Performance response, carcass evaluation and economic benefit of rabbits fed sorghum offal-based diets

An eight-week feeding trial was conducted to investigate the performance, carcass quality, haematological indices and economics of production of rabbits fed dietary sorghum offal substitute for maize grain. A total of forty (40) weaned rabbits with a mean weight range of 820-850 g were randomly distributed to five treatment diets where 0, 25, 50, 75 and 100% of sorghum offal replaced maize grain in the gross feed composition to give Diets 1 (control), 2, 3, 4 and 5, respectively. Each treatment diet was replicated eight times with a rabbit taken as a replicate. The determined chemical composition of the experimental diets ranged between 17.12% and17.43% for crude protein (CP), 11.48 and 14.89% for crude fibre (CF), 5.04 and 7.74% for ether extract or fat (EE), 54.17 and 56.41% for  nitrogen free extract (NFE) and 3069.35kcal/kg to 3241.17ME(kcal/kg). While the results on performance showed no significant difference (P>0.05) in feed intake by rabbits fed the five test diets, there appeared to be significant decrease (P<0.05) in the weight gain and feed conversion ratio of rabbits fed 50 to 100% sorghum offal-based diets. Carcass cuts that showed significant reduction (P<0.05) at 75 and 100% sorghum offal-based diets are the carcass weight, thigh, loin, shoulder and ribs weights. Organs such as liver, kidney, heart and pancreas weights  measured were significantly higher (P<0.05) at 75 and 100% sorghum offal-based diets. Haematological profile such as Packed Cell Volume(PCV), Red Blood Cells (RBC), White Blood Cells (WBC), Mean Cell Volume(MCV) and White Blood Counts such as neutrophil and basophil showed significant difference (P<0.05) at 75% and 100% sorghum offal-based diets. The serum metabolites such as albumin, globulin, cholesterol and urea showed a similar trend of significant difference (P<0.05) at 75% and 100% sorghum offal inclusion compared to other test diets. For economic production, the study revealed an optimum inclusion of sorghum offal at 50% (24.60 g/kg in feed composition) for maize grain in rabbit concentrate feed is possible. Above this level, a loss of N23.17 and N13.16 was recorded as evidenced by the cost differential and benefit cost analysis.Key words: Performance, Haematology, Serum, Sorghum offal, Rabbi

Nutritional and sensory qualities of soymilk kunnu blends

Kunnu, a beverage popular among the Northern Nigerians has a low protein value because it is made from cereals. This may  have a negative effect on the nutritional status of the people who drink it, especially on the growth rate of infants who are given kunnu as a weaning drink. This is because protein is an essential component of the balanced diet required for growth.  Research work carried out on the improvement of the nutritional value of cereals, shows that the fortification of  carbohydrate-rich foods with protein-rich foods improves its nutritious value. As a result of this, a study was carried out to fortify kunnu with soymilk and the effect on its nutritional and sensory properties was evaluated. Kunnu and soymilk were  prepared and it was fortified with soymilk in the ratio 1:1, 2:1, 3:1 and 4:1, and the proximate composition (protein, fat, ash and moisture content), chemical  composition (pH, specific gravity and sedimentation rate) and mineral content (calcium,  magnesium, phosphorus and iron content) were determined. The pH,  protein and mineral content increased as the amount of soymilk added. The pH value ranged from 4.8 to 4.3, while the protein content increased from 2.35 to 2.45%. The calcium and magnesium content also increased from 0.08 to 0.15% and 0.18 to 0.29% respectively. The fat and ash content,  however, decreased respectively from 2.8 to 2.0, and 0.91 to 0.891 with an increase in addition of soymilk. The proximate, chemical and mineral content were significantly different at P < 0.05 while the sensory properties were not significantly different at the same level. The sensory properties (colour, taste, texture, flavor and general acceptability) were, however, observed to decrease with the increase in fortification level of soymilk. The results obtained show that the fortification of  kunnu with  soymilk will result in a more nutritious beverage, but it may have a low level of acceptance with the local populace.Keywords: fortification, kunnu, soymilk, blendsLe Kunnu, une boisson populaire chez les Nigérians du Nord, a une basse valeur en protéines parce qu’il est fabriqué à partir de céréales. Ceci peut avoir un effet  négatif sur l’état nutritionnel des personnes qui le boivent. Il peut avoir un effet négatif surtout sur le taux de croissance des enfants en bas âge à qui l’on donne du kunnu comme boisson de sevrage, étant donné qu’une protéine est une composante essentielle d’un régime alimentaire équilibré requis pour la croissance. Des travaux de recherche menés sur l’amélioration de la valeur nutritive des céréales montrent que la fortification d’aliments riches en  hydrates de carbone par des aliments riches en protéines améliore sa valeur nutritive. Comme résultat de ceci, une étude a été menée en vue de fortifier le kunnu avec du lait de soja et l’effet sur ses propriétés nutritives et sensorielles a été évalué. Le kunnu et le lait de soja ont été préparés et le kunnu a été fortifié avec du lait de soja dans la proportion 1:1, 2:1, 3:1 et  4:1. La composition rapprochée (la teneur en protéines, graisses, cendre et humidité), la composition chimique (pH, gravité spécifique et taux de sédimentation) et la teneur en minéraux (calcium, magnésium, phosphore et fer) ont été déterminées. La teneur en pH, en protéines et en minéraux augmentait au fur et à mesure que la quantité de lait de soja augmentait. La valeur du pH se situait entre 4,8 et 4,3, tandis que la teneur en protéines augmentait de 2,35 à 2,45%. La teneur en calcium et en magnésium a également augmenté de 0,08 à 0,15% et de 0,18 à 0,29%  respectivement. Par contre, les matières grasses et la teneur en cendre ont baissé de 2,8 à 2,0, et de 0,91 à 0,891 avec une augmentation en plus du lait de soja. Les teneurs  rapprochées, en matières chimiques et minérales, étaient très différentes à P < 0,05 tandis que les propriétés sensorielles  n’étaient pas très différentes au  même niveau. Cependant, il a été observé que les propriétés sensorielles (couleur, goût,  texture, saveur et acceptabilité générale) baissent avec l’augmentation du niveau de fortification par du lait de soja. Les  résultats obtenus montrent que la fortification du kunnu par du lait de soja aura comme résultat une boisson plus nutritive,  mais qui peut avoir un niveau insuffisant d’acceptation auprès de la population locale. Mots-clés: fortification, kunnu, lait de soja, mélanges 

Corrosive oesophageal injuries: a preventable menace

Introduction: Potentially catastrophic presentations and lifelong complications resulting from corrosive ingestions in humans is one of the most challenging situations encountered in clinical medical practice. This study reviewed pattern, mechanisms and associated socio-medical challenges with ingestion of corrosive agents as seen in a tertiary health institution in South-western Nigeria. Methods: A retrospective review of all patients that were managed for corrosive ingestion at Ladoke Akintola University of Technology Teaching Hospital, Osogbo, Osun State, Nigeria, over a seven year period. Results: A total of 28 patients M:F: 1.6:1. There were 7 children and 21 adults. Majority (78.6%) of the patients ingested alkaline substances. Accidental ingestion occurred in 28.6% while 71.4% resulted from deliberate self harm especially among adults (66.7%). Almost two thirds (64.3%) of the patients presented after 48hrs of ingestion. Patients who presented early were managed conservatively. Most patients (64.3%) who presented late had nutritional and fluid rehabilitation. Two patients died from oesophageal perforation and resulting septicaemia. Psychiatric evaluation revealed that seven adults (25%) had psychotic illness while (42.9%) of the patients developed oesophageal strictures. Short segment strictures were managed with oesophageal dilatation with good outcome while long and multiple segment strictures were referred to cardiothoracic surgeons for management. Conclusion: Corrosive oesophageal injuries remain a prevalent and preventable condition in the developing countries. Preventive strategies should include regulation and packaging of corrosive substances, organization of psychiatric services, and education of the population on corrosive ingestion.Key words: Corrosive injuries, caustic ingestion, accidental ingestion, self harm, mechanisms, prevention, psychiatric disorders, esophageal stricture, Nigeri

Acute mechanical bowel obstruction among adults see at the Lake Akintola

No Abstrac

The role of laboratory confirmations and molecular epidemiology in global eradication of measles

This review reports on the role of laboratory confirmation and molecular epidemiology in global eradication of measles. The role of laboratory confirmation and molecular epidemiology in defining the origins of measles outbreaks cannot be overemphasized. New serological tests based on recombinant proteins detect only a fraction of the total measles virus (MV) specific antibodies. Several assays based on recombinant MV-haemagglutinin (ELISA and flow cytometry) or MV-fusion protein (flow cytometry) as well as neutralization and haemagglutination test have been evaluated using a large panel of lowtitre and negative sera. Isolation of measles virus confirmed the diagnosis. Phylogenetic trees are invaluable tools for monitoring the progress of immunization activities. Recent advances in genomic sequencing technology have lent its support to the monitoring and evaluation of vaccination programmes. More so, indigenous prepared measles antigens has been advocated to be produced, refined further and reproduced massively. This will be highly cost effective especially in field for seromonitoring and surveillance of measles. There is therefore, continual need for simpler diagnostic tests in elimination and eventual eradication of measles

Exposure to anti-malarial drugs and monitoring of adverse drug reactions using toll-free mobile phone calls in private retail sector in Sagamu, Nigeria: implications for pharmacovigilance

<p>Abstract</p> <p>Background</p> <p>Adverse drug reactions (ADRs) contribute to ill-health or life-threatening outcomes of therapy during management of infectious diseases. The exposure to anti-malarial and use of mobile phone technology to report ADRs following drug exposures were investigated in Sagamu - a peri-urban community in Southwest Nigeria.</p> <p>Methods</p> <p>Purchase of medicines was actively monitored for 28 days in three Community Pharmacies (CP) and four Patent and Proprietary Medicine Stores (PPMS) in the community. Information on experience of ADRs was obtained by telephone from 100 volunteers who purchased anti-malarials during the 28-day period.</p> <p>Results and Discussion</p> <p>A total of 12,093 purchases were recorded during the period. Antibiotics, analgesics, vitamins and anti-malarials were the most frequently purchased medicines. A total of 1,500 complete courses of anti-malarials were purchased (12.4% of total purchases); of this number, purchases of sulphadoxine-pyrimethamine (SP) and chloroquine (CQ) were highest (39.3 and 25.2% respectiuvely). Other anti-malarials purchased were artesunate monotherapy (AS) - 16.1%, artemether-lumefantrine (AL) 10.0%, amodiaquine (AQ) - 6.6%, quinine (QNN) - 1.9%, halofantrine (HF) - 0.2% and proguanil (PR) - 0.2%. CQ was the cheapest (USD 0.3) and halofantrine the most expensive (USD 7.7). AL was 15.6 times ($4.68) more expensive than CQ. The response to mobile phone monitoring of ADRs was 57% in the first 24 hours (day 1) after purchase and decreased to 33% by day 4. Participants in this monitoring exercise were mostly with low level of education (54%).</p> <p>Conclusion</p> <p>The findings from this study indicate that ineffective anti-malaria medicines including monotherapies remain widely available and are frequently purchased in the study area. Cost may be a factor in the continued use of ineffective monotherapies. Availability of a toll-free telephone line may facilitate pharmacovigilance and follow up of response to medicines in a resource-poor setting.</p

Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015

SummaryBackground The Global Burden of Diseases, Injuries, and Risk Factors Study 2015 provides an up-to-date synthesis of the evidence for risk factor exposure and the attributable burden of disease. By providing national and subnational assessments spanning the past 25 years, this study can inform debates on the importance of addressing risks in context. Methods We used the comparative risk assessment framework developed for previous iterations of the Global Burden of Disease Study to estimate attributable deaths, disability-adjusted life-years (DALYs), and trends in exposure by age group, sex, year, and geography for 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks from 1990 to 2015. This study included 388 risk-outcome pairs that met World Cancer Research Fund-defined criteria for convincing or probable evidence. We extracted relative risk and exposure estimates from randomised controlled trials, cohorts, pooled cohorts, household surveys, census data, satellite data, and other sources. We used statistical models to pool data, adjust for bias, and incorporate covariates. We developed a metric that allows comparisons of exposure across risk factors—the summary exposure value. Using the counterfactual scenario of theoretical minimum risk level, we estimated the portion of deaths and DALYs that could be attributed to a given risk. We decomposed trends in attributable burden into contributions from population growth, population age structure, risk exposure, and risk-deleted cause-specific DALY rates. We characterised risk exposure in relation to a Socio-demographic Index (SDI). Findings Between 1990 and 2015, global exposure to unsafe sanitation, household air pollution, childhood underweight, childhood stunting, and smoking each decreased by more than 25%. Global exposure for several occupational risks, high body-mass index (BMI), and drug use increased by more than 25% over the same period. All risks jointly evaluated in 2015 accounted for 57·8% (95% CI 56·6–58·8) of global deaths and 41·2% (39·8–42·8) of DALYs. In 2015, the ten largest contributors to global DALYs among Level 3 risks were high systolic blood pressure (211·8 million [192·7 million to 231·1 million] global DALYs), smoking (148·6 million [134·2 million to 163·1 million]), high fasting plasma glucose (143·1 million [125·1 million to 163·5 million]), high BMI (120·1 million [83·8 million to 158·4 million]), childhood undernutrition (113·3 million [103·9 million to 123·4 million]), ambient particulate matter (103·1 million [90·8 million to 115·1 million]), high total cholesterol (88·7 million [74·6 million to 105·7 million]), household air pollution (85·6 million [66·7 million to 106·1 million]), alcohol use (85·0 million [77·2 million to 93·0 million]), and diets high in sodium (83·0 million [49·3 million to 127·5 million]). From 1990 to 2015, attributable DALYs declined for micronutrient deficiencies, childhood undernutrition, unsafe sanitation and water, and household air pollution; reductions in risk-deleted DALY rates rather than reductions in exposure drove these declines. Rising exposure contributed to notable increases in attributable DALYs from high BMI, high fasting plasma glucose, occupational carcinogens, and drug use. Environmental risks and childhood undernutrition declined steadily with SDI; low physical activity, high BMI, and high fasting plasma glucose increased with SDI. In 119 countries, metabolic risks, such as high BMI and fasting plasma glucose, contributed the most attributable DALYs in 2015. Regionally, smoking still ranked among the leading five risk factors for attributable DALYs in 109 countries; childhood underweight and unsafe sex remained primary drivers of early death and disability in much of sub-Saharan Africa. Interpretation Declines in some key environmental risks have contributed to declines in critical infectious diseases. Some risks appear to be invariant to SDI. Increasing risks, including high BMI, high fasting plasma glucose, drug use, and some occupational exposures, contribute to rising burden from some conditions, but also provide opportunities for intervention. Some highly preventable risks, such as smoking, remain major causes of attributable DALYs, even as exposure is declining. Public policy makers need to pay attention to the risks that are increasingly major contributors to global burden. Funding Bill & Melinda Gates Foundation

Baricitinib in patients admitted to hospital with COVID-19 (RECOVERY): a randomised, controlled, open-label, platform trial and updated meta-analysis

Background: We aimed to evaluate the use of baricitinib, a Janus kinase (JAK) 1–2 inhibitor, for the treatment of patients admitted to hospital with COVID-19. Methods: This randomised, controlled, open-label, platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]), is assessing multiple possible treatments in patients hospitalised with COVID-19 in the UK. Eligible and consenting patients were randomly allocated (1:1) to either usual standard of care alone (usual care group) or usual care plus baricitinib 4 mg once daily by mouth for 10 days or until discharge if sooner (baricitinib group). The primary outcome was 28-day mortality assessed in the intention-to-treat population. A meta-analysis was done, which included the results from the RECOVERY trial and all previous randomised controlled trials of baricitinib or other JAK inhibitor in patients hospitalised with COVID-19. The RECOVERY trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936) and is ongoing. Findings: Between Feb 2 and Dec 29, 2021, from 10 852 enrolled, 8156 patients were randomly allocated to receive usual care plus baricitinib versus usual care alone. At randomisation, 95% of patients were receiving corticosteroids and 23% were receiving tocilizumab (with planned use within the next 24 h recorded for a further 9%). Overall, 514 (12%) of 4148 patients allocated to baricitinib versus 546 (14%) of 4008 patients allocated to usual care died within 28 days (age-adjusted rate ratio 0·87; 95% CI 0·77–0·99; p=0·028). This 13% proportional reduction in mortality was somewhat smaller than that seen in a meta-analysis of eight previous trials of a JAK inhibitor (involving 3732 patients and 425 deaths), in which allocation to a JAK inhibitor was associated with a 43% proportional reduction in mortality (rate ratio 0·57; 95% CI 0·45–0·72). Including the results from RECOVERY in an updated meta-analysis of all nine completed trials (involving 11 888 randomly assigned patients and 1485 deaths) allocation to baricitinib or another JAK inhibitor was associated with a 20% proportional reduction in mortality (rate ratio 0·80; 95% CI 0·72–0·89; p<0·0001). In RECOVERY, there was no significant excess in death or infection due to non-COVID-19 causes and no significant excess of thrombosis, or other safety outcomes. Interpretation: In patients hospitalised with COVID-19, baricitinib significantly reduced the risk of death but the size of benefit was somewhat smaller than that suggested by previous trials. The total randomised evidence to date suggests that JAK inhibitors (chiefly baricitinib) reduce mortality in patients hospitalised for COVID-19 by about one-fifth. Funding: UK Research and Innovation (Medical Research Council) and National Institute of Health Research

Higher dose corticosteroids in patients admitted to hospital with COVID-19 who are hypoxic but not requiring ventilatory support (RECOVERY): a randomised, controlled, open-label, platform trial

BACKGROUND: Low-dose corticosteroids have been shown to reduce mortality for patients with COVID-19 requiring oxygen or ventilatory support (non-invasive mechanical ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation). We evaluated the use of a higher dose of corticosteroids in this patient group. METHODS: This randomised, controlled, open-label platform trial (Randomised Evaluation of COVID-19 Therapy [RECOVERY]) is assessing multiple possible treatments in patients hospitalised for COVID-19. Eligible and consenting adult patients with clinical evidence of hypoxia (ie, receiving oxygen or with oxygen saturation <92% on room air) were randomly allocated (1:1) to either usual care with higher dose corticosteroids (dexamethasone 20 mg once daily for 5 days followed by 10 mg dexamethasone once daily for 5 days or until discharge if sooner) or usual standard of care alone (which included dexamethasone 6 mg once daily for 10 days or until discharge if sooner). The primary outcome was 28-day mortality among all randomised participants. On May 11, 2022, the independent data monitoring committee recommended stopping recruitment of patients receiving no oxygen or simple oxygen only due to safety concerns. We report the results for these participants only. Recruitment of patients receiving ventilatory support is ongoing. The RECOVERY trial is registered with ISRCTN (50189673) and ClinicalTrials.gov (NCT04381936). FINDINGS: Between May 25, 2021, and May 13, 2022, 1272 patients with COVID-19 and hypoxia receiving no oxygen (eight [1%]) or simple oxygen only (1264 [99%]) were randomly allocated to receive usual care plus higher dose corticosteroids (659 patients) versus usual care alone (613 patients, of whom 87% received low-dose corticosteroids during the follow-up period). Of those randomly assigned, 745 (59%) were in Asia, 512 (40%) in the UK, and 15 (1%) in Africa. 248 (19%) had diabetes and 769 (60%) were male. Overall, 123 (19%) of 659 patients allocated to higher dose corticosteroids versus 75 (12%) of 613 patients allocated to usual care died within 28 days (rate ratio 1·59 [95% CI 1·20–2·10]; p=0·0012). There was also an excess of pneumonia reported to be due to non-COVID infection (64 cases [10%] vs 37 cases [6%]; absolute difference 3·7% [95% CI 0·7–6·6]) and an increase in hyperglycaemia requiring increased insulin dose (142 [22%] vs 87 [14%]; absolute difference 7·4% [95% CI 3·2–11·5]). INTERPRETATION: In patients hospitalised for COVID-19 with clinical hypoxia who required either no oxygen or simple oxygen only, higher dose corticosteroids significantly increased the risk of death compared with usual care, which included low-dose corticosteroids. The RECOVERY trial continues to assess the effects of higher dose corticosteroids in patients hospitalised with COVID-19 who require non-invasive ventilation, invasive mechanical ventilation, or extracorporeal membrane oxygenation. FUNDING: UK Research and Innovation (Medical Research Council), National Institute of Health and Care Research, and Wellcome Trust