Adsorption of lead and chromium ions from electroplating wastewater using plantain stalk modified by amorphous alumina developed from waste cans.

Waste beneficiation is key to environmental protection and the realisation of a circular economy. Herein, amorphous alumina (a-Al2O3) derived from aluminium waste cans (AWC) was used to modify plantain stalk as an adsorbent for sequestration of lead (II) and chromium (VI) ions from electroplating wastewater. Raw plantain-stalk (RPS) and amorphous-alumina modified plantain stalk (APS) developed as adsorbents were characterised using various equipment such as x-ray diffraction (XRD), thermogravimetric analysis (TGA), scanning electron microscopy (SEM), Fourier Transform Infrared Spectroscopy (FTIR), and Brunauer-Emmett-Teller (BET). The FTIR revealed that the adsorbents are rich in functional groups that could promote the adsorption process which includes carboxyl, hydroxyl, and aliphatic groups. Also, the BET analysis showed a substantial increase in the surface area of APS (174.448 m2/g) compared to that of RPS (40.531 m2/g) which could be due to the effect of modification by the a-Al2O3. The batch adsorption studies revealed that the APS achieved 99.38% and 98.33% removal of Cr(VI) and Pb(II), respectively, which is superior to RPS adsorption efficiency. Also, the estimated and experimental data for the APS compared well under all the kinetic models studied with R2 > 0.88. This suggested that chemisorption is the most plausible adsorption mechanism of Cr(VI) and Pb(II) onto the APS. Further analysis showed that the Cr(VI) and Pb(II) adsorption followed the Langmuir model with the RL value of 0.038 and 0.999, respectively, which indicated that the two metal ions were effectively adsorbed onto the APS. Therefore, this work demonstrated that the modification of plantain-stalk with amorphous-alumina derived from AWC enhanced the characteristics of the APS and favoured its adsorption of the selected heavy metals.

Data mining of the essential causes of different types of fatal construction accidents.

Accident analysis is used to discover the causes of workplace injuries and devise methods for preventing them in the future. There has been little discussion in the previous studies of the specific elements contributing to deadly construction accidents. In contrast to previous studies, this study focuses on the causes of fatal construction accidents based on management factors, unsafe site conditions, and workers' unsafe actions. The association rule mining technique identifies the hidden patterns or knowledge between the root causes of fatal construction accidents, and one hundred meaningful association rules were extracted from the two hundred and fifty-three rules generated. It was discovered that many fatal construction accidents were caused by management factors, unsafe site circumstances, and risky worker behaviors. These analyses can be used to demonstrate plausible cause-and-effect correlations, assisting in building a safer working environment in the construction sector. The study findings can be used more efficiently to design effective inspection procedures and occupational safety initiatives. Finally, the proposed method should be tested in a broader range of construction situations and scenarios to ensure that it is as accurate as possible.

Fall-related traumatic brain injury in a Nigerian pediatric population.

BACKGROUND: Accidental falls are a common cause of disability and trauma-related death in the pediatric population, accounting for a large number of pediatric emergency hospital admissions. This multicenter study assesses the clinical characteristics, management outcomes of pediatric falls-related traumatic brain injury and associated factors in Nigeria. METHODS: A retrospective study of pediatric patients (age less than 18-years) with falls over a 2-year period. Data was extracted from clinical records and neurosurgical data sheets from three major centres in Nigeria, and was analyzed using descriptive statistics, Chi square test and multinomial regression with significance set at p < 0.05. RESULTS: 128 children presented with fall-related TBI, with a median age of 96 months (age range of 5-216 months) and M:F was 6:1. 40.6 % had moderate head injury and 55.5 % of the falls were building related. There were 52(42.6 %) children with skull fractures. Older children more commonly fell from trees and had more cases of severe head injury (14.1 %) compared with those who fell from buildings (5.5 %). Children who fell from buildings presented early (64.1 %). The 10 % mortality was mainly in children older than 5-years. Children aged 0-5 years were three times likely to fall inside/outside a building (OR: 3.3, CI: 3.06 to 243.44). Also, those who fell from trees were 6 times more likely to have a long bone fracture (OR: 6.1, CI: 1.2 to 32.6). CONCLUSIONS: In the Nigerian population Traumatic Brain Injury from falls is common among children, with older children falling more from trees and associated with high mortality.

A rare concurrence: bee venom associated acute tubular necrosis and acute interstitial nephritis.

Acute kidney injury (AKI) is generally associated with increased morbidity and mortality and is even more devastating in patients with comorbidities. Although AKI due to multiple bee stings is well established in the literature, it is still a rare entity with complex pathophysiologic mechanisms. The most commonly reported histological findings in AKI due to bee stings is acute tubular necrosis (ATN), with a few studies attributing it to acute interstitial nephritis (AIN), whereas the concurrence of both ATN and AIN is rarely reported. We hereby present a 50-year-old known Type 2 diabetes mellitus patient with a prior normal renal function, who developed AKI following multiple stings from >1000 bees. He had a kidney biopsy on account of non-recovery of his kidney function despite being on intermittent hemodialysis that showed combined features of ATN and AIN. He subsequently had a full recovery of his renal function following appropriate management.

Prevalence and Outcome of Snake Bites Among Children Admitted in the Emergency Pediatric Unit, Federal Medical Centre, Birnin Kebbi, Nigeria.

Introduction Snakebites are common and constitute an important health problem in many countries of the world, with the greatest burden occurring in rural areas of Asia and Sub-Saharan Africa. They were classified by the World Health Organization as category A of neglected tropical diseases. Most studies on snake envenoming in Nigeria were among adult populations with few among children. This study assessed the prevalence and outcome of snakebite among children in Federal Medical Centre, Birnin Kebbi. Methods This was a four-year retrospective study in which the medical records of patients with managed snakebite were reviewed. A study proforma was used to obtain information on socio-demographic characteristics, site of the bite, features of envenoming, pre-hospitalization intervention, hospital treatment, length of hospitalization, and outcome of treatment of the patients. Results There were 19 snakebite cases out of 5,195 admissions during the period under review, giving a prevalence of 0.0037 (3.7/1000) with a male:female ratio of 2:1. The majority (66.7%) of the children were aged between 11 and 15 years and the mean (± SD) age of the study population was 10.5 (± 3.3) years. The lower limb was the site of bite in 10 (55.6%) of the patients and clinical features included local pain (100%), local swelling of varying magnitude (16 (88.9%)), spontaneous bleeding eight (44.4%) among others. Ten (55.65%) patients presented after four hours of bite and the mean (±SD) duration of hospitalization was 2.11 (±0.58) days. Most (77.8%) received at least one form of pre-hospital care while only 66.7% received polyvalent anti-snake venin. The case fatality rate was 5.6% while 55.6% of patients signed against medical advice. Conclusion There was a low hospital prevalence of snakebite in children in the present study location with associated low mortality but a high rate of discharge against medical advice. Most of the patients had a pre-hospital intervention and anti-snake venin is not readily accessible.

Biochemical evaluation and molecular docking assessment of glucosamines from Neocarya macrophylla fruits against Naja nigricollis venom.

Two new glucosamines, Microphyllose A and B were isolated from the chloroform fraction of Neocarya macrophylla fruit using flash column chromatography. The structures of these compounds were elucidated based on chemical tests and the analysis of their spectral data (IR, 1D- & 2D-NMR). The compounds have demonstrated significant (p < 0.05) antivenom activity against Naja nigricollis venom with 60 and 80% protection, respectively. When subjected to molecular docking, the compounds have demonstrated different binding affinities against three toxins (phospholipase A2, neurotoxin and cardiotoxin) from Naja nigricollis venom and they were further screened for ADMET analysis based on Lipinski's and Veber's rule and the compounds have failed absorptivity for oral medications. To the best of our knowledge, this is the first report of isolation and molecular docking analysis of these compounds from medicinal plants.

Economic impact assessment of foot-and-mouth disease burden and control in pastoral local dairy cattle production systems in Northern Nigeria: A cross-sectional survey.

Milk has been envisaged as a major source of high-quality protein and bioavailable nutrients to humans. Its production is constraint by foot and mouth disease (FMD), a contagious viral disease of very high economic importance worldwide. This study was aimed at assessing the economic impact of FMD in pastoral dairy cattle herds in Nigeria and determines returns to investments in its control to better inform policy decisions. An interview questionnaire-based cross-sectional study was conducted in 660 nomadic and agro-pastoral dairy cattle herds in 2019. Economic impact analyses were conducted using the total economic cost and benefit-cost analysis models. Of the 660 pastoralists enrolled, 92.6% (n = 611) participated. Nomadic pastoralists constituted 50.7% (n = 310) of the respondents while 49.3% (n = 301) were agro-pastoralists. Most of the respondents (66.4%, n = 406) had no formal education. The value of visible losses to the herders was estimated at USD 15,591,694.30 and the cost of control by treatment of secondary infections was USD 463,673.70. The economic impact of FMD due to production losses and costs of treatment to pastoralists was estimated to be USD 16,055,368.00. Return on investment in FMD control was positive with a benefit-cost ratio of 33.6. The estimated total economic costs due to FMD have indicated that it is a disease of high economic importance to dairy production herds and must be controlled to assure food security, local incomes to herders, and protein requirement of human population, especially the children in FMD endemic countries.

Myocardial bridge.

Myocardial bridging (MB) is an anatomical variant in which an epicardial coronary artery passes under a bridge of myocardium. The most commonly affected vessel is the left anterior descending coronary artery, although other branches such as the marginal branches, diagonal branches and posterior descending right coronary artery may be occasionally involved. Technological advances in radiological techniques have enabled better diagnosis of myocardial bridges especially coronary angiography and coronary computed tomographic angiography (CCTA). During a routine angiography by means of CCTA in a 60-year-old male patient with arrhythmia, a case of MB was found in two segments of the posterior interventricular artery and a small segment of the right coronary artery. Although most cases of myocardial bridges are asymptomatic, knowledge of its pathophysiology is of great clinical importance as some cases of MBs have been associated with acute coronary syndromes, ischaemia, arrhythmias and even sudden death.

Care-seeking behavior for neonatal jaundice in rural northern Nigeria.

Objective: This study determined the predictors of maternal knowledge and health-seeking behavior for neonatal jaundice in rural Kumbotso, northern Nigeria. Study design: Cross-sectional survey. Method: A total of 361 mothers were interviewed using structured questionnaires. Knowledge scores and care-seeking practices were determined. Adjusted odds ratios were generated from logistic regression models. Results: The proportion of respondents with good, fair and poor knowledge of neonatal jaundice were (46.0%, n â€‹= â€‹166), (24.1%, n â€‹= â€‹87) and (30.0%, n â€‹= â€‹108), respectively. Of the 117 mothers with a jaundiced child, (67.5%, n â€‹= â€‹79) and (20.5%, n â€‹= â€‹24) received treatment from health facilities and traditional healers, respectively, whereas (12.0%, n â€‹= â€‹14) resorted to home remedies. Maternal education Adjusted Odds Ratio (AOR) â€‹= â€‹2.39; 95% Confidence Interval (CI): 1.16-4.91) (secondary school versus no formal), source of information on neonatal jaundice (AOR â€‹= â€‹11.3; 95%CI: 5.84-21.93) (health worker versus 'others'), recent delivery in a health facility (AOR â€‹= â€‹1.83; 95%CI: 1.06-3.14) and having a previously jaundiced child (AOR â€‹= â€‹5.06; 95%CI: 2.76-9.27) predicted knowledge. Preference for health facility treatment was predicted by a previously jaundiced child (AOR â€‹= â€‹10.04; 95%CI: 5.73-17.60), antenatal care (AOR â€‹= â€‹2.97; 95%CI: 1.43-6.15) (≥4 versus 0 visits), source of information on neonatal jaundice (AOR â€‹= â€‹2.33; 95%CI: 1.30-4.17) (health worker versus 'others'), and maternal ethnicity (AOR â€‹= â€‹0.36; 95%CI: 0.14-0.96) (Hausa-Fulani versus 'others'). Conclusion: Maternal knowledge of neonatal jaundice was sub-optimal. Being educated, health facility delivery, having had a jaundiced child, and receiving information from health workers predicted good knowledge. Having a previously jaundiced child, antenatal care, obtaining information from health workers and maternal ethnicity predicted preference for health facility treatment. Policies and programs should be strengthened to focus on prevention, early detection and prompt management of neonatal jaundice.

Impact of a 10-Year Eye Care Program in Sokoto, Nigeria: Changing Pattern of Prevalence and Causes of Blindness and Visual Impairment.

BACKGROUND: This study was undertaken to ascertain the current magnitude and causes of blindness and visual impairment in persons aged 50 years and over and to assess the impact of a 10-year eye care program in Sokoto State, Nigeria. METHODS: A rapid assessment of avoidable blindness (RAAB) survey (in persons 50 years and over) was conducted in 2016. Participants were selected in Wurno health zone using a two-stage cluster randomized sampling with probability proportional to size. Operational definitions were based on RAAB and World Health Organization eye examination record definitions. Eye care program documents were reviewed and data from a baseline survey undertaken in 2005 were reanalyzed. RESULTS: A response of 89.1% (2405 of 2700 participants) was obtained in the 2016 survey. With available correction, the unadjusted prevalence of blindness was 7.7% (95% confidence interval [CI]: 6.4, 8.9). The odds of blindness were 1.8 times higher in females than males (95% CI: 1.3, 2.4; P < 0.001). Major causes of blindness were cataract (48.9%) corneal disease (20.1%), glaucoma (10.3%), and uncorrected refractive error/aphakia (8.7%). The age- and sex-adjusted prevalence of blindness has declined from 11.6% (95% CI: 7.4, 17.0) in 2005 to 6.8% (95% CI: 5.6, 8.0%) in 2016. CONCLUSION: The blindness prevalence is high, and the major causes are avoidable in the health zone. The findings suggest that investments in the program over the last 10 years might have led to almost a halving in the prevalence of blindness in th e population. However, the small sample size of persons 50+ years from Wurno zone in the 2005 survey necessitate caution when comparing the 2005 and the 2016 surveys.

Direct Experimental Observation of in situ Dehydrogenation of an Amine-Borane System Using Gas Electron Diffraction.

In situ dehydrogenation of azetidine-BH3, which is a candidate for hydrogen storage, was observed with the parent and dehydrogenated analogue subjected to rigorous structural and thermochemical investigations. The structural analyses utilized gas electron diffraction supported by high-level quantum calculations, while the pathway for the unimolecular hydrogen release reaction in the absence and presence of BH3 as a bifunctional catalyst was predicted at the CBS-QB3 level. The catalyzed dehydrogenation pathway has a barrier lower than the predicted B-N bond dissociation energy, hence favoring the dehydrogenation process over the dissociation of the complex. The predicted enthalpy of dehydrogenation at the CCSD(T)/CBS level indicates that mild reaction conditions would be required for hydrogen release and that the compound is closer to thermoneutral than linear amine boranes. The entropy and free energy change for the dehydrogenation process show that the reaction is exergonic, energetically feasible, and will proceed spontaneously toward hydrogen release, all of which are important factors for hydrogen storage.

Time delays in the response to the Neisseria meningitidis serogroup C outbreak in Nigeria - 2017.

BACKGROUND: Nigeria reports high rates of mortality linked with recurring meningococcal meningitis outbreaks within the African meningitis belt. Few studies have thoroughly described the response to these outbreaks to provide strong and actionable public health messages. We describe how time delays affected the response to the 2016/2017 meningococcal meningitis outbreak in Nigeria. METHODS: Using data from Nigeria Centre for Disease Control (NCDC), National Primary Health Care Development Agency (NPHCDA), World Health Organisation (WHO), and situation reports of rapid response teams, we calculated attack and death rates of reported suspected meningococcal meningitis cases per week in Zamfara, Sokoto and Yobe states respectively, between epidemiological week 49 in 2016 and epidemiological week 25 in 2017. We identified when alert and epidemic thresholds were crossed and determined when the outbreak was detected and notified in each state. We examined response activities to the outbreak. RESULTS: There were 12,535 suspected meningococcal meningitis cases and 877 deaths (CFR: 7.0%) in the three states. It took an average time of three weeks before the outbreaks were detected and notified to NCDC. Four weeks after receiving notification, an integrated response coordinating centre was set up by NCDC and requests for vaccines were sent to International Coordinating Group (ICG) on vaccine provision. While it took ICG one week to approve the requests, it took an average of two weeks for approximately 41% of requested vaccines to arrive. On the average, it took nine weeks from the date the epidemic threshold was crossed to commencement of reactive vaccination in the three states. CONCLUSION: There were delays in detection and notification of the outbreak, in coordinating response activities, in requesting for vaccines and their arrival from ICG, and in initiating reactive vaccination. Reducing these delays in future outbreaks could help decrease the morbidity and mortality linked with meningococcal meningitis outbreaks.

Anti-proliferative study and isolation of Ochnaflavone from the ethyl acetate-soluble fraction of Ochna kibbiensis Hutch & Dalziel.

Anti-proliferative activity of the ethyl acetate fractions of Ochna schweinfurthiana F. Hoffm. and Ochna kibbiensis Hutch. and Dalziel methanol leaf extracts were investigated against glioblastoma multiforme (GBM U-1242 MG) cell line. O. kibbiensis significantly (p < 0.001) and dose dependently (IC50 = 25.74 µg/mL) reduced cell count. At 125 µg/mL, O. kibbiensis extract reduced cell count by about 92% compared to the untreated control. On the other hand, at 125 µg/mL, O. schweinfurthiana extract reduced cell count only by 20%, indicating a much weaker activity (IC50 = 823.51 µg/mL). Following from the result obtained, ethyl acetate fraction of O. kibbiensis was subjected to chromatographic purification. This led to the isolation of ochnaflavone; the structure of the isolated compound was identified by analysis of its nuclear magnetic resonance (NMR) spectral data and comparison with data in the literature. Although the isolated ochnaflavone could not be tested for anti-proliferative activity due to insufficient quantity, the obtained results indicate the presence of bioactive anti-GBM principles in O. kibbiensis.

Contribution of reactive oxygen species to (+)-catechin-mediated bacterial lethality.

The contribution of reactive oxygen species to (+)-catechin-mediated bacterial lethality was investigated. Minimum inhibitory concentrations (MIC) and minimum bactericidal concentration (MBC) of (+)-catechin against E. coli, P. aeruginosa and S. aureus were investigated using 96-well microtitre plate. MIC and MBC of (+)-catechin against E. coli, P. aeruginosa and S. aureus are 600 and 700; 600 and 800; 600 and 800 µg/mL respectively. The optical densities and colony forming units of (+)-catechin-treated bacteria decreased. (+)-Catechin (4× MIC) significantly increased the superoxide anion content of E. coli, P. aeruginosa and S. aureus compared to DMSO. Superoxide dismutase and catalase in (+)-catechin treated E. coli, P. aeruginosa and S. aureus increased significantly. Conversely, level of reduced glutathione in (+)-catechin-treated E. coli, P. aeruginosa and S. aureus decreased significantly while glutathione disulfide increased significantly. Furthermore, malondialdehyde and fragmented DNA increased significantly following exposure to (+)-catechin. From the above findings, (+)-catechin enhanced the generation of reactive oxygen species (superoxide anion radical and hydroxyl radical) in E. coli, P. aeruginosa and S. aureus, possibly by autoxidation, Fenton chemistry and inhibiting electron transport chain resulting into lipid peroxidation and DNA fragmentation and consequentially bacterial cell death.

The global burden of pulmonary hypertension in sickle cell disease: a systematic review and meta-analysis.

Elevated tricuspid regurgitant jet velocity (TRJV) is a surrogate measure of pulmonary hypertension (PH) in persons with sickle cell disease (SCD). We sought to estimate the burden of PH in people living with sickle cell disease based on TRJV. From 2000 to 2015, we searched electronic databases for eligible publications and included 29 studies (n = 5358 persons). We used random effects modeling to determine the pooled estimate of elevated TRJV. The overall pooled prevalence of elevated TRJV was 23.5 %(95 % CI 19.5-27.4) in persons with SCD. The pooled prevalence of elevated TRJV in children and adults with SCD was 20.7 % (95 % CI 15.7--25.6) and 24.4 % (95 % CI 18.4-30.4), respectively. TRJV is prevalent among adults and children with SCD. Our finding support international recommendations that call for screening for PH in SCD patients.

Racial Differences in DNA-Methylation of CpG Sites Within Preterm-Promoting Genes and Gene Variants.

Objective To evaluate the role DNA methylation may play in genes associated with preterm birth for higher rates of preterm births in African-American women. Methods Fetal cord blood samples from births collected at delivery and maternal demographic and medical information were used in a cross-sectional study to examine fetal DNA methylation of genes implicated in preterm birth among black and non-black infants. Allele-specific DNA methylation analysis was performed using a methylation bead array. Targeted maximum likelihood estimation was applied to examine the relationship between race and fetal DNA methylation of candidate preterm birth genes. Receiver-operating characteristic analyses were then conducted to validate the CpG site methylation marker within the two racial groups. Bootstrapping, a method of validation and replication, was employed. Results 42 CpG sites were screened within 20 candidate gene variants reported consistently in the literature as being associated with preterm birth. Of these, three CpG sites on TNFAIP8 and PON1 genes (corresponding to: cg23917399; cg07086380; and cg07404485, respectively) were significantly differentially methylated between black and non-black individuals. The three CpG sites showed lower methylation status among infants of black women. Bootstrapping validated and replicated results. Conclusion for Practice Our study identified significant differences in levels of methylation on specific genes between black and non-black individuals. Understanding the genetic/epigenetic mechanisms that lead to preterm birth may lead to enhanced prevention strategies to reduce morbidity and mortality by eventually providing a means to identify individuals with a genetic predisposition to preterm labor.

Prevlaence of chronic kidney disease markers in Kumbotso rural Northern Nigeria.

BACKGROUND: Data- on the epidemiology of Chronic Kidney Disease (CKD) from sub-SaharanAfrica are sparse. We investigated the prevalence of CKD and its early markers in Kumbotso, a rural community in northern Nigeria. METHODS: A total of 480 individuals were randomly selected from the general population using multistage stratified random sampling. Relevant- demographic and clinical data were obtained using a structured questionnaire. Biological samples (urine and blood) were drawn for relevant investigations. RESULTS: CKD (estimated glomerular filtration rate [eGFR <60 mls/min) was found in 117 participants (26%). Proteinuria was present in 106 persons (23.6%) and haematuria in 7 individuals (1.6%). The most common CKD stage was stage 1 (20%). CKD was associated with hypertension (P=0.002), diabetes (P=0.001), high cholesterol (P=0.030), smoking (P=0.015), increasing BMI (P=0.020), and increasing age (P=0.003). After adjusting for potential confounding with logistic regression modeling we found BMI, family history of hypertension, history of diabetes mellitus and family history of renal disease to be independent predictors of CKD. CONCLUSIONS: Early markers of CKD are common among rural inhabitants of northern Nigeria and this call for concerted efforts towards institution of preventive measures.

The prescribing of generic medicines in Nigeria: knowledge, perceptions and attitudes of physicians.

Generic medicines have the same efficacy and safety as originators at lower prices; however, there are concerns with their utilization in Nigeria. Objective was to evaluate physicians' understanding and perception of generics. A questionnaire was administered among physicians working in tertiary healthcare facilities in four geo-political regions of Nigeria. Questionnaire response was 74.3% (191/257) among mainly males (85.9%). The mean knowledge score regarding generics was 5.3 (maximum of 9) with 36.6%, 36.1% and 27.2% having poor, average and good knowledge respectively. Cross-tabulation showed statistical significance (p = 0.047) with the duration of practice but not with position, subspecialty or sex. The majority of respondents did not believe that generic medicines are of lower quality than branded medicines. Therapeutic failure was a major concern in 82.7%, potentially discouraging the prescribing of generics, and a majority (63.9%) did not support generic substitution by pharmacists. Knowledge gaps were identified especially with the perception of generics, which need to be addressed.

A novel antimicrobial flavonoid from the stem bark of Commiphora pedunculata (Kotschy & Peyr.) Engl.

A new flavonoid, 2-(3,5-dihydroxy-4-methoxy-phenyl)-3,5-dihydroxy-8,8-dimethyl-2,3-dihydro-8H-pyrano[3,2]chromen-4-one, together with previously reported epicatechin was isolated from the ethyl acetate soluble fraction of the methanol extract of the stem bark of Commiphora pedunculata. The structures of these compounds were elucidated based on extensive analysis of their spectral data, including 1 and 2D NMR. The compounds were active against 9 out of 12 tested microorganisms including a resistant strain; vancomycin-resistant entrococci (VRE), Escherichia coli, Staphylococcus aureus and Candida albicans. The zones of inhibition ranged between 22 and 34 mm against the microorganisms. The minimum inhibitory concentration was as low as 6.25 µg/mL against Shigella dysentriae, Bacillus cereus and S. aureus while the minimum bactericidal concentration was as low as 50 µg/mL against Pseudomonas aeruginosa, VRE and C. albicans. This is the first report of the isolation of the compound.

Pregnancy outcomes in women with sickle-cell disease in low and high income countries: a systematic review and meta-analysis.

BACKGROUND: Pregnancy in women with sickle-cell disease (SCD) is associated with increased adverse outcomes. Findings on the association between SCD and adverse pregnancy outcomes are conflicting, and the results do not address whether these associations are similar in both low- and high-income countries. OBJECTIVES: We conducted a systematic review and meta-analysis to evaluate pregnancy outcomes associated with SCD. SEARCH STRATEGY: The MEDLINE database was searched using medical subject headings (MeSH) and keywords for articles on pregnancy outcomes in women with SCD. SELECTION CRITERIA: We used full research articles published in English that compared women with SCD with women who did not have SCD, as controls. DATA COLLECTION AND ANALYSIS: Data were abstracted and analysed using comprehensive Meta-analysis 2.2. The primary outcomes were intrauterine growth restriction and perinatal mortality. Secondary outcomes were rates of caesarean sections, pre-eclampsia, eclampsia, postpartum haemorrhage, maternal mortality, prematurity, and low birthweight. Random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (95% CIs). MAIN RESULTS: Sixteen studies met all of the selection criteria and were included in the analysis. SCD was associated with intrauterine growth restriction (pooled OR 2.79, 95% CI 1.85-4.21), perinatal mortality (pooled OR 3.76, 95% CI 2.34-6.06), and low birthweight (pooled OR 2.00, 95% CI 1.42-2.83). SCD was also associated with an increased risk of pre-eclampsia (pooled OR 2.05, 95% CI 1.47-2.85), maternal mortality (pooled OR 10.91, 95% CI 1.83-65.11, P = 0.009), and eclampsia (pooled OR 3.02, 95% CI 1.20-7.58). CONCLUSION: Pregnancy in women with SCD is associated with increased risks of adverse perinatal and maternal outcomes in both low- and high-income countries. TWEETABLE ABSTRACT: This meta-analysis showed worse pregnancy outcomes in women with sickle-cell disease compared with controls.