Thyroid function profile in cord blood and postnatal changes at 24 and 72hours in healthy term Nigerian neonates

Background: Studying the acute postnatal changes of newborn thyroid  function is essential for determining the best timing of screening for  congenital hypothyroidism. There is paucity of literature on neonatal  thyroid function and particularly the postnatal changes in Nigeria.Objectives: To describe the profile of thyroid function in cord blood and the postnatal changes at 24hours and 72hours in healthy term neonates  delivered in Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto.Subjects and methods: This was a prospective, descriptive and cross sectional study conducted over a six month period (between July-December 2009). Forty seven consecutively delivered healthy term neonates had their serum T3, T4, TSH assayed at birth, 24 and 72hours using the Enzyme linked immunosorbent assay (ELISA) technique. Data obtained are presented as mean, median and standard deviation (SD). Paired- t- testwas used for statistical inference.Results: The mean (SD) of the serum hormone concentrations in cord blood, and venous blood at 24hours and 72hours, respectively were as follows: T3, 0.58 (0.56) nmol/l, 1.15 (0.77)nmol/l, 0.83 (0.74)nmol/l; T4, 91 (83.1)nmol/l, 121.5 (106.4)nmol/l, 104.2 (84.2) nmol/l; and TSH, 5.95 (5.81)mU/l, 8.61 (8.34)mU/l, 2.52 (2.61) mU/ l.. The mean serum T3, T4 and TSH at 24hours were higher than cord blood levels (p<0.001, 0.03, 0.05 respectively). The mean serum T3 and T4 at 72hours, were higherthan cord blood levels (p = 0.07, 0.44), whereas TSH at 72hours was significantly lower than cord blood levels; (p<0.001).Conclusions: There was a rise, above cord level, of T3, T4 and TSH at 24hours, and a decline at 72hours, the latter being most marked in TSH. It is recommended that serum TSH taken at or greater than 72hours of life may be utilized for screening for congenital hypothyroidism in term babies,using postnatal age appropriate reference ranges. Serum T3, T4 should then be assayed for confirmation in all neonates with a positive TSH screening.Key words: Thyroid profile, postnatal changes, Term, Healthy neonates

Triceps skin fold thickness as a measure of body fat in Nigerian adolescents

Background: Skin fold thickness (SFT) at selected areas offers a simple method of subcutaneous fat assessment and provides a good estimate of obesity and body fat distribution. The triceps SFT has been shown to be one of the best and most popular sites for SFT measurement in children.Objective: To assess the body fat of school adolescents and to comparethe performance of triceps SFT with Bioelectrical impedance method in the detection of overweight (OW) and obesity (OB) among the subjectsMethods: The study was cross sectional; involving secondary schoolstudents within Sokoto metropolis. Subjects were selected by a multistagerandom sampling method. Harpenden skin fold caliper (ASSIST Creative Resources Ltd, LL13 9UG, UK) and Tanita Body fat scale (model UM-030, Tanita, UK Ltd; 2004) were used respectively to measure the triceps SFTand body fat content (%) according to the manufacturer’s instructions. Results: The mean triceps SFT values were 8.9mm (±4.7) for malesand 12.9mm (±4.6) for the females (p<0.001). Mean % BF values were8.2 ± 4.1% for the males, and 20.0 ± 6.8% for the females (p<0.001).The triceps SFT gave a prevalence of overweight of 2.5%, while that of obesity was 0.8%. With the BIA method, 2.5% of the subjects wereclassified as overweight and 1.7% as obese.Conclusion: Triceps SFT remain a fair surrogate for the assessment ofadiposity, the component of overweight that leads to pathology.Key words: Skin fold thickness, bioelectrical impedance analysis, body fat, obesity, adolescent

Neonatal Bacterial Meningitis And Dexamethasone Adjunctive Usage In Nigeria

Objective: Neonatal bacterial meningitis is devastating, with attendant high mortality and neurological sequelae. We, therefore, aimed to delineate its current incidence, etiologic, clinical, laboratory spectra, and the effect of steroid therapy on the outcome. Methodology: Babies admitted from1992 to 1995 in the Special Care Baby Unit of the University of Maiduguri Teaching Hospital, Maduguri, Nigeria, with bacterial meningitis were studied prospectively. Neonatal bacterial meningitis was confirmed if the cerebrospinal fluid (CSF) microbiological, chemical, immunological and clinical criteria were satisfied. Detailed neurological follow-up was made. Result: Sixty-nine cases of neonatal bacterial meningitis were encountered, (25 were early-onset, and 44 late-onset); the incidence was 6.5/1000 live births. 22 Positive CSF cultures were grown in early-onset meningitis, and 28 in late-onset disease. Low birth weight showed higher risk of bacterial meningitis and it was significantly more likely in the preterm. X2=24.19, p = 0.000001). Gram-negative pathogens were more isolated (28/50, 56%); Escherichia coli (11) being the commonest, while of the Gram-positive pathogens Staphylococcus aureus was most predominant overall (13/50). Concomitant blood culture was positive in 39/50 (78%), inclusive of all 22 “definite” early-onset disease. The CSF WBC was minimally raised (25-30 x 106/L) in 11 (22%) of “definite” neonatal bacterial meningitis. Detection of unusual pathogens was noteworthy: N. meningitidis (2) and H.influenzae (2), contributing 0.6 and 2.2 per 1000 live births and admissions, respectively. Overall mortality was 24.6%. Of the forty survivors, 9(22.5%) had neurological sequelae: sensorineural hearing deficit (3), hydrocephalus (2), subdural effusion (2), hemiparesis (1), afebrile (recurrent) seizure (1), and there was reduced developmental quotients at 24 months follow-up in 33. Dexamethasone therapy decreased mortality significantly; p = 0.0004. Conclusion: The new information highlighted by this research includes the lack of Group B Streptococcus isolation, the finding of S. pneumoniae, N.meningitidis, H.influenzae and S. aureus as significant pathogens, usefulness of blood cultures in the detection of neonatal bacterial meningitis, increasing resistance of Gram-positive neonatal pathogens to cloxacillin, low CSF WBC, and the finding that the adjunctive use of dexamethasone significantly decreases case fatality and neurological sequelae. Nigerian Journal of Clinical Practice Vol. 11 (3) 2008: pp. 235-24

Substance use among secondary school adolescents in Gwagwalada Area Council, Abuja, Nigeria

Background: Adolescent substance use is a growing epidemic that is placing heavy burdens on individuals, families and communities hence the stimulus for this study.Aim/Objectives: To determine the prevalence and pattern of substance use among secondary school adolescents in Gwagwalada Area Council, Abuja, Nigeria.Methods: A questionnaire-based, cross-sectional, descriptive study done over a three-month period among secondary school adolescents aged 10 to 18 years old after obtaining appropriate ethical approvals, consent and assent.Results: A total of 1,196 questionnaires were analysed, of which 641 (53.6%) were females and 1,052 (87.96%) from public schools. The overall prevalence rate for lifetime use was 72.7%. The substance with the highest prevalence rates for lifetime, annual and current use was kola nut (44.3%, 24.4 and 11.0%, respectively) and lowest for heroin (0.7%, 0.6% and 0.5%, respectively). There was a statistically significant male preponderance for licit substance use and a non-statistically significant female preponderance for illicit substance use. 507(42.4%) students were single substance users while 363 (30.35%) students were multiple substance users. Age at first use was at ten years of age or less.Conclusion and recommendations: There is need for strengthening substance use prevention programmes and implementing regulatory laws on sale and use of substances. Stiffer penalties for offenders are recommended.Keywords: Prevalence;substance use; adolescent; secondary school; Nigeri

Effect of metabolites produced by Trichoderma species against Ceratocystis paradoxa in culture medium

Metabolites released from Trichoderma viride, T. polysporum, T. hamatum and T. aureoviride were tested in culture medium against Ceratocystis paradoxa, which causes black seed rot in oil palm sprouted seeds. The Trichoderma metabolites had similar fungistatic effects on the growth of C.paradoxa except those from T. aureoviride. The inhibition varied depending on the Trichoderma species producing the metabolites; from 2.0% to 64% in volatile, 0.0% to 74% in non-volatile and 0.0% to 81% from direct-diffusible metabolites. C. paradoxa growth was significantly reduced in the presence ofmetabolites produced by T. viride and T. polysporum than the other species. T. aureoviride had the least growth inhibition, and medium containing direct-diffusible metabolite supported highest inhibition of C. paradox

Nutritional knowledge, dietary habits and nutritional status of diabetic patients attending teaching hospitals in Lagos, Nigeria

Background: This study assessed the nutritional knowledge, dietary habits and nutritional status of adult diabetic patients attending teaching hospitals in Lagos State, Nigeria.Methods: A cross-sectional study was conducted among adult diabetic patients attending the out-patient clinics of the two Teaching Hospitals in Lagos. Respondents were recruited from the clinics consecutively until the desired sample size (342) was obtained. A pre-tested interviewer-administered questionnaire was used to collect data. Dietary habits were assessed using food frequency questionnaire and BMI was assessed following standard procedure and compared with the World Health Organization (WHO) standards. Data was analyzed using IBM SPSS (Version 20). Chi-square and fisher’s exact probability test were used to determine the association between variables. The level of significance was set at p-value less than 5%.Results: The mean age of the respondents was 59.6 + 13.0 years. Only 125 (37%) of the respondents had good nutritional knowledge. Majority ate three meals every day, 237 (69.3%) and have had dietary counseling, 255 (74.6%). More than half of the respondents, 202 (59.1%) skipped meals, 80 (23.4%) consumed alcohol while only 42 (12.3%) ate fruits and vegetables daily. The commonest food consumed was processed cereals. Majority of the respondents were overweight or obese (74%). Obesity was associated with being female and not having dietary counseling.Conclusion: Nutritional knowledge and dietary habits were poor while overweight and obesity were high. Dietary counseling will be necessary to improve the dietary pattern and nutritional status of the diabetic patients.Keywords: Nutritional knowledge; Dietary pattern; Body Mass Index; Diabetic patients; Teaching hospitals; Lago

Intrusive and Non-intrusive Methods for Fluid Diagnostics and Flow Condition Monitoring in a Control valve

Process control systems consist of numerous control loops, linked together in producing a particular product to be used for carrying out experiments or to be sold. For each of these loops, they are designed to ensure that significant flow parameters such as temperature, velocity, pressure, level, flow, etc. operate within a set range to ensure end product quality. Signal and disturbances for external control loops are sent to these control loops, or sometimes, generate their own internal disturbances, adversely affecting these variables. After measurement, comparison and calculation, the strategy that has been selected by the specific controller such as (Proportional, Proportional Integral, Proportional Integral Derivative, etc.) must be implemented by a final control element. One common FCE (final control element) largely used in the industry for process control is the control valve. The manipulation of the flowing fluid, such as water, chemical compounds, steam, gas, etc., are done by the control valve for load disturbance to be compensated, and ensure that the process variable and the desired set point are as close as possible. Due to its importance in a flow loop, it is very important to know the control valve flow characteristics. Because of the fast development in simulating flow and using numerical technique for flow diagnostics, understanding flow inside the valve has become possible for the valve performance to be estimated. This thesis investigates methods for diagnosing flow for both single phase and multiphase flow under various flow conditions and probe designs. This thesis reports the results of experiments on the control valve flow characteristics using a range of statistical parameters obtained from: airborne acoustic signal microphone, vibration signal from an accelerometer on the valve body and fivehole multihole probes (MHP) placed ingeniously inside the valve at different sections of the valve inlet and outlet. An assessment on the behaviour of the fluid using these three methods has been presented. For the multihole probe (MHP), different probe lengths and heights have been used to obtain local flow parameters and analyse how these parameters vary at different sections from inlet to outlet. Detailed experimental investigations were conducted for diagnosing the valve flow behaviour. The signatures from these sensors (vibration and acoustic) have been analysed by making use of different statistical parameters including peak amplitude, kurtosis, RMS (root mean square), variance and Peak-to-Peak. In addition, both signals from the vibration and acoustic sensors were then transformed to frequency domain and analysed using Fast Fourier Transform (FFT) and mean frequency. Analyses for both signals in frequency domain were also carried out under various ranges of frequency. The results revealed that vibration technique gives a clearer picture into how the signal changes with different flow and valve behaviour. This research also found that frequency range between 0 to 1 KHz was more sensitive in determining the valve behaviour at various conditions. Concerning this research, it can be suggested that lower frequency range sensors (vibration and accelerometer) can be used to capture the behaviour of the control valve and detect any form of fault, which are cheaper than higher frequency range sensors. The results also reveal that the combination of all of these techniques could be applied to increase the reliability of the valve and fault detection. The combination of all experimental methods can be considered robust, providing detailed information about the valve performance and flow diagnostics, hence, assisting in prolonging the valve life and protect the control system from any emergency shutdown

Screening for Cervical Cancer: Experience from a University Hospital in North Western Nigeria (2007‑2009)

Background: Cervical cancer is the most common gynecological cancer among women in Nigeria. The incidence is on the increase and poses a public health problem. The etiological agent is the human papilloma virus that is sexual transmitted. The cervical cancer incidence is related to lifestyle, poverty and sexual practices. Fortunately, it is a preventable disease as it is preceded by a pre‑invasive phase that can be detected and treated. There is paucity of report in literature on cervical cancer screening in Sokoto North‑West Nigeria.Aim: To determine the uptake, indications and results of cervical cancer screening in Usmanu Dan‑fodiyo University Teaching Hospital (UDUTH), Sokoto.Materials and Methods: A 3‑year descriptive study of the results of cervical cytology among women who attended the gynaecological out‑patient clinic of UDUTH, Sokoto.Results: During the period of study, 126 cervical smears were taken and 96% (121/126) of them were considered adequate for cytological evaluation thus constituting the subjects of the study. The average annual uptake of cervical smear was 1.29%. The main indications for cytologic smears were abnormal uterine bleeding 33.9% (41/121) and suspected carcinoma of the cervix 28.1% (34/121). Cytologic study was positive for dysplastic cells in 7% (25/121) of cases. Ten percent (12/121) of them were high grade squamous intra‑epithelial lesions while invasive carcinoma was seen in 3.3% (4/121) of the smears. Conclusion: Presence of abnormal cervical smear in 20% of the study subjects underscores the need for routine screening for cervical cancer. While organized national screening policy is awaited, opportunistic screening should be maximized. Keywords: Cervical cancer, cervical cytology, north‑west Nigeri