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Interferon-gamma in suppurative otitis media: significance of otorrhoea type and disease outcome
- A O Lasisi, O Olayemi, O G Arinola, S A Omilabu
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- Journal:
- The Journal of Laryngology & Otology / Volume 123 / Issue 10 / October 2009
- Published online by Cambridge University Press:
- 29 July 2009, pp. 1103-1107
- Print publication:
- October 2009
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Background:
Interferon-γ has been reported to have an immunoregulatory role in otitis media with effusion. However, such a role remains to be determined in acute suppurative otitis media.
Aim:To determine the levels of interferon-γ in middle-ear secretion in children with acute suppurative otitis media, and to determine the significance of interferon-γ to the nature of otorrhoea and the outcome of otitis media.
Settings and design:Prospective, longitudinal follow up of patients selected from community and tertiary health centres.
Methods:We selected children with acute suppurative otitis media, diagnosed as otorrhoea of less than three months' duration. Middle-ear secretions were collected by pipetting and stored at −80°C. Interferon-γ was assayed using enzyme-linked immunosorbent assay. The patients were treated and followed up for nine to 12 months, to separate those with resolved acute suppurative otitis media from those with chronic suppurative otitis media.
Result:The study initially included 358 cases of acute suppurative otitis media. Nine-month follow up was achieved in 304 patients (85 per cent). Of these patients, acute suppurative otitis media resolved in 187 (61 per cent), while chronic suppurative otitis media was evident in 117 (39 per cent). The children with completed follow up comprised 173 boys and 131 girls, aged between four months and nine years (mean age 6.6 years; standard deviation 1.32). These children had purulent otorrhoea in 171 cases (56 per cent) and mucoid otorrhoea in 133 cases (44 per cent). The children's middle-ear secretion interferon-γ concentrations ranged from 12 to 126 pg/ml. The mean middle-ear secretion interferon-γ concentration was 27.2 pg/ml (standard deviation 8.8) in patients whose acute suppurative otitis media resolved, and 73.1 pg/ml (standard deviation 9.5) in those progressing to chronic suppurative otitis media. In children with purulent otitis media, the mean middle-ear secretion interferon-γ concentration was 43.5 pg/ml (standard deviation 15.6); in those with mucoid otitis media, it was 74.3 pg/ml (standard deviation 19.1). Univariate analysis revealed significant differences in middle-ear secretion interferon-γ concentration, comparing resolved acute suppurative otitis media and chronic suppurative otitis media cases (p = 0.00), and comparing purulent and mucoid otitis media cases (p = 0.00). Pearson correlation testing revealed significant inverse correlation between interferon-γ concentration and middle-ear secretion immunoglobulin G concentration (p = 0.01), immunoglobulin E concentration (p = 0.03) and immunoglobulin A concentration (p = 0.00).
Conclusion:A high concentration of interferon-γ in middle-ear secretions promotes chronicity of suppurative otitis media. Further research in this area may lead to the development of agents which assist the control of suppurative otitis media chronicity.
MALE PARTICIPATION IN PREGNANCY AND DELIVERY IN NIGERIA: A SURVEY OF ANTENATAL ATTENDEES
- O. OLAYEMI, F. A. BELLO, C. O. AIMAKHU, G. O. OBAJIMI, A. O. ADEKUNLE
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- Journal:
- Journal of Biosocial Science / Volume 41 / Issue 4 / July 2009
- Published online by Cambridge University Press:
- 23 March 2009, pp. 493-503
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This was a cross-sectional study carried out on 462 pregnant women attending antenatal care in Ibadan, Nigeria. The study's aims were to assess the level of participation of Nigerian men in pregnancy and birth, the attitude of the women and likely targets for improved care delivery. Three hundred and forty-nine women (75.5%) were aware that husbands could participate in childbirth. Most women did not think it was their husbands' place to attend antenatal clinic (48.3%) or counselling sessions (56.7%). Nearly all husbands (97.4%) encouraged their wives to attend antenatal clinic – paying antenatal service bills (96.5%), paying for transport to the clinic (94.6%) and reminding them of their clinic visits (83.3%). Three hundred and thirty-five husbands (72.5%) accompanied their wives to the hospital for their last delivery, while 63.9% were present at last delivery. More-educated women were less likely to be accompanied to the antenatal clinic, while more-educated men were likely to accompany their wives. Yoruba husbands were less likely to accompany their wives, but Yoruba wives with non-Yoruba husbands were 12 times more likely to be accompanied. Women in the rural centre were less likely to receive help with household chores from their husbands during pregnancy, while educated women were more likely to benefit from this. Monogamous unions and increasing level of husbands' education were associated with spousal presence at delivery. It appears that male participation is satisfactory in some aspects, but increased attendance at antenatal services and delivery would be desirable.
ATTITUDE AND PREFERENCES OF NIGERIAN ANTENATAL WOMEN TO SOCIAL SUPPORT DURING LABOUR
- I. O. MORHASON-BELLO, O. OLAYEMI, O. A. OJENGBEDE, B. O. ADEDOKUN, O. O. OKUYEMI, B. ORJI
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- Journal:
- Journal of Biosocial Science / Volume 40 / Issue 4 / July 2008
- Published online by Cambridge University Press:
- 01 July 2008, pp. 553-562
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This was a hospital-based cross-sectional study of 224 randomly selected antenatal women receiving care at the University College Hospital, Ibadan, Nigeria. The study aimed to seek the attitude and preferences of respondents about social support during childbirth and also identify variables that may influence their decisions. Seventy-five per cent of respondents desired companionship in labour. Approximately 86% preferred their husband as companion while 7% and 5% wanted their mother and siblings as support person respectively. Reasons for their desire for social support were emotional (80·2%), spiritual (17·9%), errands (8·6%) and physical activity (6·8%). Socio-demographic variables found to be statistically significant on logistic regression analysis for the desire of a companion in labour were nulliparity (OR 3·57, 95% CI 1·49–8·52), professionals (OR 3·11, 95% CI 1·22–7·94) and women of other ethnic groups besides Yoruba (OR 2·90, 95% CI 1·02–8·26), which is the predominant ethnic group in the study area. Only those with post-secondary education were found to want their husbands as doula (OR 2·96, 95% CI 1·08–8·11). More than half of the respondents wanted information about labour prior to their experience. It is important that Nigerian women are allowed the benefit of social support during childbirth, particularly as there is a lack of one-to-one nursing care and other critical services, including epidural analgesia in labour, at many of the health care facilities in Nigeria. Men could play a pivotal role in the process of introducing support in labour so as to improve the outcome for both the mother and her newborn.