during the study period every 3 months or until death. RESULTS: Three hundred patients were included in our analysis. Seventy-one percent of patients received a recommended surgical operation. Of those that didn't undergo surgery as recommended, 37% cited cost as the main reason, 30% declined due to personal reasons, and less than 5% absconded or were lost to follow up. Approximately half of patients (50.5%) received a chemotherapy regimen when it was recommended, and 4.1% received radiotherapy when this was advised as optimal treatment. With therapy, the median overall survival for patients diagnosed with stage III and stage IV CRC was 24 and 10.5 months respectively. Overall, we found significantly better median survival for patients that received the recommended treatment (25 vs 7 months; P < .01). CONCLUSIONS: A number of patients were unable to receive the recommended treatment, reflecting some of the burden of untreated CRC in the region. Receiving the recommended treatment was associated with a significant difference in outcome. Improved healthcare financing, literacy, training, access, and a better understanding of tumor biology will be necessary to address this discrepancy.

Prevalence of Methicillin Resistant Staphylococcus aureus(MRSA) in pigs and workers at abattoirs in Trinidad and Tobago

Introduction: Methicillin resistant Staphylococcus aureus (MRSA), a major cause of zoonotic infections, has emerged globally in livestock, particularly pigs. People with occupational contact with food producing animals are at high risk of colonization. The aim of this study was to determine the prevalence of MRSA in pigs and abattoir workers throughout Trinidad and Tobago as well as their resistance to other antimicrobial agents. Methodology: Nasal and skin behind the ear swabs from pigs and nasal swabs from humans were enriched in Mueller Hinton broth with 6.5% sodium chloride, followed by phenol red mannitol broth with 75 mg/L aztreonam and 5 mg/L ceftizoxime. The enriched sample was then plated on both CHROMagar MRSA and Brilliance MRSA. All incubation was at 37ºC for approximately 24 h. Suspect MRSA isolates were confirmed as MRSA using the Penicillin-Binding Protein (PBP2a) test kit and polymerase chain reaction (PCR) to detect the mecA gene. Resistance of the S. aureus and MRSA isolates to 16 antimicrobial agents was determined using the disc diffusion method. Results: Of the 929 pigs and 44 humans sampled, MRSA strains were isolated at a frequency of 0.9% (8/929) and 2.3% (1/44) respectively. All isolates exhibited resistance to one or more of the 16 antimicrobial agents. Conclusions: The study demonstrated that pigs and workers at slaughter houses in Trinidad and Tobago harbour multidrug resistance S. aureus and MRSA. This is of public health significance as occupational exposure of humans can lead to an increased risk of infection and therapeutic failure.

Molecular analysis of Salmonella isolates from poultry by pulsed-field gel electrophoresis

Objective: The study was conducted to determine geneticrelatedness of Salmonella serotypes by pulsed field gel electrophoresis (PFGE). Design and Methodology: A total of 1503 caecal samples of freshly slaughtered poultry were randomly collected from 'pluck shops' across the country. The samples were screened for Salmonella by biochemical, serological and molecular methods. The Salmonella serotypes were analyzed for genetic relatedness for phenotypic antimicrobial resistance, resistance and virulence gene profiles by PFGE generated by digestion with XbaI. Results: Ten different serotypes were detected from all 91 Salmonella isolates. PFGE fingerprinting profiles showed that the Salmonella serotypes in general, were genetically diverse with the detection of a total of 20 PFGE groups. The antibiograms of the isolates were also clearly very variable, which suggest that genotypic antimicrobial resistance may not relate to the phenotypic antibiograms in dendrograms, except for qnrB gene. Results demonstrated a varied spectrum of antimicrobial resistance and PFGE patterns among Salmonella isolates and signify the importance of sustained surveillance of foodborne pathogens in retail poultry pluck shops. Conclusions: The findings provide evidence that poultry from pluck shops are colonized by pathogenic Salmonella harboring antimicrobial resistance genes. The study also reported for the first time in Trinidad, molecular characterization of Salmonella isolates from poultry regarding the relatedness of antibiograms, possession of resistance and virulence genes using their PFGE profiles. The epidemiological surveillance of these serotypes would be necessary to evaluate their possible impact on human health in the country and possibly in the Caribbean region.

Prevalence of Salmonella species in broilers during slaughtering by processing plants in Trinidad using three isolation methods

Objective: To determine the prevalence of Salmonella species during slaughtering and dressing of broiler chickens at four poultry processing plants in Trinidad using three isolation methods. Design and Methodology: In this cross-sectional study, a total of 396 samples were collected from all four commercial poultry processing plants in Trinidad. Samples collected comprised swabs of cloacae pre-slaughter, pre evisceration and post evisceration carcasses; immersion chiller water, neck skins, whole carcasses and chicken parts (final product). Isolation and identification of Salmonella spp. were performed using standard bacteriological techniques (whole carcass enrichment, whole carcass rinse and neck skin methods). Results: The overall prevalence of Salmonella spp. was 27.5% (109/396). The prevalence of Salmonella spp. was 2.2% (2/90), 55.6% (25/45), 37.8% (17/45), 27.8% (25/90), 5.6% (2/36), 44.4% (20/45) and 40.0% (18/45) for cloacal swabs, preevisceration carcasses, post evisceration carcass swabs, neck skins, immersion chiller water, whole carcass and chicken parts respectively (p<0.001). Salmonella was isolated from 52.3% (46/88), 19.3% (34/176), 11.4% (5/44) and 27.3% (24/88) of the samples from Plant A, B, C and D respectively (p<0.001). Overall, Salmonella was detected in 27.2% (49/180), 27.8% (25/90) and 39.4% (71/180) carcasses by whole carcass rinse, neck skin method and whole carcass enrichment method respectively (p= 0.028). Conclusion: Data from the study indicate the extent of contamination by Salmonella spp. throughout the various stages of broiler processing at the four plants studied and, of significance is the risk of salmonellosis posed to consumers of contaminated, undercooked chicken sold to retail outlets by these processing plants in the country.

Cytokines changes in beagle dogs vaccinated and challenged with virulent Leptospira strains

Objective: To determine the immune response of dogs by measuring the levels of cytokines tumour necrosis factor (TNF) α, interleukin (IL)-4 and interferon (IFN) γ pre- and post-vaccination with a locally produced killed whole-celled Leptospira vaccine. Design and Methodology: Three separate vaccine-challenge experiments involving 21 beagle dogs were conducted. Study 1 (duration of immunity), used 6 vaccinated and 3 non-vaccinated (control) dogs. Vaccination was done at 12 and 16 weeks of age and challenged at 12 months of age with 1-2.5 x 108 live Leptospira. Study 2 (onset of immunity) also contained the same number of dogs as study 1. Vaccination was done at 12 and 16 weeks of age and challenged at 18 weeks of age. Study 3 (onset of immunity study), as study 2, used 4 vaccinated and two control dogs but challenged with 1-2.5 X 109 live Leptospira. Blood samples were collected to measure the levels of TNF α, IL-4 and IFN γ in dogs 2 days pre-challenge and daily thereafter until day 7 post-challenge. Results: For cytokine TNF α, pre-challenge levels for Study 1, 2 and 3 were 0.0000, 0.0755 and 0.0705 pg/ml which increased to a maximum post-challenge level of 49.05 pg/ml, 0.47 pg/ml and 1.667pg/ml respectively. For cytokine IL-4 and IFN γ the level increased from 0.00 pg/ml to a maximum post-challenge level of 52.67 pg/ml, 243.34 pg/ml and 989.14 pg/ml; and 281.91 pg/ml, 1223.85 pg/ ml and 1778.95 pg/ml respectively. Conclusion: The locally produced Leptospira vaccine induced immune response post-challenge with live Leptospira.

Prevention of severe clinical signs and pathological lesions of leptospirosis in experimentally challenged dogs

Objective: To prevent severe clinical and pathological findings of leptospirosis in dogs vaccinated against L. interrogans serovar Copenhageni. Design and Methodology: Two vaccination-challenge experiments involving 22 dogs were performed using a vaccine prepared from formalin-killed cultures of L. interrogans serovar Copenhageni. The dogs were challenged by administering a suspension of 1 x 109 of a virulent strain of serovar Copenhageni (8 mL) at 2 weeks (Study 1: Onset of immunity) and 14 months (Study 2: Duration of immunity) after primary and secondary vaccinations. Each dog was observed for clinical signs of leptospirosis for five weeks post-challenge (PC). Any dog which showed irreversible clinical signs of leptospirosis was humanely euthanized, and a necropsy performed. Results: One (20.0 %) vaccinated puppy in Study 1 showed mild clinical signs (PC) which lasted for one day. Five (100.0 %) non-vaccinated (controls) puppies exhibited irreversible signs of acute severe leptospirosis PC, as well as significant postmortem lesions consistent with leptospiral infection. In Study 2, no clinical signs were exhibited by the vaccinated group of dogs PC, while two (40.0 %) non-vaccinated dogs exhibited mild clinical signs for 2 to 3 days, after which they recovered. Conclusions: The vaccine was successful in protecting vaccinated dogs against acute leptospirosis 2 weeks and 14 months after a vaccination schedule of two doses of the bacterin (primary and booster doses), since all vaccinated dogs were clinically normal after challenge with a virulent inoculum of serovar Copenhageni.

Utilization of surgical antibiotic prophylaxis for obstetrics and gynaecology surgeries in Northern Nigeria.

Background Audit of antibiotic prophylaxis is an important strategy used to identify areas where stewardship interventions are required. Objectives To evaluate compliance with surgical antibiotic prophylaxis in obstetrics and gynaecology surgeries and determine the Defined Daily Dose (DDD) of antibiotic. Settings Three public tertiary hospitals located in Northern Nigeria. Methods This prospective study included women who had obstetrics and gynaecology surgeries with no infection at the time of incision. Appropriateness of antibiotic prophylaxis was determined by a clinical pharmacist. DDD of antibiotics was determined using ATC/DDD index 2017 from the World Health Organization Collaborating Centre for Drugs Statistics Methodology. Main outcome measure Compliance with antibiotic prophylaxis and DDD of antibiotic per procedure. Results A total of 248 procedures were included (mean age: 31.7 ± 7.9 years). Nitroimidazole in combination with either beta-lactam/beta-lactamase inhibitor or third generation cephalosporin were the most prescribed antibiotics. Redundant anaerobic antibiotic combination was detected in 71.4% of the procedures. Timing of antibiotic prophylaxis was optimal in 16.5% while duration of prophylaxis was prolonged in all the procedures (mean duration was 8.7 ± 1.0 days). The DDD of antibiotics prophylaxis was 16.75 DDD/procedure. Antibiotic utilisation was higher in caesarean section and myomectomy (17.9 DDD/procedure) than hysterectomy (14.5 DDD/procedure); P < 0.001. Redundant metronidazole represents one-third of total DDD and 87% of the DDD for metronidazole. Conclusion Excessive and inappropriate use of antibiotic prophylaxis was observed in women who had obstetrics and gynaecology surgeries. These observations underline the need for antimicrobial stewardship interventions to improve antibiotic use.

Serological evidence of widespread exposure of Grenada fruit bats to chikungunya virus.

Antibody detection against selected potentially zoonotic vector-borne alphaviruses and flaviviruses was conducted on sera from bats from all six parishes in Grenada, West Indies. Sera were tested for (i) antibodies to flaviviruses West Nile virus, St. Louis encephalitis virus, Ilhéus virus, Bussuquara virus (BSQV), Rio Bravo virus and all four serotypes of dengue virus (DENV) by plaque reduction neutralization test (PRNT); (ii) antibodies to alphaviruses western equine encephalitis virus, Venezuelan equine encephalitis virus and eastern equine encephalitis virus by epitope-blocking enzyme-linked immunosorbent assay (ELISA); and (iii) antibodies to the alphavirus chikungunya (CHIKV) by PRNT. Two species of fruit bats were sampled, Artibeus jamaicensis and Artibeus lituratus, all roosting in or within 1,000 m of human settlements. Fifteen (36%) of the 42 bats tested for neutralizing antibodies to CHIKV were positive. The CHIKV-seropositive bats lived in localities spanning five of the six parishes. All 43 bats tested for epitope-blocking ELISA antibody to the other alphaviruses were negative, except one positive for Venezuelan equine encephalitis virus. All 50 bats tested for neutralizing antibody to flaviviruses were negative, except one that had a BSQV PRNT80 titre of 20. The CHIKV serology results indicate that bats living close to and within human settlements were exposed to CHIKV in multiple locations. Importantly, bats for this study were trapped a year after the introduction and peak of the human CHIKV epidemic in Grenada. Thus, our data indicate that bats were exposed to CHIKV possibly during a time of marked decline in human cases.

Antimicrobial susceptibility of Leptospira isolates from dogs and rats to 12 antimicrobial agents.

This study determined the antimicrobial susceptibilities of 67 isolates of Leptospira from dogs (suspect canine cases: n=7 and stray dogs: n=6) and rodents (n=54) in Trinidad to 12 antimicrobial agents using broth microdilution and macrodilution techniques. Commonly used antimicrobial agents such as the penicillin G and ceftriaxone had relatively low minimal inhibitory concentrations (MICs) while doxycycline displayed a relatively higher value but was still considered to be effective. While imipenem was the most effective with low MIC values in vitro, sulphamethoxazole-trimethoprim had the highest i.e. least effective. Based on these results, the drugs commonly used in the treatment of leptospirosis (penicillin G, penicillin-streptomycin, doxycycline and ceftriaxone) in both humans and animals in Trinidad appear to have similar MICs and MBCs in vitro when compared with published reports. The serovar of Leptospira spp. and in most cases the origin of the isolates did not significantly (P>0.05) influence their susceptibilities to the antimicrobial agents tested.

Seroepidemiology of selected alphaviruses and flaviviruses in bats in Trinidad.

A serosurvey of antibodies against selected flaviviruses and alphaviruses in 384 bats (representing 10 genera and 14 species) was conducted in the Caribbean island of Trinidad. Sera were analysed using epitope-blocking enzyme-linked immunosorbent assays (ELISAs) specific for antibodies against West Nile virus (WNV), Venezuelan equine encephalitis virus (VEEV) and eastern equine encephalitis virus (EEEV), all of which are zoonotic viruses of public health significance in the region. Overall, the ELISAs resulted in the detection of VEEV-specific antibodies in 11 (2.9%) of 384 bats. Antibodies to WNV and EEEV were not detected in any sera. Of the 384 sera, 308 were also screened using hemagglutination inhibition assay (HIA) for antibodies to the aforementioned viruses as well as St. Louis encephalitis virus (SLEV; which also causes epidemic disease in humans), Rio Bravo virus (RBV), Tamana bat virus (TABV) and western equine encephalitis virus (WEEV). Using this approach, antibodies to TABV and RBV were detected in 47 (15.3%) and 3 (1.0%) bats, respectively. HIA results also suggest the presence of antibodies to an undetermined flavivirus(es) in 8 (2.6%) bats. Seropositivity for TABV was significantly (P<0.05; χ2) associated with bat species, location and feeding preference, and for VEEV with roost type and location. Differences in prevalence rates between urban and rural locations were statistically significant (P<0.05; χ2) for TABV only. None of the aforementioned factors was significantly associated with RBV seropositivity rates.

Antimicrobial susceptibility of Leptospira isolates from dogs and rats to 12 antimicrobial agents

This study determined the antimicrobial susceptibilities of 67 isolates of Leptospira from dogs (suspect canine cases: n=7 and stray dogs: n=6) and rodents (n=54) in Trinidad to 12 antimicrobial agents using broth microdilution and macrodilution techniques. Commonly used antimicrobial agents such as the penicillin G and ceftriaxone had relatively low minimal inhibitory concentrations (MICs) while doxycycline displayed a relatively higher value but was still considered to be effective. While imipenem was the most effective with low MIC values in vitro, sulphamethoxazole-trimethoprim had the highest i.e. least effective. Based on these results, the drugs commonly used in the treatment of leptospirosis (penicillin G, penicillin-streptomycin, doxycycline and ceftriaxone) in both humans and animals in Trinidad appear to have similar MICs and MBCs in vitro when compared with published reports. The serovar of Leptospira spp. and in most cases the origin of the isolates did not significantly (P>0.05) influence their susceptibilities to the antimicrobial agents tested

Seroepidemiology of leptospirosis in dogs and rats in Trinidad.

Stray dogs (n=207), suspected canine cases of leptospirosis (n=50) and rats (n=200) from the Caribbean island of Trinidad were subjected to the Microscopic Agglutination Test (MAT) for leptospirosis. The seroprevalence in stray dogs was 15.5% (n=32), the predominant serogroup was Icterohaemorrhagiae (14.5%; n=30) with agglutinations to serovars Copenhageni at 5.8%, Icterohaemorrhagiae at 4.8%, Mankarso at 3.9%. The seroprevalence among suspected canine cases was 72% (n=36) with Icterohaemorrhagiae again being the predominant serogroup at 60% inclusive of serovars: Copenhageni, 44%; Mankarso, 14%; and Icterohaemorrhagiae 2%. A seroprevalence of 16.5% was determined in rats, all agglutinations were to the Icterohaemorrhagiae serogroup (inclusive of serovars Copenhageni, 9.5%; Icterohaemorrhagiae, 5.5%; and Mankarso, 1.5%). Overall serovar Copenhageni was the most common serovar as 11.6% of all the animal species tested by the MAT were positive and may be an important zoonotic serovar in Trinidad. The titres of infecting serovars of Leptospira in suspected canine cases of leptospirosis were considerably higher than that found in stray dogs and in rats where the lowest titres were found. Age and sex were not significant risk factors except in the case of rats where age was significant, indicating that juvenile rats were at a significantly higher risk. There was no definite pattern of the distribution of positive animals or the serovars when using the MAT. Data obtained in the current study indicate that dogs and rats in Trinidad have the potential to be sources of leptospiral infections for humans. This potential has public health implications making it imperative to control rat and stray dog populations in the island to reduce the risk of human leptospirosis.

A COMPARATIVE STUDY OF INTRAMUSCULAR ACETAMINOPHEN VERSUS INTRAMUSCULAR PENTAZOCINE AS LABOUR ANALGESIA IN ZARIA, NORTHWESTERN NIGERIA.

BACKGROUND: Intramuscular pentazocine is a common labour analgesic in Zaria, Nigeria due to its low cost and availability. Though also cheap and readily available the use of intramuscular acetaminophen is not popular and hence the need for a comparative study. AIM & OBJECTIVES: To compare the efficacy of intramuscular acetaminophen versus intramuscular pentazocine on women in labour as well as the effects of both drugs on APGAR scores of their newborn. METHODOLOGY: A randomized, comparative study was conducted on 188 eligible, parturients from June to September, 2013. The subjects were selected during antenatal classes and early active labour, counseled, taught about the pain scoring systems after obtaining written consent from them. Randomization was done using the WINPEPI software by Abrahamson in order for each woman in labour to receive either intramuscular acetaminophen 15mg/kg stat or pentazocine 1mg/kg at cervical dilatation of 4-6cm. The data obtained included the patients demographics, hourly pain scores, APGAR scores, patients' satisfaction and side effects. RESULTS: The mean age was 28.1years ± SD 5.2years. The majority of the subjects (53.5%) were Hausa-Fulani and 70.1% were muslims; 64% were booked for antenatal care while 58.5% had received secondary school education. The average duration of labour was 5.4hours. Acetaminophen was administered to 91(48%) subjects while pentazocine was administered to 97(52%). Sixty-nine percent and 80% experienced adequate pain relief in the acetaminophen and pentazocine groups respectively at one hour. The pain scores was statistically significant at one hour but comparable in both groups afterwards: p=0.01, 0.52, 0.338 and 0.389 at 1(st), 2(nd), 3(rd) and 4(th) hours on the linear/visual analogue scale and comparable on the verbal rating scale. There was no difference in the 1(st) and 5(th) minute APGAR scores of the babies delivered (p=0.24 and 0.63 respectively). Patients' satisfaction was comparable but the pentazocine group experienced more side effects. CONCLUSION: Intramuscular acetaminophen gave comparable labour analgesia with fewer side effects when compared with pentazocine.

Seroepidemiology of leptospirosis in dogs and rats in Trinidad

Stray dogs (n=207), suspected canine cases of leptospirosis (n=50) and rats (n=200) from the Caribbean island of Trinidad were subjected to the Microscopic Agglutination Test (MAT) for leptospirosis. The seroprevalence in stray dogs was 15.5% (n=32), the predominant serogroup was Icterohaemorrhagiae (14.5%; n=30) with agglutinations to serovars Copenhageni at 5.8%, Icterohaemorrhagiae at 4.8%, Mankarso at 3.9%. The seroprevalence among suspected canine cases was 72% (n=36) with Icterohaemorrhagiae again being the predominant serogroup at 60% inclusive of serovars: Copenhageni, 44%; Mankarso, 14%; and Icterohaemorrhagiae 2%. A seroprevalence of 16.5% was determined in rats, all agglutinations were to the Icterohaemorrhagiae serogroup (inclusive of serovars Copenhageni, 9.5%; Icterohaemorrhagiae, 5.5%; and Mankarso, 1.5%). Overall serovar Copenhageni was the most common serovar as 11.6% of all the animal species tested by the MAT were positive and may be an important zoonotic serovar in Trinidad. The titres of infecting serovars of Leptospira in suspected canine cases of leptospirosis were considerably higher than that found in stray dogs and in rats where the lowest titres were found. Age and sex were not significant risk factors except in the case of rats where age was significant, indicating that juvenile rats were at a significantly higher risk. There was no definite pattern of the distribution of positive animals or the serovars when using the MAT. Data obtained in the current study indicate that dogs and rats in Trinidad have the potential to be sources of leptospiral infections for humans. This potential has public health implications making it imperative to control rat and stray dog populations in the island to reduce the risk of human leptospirosis.

Calabash pregnancy: a malingering response to infertility complicated by domestic violence.

This is a case report of a 20-year old para 0+0 who presented with an 11-month pregnancy. On evaluation, the pregnancy was found to be a fake made-up 'calabash pregnancy'. There were no pregnancy symptoms and she had just menstruated three weeks prior to presentation. This was a deliberate event in response to delayed pregnancy attainment complicated by domestic violence. Domestic violence was in the form of verbal and physical abuse and later was on a monthly basis precipitated by onset of her menstrual flow. The patient's age, monogamous union and the fact that she is an orphan made her vulnerable to domestic violence.

Efficacy of commonly used anthelmintics: first report of multiple drug resistance in gastrointestinal nematodes of sheep in Trinidad.

In Trinidad, small ruminant farms are semi-intensively managed under tropical conditions which support the development and survival of the infective stages of the helminths. Local farmers use anthelmintics to control gastrointestinal nematodes frequently. Frequent use of anthelmintics has the potential to select for populations of nematodes resistance to those chemicals. Hence, an attempt was made to study the efficacy of commonly used drugs on gastrointestinal nematodes of sheep. Three farms situated in different counties in Trinidad were selected. Sheep aged 6-15 months and not treated with anthelmintics for a minimum of six months previous and with faecal egg count (FEC)>150 eggs per gram were selected for study. They were allocated into 5 groups, each consisting 10 animals. The Group TA animals were treated once with albendazole (5mg/kg. b.wt.), group TF with fenbendazole (5mg/kg.b.wt.), group TI animals with ivermectin (200 µg/kg b.wt.), group TL with levamisol (7.5mg/kg b.wt.). The group NTC animals were not given any drug and served as control. The number of nematode eggs per gram of faeces from each animal was determined before treatment and at 14 days after treatment. The anthelmintic susceptibility to different drugs was detected by FECRT (in vivo) with EPG recorded at 14 day post-treatment. The data analysis using FECRT revealed that efficacy of albendazole (46-62%), fenbendazole (44-61%) and levamisol (53-81%) were reduced compared to ivermectin (95-97%). An attempt has also been made to find a suitable method for calculation of FECR (%).

Occurrence and genetic relatedness of Listeria spp. in two brands of locally processed ready-to-eat meats in Trinidad.

Contamination of locally produced, ready-to-eat meats by Listeria spp. has been previously reported at one processing plant in Trinidad. However, the status of this pathogen in locally produced products sold at retail outlets is unknown. This study was conducted to establish whether there is a risk to consumers of locally processed meats caused by the presence of Listeria spp., and whether a link exists between the presence of the pathogen in retail products and the manufacturing plant of one brand (B). Four hundred and eighty ready-to-eat meat products of two popular local brands (A and B) were collected from retail outlets and analysed for the presence of Listeria spp. together with food samples and surfaces from one manufacturing plant (B). Eighty-eight of the retail products (18·3%) were contaminated with Listeria spp., of which, 52·3% were L. innocua, 44·3% were L. monocytogenes and 3·4% belonged to the L. seeligeri-L. welshimeri-L. ivanovii (Siwi) group. L. innocua was found in 15 in-process food samples and on three surfaces of equipment at plant B. Four in-process food samples were also contaminated with Siwi isolates. Repetitive extragenic palindromic PCR DNA fingerprinting showed a possible association between strains of different Listeria spp. and brand as well as with manufacturing plant B.