Which factors actually influence the development and progression of overt nephropathy in Nigerian diabetics?

A journal article on Diabetes Mellitus (DM) in Nigeria.Diabetes Mellitus (DM) is the commonest endocrine disease in the world, with a worldwide prevalence of 4% in adults.1 In Nigeria the prevalence of DM ranges from 2.4 to 6% and varies from relatively rural to urban communities.2 One of the most serious complications of DM is diabetic nephropathy (DN) with a prevalence of about 4Q%.3 Unlike the previous reports which documented the rarity of diabetic nephropathy amongst Nigerians4'11, it is now.a leading cause of end stage renal disease (ESRD) in the world, as it accounts for about half of the total population of patients recruited to renal replacement treatment programmes in the western world.12 Even locally, the prevalence of DN had increased significantly in the last 15 years from almost 0% of the causes of chronic renal failure to the third commonest cause accounting for 3 to 5% of the causes of ESRD

An intelligent model of variations contingency on construction projects

SIGLEAvailable from British Library Document Supply Centre-DSC:DXN015215 / BLDSC - British Library Document Supply CentreGBUnited Kingdo

Prevalence of blindness and visual impairment in Atakunmosa West Local Government Area of southwestern Nigeria

Blindness survey remains a useful tool for eye care needs assessment. A cross sectional survey of Atakunmosa West Local Government Area, a rural community of southwest Nigeria with no form of eye care facility was carried out. The objective of this study was to define areas of eye care need and develop programme for elimination of avoidable blindness in the region. Multistage cluster sampling technique selected 1,248 respondents across all the eleven health districts. Respondents had visual acuity and ocular examination. Blindness was defined as presenting visual acuity (pva) of <3/60 in the better eye and visual impairment as pva of <6/18 in the better eye. Out of the 1,248 respondents screened, 14 (1.1%) were blind and 78 (6.3%) were visually impaired. There was an increasing risk of blindness and visual impairment with age; occurring more commonly after 60 years of age. The prevalence of blindness and visual impairment were higher in females although not statistically significant (P= 0.70; 0.46 respectively). Blindness was caused mainly by cataract (57.2%), glaucoma (14.3%) and congenital childhood blindness (14.3%). Cataract (57.7%), glaucoma (16.7%) and uncorrected refractive error (15.4%) were the leading causes of visual impairment. Blindness was avoidable in 85.7% of cases. Qualitative and subsidised cataract surgical and refractive services are needed urgently in this region and therefore, the incorporation of eye health care into the existing primary health care system may ensure programme sustainability

Chromosomal abnormalities in couples with recurrent abortions in Lagos, Nigeria

The study was to investigate the prevalence of chromosomal abnormalities in  couples with two or more recurrent miscarriages of unknown cause. The study  population included 55 women and 32 male partners with medical history of 2 or  more consecutive abortions and primary infertility. The controls were 20 healthy  couples with at least one live delivery and without a history of pregnancy loss.  Individuals with medical disease or reproductive organic abnormality were excluded from the study. Chromosomal analysis was performed on peripheral blood   lymphocytes cultured for 72 hours, using Trypsin-Giemsa (GTG) banding. In all cases, at least 20 metaphases were analyzed and 2 karyotypes were prepared, using light microscopy. Out of 78 cases of karyotype analyzed, 6 cases (7.7%) of abnormal chromosome karyotypes and two (2) Y chromosome variants (2.56%) were seen. No case of structural anomaly was seen. There was no case of  chromosomal abnormality seen among the control group in this study. The median age and age range of couples with recurrent miscarriages were 33 years and 28-42 years respectively for the females and 37 and 31-51 years for the males. The male to female ratio is 1:1. The most frequent age group of involvement is 35-39  (44.9%) followed by 30-34 (33.3%) and then 40-44(14.1%) Chromosomal  alterations affected most commonly age group 30-34(3.84%) followed by group 40-44 (2.56%). All the groups have equal average number of pregnancy wastage of 4 per couple. Of the 6 abnormal cases, 1 case (1.28%) each of the mosaic  Kleinfelter syndrome (XXY) and Superman (XYY) as well as 2 cases of   translocations made up of reciprocal and Robertsonian types. Also seen are 1case (1.28%) each of mosaic Turners syndrome and trisomy X. An association between chromosomal abnormalities and recurrent miscarriage of pregnancy was observed inthe study. Etiologic identification of genetic factors represents important clinical information for genetic counseling and orientation of the couple about the risk for future pregnancies and decreases the number of investigations needed to elucidate the possible causes of miscarriages.Keywords: Chromosomal abnormalities, recurrent miscarriages, Genetic counselling

Ten year review of diabetic retinopathy at the Guinness Eye Centre, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos

Background: Diabetic retinopathy is an important complication of diabetes mellitus, which may lead to blindness.Objective: The study is to analyze posterior segment lesions in Diabetes Mellitus patients seen in Guinness Eye Centre, Lagos University Teaching Hospital in relation to the number, duration and severity.Methods: All the case files of Diabetes Mellitus patients seen during the period of study were retrieved and data extracted from them were analyzed. Such information included age, sex, duration of Diabetic Retinopathy and its severity.Results: A total of 84 case files were reviewed. There were 47 males and 37 females with a male to female ratio of 1.3:1. No diabetic patient was seen in the age group 30 years and below. Fifty-five (65%) patients who presented themselves did so very late. Of the 35 patients found to have diabetic retinopathy at presentation, 16 had the disease bilaterally. The most common form of Diabetic Retinopathy was clinically significant macula oedema. The study shows that a high proportion of the patients (41.6%) had Diabetic Retinopathy.Conclusions: Patients with DM should be referred early for eye examinations. Physicians Residents should be made to rotate through eye Departments for a period of at least 2 weeks so they can learn fundoscopy. Diabetic patients should be educated on the eye complications that may arise from their condition. Regular eye screening with fundus camera and laser therapy should be part of the routine management of Diabetics in Nigeria as is done in advanced countries.Keywords: Diabetic Retinopathy, Routine Screening and Treatmen

Pattern of ocular morbidity among children seen in a Nigerian Teaching Hospital

Background: Children are peculiar beings and their eye care needs are different from that of adults. This is because a delay in treatment for some causes of childhood blindness can lead to amblyopia. Furthermore, the number of “blind years” resulting from childhood blindness is more than double the number of “blind years” attributable to adult cataract. Therefore, there is a level of urgency about managing eye diseases in children.Objective: This study was conducted to describe the pattern of ocular morbidity among children below 16 years of age seen at the Guinness Eye Centre, Lagos University Teaching Hospital with a view to determine the most common causes of childhood ocular morbidity in this centre.Methods: A retrospective, descriptive study of new patients below the age of 16 years who presented to the Guinness Eye Centre, Lagos University Teaching Hospital (LUTH) between January, 2012 and June, 2013. Children with no eye disorder and those who defaulted from clinic with inconclusive diagnosis were excluded from the study.Results: A total of 4,253 new patients were seen over the eighteen months under review out of which 723 were analysed constituting 17% of all new patients seen in the clinic. The most frequently seen age group was 0-5 years (41.8%) with 74.3% of all the children presenting in their first decade of life. Refractive error (19.5%) was the most common ocular morbidity seen, followed by ocular trauma(13.1%), allergic conjunctivitis (11.1%) and cataract (10.9%).Conclusion: Refractive error, ocular trauma, allergic conjunctivitis and cataract were responsible for more than half of the ocular morbidities in this study. This information will help in prioritization of equipment acquisition for effective and efficient children eye care services in this centre in the face of limited resources.Keyword: Ocular Morbidity, Children Hospital, Nigeri

Mathematical Modelling of Egg Production Curves of Shikabrown® Parents

This study was conducted to evaluate egg production curves of Shikabrown® parents, using mathematical models. A total of 200 birds: 100 from each of the two strains of Shikabrown® parents (sire and dam) lines at the Breeding Unit of Poultry Research Programme, National Animal Production Research Institute (NAPRI) were used for the study. The birds were obtained from the selected lines (sire and dam) and were denoted as Strain A and Strain B, respectively. Body weight (BWT), age at sexual maturity (ASM), egg number (EGGNO), and egg weight (EWT) were examined. Four non-linear models (Logistic, Richard, Gompertz, and Exponential) and a linear model were used to predict the efficiency of weekly bodyweight and egg production traits. The adequacies of the models were fitted using R Package, version 3.0.3. High coefficients of determination for BWT (R2 = 0.84 - 0.93) were recorded in the models for both Strains. Strain A had higher R2 (0.93) for BWT in Richard, Gompertz and Exponential models while Strain B recorded (R2 = 0.89) in Logistic, Richard and Gomprtz models. High coefficient of determination was obtained in a reproductive trait; egg number; in which almost all the models gave (R2 = 0.70). Exponential model recorded a higher R2 (0.93) for EGGNO in strain A. EWT in strain A recorded higher R2 (0.96) coefficient of determination across the four nonlinear models except linear model with (R2 = 0.95) for egg weight. Significant differences (P&lt;0.05) were observed in the birds' performance for BWT and EWT, with strain B having a higher BWT (1.59±0.01) and Strain A having a higher EWT (48.75±0.17). Similarly, age of birds in lay had a concomitant significant differences (P&lt;0.05) in their BWT as well as their EWT. The birds performed better for BWT and EWT in week 26 and 27 for both Strains. It was concluded that Strain significantly (P&lt;0.05) had effect on BWT and EWT of Shikabrown® parent with Stain B performing better than Strain A in the former trait and strain A better than strain B in the latter trait. R2 identified differences between Strains in predicting egg production traits. Strain B was adjudged good and profitable because the Strain had the highest mean values in body weight and egg number and it is being recommended as one of the lines for future improvement of Shikabrown®. Keywords: Mathematical models, Egg Production Curves, Body weight, ASM, Egg Number, Egg weigh

Prevalence and causes of low vision in Kosofe Local Government, south western Nigeria

Background: Low vision is a very important area in Ophthalmology, however, some Ophthalmologists and eye health  practitioners are not paying enogh attention to this area of ophthalmic practice. Hence, this determination of prevalence and causes of Low Vision in Kosofe Local Government Area of Lagos, South Western Nigeria.Objective: To determine the prevalence and pattern of Low Vision in Kosofe Local Government in Nigerians over 16 years of age with a view to increase awareness of low vision and to provide data to facilitate the establishment of low vision services in Kosofe Local Government Area of Lagos.Methods: A descriptive, cross-sectional study where eligible subjects filled structured interviewer administered questionnaires, after which they underwent full ophthalmological examination including visual acuity and full refraction. Low vision was defined as best corrected visual acuity equal to/worse than 6/18 to light perception in the better eye. Data analysis was done using Statistical Package for Social Sciences (SPSS) version 17 and a p value &lt;0.05 considered statistically significant.Results: Of the three hundred subjects examined, the female : male was 1.3:1 with the age range of 16 and 74years.Low vision was found in 31 (10.3%) Subjects. Cataract was the leading cause of low vision in 14 (45.16%) respondents, followed by glaucoma 8 (25.8%) and refractive errors 3 (9.68%). There was a statistically significant association between low vision and these risk factors -advanced age, low educational level, poor income and past ocular trauma (p&lt;0.05), with ocular trauma having the strongest association with low vision.Conclusion: Low vision is prevalent in Kosofe Local Government Area of Lagos State and the main causes are avoidable. There is a need for enlightenment to reduce the burden of low vision.Keywords: Low Vision; Prevalence; Causes; Lagos; South Western Nigeri

Effects of selenium supplementation on pregnancy outcomes and disease progression in HIV-infected pregnant women in Lagos: A randomized controlled trial

Objective To examine the effects of selenium supplementation on pregnancy outcomes and disease progression among HIV-infected pregnant women in Lagos. Methods A randomized, placebo-controlled trial conducted among HIV-positive pregnant women between September 2018 and August 2019. At enrollment, 90 women were randomly assigned into each treatment arm to receive either a daily tablet of 200 μg elemental selenium or a placebo. Relevant participants' sociodemographic and clinical data were collected at enrollment and delivery. Results Women in the selenium arm had a significantly lower risk of preterm delivery (relative risk [RR] 0.32, 95% confidence interval [CI] 0.11–0.96) and a non-significant reduction in the risk of delivering term neonates with a low delivery weight (RR 0.24, 95% CI 0.05–1.19). Supplemental selenium does not increase the risk of perinatal death and adverse drug events. Conclusion The study reported a beneficial effect of prenatal selenium supplements on the risk of preterm delivery with no further reduction in risk among HIV-infected women who used the supplements for more than 14 weeks. Trial registration Pan African Clinical Trial Registry (PACTR201809756724274)