Methanolic Moringa oleifera leaf extract protects against epithelial barrier damage and enteric bacterial translocation in intestinal I/R: Possible role of caspase 3.

Background: Activation of caspase 3 has been implicated in the pathogenesis of I/R injury in various organs, but there is a paucity of data on its role in IIRI. Also, no reports were found on the beneficial role of methanolic Moringa oleifera leaf extract (MMOLE) in IIRI. This study investigated the involvement of caspase 3 in IIRI, and the impact of MMOLE in IIRI. Methods: Male Wistar rats were randomized into five groups; the sham-operated group that was sham-operated and received 0.5 ml of distilled water for 7 days prior to sham surgery, and the IIRI, febuxostat (FEB) +IIRI, low dose MMOLE (LDMO)+IIRI, and high dose MMOLE (HDMO)+IIRI groups that underwent I/R and also received 0.5 ml of distilled water, 10 mg/kg of febuxostat, 200 mg/kg of MMOLE, and 400 mg/kg of MMOLE respectively for 7 days prior to I/R. Markers of hepatic function, oxidative stress, and inflammation as well as enteric bacterial translocation and histoarchitecture integrity of intestinal and hepatic tissues were evaluated. The bioactive components of MMOLE were also determined by GC-MS. Results: As revealed by GC-MS, the active bioactive components of MMOLE were thiosemicarbazone, hydrazine, 1,3-dioxolane, octanoic acid, 1,3-benzenediamine, 9-octadecenoic acid, oleic acid, nonadecanoic acid, 3-undecanone, phosphonic acid, and cyclopentanecarboxylic acid. MMOLE alleviated IIRI-induced rise in intestinal and hepatic injury markers, malondialdehyde, TNF-α, IL-6, and myeloperoxidase activities. MMOLE improved IIRI-induced suppression of reduced glutathione, thiol and non-thiol proteins, and superoxide dismutase, catalase and glutathione peroxidase activities. These were associated with suppression of IIRI-induced caspase 3 activity and bacterial translocation. Histopathological evaluation revealed that MMOLE attenuated IIRI-induced alterations in intestinal and hepatic histoarchitecture integrity. MMOLE also militated against increased absolute and relative intestinal and hepatic weight, intestinal and hepatic injuries, epithelial mucosal barrier dysfunction, and enteric bacterial translocation associated with IIRI by downregulating oxidative stress-mediated activation of caspase 3. Conclusion: IIRI is associated with a rise in caspase 3 activity. Also, MMOLE confers protection against IIRI, possibly due to its constituent bioactive molecules, especially hydrazine, 9-octadecenoic acid, 1,3-dioxolane, oleic acid, and nonadecanoic acid.

Grandmultiparity: evaluating obstetric and neonatal outcomes after eliminating confounders.

AIMS AND OBJECTIVES: The objective was to evaluate obstetric and neonatal outcomes in booked grandmultiparas (para e"5) and compare with outcome in age and social status matched booked multiparas (para 2-4) after eliminating confounders. PATIENTS AND METHODS: A cohort study with grandmultiparas (subjects) and age and social status matched multiparas as controls. All participants were counseled and an informed consent obtained at the antenatal clinic. Maternal demography and history were taken; they were subsequently monitored during pregnancy, labour and immediate puerperium. The main outcome measures were obstetric and neonatal outcomes among subjects and controls. RESULTS: The incidence of grandmultiparity was 4.1%. During antenatal period, grandmultiparas had statistically significantly higher occurrence of late antenatal booking (P=0.0202), anaemia (P=0.0024) and past history of poor perinatal outcome (P=0.0124). Grandmultiparas had statistically significant occurrence of preterm delivery (P=0.0389) and higher but not statistically significant mean duration of labour (P=0.3532), intrapartum complications (P=0.2014) and postpartum haemorrhage (P=0.2126). Neonates of grandmultiparas had statistically significant low first minute Apgar scores (P=0.0011) with higher but not statistically significant occurrence of low birth weight (P=0.1613) and neonatal intensive care admission (P=0.7202). The perinatal mortality rates were 136 and 75 per 1 000 deliveries for grandmultiparas and multiparas. There were no maternal deaths during the study period. CONCLUSION: After controlling for age and social class, booked grandmultiparas had poorer obstetric and neonatal outcome compared to booked multiparas but these were majorly statistically insignificant due to effect of modern antenatal care.

Reliability of urine multistix and gram stain in the detection of asymptomatic bacteriuria in pregnancy.

BACKGROUND: urinary tract infection is a common problem during pregnancy. Asymptomatic bacteriuria can cause the development of serious complications affecting both the mother and foetus. Urine culture, the traditional screening test is relatively expensive, time consuming and requires a microbiology laboratory and trained staff. However simpler, less expensive tests which include urine multistix and urine gramstain better suited for developing countries are available. OBJECTIVE: to determine the sensitivity, specificity and predictive values of multistix nitrite, leucocyte esterase (LE) and urine gram staining for asymptomatic bacteriuria in pregnancy. METHODS: A cross-sectional study was carried out from 1st July to 31st October 2007, at the University of Ilorin Teaching Hospital (UITH) on 125 consenting asymptomatic pregnant women. A structured proforma was used to collect information from the women and a midstream urine specimen collected in two sterile bottles. One was tested with Multistix® for the presence of nitrite and leucocyte esterase and the other for bacteriological culture and urine gram stain. RESULTS: using the gold standard of urine culture, the sensitivities of Multistix® nitrite and leucocyte esterase were each 14% and the specificity 100% and 96% respectively. Urine gram stain had a sensitivity of 98% and a specificity of 74.7%. CONCLUSION: multistix® nitrite and leucocyte esterase are not sufficiently sensitive to be used as a screening tool for asymptomatic bacteriuria. Urine gram stain can be used in areas where facilities are inadequate for culture but cannot replace it. More studies are required to determine the accuracy of urine gram-stain.

Thyroid diseases in pregnancy: a review.

OBJECTIVE: To provide an overview of the pathophysiology of thyroid diseases in pregnancy and the various treatment methods currently available in its management. DATA SOURCE: Review of literature was affected through index medicus search of major published journals and books. DATA SELECTION: Published data on thyroid diseases on women in the reproductive age group over the last four decades were utilised. DATA EXTRACTION: Abstracts and full text of selected manuscripts were read and analysed to determine their contribution to this article. DATA SYNTHESIS: All relevant articles were reviewed and contributions extracted. CONCLUSION: Thyroid diseases are the second most common endocrinopathies in pregnancy. Numerous hormonal changes and metabolic demands occur in pregnancy resulting in complex changes in maternal thyroid function. Thyroid diseases involves a multidisciplinary team approach to achieve good metabolic control and excellent obstetric care in order to ensure normal maternal and perinatal outcome.

Contraceptive method choices among adolescents in a Nigerian tertiary institution.

This study was undertaken to describe adolescents, use of contraceptive methods and to examine factors that motivate their choice. Face-to-face interview of single, randomly selected 971 males and females aged 18-24 years in a Nigerian tertiary institution was conducted. Among sexually active males and females 72 percent and 81 percent respectively had ever used contraception. The commonest methods ever used by the males and females respectively were the condom (43 percent) and rhythm (31 percent). While females were mainly motivated by pregnancy prevention irrespective of the sexual relationship, the males were more concerned about disease prevention in unstable sexual relationships. However, adolescents whose choice was motivated by disease prevention did not choose the condom significantly more frequently than other methods. The college clinic, complimented by other programmes, should be strengthened for reproductive health services.

PIP: The use of contraceptives among adolescents is significantly different from that of older married couples, and it is influenced by educational, developmental, social, and psychological factors. This study provides information about the prevalence of contraceptive methods used among single adolescents in college and examines the factors that motivate their choice. 971 randomly selected males and females aged 18-24 years in a Nigerian tertiary institution were interviewed personally. The analysis of these 971 single adolescents having similar age distributions but different ethnic and religious backgrounds showed that most respondents (97.7% and 98.4% of males and females, respectively) knew at least one method of contraception. The commonest methods ever used were the condom (43%) and the rhythm method (31%). Females were mainly motivated by the need to prevent pregnancy, while males were more concerned with disease prevention in unstable sexual relationships. Adolescents who based their contraceptive choice on disease prevention did not choose the condom more frequently than other methods. Factors militating against contraceptive use by sexually experienced respondents included religious belief and fear of complications. The study recommends that college clinics be strengthened to manage reproductive health services. Programs should include information, education, and communication efforts targeted at these young people.

Pattern of congenital malformations in Nigerian children.

A series of 252 abortuses, stillbirths and neonates at the University of Ilorin Teaching Hospital and ECWA Hospital, Egbe, in Nigeria, were examined by autopsy dissection between 1983 and 1985. Their clinical cohorts in the nurseries, pediatric wards and those subjected to operations were also reviewed. Primary school children volunteers in two Ilorin schools were also examined in 1987 for cardiopulmonary malformations and umbilical hernia. Incident rates for congenital malformations ranged from 0.08 to 38.27% for congenital groin hernia, 2.39 to 8.73% for umbilical hernia, and 0.21 to 21.05% for the entire gastrointestinal tract. Other incident rates are 0.10 to 7.14% for genitourinary tract, 0.33 to 6.69% for CNS, 0.16 to 5.55% for musculoskeletal system, 0.26 to 4.76% for cardiovascular and 0.06 to 3.9% for bronchopulmonary malformations. The scope of the study is expected to make it adaptable in other developing countries.

Twin birthweight in Nigeria and the effect of sex-pair and parity.

In a retrospective study the mean birthweight, mean birthweight sum and their variation within parity and sex-pair are determined for 622 consecutive twin pairs among 17.726 deliveries conducted over an 18-month period at the University of Ilorin Teaching Hospital, Ilorin, Nigeria. Overall mean birthweight 2.5 +/- 0.5 kg, and birthweight sum 4.9 +/- 1.1 kg are obtained. First twin weighed 2.52 +/- 0.5 kg, slightly heavier than second twin, 2.48 +/- 0.5 kg. 55% of all twins weighed 2.5 kg or less. Male twins were heavier than females in unlike-sex pairs. Male co-twins weighed more than female co-twins, and unlike-sex twins weighed more than like-sex twins. Mean birthweight, and mean birthweight sum were lowest in para: 1, increasing gradually to a plateau in para: 4 and above. Several factors including preponderance of maleness and unlike-sex pairs in the twinning incidence in Nigeria, and the high proportion of our patients registered for antenatal care, may have positively influenced the overall mean birthweight.